An integrated patch-clamp potentiostat with electrode compensation.

We present the first fully integrated implementation of a patch-clamp measurement system with series-access resistance and parasitic capacitive compensation capability. The system was implemented in a 0.5- mum silicon-on-sapphire process and is capable of recording cell membrane currents up to plusmn20 nA, with an rms noise of 5 pA at 10-kHz bandwidth. The system can compensate for the capacitance and resistance of the electrode, up to 20 pF and up to 70% of the series-access resistance, respectively. The die size is 1150 by 700 mum. The power consumption is 300 muW at 3.3 V. The integrated patch-clamp system will be used to fabricate high-throughput planar patch-clamp systems.

Alterations in grip strength during male sexual arousal.

Although it is known that alterations in grip strength occur under a number of conditions, little is known about relationships between grip strength and sexual arousal. This relationship was investigated in 30 healthy heterosexual males, who viewed both erotic and nonerotic videos. A questionnaire was used to assess the extent of sexual arousal. The grip strengths of both hands were measured with a five-position (P1-P5) dynamometer, before and after watching the videos. After watching the erotic video, there was a statistically significant reduction in grip strength for the P2 position, with nonsignificant overall reductions in grip strength for all other positions tested. No such effect was observed in control tests. The results indicate that during sexual arousal, the neural system is likely to reduce the output to muscles not directly related to sexual function, presumably to enhance the physiological responses of sexual arousal.

Inappropriate sexual behaviours of patients towards practising physiotherapists: a study using qualitative methods.

BACKGROUND AND PURPOSE: Recent research recognizes the occurrence of inappropriate sexual behaviour (ISB) by patients towards health professionals. The objective of this study was to explore in-depth the clinical context and effect of incidents of ISB towards practising physiotherapists. METHOD: In-depth interviews were conducted with a sub-sample of nine physiotherapists who were part of a larger survey on ISB. Quantitative analyses of the survey responses are reported elsewhere. Interview participants were asked to describe an incident of ISB by a patient that was either perceived to be the worst or was the most recent. They were asked questions on a variety of themes, such as their relationship with the patient prior to incident, the effects of the incident, the strategies used to deal with the incident, and changes in practice as a result of the incident. RESULTS: All interview participants reported encountering some level of ISB from patients. Although the overall frequency of these behaviours was relatively low, the range of behaviours was diverse. Regardless of the perceived severity of the incident, only four participants labelled their experience as 'sexual harassment'. Many reported negative effects on work performance. Participants mainly used physical measures to prevent further incidents, rather than confronting the perpetrator or reporting the incident. CONCLUSIONS: The findings are discussed in the context of theory pertaining to boundaries and issues of transference and counter-transference. This emphasized the need for effective communication skills training of both undergraduate and graduate physiotherapists in the prevention and management of ISB from patients.

Self-evaluation of skills as a method of assessing learning needs for continuing education.

Identification of self-perceived learner needs is important in continuing education programmes for health professionals. This paper describes the use of a self-evaluation skill inventory as a method of determining priorities for continuing education of a category of middle-level health professionals.

Observer evaluation as a tool for field level evaluation of performance.

A field-level assessment of the job performance of a category of health professionals was carried out using the technique of non-participant observation of client-health worker interactions. Presenting the data so obtained in the form of a 'performance profile' enabled identification of areas in which this category of health workers showed a lower level of performance, indicating areas where alterations in basic and in-service training programmes are required.

New training for new roles.

Assistant medical practitioners in Sri Lanka are justifiably dissatisfied with their training, which should be modified so that they are enabled to function more effectively in the country's predominantly rural communities. Furthermore, in order to motivate these health professionals to the greatest possible extent, they should be offered an attractive career structure.

PIP: Sri Lanka's population is about 15 million, 80% of whom live in rural areas. There are 2051 medical officers and 957 assistant medical practitioners (AMPs). AMPs work with the rural population and provide primary health care. The AMP was introduced in 1974 as a new category of midlevel health professional. Before that there had been an "apothecary" category. A 3-year training course was begun in Colombo, Peradeniya, Jaffna, and Kalutara. Each AMP is in charge of a subdivisional health center, having managerial and administrative functions along with their medical duties. A survey was conducted among trainee AMPs to discover their views on the relevance and adequacy of their training program and to analyze their job satisfaction level. A questionnaire was mailed to each AMP. 501 were completed and returned. All but 1% were under 39 years of age. Half considered the teaching or record keeping and administration unsatisfactory. They also thought that mental health and family and sexual problems were not dealt with. The community medicine course, rated as satisfactorily taught by over 90% of the AMPs, was considered relevant by 52% of the Colombo graduates, and 60% of AMPs from Peradeniya. Over 95% of AMPs were not satisfied with promotion, salaries, and increments. There was much dissatisfaction with opportunities for professional advancement and facilities for inservice training and self education. The only major satisfaction source was the respect and regard of other health workers and the community. The career structure should be reviewed and continuing education started for this group of health workers.