Hand and microvascular surgery. Evolution to present practice

Over the past 25 years, hand and microvascular surgery have emerged and flourished as a super specialty plastic surgery. Successful replantation of a completely amputated extremity on position is now not enough without adequate functional outcome. Free tissue transfer has evolved into a reliable reconstructive option in the treatment of complicated wounds.     

浅议教学辅助人员的现状及素质培养

高素质的师资队伍应包括高水平的教师和高水平的教学辅助人员。目前教辅人员存在着知识水平偏低、知识陈旧、知识结构不合理等问题。应充分认识到教辅人员的重要作用 ,通过帮助他们改善知识结构 ,加强继续教育等措施 ,提高教辅人员的专业素质     

Giving patients their own records in general practice: experience of patients and staff

Patients have reacted positively to seeing their medical records in a general practice which has a predominantly working class population in south east London. Most patients were familiar with the information in their records. Older people tended to avoid reading their notes. There have been few inaccuracies and unpleasant reactions reported, and few problems have arisen.     

住院医师规范化培训的组织、管理与实践

为保障住院医师规范化培训的顺利开展,上海交通大学医学院附属第九人民医院在组织构架和规章制度建立基础上,针对师资队伍建设、学员招收、招录程序、培训年限、培训计划和培训内容的制定、考核管理和培训质量监控的实施等进行了有效探索,对住院医师规范化培训基地建设与发展起到了很好的推动作用。     

民办高校师资队伍建设理论与实践

建设一支结构合理的高素质教师队伍 ,是民办高校赖以生存和发展的关键。分析当前民办高校教师普遍存在的创新意识不强、不安心等心态及其原因 ,湘南医学高等专科学校从解除教师不良心态着手 ,从创造良好的人际环境、建立科学用人制度、建立教师社会保障体系、完善激励机制、提高待遇、提供深造与发展机会等方面努力 ,对创造尊重人才、激励引导、诚信务实的工作环境 ,建设好教师队伍工作收到了较好的效果。     

ACMC: past, present and future.

In this article, the president of the Association of Canadian Medical Colleges (ACMC) and its director of research review the issues that have confronted ACMC since its inception: the founding of ACMC; development of the clinical teaching unit; creation of the Medical Research Council and expansion of the research mission; the Royal Commission on Health Services and the founding of new faculties of medicine; ACMC's in-house research program; accreditation and ACMC's links with medical education in the United States; and French-language medical education in Canada. The review points out the perennial nature of many of these issues, and how often perceived solutions to the problems later become problems themselves. It ends on the optimistic note that ACMC can successfully meet the challenges of the future.     

Supportive follow-up for cigarette smokers in a family practice: issues of method, analysis and state of the art.

Kozlowski and Page have criticized a study published in 1982 in CMAJ on the effects of supportive follow-up on the rate at which patients quit smoking cigarettes. We agree with some of their general sentiments about the need for establishing a consensus on the evaluation of smoking cessation programs. More specifically, we defend the particular analysis originally used, given the state of knowledge and constraints on the study. We examine their main objections: the definition of successful cessation, the design of the study, the exclusion of patients lost to follow-up, the methods of statistical analysis used and the strength of more recent evidence on the usefulness of follow-up visits. We believe that the role of supportive follow-up deserves further evaluation.     

Integrated child development services scheme (ICDS) in India: its activities, present status and future strategy to reduce malnutrition

Integrated Child Development Services Scheme (ICDS) provides an integrated approach for converging all the basic services for improved child care, early stimulation and learning, health and nutrition, water and environmental sanitation aimed at the young children, expectant and lactating mothers, other women and adolescent girls in a community. Its objectives are: To improve nutritional and health status of children of 0-6 years; to reduce the incidence of mortality, morbidity, malnutrition and school dropout; to achieve effective co-ordination amongst various departments to promote child development; to lay foundation of proper psychological,physical and social development of the child; to enahance mother's capability to look after normal health and nutritional needs of the child. ICDS services are provided through a village based centre ie, the Anganwadicentre for the services of: Supplementary nutrition, immunisation, health check-up, referral services, treatment of minor illnesses, nutrition and health education to women, preschool education to children and supports for water supply, sanitation, etc. Several government departments and their services are co-ordinated at village, block, district, state and central levels. The Anganwadiworker is the most peripheral functionary which implements the programme services at the village/community level. In projects where able leadership has been provided, ICDS has been reported to be better. Though there are some shortcomings in ICDS, till future thrust of the programme is necessary for aiming of the upliftment of underprivileged section of the population. Operative research in various areas is suggested which can help in improving the efficiency of ICDS.