Health Professions General Health Professions

Healthcare Systems and Challenges

Description

This cluster of papers focuses on the impact of healthcare workforce, including doctors' strikes, workforce planning, and the response to COVID-19, on public health and healthcare delivery in the UK. It also addresses issues such as health inequalities, NHS management, and the role of ethnic minorities in healthcare.

Keywords

NHS; healthcare workers; COVID-19; doctors' strikes; public health; health inequalities; primary care; workforce planning; ethnic minorities; patient mortality

to food banks in the United Kingdom.Rachel Loopstra and colleagues ask, is this due to supply or demand? to food banks in the United Kingdom.Rachel Loopstra and colleagues ask, is this due to supply or demand?
Summary This paper describes typifications of good and bad patients made by staff working in three English hospital Accident and Emergency departments, commonly known as Casualty departments. The staff explain … Summary This paper describes typifications of good and bad patients made by staff working in three English hospital Accident and Emergency departments, commonly known as Casualty departments. The staff explain or defend their behaviour and their hostile evaluations by accounts which in many respects parallel the classic description by Parsons of the sick role.1 The data presented are most easily interpreted as cases where certain sorts of patients are unable to achieve entry into what is essentially the legitimate career of sickness, and this will lead into a disussion of the relationship between sicknesses and deviance.
In December 2000 Nottingham University announced the establishment of an international centre for corporate social responsibility, with initial funding of £3.8m provided by British American Tobacco (BAT). To protest aganst … In December 2000 Nottingham University announced the establishment of an international centre for corporate social responsibility, with initial funding of £3.8m provided by British American Tobacco (BAT). To protest aganst their university's acceptance of money from the tobacco industry, an MBA student refused to accept his “student of the year” award; Richard Smith, editor of the BMJ , resigned from his post as professor of medical journalism; a cancer research team decided to relocate; and a member of the European parliament relinquished her roles at the university. Nottingham joins a long list of universities that have accepted funding from the tobacco industry. Other academic institutions have, however, taken the opposite stance and severed their ties with this industry. For example, Brigham and Women's and Massachusetts General hospitals in Boston, the MD Anderson Cancer Center in Houston, the Roswell Park Cancer Institute in Buffalo, and the University of Sydney all have policies precluding acceptance of research funds from the tobacco industry.1 The …
An important obstacle to improving men's health is their apparent reluctance to consult a doctor. US research shows that men with health problems are more likely than women to have … An important obstacle to improving men's health is their apparent reluctance to consult a doctor. US research shows that men with health problems are more likely than women to have had no recent contact with a doctor regardless of income or ethnicity.1 This reluctance means that men often do not seek help until a disease has progressed.2 Late presentation can have serious consequences. For example, deaths from melanoma are 50% higher in men than women despite a 50% lower incidence of the disease. So why do men delay seeking help, and what can be done to overcome the problem? #### Summary points Men do care about health issues but often find it difficult to expresses their fears Men tend to attend their general practitioner later in the course of a condition than women and this phenomenon is exacerbated by social class inequalities Uptake of health information and health services can be improved by making them male friendly, anonymous, and more convenient Better use should be made of services such as NHS Direct, pharmacists, occupational health, and online advice The nature of medical school education and medical training may contribute to potential problems in consultations between male doctors and patients Suicide is now the single greatest cause of death among young men in most of the United Kingdom. One reason that more men die from suicide than women is that men are more likely to choose methods such as hanging or shooting that leave little room for medical intervention. Even so, men are less likely to talk about their problems with their peers or health professionals. Although the Samaritans claim that a large proportion of men have visited their general practitioner in the months before they take their own lives,3 a report by the Men's Health Forum concludes the opposite. A …
Examining the interactions between patients and doctors, this book aims to show how physicians' focus on physical complaints often fails to address patients' underlying concerns and also reinforces the societal … Examining the interactions between patients and doctors, this book aims to show how physicians' focus on physical complaints often fails to address patients' underlying concerns and also reinforces the societal problems that cause or aggravate these maladies.
