A “citizens’ jury” of 25 women, assembled this week to provide advice for the drafting of a new leaflet on breast cancer screening, has reached consensus on some of the tricky issues.
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To be effective in relieving suffering, doctors must strike a balance between paucity and excess of empathy.
As a young doctor working in the E.R. my capacity for compassion, and that of my colleagues, was often stretched; this was particularly the case when my patients could be said to have brought misfortune on themselves. I saw drug addicts suffering overdose, teenagers retching after self-poisoning, thieves injured through being arrested, all treated more brusquely than other theoretically more blameless patients.
I tried hard to maintain empathy, reflecting that the overdosed, self-poisoned and criminal may no more have brought their problems on themselves than those with skiing or horse-riding injuries or heart palpitations through overwork.
But it’s complicated: I’ve stitched up many slashed wrists cut not through willfulness but as a release from intense anguish; I’ve attended alcoholics for whom alcohol was clearly a substitute for love.
I may not have always succeeded, but I always hoped that my humanity, or my professional duty to provide a high standard of care, would step in when my compassion was running low.
By GAVIN FRANCIS
Via Edwin Rutsch
Lecture 1: Communication, Power and the State in the Network Society
Power in the network society is exercised through networks. There are four different forms of power under these social and technological conditions:
Counterpower is exercised in the network society by fighting to change the programs of specific networks and by the effort to disrupt the switches that reflect dominant interests and replace them with alternative switches between networks. Actors are humans, but humans are organized in networks. Human networks act on networks via the programming and switching of organizational networks. In the network society, power and counterpower aim fundamentally at influencing the neural networks in the human mind by using mass communication networks and mass self-communication networks.
Via Pierre Levy
Conflicting health information is increasing in amount and visibility, as evidenced most recently by the controversy surrounding the risks and benefits of childhood vaccinations. The mechanisms through which conflicting information affects individuals are poorly understood; thus, we are unprepared to help people process conflicting information when making important health decisions. In this viewpoint article, we describe this problem, summarize insights from the existing literature on the prevalence and effects of conflicting health information, and identify important knowledge gaps. We propose a working definition of conflicting health information and describe a conceptual typology to guide future research in this area. The typology classifies conflicting information according to four fundamental dimensions: the substantive issue under conflict, the number of conflicting sources (multiplicity), the degree of evidence heterogeneity and the degree of temporal inconsistency.
The series of reports explores new forms of teaching, learning and assessment for an interactive world, to guide teachers and policy makers in productive innovation.
This fifth report, produced in collaboration with the Learning Sciences Lab at the National Institute of Education, Singapore, proposes ten innovations that are already in currency but have not yet had a profound influence on education.
Via Pierre Levy
As payment and care delivery models shift in the United States from episodic, fee-for-service care toward population health and value-based reimbursement, health care leaders are focused more than ever on patient engagement as a key to driving down costs and improving outcomes. And yet, as so many of us know who have attempted to manage our own care or tend to sick family members, the U.S. health care system rarely feels like it’s been set up to help us succeed.
What’s needed is a fundamental redesign of the patient’s role — from that of a passive recipient of care to an active participant charged with defined responsibilities, equipped to dispatch them, and accountable for the results. In other words, we need to view the patient’s role as a job and then design that job in such a way as to drive the best health outcomes possible.
The Virtual Health Library is a collection of scientific and technical information sources in health organized, and stored in electronic format in the countries of the Region of Latin America and the Caribbean, universally accessible on the...
Via Giovanna Marsico
Don't listen to those pesky public health advocates talking about soda warning labels and soda taxes. Big Soda can solve the world's chronic disease crisis on its own. Sure, its products and marketing have contributed to unprecedented rates of Type 2 diabetes, heart disease and non-alcoholic fatty liver disease, but Big Soda has pledged to reduce the…
Medical associations are rethinking their opposition to laws modelled on Oregon’s Death with Dignity act
ON OCTOBER 5th the health committee of Washington, DC’s state council will vote on a Dignity in Dying Act brought forward by one of its Democratic members, Mary Cheh. Like many proposed doctor-assisted-dying laws debated across America in the past year, it is modelled on that of Oregon, which in 1997 became the first American state to make doctor-assisted dying legal in some circumstances. It allows terminally ill patients whom doctors expect to live no more than six months to be prescribed life-ending medicine, subject to checks of mental health and capacity. Four other states have since followed, most recently California, where a doctor-assisted-dying law came into force in June.
