Doctors on the medical profession

Over the past two to three decades there has been vigorous debate in the sociological literature as well as in popular forums concerning the changing social position and status of the medical profession and the extent to which consumerism has entered the doctor-patient relationship. Few qualitative sociological inquiries, however, have directly sought the views of medical practitioners themselves on these issues. To address this hiatus, this article discusses the findings from an empirical study using semi-structured indepth interviews with 20 doctors living and working in Sydney about their views on the contemporary status of the medical profession and their experiences of medical practice. Three major aspects are discussed: the extent to which the social position of doctors has changed, the impact of consumerism on medical practice and the qualities of a ‘good’ doctor. The implications of these data for theorising the nature of contemporary medical practice, power and professional status is explored, with particular reference to the insights offered by Foucauldian theory.     

428例用药不合理医嘱分析

多种抗菌素问世后，用药方案与药物配伍不合理的现象逐渐引起人们的重视。笔者分别收集１９９１年－１９９３年共１４０７例住院病例医嘱，其中用药不合理４２８例（３５．６％），在４２８例中联合用药不合理３９７例（９２．８％），时辰用药不合理３１例（７．２％）。故临床用药中降低疗效或增加毒副作用，对疾病恢复增加了难度。     

不同记忆负荷对事件相关电位—P300的影响

我们研究了不同记忆负荷条件下,ERP-P_(300)变化的规律性和特点及ERP-P_(300)与脑力负荷难度之间的关系。在三种脑力作业时,要求受试者记忆2、4、6位随机数字。结果表明,1、随着记忆数字增加,P_(300)波幅相应增大,三种记忆作业P_(300)波幅之间均有显著性差异。2、记忆错误率和记忆难度主观评价值,亦随着记忆数字增加而增大,且在三种记忆作业之间均有显著性差异。3、P_(300)波幅和记忆难度主观评价值之间相关分析表明呈正相关(P<0.01)。我们建议,P_(300)波幅测量可以作为评价脑力负荷的一项客观指标。     

农村居民医疗服务潜在需求量及影响因素分析

目的 了解农村居民医疗服务的潜在需求及其影响因素。方法 采用分层多阶段整群抽样方法，对湖北省宜昌地区5县1839名农村居民进行问卷调查。结果 该地区治病未就诊率为13．21％，男女性未就诊率分别为12．01％，15．56％，采用Logistic回归分析方法，筛选出影响患病未就治的主要因素为性别、健康状况、对健康的重视程度、婚姻状况以及不同县等。结论 在农村要完善合作医疗保障制度，对医疗机构建设应以提高服务质量、降低成本、遏制费用增长为主要目的，并能提供更多的医疗服务，使患能及时利用医疗服务。     

谈医疗设备漏电对人体的电击

医疗设备可以为临床工作提供大量诊断信息和治疗手段，而医疗设备的漏电也会使病人电击灼伤以至危及生命。国务院发布《医疗事故处理条例》以后引起了医疗界高度重视，临床诊疗活动中如何安全使用医疗设备也是预防医疗事故的重要方面。本文着重介绍了电击的种类、对人体的危害及防护措施。     

Internet tools in the medical classroom

Summary: The Internet contains a vast amount of medically relevant information. In order to access this information, however, many networks require one to master applications written in UNIX, an operating system considered by many not to be user friendly. Although these tools may be available on the campus, it is difficult to teach their use unless there is some immediate benefit to the already busy user. From that standpoint, it is important for instructors to realize that common UNIX applications can be utilized as classroom tools to significantly enhance the learning experience by facilitating teacher/student communication. Also, whilst the student enjoys greater communication with the instructor (and with other students) he/she is also becoming adept at using information management tools.     

Effects of cadaver dissection on the attitudes of medical students

Summary: Summary. A study was conducted to determine whether the attitudes of medical students to death and caring changed during the 3 months following exposure to cadaver dissection. All first-year students were invited to complete a questionnaire immediately before their initial cadaver dissection experience, after 6 weeks, and after a further 3 months. The questionnaire reflected attitudes to death, violent death, death of someone known to the respondent and caring when someone known to the respondent is seriously injured. Ethnicity and previous exposure to dying has no effect on responses, but overall men students' reactions were significantly less than for women ( P < 0.001). The responses given on the final part of the questionnaire after 3 months were significantly lower than those to most questions in the first part of the questionnaire. The exceptions were those questions where the subject in the given scenario was known to the respondent, where reactions were rated significantly greater ( P < 0.001) in the follow-up questionnaire and can be explained on the basis that they were a personal referent.
Students rapidly develop a coping mechanism which enables them to view cadaver dissection as an occupation quite divorced from living human beings. During these early months of training solicitude decreases for those who die who are unknown to them, but concern for personal referents increases. Educators should be aware of the dramatic change of attitudes among students and the process of professionalization which might influence their caring of future patients.     

The potential of an anaesthesiologist–manned ambulance service in a rural/urban district

The use of anaesthesiologists in prehospital emergency care is controversial. We wanted to assess the impact of an anaesthesiologist and a short time interval from acceptance of a mission to take–off at survival rates in a rural/urban emergency medical service. Prospectively registered data for 991 consecutive patients through a 12–month period were retrospectively evaluated by an independent foreign expert. Of all primary missions, 3.3% were considered probably lifesaving from site of injury to receiving hospital. Of these, the lifesaving result in 50% were dependent on both the qualifications of the anaesthesiologist and a short response time. Survival from hospital admission to discharge was 44%. All patients were discharged to their own homes, able to live a fully functional life. The consistent use of anaesthesiologists compared to less qualified personnel and the maintaining of response times below presently required minima doubles the potential for lives saved in services comparable to the one studied.