Soules, Michael R. MD; Sherman, Sherry PhD; Parrott, Estella MD, MPH; Rebar, Robert MD; Santoro, Nanette MD; Utian, Wulf MD, PhD; Woods, Nancy RN, PhD Author Information Soules, Michael R. MD; Sherman, Sherry PhD; Parrott, Estella MD, MPH; Rebar, Robert MD; Santoro, Nanette MD; Utian, Wulf MD, PhD; Woods, Nancy RN, PhD Author Information
~~~Society for Medical Improvement, of which Wendell CONTAGIOUSNESS OF PUERPERAL FEVER Holmes was a member, the stated business having been concluded somewhat early, one of the members, An Address delivered … ~~~Society for Medical Improvement, of which Wendell CONTAGIOUSNESS OF PUERPERAL FEVER Holmes was a member, the stated business having been concluded somewhat early, one of the members, An Address delivered to the Trowbridge Division of the in order to fill up the time, renorted an incident that had Bath and Bristol Branch of the British Medical Association.recently occurred in the neighbourhood.A physician had
Abstract Within the context of globalization, health care reform is occurring around the world. This paper explores the neoliberal mind set shaping health care reform in the UK, Canada, United … Abstract Within the context of globalization, health care reform is occurring around the world. This paper explores the neoliberal mind set shaping health care reform in the UK, Canada, United States, Australia and New Zealand. Neoliberalism is comprised of three principles: individualism, free market via privatization and deregulation, and decentralization. After describing the nature of a health care system that is shaped by those embracing this mind set, an alternative approach is introduced that could bring dignity and a human face to health care. The basic premise of the paper is that we must broaden our analysis of health care by understanding and challenging the neoliberal mind set.
Swedish health care and national health registers are dependent on the presence of a unique identifier. This paper describes the Swedish personal identity number (PIN) and explores ethical issues of … Swedish health care and national health registers are dependent on the presence of a unique identifier. This paper describes the Swedish personal identity number (PIN) and explores ethical issues of its use in medical research. A ten-digit-PIN is maintained by the National Tax Board for all individuals that have resided in Sweden since 1947. Until January 2008, an estimated 75,638 individuals have changed PIN. The most common reasons for change of PIN are incorrect recording of date of birth or sex among immigrants or newborns. Although uncommon, change of sex always leads to change of PIN since the PIN is sex-specific. The most common reasons for re-use of PIN (n = 15,887), is when immigrants are assigned a PIN that has previously been assigned to someone else. This is sometimes necessary since there is a shortage of certain PIN combinations referring to dates of birth in the 1950s and 1960s. Several ethical issues can be raised pro and con the use of PIN in medical research. The Swedish PIN is a useful tool for linkages between medical registers and allows for virtually 100% coverage of the Swedish health care system. We suggest that matching of registers through PIN and matching of national health registers without the explicit approval of the individual patient is to the benefit for both the individual patient and for society.
We present a model with leverage and margin constraints that vary across investors and time. We find evidence consistent with each of the model’s five central predictions: (1) Since constrained … We present a model with leverage and margin constraints that vary across investors and time. We find evidence consistent with each of the model’s five central predictions: (1) Since constrained investors bid up high-beta assets, high beta is associated with low alpha, as we find empirically for U.S. equities, 20 international equity markets, Treasury bonds, corporate bonds, and futures; (2) A betting-against-beta (BAB) factor, which is long leveraged low beta assets and short high-beta assets, produces significant positive risk-adjusted returns; (3) When funding constraints tighten, the return of the BAB factor is low; (4) Increased funding liquidity risk compresses betas toward one; (5) More constrained investors hold riskier assets.
The label ‘modernisation’, originally coined to signify reform within the Labour Party, has since 1997 increasingly been used as a descriptor of various facets of public policy. This paper addresses … The label ‘modernisation’, originally coined to signify reform within the Labour Party, has since 1997 increasingly been used as a descriptor of various facets of public policy. This paper addresses three questions, all in the context of health policy. What (if anything) is the impact of the notion of modernisation on NHS medical labour process, what is its substantive content, and how might we explain its rise to prominence? On the first question, I suggest that a model of medicine (which I term ‘scientific-bureaucratic medicine’) is being developed that embodies many of the specific characteristics of Fordist labour processes. On the second question, I suggest that ‘modernisation’ denotes a philosophy towards the governance of the NHS which entails the distinctive characteristics of the project which social theorists have termed ‘modernity’. The third question has particular significance in a social context (variously termed ‘late modernity’ or ‘postmodernity’) generally thought of as characterised by trends towards postFordist labour processes. I tentatively suggest that scientific-bureaucratic medicine can be viewed as the state's (not necessarily successful) strategy for coping with radical consumerism and changing perceptions of risk and expertise in the context of health and medicine.
