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The goal is to achieve that the maximum possible number of nurses arrive at the deep conviction that practice without theory is only routine and that theory without practice which justifies it is empty erudition. Therefore, the objective of this article is to reflect about the excessively frequent incoherence between that which is taught in schools and the practice which is carried out by the great number of nurses in our country.

Objectives: To construct a valid instrument to evaluate the clinical competence of family doctors and establish professional standards., Design: Construction of an objective and structured clinical evaluation test by the Test Committee of the Catalan Society of Family and Community Medicine (SCMFiC) with 27 representative clinical situations of primary care practice. This used various evaluative instruments and lasted 5 hours and 30 minutes., Setting: 2 Barcelona health districts for the two runnings of the test., Participants: Family doctors, SCMFiC members, who took part voluntarily after having been invited by letter., Measurements and Main Results: 23 doctors took part in the first running of the test. Their average age was 36.6 (SD 6.9) and 52.2% of them were women. 46 doctors took part in the second test. Their average age was 30.9 (SD 2.1) and 76.1 were women. The test had an overall reliability coefficient (Cronbach's alpha) of 0.83 the first time and 0.65 the second time. The overall mean score of the participants the first time was 56.9 (SD 19.2), with 100 the top score possible, and 62.1 (SD 4.1) the second time., Conclusions: This SCMFiC experiment is the first time the clinical competence of family doctors has been assessed in our area. It was a reliable and valid test to assess the competence of our health professionals.

This article presents an analysis about power and leadership regarding the nursing profession in Spain and poses some strategies which, from the aforementioned perspective, allow the compromise nurses have with society to develop. This article has three sections: one which defines terms such as power, leadership, representative, corporation, ...; a second section which analyzes and makes proposals, wherein the current situation of the nursing profession is described in relation with the elements defined as the shapers of professional power, and proposals are posed along the lines of one to demand clear guidelines for nurses' professional role, to act in a "corporational" way, in positive terms, or to recognize the importance "informal" power networks hold; and finally, a section of conclusions.

The author offers her personal vision as to the determining factors that define the functions and responsibilities within the health care system, especially in regards to aspects that are strongly identified as stereotypically female. An analysis is made as to how that identification is constructed and perpetuated, thus maintaining its marginalizing consequences. Strategies to fight against this treatment and ways to develop professionally are proposed.

Objectives: To assess the consequences of the Selective Financial Decree for prescription drugs in Catalonia., Methods: Observational longitudinal study of the registry of prescribed pharmaceutical specialties that were charged to the Catalan Service of Health, from august 1991 to July 1994. 243.8 million of prescriptions were analyzed., Results: Between the 12 months prior to the Decree and the 12 months following, the number of drug prescriptions was reduced by 10%. As a whole, the drugs included in the decree were loosing sales before the Decree; 38% of then were not been prescribed at all during the period studied. The main groups affected by the Decree were, vitamins associations, stimulants an associations with cough suppressants, mainly with a low therapeutic value. There has only been and important and clear substitution effect in antianemic and cough suppressants associations., Conclusion: In general, substitutions between pharmaceutical groups were few and positive.

Objective: To determine whether the following factors-medical training in family practice, age of the doctor, health care organization and percentage of patients over 65 years--influence the quality of pharmaceutical prescription as measured in terms of its intrinsic value and potential use of the prescription., Design: Descriptive cross study. SITE. Regional health authorities of Costa de Ponent. Barcelona., Participants: 400 general practitioners throughout the whole of 1992., Main Measurements and Results: Doctors belonging to the new health system and specialising in family practise, present higher intrinsic value and potential use of the prescription (statistically confirmed), as well as a greater concentration of prescription of the top 100 prescribed medicines. Doctors no more than 40 years old had better prescription but no statistical differences were found. An aged population had nearly no influence., Conclusions: The characteristics of the doctor (organization, training) are conditioning factors in the quality of pharmaceutical prescription.