Lege Artis Medicinae

[“I can’t do it alone.” Household workload and division of labour among Hungarian female physicians]


FEBRUARY 22, 2013

Lege Artis Medicinae - 2013;23(02)

[BACKGROUND - Mental and somatic morbidity and role conflict among female physicians has become an issue of growing interest in the Hungarian and international literature. Among the potential backgrounds factor, the household labour is a less studied field. METHODS - A qualitative, pilot study (N=36) was conducted among female physicians in Hungary. The structured interview was focused on amount and division of household labour, the attitudes of household labour division and the harmonization of professional workload and household work. RESULTS - About of 66% of interviewed female physicians do the household work alone. About 33% is supported by partner in the household labour, and in one case the male partner does the household work alone. The responders are not satisfied with the division of household labour, and they want the amount of professional workload and household work both to be reduced. CONCLUSIONS - Our study is a pilot for further quantitative research. Our findings suggest that the Hungarian female physicians have traditional household labour division. The lack of the division is important to understand the problem of role conflict and the morbidity.]



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Related contents

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[Who are the happy female physicians in Hungary?]


[BACKGROUND - The female Physicians’ well-being and happiness has become the latest researching field of the “Physicians studies”. In Hungary the researches haven't focused on this subject. Our aim was to examine the subjective well-being of the Hungarian female Physicians. METHODS - Representative, cross-sectional, quantitative survey on a representative sample of female Physicians (N=408). Modified version of WHO Well- Being Index was performed to measure of subjective Well-Being. RESULTS - We have found that the key to the Hungarian female Physicians’ wellbeing is the “time”. Significantly higher rate of well-being is associated with reduced work-hours (8 hour or less, p=0.000), and duty hours (p=0.042), having one hour free time daily (p=0.021) and they satisfied with the time of doctor-patient interaction (p=0.021). The higher rate of Well-Being scores haven't associated with age, marital status, number of children and the speciality. CONCLUSION - Similarly to the national trends, the Hungarian female Physicians' well-being is depending on the work and the satisfaction with work. The satisfied healer is the key of the health system therefore the future studies and the prevention and intervention have to focus on the Physicians’ well-being.]

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

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Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]