Women and Smoking: A Report of the Surgeon General Get access Nicotine & Tobacco Research, Volume 4, Issue 1, February 2002, Pages 7–20, https://doi.org/10.1080/14622200210135650 Published: 01 February 2002 Women and Smoking: A Report of the Surgeon General Get access Nicotine & Tobacco Research, Volume 4, Issue 1, February 2002, Pages 7–20, https://doi.org/10.1080/14622200210135650 Published: 01 February 2002
Blame austerity not immigration for the inequality underlying the referendum decision On the same day that the United Kingdom voted to leave the EU, huge rises in UK death rates … Blame austerity not immigration for the inequality underlying the referendum decision On the same day that the United Kingdom voted to leave the EU, huge rises in UK death rates were reported. These rises followed the austerity policies enacted by the 2010 coalition government.1 Self reported health was a key component of David Cameron’s wellbeing index, and it has declined in every year of his premiership, most rapidly towards the end.2 In March 2016 the Office for National Statistics (ONS) reported: “The proportion of people aged 16 and over in the UK who were somewhat, mostly or completely satisfied with their health was lower in the financial year ending 2014 (57.8%) than in the previous year (59.3%). The way in which people view their health is crucial to well-being.”3 Brandishing the slogan “Vote leave, take control,”4 the Leave campaign secured 51.9% of the referendum vote. However, 13 million registered voters did not vote, …
The MRC expects all scientists, both clinical and nonclinical, funded by the Council (ie, MRC employees, visiting workers in MRC establishments, and recipients of MRC grants or training awards) to … The MRC expects all scientists, both clinical and nonclinical, funded by the Council (ie, MRC employees, visiting workers in MRC establishments, and recipients of MRC grants or training awards) to adopt the highest achievable standards in the conduct of their research. This means exhibiting impeccable scientific integrity and following the principles of good research practice.
Coronavirus: covid-19 has killed more people than SARS and MERS combined, despite lower case fatality rate Coronavirus: covid-19 has killed more people than SARS and MERS combined, despite lower case fatality rate
Scientists and senior doctors have backed claims by France’s health minister that people showing symptoms of covid-19 should use paracetamol (acetaminophen) rather than ibuprofen, a drug they said might exacerbate … Scientists and senior doctors have backed claims by France’s health minister that people showing symptoms of covid-19 should use paracetamol (acetaminophen) rather than ibuprofen, a drug they said might exacerbate the condition. The minister, Oliver Veran, tweeted on Saturday 14 March that people with suspected covid-19 should avoid anti-inflammatory drugs. “Taking anti-inflammatory drugs (ibuprofen, cortisone . . .) could be an aggravating factor for the infection. If you have a fever, take paracetamol,” he said. His comments seem to have stemmed in part from remarks attributed to an infectious diseases doctor in south west France. She was reported to have cited four cases of young patients with covid-19 and no underlying health problems who went …
NHS hospitals in England have been told to suspend all non-urgent elective surgery for at least three months from 15 April to help the service deal with the covid-19 pandemic. NHS hospitals in England have been told to suspend all non-urgent elective surgery for at least three months from 15 April to help the service deal with the covid-19 pandemic.
"When this is all over, the NHS England board should resign in their entirety." So wrote one National Health Service (NHS) health worker last weekend. The scale of anger and … "When this is all over, the NHS England board should resign in their entirety." So wrote one National Health Service (NHS) health worker last weekend. The scale of anger and frustration is unprecedented, and coronavirus disease 2019 (COVID-19) is the cause. The UK Government's Contain–Delay–Mitigate–Research strategy failed. It failed, in part, because ministers didn't follow WHO's advice to "test, test, test" every suspected case. They didn't isolate and quarantine. They didn't contact trace. These basic principles of public health and infectious disease control were ignored, for reasons that remain opaque.
Covid-19: A&E visits in England fall by 25% in week after lockdown Covid-19: A&E visits in England fall by 25% in week after lockdown
Rafi Kabarriti, MD; N. Patrik Brodin, PhD; Maxim I. Maron, MSc; Chandan Guha, MD, PhD; Shalom Kalnicki, MD; Madhur K. Garg, MD, MBA; Andrew D. Racine, MD, PhD Rafi Kabarriti, MD; N. Patrik Brodin, PhD; Maxim I. Maron, MSc; Chandan Guha, MD, PhD; Shalom Kalnicki, MD; Madhur K. Garg, MD, MBA; Andrew D. Racine, MD, PhD
keen eye for the patient and public engagement 4 -contribute to trustworthy policies.Once the arguments resulting from these principles are arranged, the questions resulting from the principle of solidarity and … keen eye for the patient and public engagement 4 -contribute to trustworthy policies.Once the arguments resulting from these principles are arranged, the questions resulting from the principle of solidarity and reciprocity can be addressed: how much burden can be expected from different groups and who ought to be given some leeway?Finally, given the analysis based on the previous principles, the public needs to be informed to enable their autonomous decision-making about, e.g., supporting or protesting the isolation of people in LTCF.Finally, we want to call upon the public health community not to shy away from openly discussing the moral distress. 5The Covid-19 pandemic causes.We need to collect the stories about the situations where members of the public health community were hindered in doing what was the ethically appropriate action due to circumstances beyond their control, for example, institutionalized impediments.Sharing these stories is necessary first of all to avoid discouragement on both an individual and organizational level.Secondly, it creates insight into what the public health community deems as 'ethically appropriate actions'.Thirdly, these situations of moral distress are a treasure trove for an evaluation of where and when systems 'test our humanity'.
