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Pediatric physical therapy in southern estonia: profile of an emerging profession.

PURPOSE: The purpose of this study was to provide preliminary information on the professional identity and practice of Estonian pediatric therapists. METHOD: A survey was conducted among 18 therapists using a questionnaire translated and administered verbally. RESULTS: Therapists were found to have various educational and experiential backgrounds such as nursing, physical education, and a new program of physical therapy. They were involved with infants and children up to the age of 16 years. They worked mostly full-time and provided therapy to clients who have a wide variety of conditions; they emphasized individual and direct service. Assessment was primarily based on observation and teamwork was associated with multidisciplinary interaction. CONCLUSIONS AND IMPLICATIONS: The emerging profession is progressively achieving international standards and in May 1999 became a member of the World Confederation for Physical Therapy.

Journal Article↗

[The medical and pharmaceutical profession and the mutual care system in the writings of Jaime Vera (1859-1918)].

This article presents the perspectives of the physician and politician Jaime Vera y López (1859-1918), co-founder of the Spanish Socialist Workers' Party, on the medical profession, medical practice, and healthcare systems. It compares the Report (Informe) that he presented to the Comisión de Reformas Sociales (1884) with his later writings published in the socialist press ("Farmacia y cooperación obrera,, 1914 and "La locura en los niños. Camino del remedio", 1916). We observe the discrepancies between the political-programme documents and the articles centring on professional questions and highlight how his theoretical focus is modified when applied to matters of medical practice.

Delivery of Health Care↗

[The internist--a many-sided profession].

"Internal medicine" in the USA, and "general medicine" in the UK, are increasingly assuming the form of basic medical knowledge with a view to subsequent specialization. In Switzerland, three types of practising internists or physicians (in the strict sense) can be described: the internist as general practitioner, the general internist with a main centre of interest, and the subspecialist. Continuing medical education must take these manifold aspects of the profession into account. For practising physicians, joint meetings of internists of the second and third types are desirable, on the lines of those for physicians in the major hospitals.

Education, Medical, Graduate↗

Chiropractic in the United States and the changing health care environment: a view from outside the profession.

This paper is divided into three main parts. The first part describes chiropractic in the 1960s, 1970s and 1980s. While harassment by the medical profession largely characterized the 1960s, the health care environment of the 1970s was more favorable. However, during the 1980s, the spread of prospective payment schemes and the intensification of competition have largely hurt the development of chiropractic. All three possibilities: co-optation, subordination and nationalization are problematic as far as chiropractic is concerned. In light of these prospects, this paper makes four policy recommendations: research, education, alliance-building and politics (or REAP). The paper concludes with a brief discussion of each one.

Chiropractic↗

Report of the National Commission on Nurse Anesthesia Education. Current and future perspectives regarding the framework for nurse anesthesia education: nurse anesthesia curriculum in the College of Pharmacy and Allied Health Professions, Wayne State University.

The nurse anesthesia educational program at Wayne State University, Detroit, is one of four allied health programs that offers a master's degree from the College of Pharmacy and Allied Health Professions. The program itself is housed in a teaching hospital, where CRNAs control and deliver the coursework. Advantages and limitations of this arrangement are analyzed and discussed.

Curriculum↗

Snails and snail farming: an introduction for the veterinary profession.

In the past veterinary interest in snails has been confined to their role in the transmission of disease; nowadays the trend to keep these animals in captivity--for food, for study, as 'companion animals'--means that the profession is increasingly likely to be consulted about their health, welfare or conservation. An understanding of the biology of snails is an important prerequisite to work with them. Land snails are hermaphrodite and have a complex reproductive system; other organs also show special adaptations. Management methods vary considerably and farmed snails can be maintained under extensive or intensive conditions. Methods for handling and transporting them are important considerations. There is little published information on the diseases and pathology of snails but suboptimum environment, poisons, nutritional deficiencies, predators and parasites are known to cause, or contribute, to their mortality.

Animal Husbandry↗

Showcasing a profession: getting nursing on the newsstand.

