Lege Artis Medicinae

[What is the doctor like, if female? - Female doctors’ ideal image based on empirical studies]

MOLNÁR Regina, GIRASEK Edmond, CSINÁDY Adriána, BUGÁN Antal

MARCH 22, 2012

Lege Artis Medicinae - 2012;22(03)

[The aim of our study was to examine thestereotypes about female doctors and howdo the female medical students perceivethe working female doctors whom are theirrole models. In the first study (247 from theAlbert Szent-Györgyi Medical and Pharma-ceutical Centre at the University of Szegedand 256 from the Medical and HealthScience Centre of the University ofDebrecen) the female medical students’professional socialization was compared tothe male counterparts’. In the second study(from University of Szeged, 214 femalemedical students, 132 female jurist stu-dents) female medical and jurist students'professional socialization was comparedincluding the comparison of stereotypes inconnection with working female doctorsand jurists. Female medical students’ professionalsocialization is different that of male coun-terparts in several aspects: being morealtruistic, more family centered, gettingcommited to the profession earlier, havingmore ambiguous carrier planes, and asmaller percentage of their parents’ has adegree or is a medical doctor, then for malemedical students. The female medical doc-tor has positive, idealistic, altruistic charac-ters according to both female studentgroups’ opinions. The female doctor’simage is more often associated with char-actersitics implying problems by femalemedical students then jurists. The unfold-ing image of these stereotypes is a femaledoctor who is willing to help, however,faceing lots of hardnesses during work.If the female medical students’ image of theproblematic life of these idealistic femaledoctors’ is known, it provides an opportu-nity to prepare them for the hardnessesthey’ll face avoiding role conflicts andhealth problems in the future.]

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[INTRODUCTION - Since the end of the pastcentury, the basis/bolus method has been adeterminate factor of adjusting insulin thera-py. Experiences with insulin pump treatmentprove that well-quantified and adequatelytimed basal insulin treatment can fully com-pensate for the diurnal glucose-producingactivities of the liver and the diurnal changesin the activity of insulin receptors. Suitablyselected basal insulin treatment can, there-fore, keep the changes in blood sugar levelthat are dependent of the diet’s carbohydratecontent well under control. CASE REPORT - By presenting the approxi-mately five-year treatment of an adolescentboy, the author presents the current options(and failures) of insulin therapy that might beused with more or less success. Each treat-ment approach had its place in the variousstages of the patient’s diabetes. Nevertheless,insulin pump therapy, admittedly the moststate-of-the-art method today was unsuccess-ful due to patient’s lack of compliance, thusthis treatment had to be stopped. Still, on thebasis of the experiences with insulin pumptherapy, the restored intensive-conservativetreatment was set up on glargine basalinsulin, defining doses of bolus in correlationwith 10 grams of carbohydrate, which madethe diet less strict. This approach resulted ina considerable improvement of the patient’smetabolic profile. CONCLUSION - The right choice of thedoses and efficacy curve of basal insulin isessential for achieving a good metabolic bal-ance during intensive-conservative therapy.In case of deteriorating metabolic balance,suspending the inefficient insulin pump ther-apy is justified and means no disadvantagefor the patient, as long as the subsequentadjustment is prudent. By defining doses of ashort-acting bolus insulin analogue in corre-lation with carbohydrate intake along withglargine therapy permits adaptation to themetabolism of patients with poor compli-ance and unsatisfactory lifestyle - in expec-tation of better results. ]

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[Epidemiological surveillance systems used by international organisations in military crisis management operations]

KOPCSÓ István, KISS Antal Zsolt

[Facing new challenges and growing requirements, the renewal and adjustment of doctrines, methods and technology is an indispensable progressive need for modern militaries. In order to achieve the maximal protection of troops and conservation of fighting strength, innovation is continuous and has greatly accelerated in the whole spectrum of Force Health Protection. Owing to the development of technology, portable capabilities that had been available only in the hinterland have become available in the military medical support area. Utilising mobile information technology solutions, the continuous, real-time information flow between the tactical level medical units and the higher level medical analysts and decision makers has become technically feasible, which results in a significant widening of epidemiological surveillance capabilities as well. We discuss the current challenges of expeditionary- type military operations and their general epidemiological aspects and the morbidity reporting and monitoring systems used in international military missions. Furthermore, we overview the milestones of the development of the NATO near-real-time epidemiological surveillance system, the NATO Deployment Health Surveillance Capability, which functions as a branch of the Budapestbased multinational NATO Centre of Excellence for Military Medicine.]