Steven H. Woolf, MD, MPH; Derek A. Chapman, PhD; Roy T. Sabo, PhD; Daniel M. Weinberger, PhD; Latoya Hill, MPH; DaShaunda D. H. Taylor, MPH Steven H. Woolf, MD, MPH; Derek A. Chapman, PhD; Roy T. Sabo, PhD; Daniel M. Weinberger, PhD; Latoya Hill, MPH; DaShaunda D. H. Taylor, MPH
England's health secretary, Matt Hancock, has told parliament that a new variant of covid-19 has been identified and may be driving infections in the south east, leading to headlines about … England's health secretary, Matt Hancock, has told parliament that a new variant of covid-19 has been identified and may be driving infections in the south east, leading to headlines about "mutant covid." <b>Jacqui Wise</b> answers some common questions
Penny Harrison takes a look at how the NHS intends to tackle the many challenges it faces by implementing the NHS Long Term Workforce Plan Penny Harrison takes a look at how the NHS intends to tackle the many challenges it faces by implementing the NHS Long Term Workforce Plan
This text explains the act of prognosis in its varying forms - doctors telling patients if their cancer is curable, when their pain will stop, if they will live to … This text explains the act of prognosis in its varying forms - doctors telling patients if their cancer is curable, when their pain will stop, if they will live to see their child graduate from college - from the perspective of doctors. Nicholas Christakis examines why physicians are reluctant to predict the future, what uses doctors make of prognosis, the symbolism it contains, and the practical and emotional difficulties it involves. Drawing on his experiences both as a doctor and as a sociologist, the author conducted interviews with physicians; he searched medical textbooks and medical school curricula for discussions of prognosis; and he developed quantitative data showing that physicians are systematically optimistic in their predictions. With its combination of approaches and methods, this book is a study of a murky area of medical practice that, despite its importance, is only partially understood and rarely discussed. Christakis argues that physicians and the medical profession as a whole have the duty to prognosticate, and shirking the difficult questions - as most doctors tend to do - advances neither medical knowledge nor the care seriously ill patients receive. The book aims to be a clarion call for a renewed effort to understand and improve the art and science of prognostication.
| BDJ Team
Tyrimo tikslas. Išnagrinėti mikroplastiko patekimo į žmogaus organizmą šaltinius ir galimą įtaką reprodukcinei sistemai. Metodai. Literatūros apžvalga atlikta naudojantis „Google Scholar“, „PubMed“ ir „ScienceDirect“ duomenų bazėmis, analizuojant publikacijas nuo 2018 … Tyrimo tikslas. Išnagrinėti mikroplastiko patekimo į žmogaus organizmą šaltinius ir galimą įtaką reprodukcinei sistemai. Metodai. Literatūros apžvalga atlikta naudojantis „Google Scholar“, „PubMed“ ir „ScienceDirect“ duomenų bazėmis, analizuojant publikacijas nuo 2018 m. Nagrinėti straipsniai, kuriuose aptariami mikroplastiko šaltiniai, poveikis vaisiui bei vyrų ir moterų reprodukcinei sistemai. Rezultatai. Mikroplastiko dalelių aptinkama moters reprodukciniuose organuose, placentoje, vyro spermoje ir sėklidėse. Įrodyta, kad mikroplastikas gali sukelti hormonų pusiausvyros sutrikimus, kiaušidžių pažeidimus ir nevaisingumą moterims, vyrams – pabloginti spermatozoidų kokybę ir hormonų apykaitą. Mikroplastikas prasiskverbia per placentą, o tai siejama su padidėjusia persileidimo rizika ir galimu neigiamu poveikiu vaisiaus nervų sistemai. Išvados. Pagrindiniai mikroplastiko šaltiniai: patalpų oras, geriamasis vanduo ir maistas. Organizmas tik iš dalies pašalina mikroplastiką, todėl jo kaupimasis gali sukelti oksidacinį stresą, uždegiminius procesus. Siekiant sumažinti poveikį, rekomenduojama naudoti HEPA filtrus, vėdinti patalpas, vengti plastikinių indų ir įrankių.