Detection and measurement of spin-dependent dynamics in random telegraph signals.

A quantum point contact was used to observe single-electron fluctuations of a quantum dot in a GaAs heterostructure. The resulting random telegraph signals (RTS) contain statistical information about the electron spin state if the tunneling dynamics are spin dependent. We develop a statistical method to extract information about spin-dependent dynamics from RTS and use it to demonstrate that these dynamics can be studied in the thermal energy regime. The tunneling rates of each spin state are independently measured in a finite external magnetic field. We confirm previous findings of a decrease in overall tunneling rates for the spin excited state compared to the ground state as an external magnetic field is increased.

[What happens behind closed doors when physicians become problems? Informal mechanism revealed in a case study]. / Vad händer i slutna rum då läkare blir problem? Informella mekanismer avslöjas i fallstudie.

Problem doctors are a heterogeneous group, and it is sometimes difficult to determine whether a doctor is incompetent or simply makes repeated mistakes hard to avoid completely under pressure of the clinical work-load. The profession has a small repertoire of informal methods for dealing with situations where a colleague has become a problem. An interview study, carried out in Britain and Sweden, revealed the approaches most commonly used. It also showed that the problem doctor's colleagues often hesitate too long in taking the informal approach that the problem is much more difficult to resolve by the time department heads and administrators become involved.

Growth of private medicine in Sweden: the new diversity and the new challenge.

The growth of private medical care in Sweden has occurred despite the lack of overt encouragement by the long-term Social Democrat government. This can be documented from official government statistics, private insurance sales, media sources, membership growth in the private doctors association, purchase of private risk insurance, growth of private health care organizations and services, and particularly an increase in public sector private contracting. While the percent of the population with private insurance is close to 1%, it is probable that over 20% of physicians engage in some form of private practice. Explanations range from increasing criticism of poor service orientation in the public system, long waiting lists and the reduced rate of public spending, to a general atmosphere that asserts more individual choice. With the Social Democrats now out of power, it is likely that the Moderate coalition will officially promote some forms of privatization. What will be the impact on the long-cherished Swedish principle of equity?

The Swedish medical care programs: an interim assessment.

The medical care program (MCP) concept emerged from a conviction that it would be possible to combine biomedical knowledge about a certain disease, principles of care and an efficient organization into a holistic approach to care. The purpose of the present review of nine MCPs was to: (1)provide and overview of MCP development and and evaluation in the Stockholm County; (2) present different perspectives regarding the current status of the MCP policy and future developments; and (3) contribute to a discussion of factors which enhance or block the effectiveness of MCPs. Information was gathered during interviews with 32 representatives of professionals and interest groups. The majority of MCPs were initiated by medical professionals while two, the program for alcohol disorders and that for rheumatoid diseases, were initiated by politicians or the rheumatoid patients. Three central problems were identified: (1) the original desire for standardization and the emergent demand for local variation; (2) ambiguities about specific roles of the newly developing general practitioners; and (3) lack of resources to develop, implement and evaluate MCPs to the standards of the original concept. The experience of the MCPs certainly has increased understanding of the policy-program-implementation-outcome process and inevitable gaps that materialize as policy struggles towards implementation.

Beyond equity: Swedish health policy and the private sector.

The rapid development of private medicine in Sweden poses a challenge to that nation's traditional commitment to equity and a public system of health care. Economic constraints in public-sector spending, physician intent in private practice, popular interest in individual choice, and criticism of the public system have been the stimulus. The dominant Social Democrats will likely accept those elements of the private sector that are ideologically compatible, but resist others.

Physician maldistribution in cross-cultural perspective: United States, United Kingdom, and Sweden.

Physician maldistribution is a widely recognized problem facing virtually all health care systems. In this study, information from three health care systems--the United States, the United Kingdom, and Sweden--was used to address two questions: How do organizational features of health care systems affect their ability to deal with the problem of physician maldistribution? What are the effects of physician distribution on the health status of populations? It was found, first, that all three systems perceived similar problems of physician maldistribution and drew on a repertoire of similar solutions, none of which was altogether responsive to the problem. Second, the relationship of physician distribution to health status was found to be ambiguous, with some evidence that physician/population ratios may affect some health measures but not others.

The Barefoot Doctors of China: from political creation to professionalization.

The Barefoot Doctor policy of the Peoples Republic of China (PRC) has recently been changed. Rather than remaining a permanent corp of paraprofessionals, Barefoot Doctors (BFD) are to be upgraded, certified, and paid wages for full-time medical work in a process of slow professionalization. This article includes a brief historical description of BFD policy evolution and a literature review that notes problems in the equitable implementation of the original policy. An update in information is added based on original material collected in 1979 and 1981, providing a current picture of efforts to implement the new professional focus. While BFDs everywhere are taking the certification examinations, there are almost no signs of other features of the new policy.

PIP: The Barefoot Doctor policy of the Peoples Republic of China has recently been changed. Rather than remaining a permanent corp of paraprofessionals, Barefoot Doctors (BDF) are to be upgraded, certified, and paid wages for full time medical work in a process of slow professionalization. This article includes a brief historical description of BFD policy evolution and a literature review that notes problems in the equitable implementation of the original policy. An update in information is added based on original material collected in 1979 and 1981, providing a current picture of efforts to implement the new professional focus. While BFDs everywhere are taking the certification examinations, there are almost no signs of other features of the new policy which include: new standards with increased emphasis on medical work; a 2 level system of examinations (competency test and advanced certifying examination for "country or village doctor"); reserved places for the most promising BFDs in medical schools; work as full time practitioners; salaries instead of workpoints. Tables include information on the distribution of BFDs and specific training programs.