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[Aims of the study: The aim of the study was to explore how did the institutes manage to achieve the legal requirements related to nursing documentation since the introduction of the law. The other aim was to determine the conditions of effective application of the nursing documentation. Sample and methods: Qualitative and quantitative methods were applied as well. In a quantitative, cross-sectional study a questionnaire survey was performed involving 150 nurses. By the means of retrospective data analysis 200 closed nursing documentation were examined. The data analysis was carried out with SPSS 17.0 statistical software. The level of significance was set to p<0.05. Results: The nursing documentation is not personalized (p<0.01) and its information content is not sufficient to learn about the patient’s condition at the time of admission and to evaluate the effects of nursing on the state of the patient. The personalization and information content strongly depends on the nurses’ attitude towards the administration process. Conclusions: As the theory and practice of the nursing documentation are not in accordance, it is necessary to define the principles more precisely and to survey and reorganize the existing documentations. ]

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[Geriatric oncology has an increasing role since in several types of cancer the median age at diagnosis is above 60 years of age. The treatment of elderly patients are frequently set back by prejudice, stereotypes and lack of information. All these lead to the fact that even in well-developed countries elderly cancer patients often do not receive the necessary treatments. This is even more true in poor-countries, where the fi nancial defi cit accumulated in health care is often attempted to be reduced by the treatment of elderly. If a paediatric oncology patient does not get suffi cient cancer treatment there is a fi erce protest, but everybody is silent if this occurs in the case of an 80 years old patient. For this unacceptable situation both authorities (fi nancing) and professional bodies (treatment, education) are responsible. Clinical data show that elderly cancer patients get the same benefi t of active oncology treatment, as younger ones. Age on its own does not contraindicate any cancer treatment. The aim of this review is to prove by data, that elderly cancer patients should also get active oncology treatment. The questions of assessment include frailty, the relationship of cancer development and ageing, and other problems related to the oncology treatment of elderly patients are also discussed.]

Clinical Neuroscience

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CSATLÓS Dalma, FERENCI Tamás, KALABAY László, LÁSZLÓ Andrea, HARGITTAY Csenge, MÁRKUS Bernadett, SZAKÁCS ZOLTÁN, TORZSA Péter

[Objective - Obstructive sleep apnea syndrome (OSAS) without treatment can cause serious cardiovascular, cardiorespiratory, neurological and other complications. Family physicians have an important role in recognizing the disease. The aim of the study is to assess the knowledge and attitude of family physicians related to sleep apnea. Whether OSAS screening is realized during the general medical checkup for drivers. Methods - In the cross-sectional study we used a validated OSAKA questionnaire in mandatory continuous medical education courses, supplemented with four additional questions. Results - 116 family physicians and 103 family medicine residents filled out the questionnaire. Hungarian family physicians, especially male doctors lack the adequate knowledge of sleep apnea. The average score of female physicians was significantly higher than that of males (13.4±1.8 vs. 11.7±2.6, p=0.005). The more sprecializations the doctor has, the higher the score. Zero or one special examination holders reached 12.5±2.3 points, two special examination holders 12.7±2.2 points. three or four special examination holders reached 14.0±2.1 (p=0.05). Residents’ average score was 12.1±2.4 points, which is higher than that of family doctors (p=0.012). Female residents also had higher average points than male residents (12.6±2.0 vs. 11.3±2.7; p=0.008). The size, location and type of the practice or the doctor’s age did not show any statistically significant correlation with the number of points achieved. According to our regression analysis, corrected to variables in the model, we found correlation between gender and medical knowledge, but there was no correlation between age, number of specialities, body mass index and the theoretical knowledge of the doctors. In terms of attitude female GPs had higher average scores than male GPs (3.5±0.6 vs. 2.9±0.6, p<0.001). Despite the modification of the 13/1992 regulation only 39% of the practices carried out regularly the required OSAS screening as part of the medical examination for a driving licence. Conclusions - Despite the high prevalence and clinical importance of OSAS, GPs often do not recognize sleep apnea and they have difficulty in treating their patients for this problem.]