Interacting with the media is a method of showcasing the nursing profession. Clinical nurse specialists (CNSs) have a variety of opportunities available for these interactions: appearing on television, participating in a radio program or writing to the media. A survey completed by the authors indicated that CNSs had many media interactions, yet overall, only 17% of all nurses surveyed used writing. This paper begins by discussing where to publish and how to prepare and target the audience. General and specific guidelines for publishing feature articles, health tips, letters to the editor, and other publishing possibilities are presented.

Humans↗

From plague and tuberculosis to AIDS: a reflection on the medical profession.

Physicians have frequently been exposed to personal risk during the course of medical practice. This risk has been most obvious during the great communicable disease epidemics occurring in the past and is, of course, present also when medical care is provided during wartime. Recent public pronouncements of some physicians regarding their ethical responsibility in the care of patients with communicable diseases, particularly acquired immunodeficiency syndrome (AIDS), have raised questions in the public mind as to the responsibilities of the medical profession. We reviewed the history of medicine to examine the traditional responsibilities of physicians in similar circumstances. Examples from our historical tradition should be of value to each physician and to society in determining the appropriate responsibilities of present-day physicians.

Acquired Immunodeficiency Syndrome↗

A look in the mirror: a critical and exploratory study of public perceptions of the chiropractic profession in New Jersey.

This paper reports the results of a telephone survey of 693 respondents which was commissioned by the New Jersey Chiropractic Society. This exploratory study provides a broad-ranging and critical examination of key aspects relating to the chiropractic profession as it is practiced in New Jersey. The study concludes that chiropractic in New Jersey is a viable means of treating various disorders, but there remains much confusion and distrust among prospective and current patients as well as the threat of heightened competition from other health professionals. Chiropractic must develop clear boundaries around the number and extent of the conditions it claims to treat, and must substantiate its claims with valid clinical trials. A research-based education campaign is necessary if the discipline is to encourage nonusers to become users. The most powerful vehicle for influencing public opinion and the number of referrals is family and friends. The findings also indicate that comparisons with medical doctors can backfire, making the "chiropractic physician" (the professional label preferred by most respondents) less qualified by comparison. Rather than reject the paradoxical nature of their role as primary care physicians and specialists in spine-related disorders, chiropractors should embrace this uniqueness and establish themselves as a integral component of the health care network. Clearer boundaries, a grounding in scientific clinical research and better interprofessional relations can ensure continued growth and success in New Jersey.

Adult↗

[Attitudes towards the profession of medical students of the University of Navarra].

A recent sounding hold among the medicine students of the Navarra University provided us sufficient information about some aspects of this profession and the evolution that might suffer through the career time. The enquiry used 534 students of different grades. The deep and the up-to-date technical training is considered a fundamental characteristic of the good professional though the hospital medicine is the most desirable working option. However, the improvement of the present sanitary situation pass obligatorily--as stated by the inquirees--by the impulse to the primary medicine.

Adolescent↗

[The profession of beautician].

The Authors, after a concise normative excursus about the beautician activity, dwell upon the aspects of medicolegal interest emerging from the Italian law n. 1, 4/1/90. This measure is the first specific legislative regulation of an activity which sometimes goes beyond a purely aesthetic service, since these services could be included among the peculiar acts of the medical profession. From the interpretation of the law, in particular the first article, it comes out that the professional field of action of the beautician is too wide but ambiguous, considering that certain services should be accomplished only by entitled and academically qualified people. For this reason, at the moment, the medical examiner charged by the Authorities cannot produce sufficiently pertinent and motivated technical consultation.

Beauty Culture↗

["Pink collar" medicine: implications of the feminization of the profession].

The rising number and proportion of women in medicine has implications for patient care as well as for the health care delivery system as a whole. Women physicians tend to establish more reciprocal relationships with patients, and are more likely to listen to psycho-social problems than their male colleagues. Other gender-based differences are evident in the practice settings and sites chosen by the two sexes. Women cluster in certain specialties, and are more likely to locate in urban areas and have salaried practices. They also work fewer hours and have lower incomes than their male counterparts. These differences have created heirarchical distinctions within the medical profession. This in turn suggests the possibility of the creation of a "pink collar" medicine.

Female↗

Near-patient testing: implications for laboratory-based professions.