If DC’s proposal passes in the committee—as it is expected to, by a three-to-two margin—it will go to a whole-council vote. According to Ms Cheh’s calculations, it has “way more than enough” support to pass there, too. It would then arrive on the desk of Washington DC’s mayor, Muriel Bowser. What happens after that is unclear. Her office would not say whether she supported the principle of offering the terminally ill help to die, nor what she thought of the specific legislation under consideration.
The new record opens with the title track, “You Want It Darker,” and in the chorus, the singer declares:
I’m ready my Lord.
Hineni is Hebrew for “Here I am,” Abraham’s answer to the summons of God to sacrifice his son Isaac; the song is clearly an announcement of readiness, a man at the end preparing for his service and devotion. Cohen asked Gideon Zelermyer, the cantor at Shaar Hashomayim, the synagogue of his youth in Montreal, to sing the backing vocals. And yet the man sitting in his medical chair was anything but haunted or defeated.
ParoleFertili.it è uno spazio narrativo online per condividere il viaggio alla ricerca di un figlio. In pochissimo tempo sono state donate decine di storie. Cosa ci raccontano? Che sfide ci lanciano?
Come interpretare questa mancanza di storie maschili? Si potrebbe essere tentati di confondere l’assenza con l’indifferenza o, forse peggio, con un vissuto della PMA (procreazione medicalmente assistita) meno problematico.
An ebook is an excellent choice for a freemium or a premium. It allows you to give valuable knowledge to people, which anchors your expertise in their minds. It also entitles you to tactfully pitch them while they’re reading. Best of all, an ebook is the easiest way to attract the benefits from the principle of “Givers Gain.”
Before you think, “I can’t write!” or “I don’t want to write a whole book just to give it away!” let me assure you that an ebook is a great giveaway, worth the effort and doesn’t have to be anywhere near as long as a “regular” book.
Via Marie Ennis-O'Connor
This article presents a qualitative study realized in the Children’s University Hospital of Parma, Italy, aimed at observing the effects of the fictional narrative in the emotions of the young patients. The results showed that, especially by means of projection, identification and symbolization, the imagination helps the children to elaborate in a positive way the bad emotions elicited by the experience of the disease and of the stay in hospital. Furthermore, the study was useful to the healthcare professionals in order to understand the emotive, cognitive and relational needs of the patients. We suggest the introduction of creative expression in the narrative medicine in addition to the autobiographical accounts, the questionnaires and the interviews in some particular care contexts.
If used properly, pre-exposure prophylaxis (PrEP) can stop transmission of the human immunodeficiency virus (HIV) with 90% effectiveness. Although men who have sex with men make up more than half of those infected with HIV in the United States, according to the Centers for Disease Control and Prevention (CDC), many are not aware of the benefits of PrEP. “Doctors have limited time with their patients, but with gay and bisexual male patients, physicians definitely need to make it a point to discuss HIV risks and whether PrEP is a good option,” Julia R. G. Raifman, ScD, a post-doctoral fellow in the Johns Hopkins Bloomberg School of Public Health’s Department of Epidemiology, said in a news release. - See more at: http://www.mdmag.com/medical-news/the-people-most-at-risk-for-hiv-dont-know-about-prep#sthash.Lb9XVPtY.dpuf
"This report provides some intriguing suggestions for designers of blended and online learning. As the report states:
The examples of initiatives discussed ….. may be used as inspiration for course teams, departments or institutions to explore innovative practices.
It is clear that universities are going to change, not just because technology is at last beginning to radically shake up how we design courses, but also because the needs of learners are changing. In the end, the value of any new online pedagogy will be judged by how well it helps meets these needs. This report provides many useful ideas and examples that should help stimulate such developments."
Via Dennis T OConnor, Peter Mellow
Here’s the good news: Thanks to the Affordable Care Act, or Obamacare, more Americans have access to health care than ever before. The bad news? The care itself hasn’t improved much. Despite the hard work of dedicated providers, our health care system remains chaotic, unreliable, inefficient, and crushingly expensive.
There is no shortage of proposed solutions, many of which have appeared in these pages. But central to the best of them is the idea that health care needs more competition. In other sectors of the economy, competition improves quality and efficiency, spurs innovation, and drives down costs. Health care should be no exception.
The Access to Medicine Index analyses the top 20 research-based pharmaceutical companies on how they make medicines, vaccines and diagnostics more accessible in low- and middle-income countries.
2016 Access to Medicine Index Overall Ranking
In 2016 moderate progress is visible in the pharmaceutical industry’s efforts to improve access to medicine. GSK leads for the fifth time, ahead of Johnson & Johnson, Novartis and Merck KGaA.
