Satisfaction and Job Stress in General Practice

This paper investigates sources of job satisfaction and dissatisfactionin general practice and identifies pressures and difficultiesexperienced by general practitioners in their work. The studyrevealed wide spread job satisfaction based on three separate(but independent) aspects of general practice: clinical, psychosocialor managerial. Despite this, significant pressures were experiencedand, in common with previous studies over the last 20 years,this research found continuing problems affecting young generalpractitioners in particular. The main pressures currently experiencedwere uncertainty and insecurity about work, isolation, poorrelationships with other doctors, disillusion with the roleof the general practitioner, and an awareness of changing demands.These pressures were related to experience in general practice,amount of study leave and practice organization. Like previousstudies, it also appears from this research that continuingeducation could play an important role in attenuating thesediffi culties. It is argued that the emphasis should be on developingsupport, confidence and better contacts between general practitioners,as well as teaching knowledge and skills.     

Patient Characteristics Associated with the Labelling of Asthma

Patient characteristics associated with the asthma label wereinvestigated in 262 children, aged 8 years, who reported wheezingillness in the previous 12 months. Children were first identifiedby a screening questionnaire administered to the parents ofall 8 year old schoolchildren in Croydon, south London. Interviewswere conducted with those reported to have had a wheezing illnessin the previous 12 months to obtain details of the child's illness,medical care, demographic and socioeconomic characteristics.Multivariate analysis showed that the likelihood of being labelledasthmatic was increased in those who had a parental historyof hayfever [odds ratio (OR) = 2.24, 95% confidence interval(Cl) = 1.22–4.14] or at least two allergic provoking factors(OR = 3.83, 95% Cl = 1.44–10.15). No significant associationswere found between asthma labelling and children's socioeconomiccharacteristics or use of general practitioner services. Thesefindings suggest that wheeze is likely to be labelled asthmawhen the clinical history suggests an allergic aetiology.     

Retrograde ejaculation: a systematic approach to non-invasive recovery of spermatozoa from post-ejaculatory urine for artificial insemination

Summary. Retrograde ejaculation is an uncommon but treatable form of male infertility. Successful recovery of live spermatozoa from the post-ejaculatory urine for artificial insemination is dependent on careful regulation of pH and osmolarity of the urine into which ejaculation takes place, and separation of the motile spermatozoa from the debris and cells which are found in these samples. Three pregnancies established by artificial insemination of spermatozoa recovered by non-invasive means from the bladders of men suffering from retrograde ejaculation are described. The techniques for preparing the urine for spermatozoal survival, and for removal of cells and debris by sedimentation or buoyant density centrifugation are discussed.