The current upheaval being experienced by the National Health Service in the UK is due partly to political and partly to technological changes in the mode of delivery of health care. The two can not be separated completely, but the implications for laboratory-based health care professions of technological changes that have occurred in their specialty, mainly within the last 10 years, are considered. These have made it increasingly possible to carry out previously complicated analytical manoeuvres outside the confines of a well-founded laboratory, but in doing so have brought with them problems as well as advantages for the providers of health care, as well as for its recipients--i.e. the patients.

Emergency Medical Services↗

[The health consultant. A new profession].

The facilitator is a new profession developed first in Oxfordshire in 1982 for the purpose of promoting prevention in primary health care. There are at present more than 100 facilitators in Britain and some in Holland, most of them working on prevention of cardiovascular disease, but recently some also in connection with the HIV-epidemic. In brief, the task of the facilitator is to bridge the gap or establish a new channel of communication between the general practitioner and his coworkers on the one side and the specialized health service on the other. The paper describes the tasks and working methods of the facilitator in some detail, particularly with respect to prevention of HIV-infection and control and care of HIV-positive and AIDS-sick patients in general practice. A trial project involving facilitators is planned in Oslo.

Acquired Immunodeficiency Syndrome↗

Trends in quality assurance in the dental profession.

I have dealt with three questions concerning trends in quality assurance. In summary, we must ask ourselves whether the profession can develop methods for dealing effectively with dentists whose performance is found to be continually unsatisfactory. This may be achieved by making available effective tools for others to use in developing quality assurance systems. These tools will involve criteria and standards for services, appropriateness of treatment, measuring outcomes of care, and methods for assessing dental practices. This may involve working closely with consumer representatives to assist in gaining the consumer's point of view and incorporating it into the technology of quality assurance. Berwick, in a recent article in the New England Journal of Medicine, called for the application of a "Theory of Continuous Improvement" rather than the "Theory of Bad Apples." His view is that we should examine the process itself and try to improve it rather than look for outliers or bad apples. His point of view is consistent with the concept of quality assurance I have been talking about. Quality assurance systems should assure quality by proper assessment, identifying strengths and weaknesses in the provision of care. The strengths should be reinforced and the weaknesses should be rectified. This necessitates positive communication between those who perform quality assurance and those who are being evaluated. It also assumes that the technology is appropriate, recommendations are reasonable and that, when changes are made, quality will improve. In order to make the theory of continuous improvement work, it should be consistent with financial incentives and professional values.(ABSTRACT TRUNCATED AT 250 WORDS)

Dentistry↗

Societal trends toward accountability in the professions.

The rising demand in all areas of the American culture for accountability in the professions is well documented. Recertification as a documentation of that accountability is being pressed by consumer groups as well as those who are charged with protecting the public welfare. The American Board of Orthopaedic Surgery's time-limited certificates have made recertification, at least for the more recent certificate holders, mandatory. The negative attitude of the orthopedic surgeon toward the recertification process needs to be reexamined in light of recent demands for accountability. Orthopedic surgeons must be willing to discuss these issues as components of professionalism.

Attitude of Health Personnel↗

[Survey of what dental students feel regarding their profession (3). The relation with their self concept].

The present survey was undertaken to find out how dental student feel about their profession and what type of the self concept they have. The subjects were 263 students in the 5th and 6th grades of dental school, Aichi-Gakuin University. The pattern of self concept as dental students or dentists was classified into three types, based on a survey of twenty statements test. These types were positive, negative and neutral. The results were as follows: 1. In both the 5th and 6th grades, statements about "present satisfaction as a dental student", in the 5th grade, "progress of university entrance examination", and in the 6th grade, "feelings about the scholastic side of dentistry", were strongly related to their type of self concept. But in both the 5th and 6th grades, there were few related statements about "the motive for entering the dental school" and "occupational choice after graduation". 2. In the result of the multivariate analysis Discriminant Analysis by the Second Class of Hayashi's Quantifying Theory, those students who were graded as "positive" had the following characteristics: (1) Regarding entrance examinations, they took only one examination for dental school when they entered. (2) When choosing dentistry as their occupation, they had not thought of it as a "self supporting occupation" or "occupation of high social standing". (3) Their present interest is learning about dentistry. (4) After their graduation from dental school, they would like to be professional dentists or, a practicing dentists or students of clinical dentistry in the hospital of the dental school.

Adult↗