GSK leads for the fifth time ahead of Johnson & Johnson, Novartis and Merck KGaA. Critically, these companies show needs-orientation, matching actions to externally identified priorities in the access agenda. For example, they invest in R&D for urgently needed products, even where commercial incentives are lacking. Their access strategies support commercial objectives, with clear business rationales.
Lower ranked companies have each improved in at least one measure, and withstood closer scrutiny: the 2016 Index used tougher measures than in 2014. Change by these companies has been incremental. Exceptions are Takeda, which launched a new access strategy and rose from 20th place, and Bayer, which lost ground as others improved.
In the top ten
Following the first four, the remaining companies in the top ten each show strength in at least one area, yet have room to deepen engagement in access to medicine. There have been two significant shifts in this group. Novo Nordisk falls to 10th place. Its solid access frame- work applies to few products (albeit those considered key for access). AstraZeneca joins the top ten, with an expanded access strategy and notable pricing practices.
Lagging furthest behind are Roche** and Astellas. Roche is less transparent than its peers, yet it advances in other measures, with new access initiatives and strong processes for ensuring compliance. While Astellas shows some improvements, such as a new pledge not to enforce IP rights in certain poor countries, these were not sufficient to avoid being overtaken.
- Best practices
- Company records Cards
- Key findings
Via rob halkes
EVERY six seconds a person somewhere in the world dies as a consequence of diabetes, according to estimates by the International Diabetes Federation (IDF). In 2015 5m lives were lost to the disease, more than were claimed by AIDS, tuberculosis and malaria combined. Moreover, the toll is rising faster than forecasters have expected. Nearly half of these deaths are among people younger than 60. In parts of Africa, where the condition is much less likely to be diagnosed, that share is more than four-fifths.
The rise of diabetes has been misjudged repeatedly. In 1995 the World Health Organisation estimated that 135m 20- to 79-year-olds had diabetes, and that this figure would more than double in three decades. But reality outpaced this stark projection by a huge margin: just twelve years later the number of people with diabetes had already nearly doubled. Since then, the rise of diabetes has been so steep that prevalence closed in on projections even faster. In 2015, the estimated global prevalence had reached 8.8%, nearly double that in 1995. By 2040, the IDF reckons that a tenth of humanity will have the condition. Already, diabetes gobbles up 12% of health spending globally; in some countries, the share is as much as a fifth.
Medical error is not included on death certificates or in rankings of cause of death. Martin Makary and Michael Daniel assess its contribution to mortality and call for better reporting
The day after arranging a recent photo shoot, I got one of those emails that reporters dread. The woman who was photographed said she needed to speak with me. Could I call her? It was urgent.
Uh-oh, I thought. Was she getting cold feet? Was she backing out of the story, or having second thoughts about the photos?
One of the toughest challenges of being a medical reporter is persuading a patient to speak openly about a health issue. In this case, the topic was deeply personal. I was writing about women who had decided against breast reconstruction after mastectomies. They call it “going flat,” and I decided to pursue the story after seeing a video on Facebook in which two women bare their flat chests and scars after breast cancer.
Insider delivers behind-the-scenes insights into how news, features and opinion come together at The New York Times. In this article, Well reporter Roni Caryn Rabin reflects on why the women whom she and photographer Béatrice de Géa featured in a recent story about “going flat” after mastectomies were surprisingly eager to reveal themselves to the world.
The global prescription pharmaceuticals market was estimated to be USD 1,114 billion in 2015. The market is mature and highly consolidated. The top-10 pharmaceutical companies in this market had share of over 30% in 2015. These companies are large and established organizations that are primarily located in U.S. and Europe. They offer drug products for…
Via Lionel Reichardt / le Pharmageek
Globally, cardiovascular disease (CVD) – including heart disease (coronary arteries and muscle), cerebrovascular disease (involving arteries of the neck and brain), and peripheral artery disease (arteries supplying blood to arms and legs) – is the leading cause of death. Of an estimated 16 million annual deaths under the age of 70 from non-communicable diseases, 37% are due to CVD. On a more positive note, most CVDs are preventable and the emergence of digital health technologies will play a pivotal role in how CVD is approached and prevented by some of the stakeholders in healthcare: providers, patients, caregivers, and technology companies.
Via Philippe Marchal
A NEW INVESTIGATION has revealed the extent of the financial relationship between the pharmaceutical industry and doctors and hospitals in Ireland.
Via Pharma Guy