Suchergebnisse

Background: Recently, euthanasia and assisted suicide (EAS) in patients with psychiatric disorders, dementia, or an accumulation of health problems has taken a prominent place in the public debate. However, limited is known about this practice. The purpose of this study was threefold: to estimate the frequency of requesting and receiving EAS among people with (also) a psychiatric disorder, dementia, or an accumulation of health problems; to explore reasons for physicians to grant or refuse a request; and to describe differences in characteristics, including the presence of psychiatric disorders, dementia, and accumulation of health problems, between patients who did and did not request EAS and between patients whose request was or was not granted. Methods: A nationwide cross-sectional survey study was performed. A stratified sample of death certificates of patients who died between 1 August and 1 December 2015 was drawn from the central death registry of Statistics Netherlands. Questionnaires were sent to the certifying physician (n = 9351, response 78%). Only deceased patients aged ≥ 17 years and who died a non-sudden death were included in the analyses (n = 5361). Results: The frequency of euthanasia requests among deceased people who died non-suddenly and with (also) a psychiatric disorder (11.4%), dementia (2.1%), or an accumulation of health problems (8.0%) varied. Factors positively associated with requesting euthanasia were age (< 80 years), ethnicity (Dutch/Western), cause of death (cancer), attending physician (general practitioner), and involvement of a pain specialist or psychiatrist. Cause of death (neurological disorders, another cause) and attending physician (general practitioner) were also positively associated with receiving euthanasia. Psychiatric disorders, dementia, and/or an accumulation of health problems were negatively associated with both requesting and receiving euthanasia. Conclusions: EAS in deceased patients with psychiatric disorders, dementia, and/or an accumulation of health problems is relatively rare. Partly, this can be explained by the belief that the due care criteria cannot be met. Another explanation is that patients with these conditions are less likely to request EAS.

Background: Greenland struggles with a high prevalence of smoking, alcohol and drug abuse. In response to the increasing need for preventive initiatives, the first public health program Inuuneritta was introduced in 2007. Internationally, frameworks focus primarily on the implementation of a single, well-described intervention or program. However, with the increasing need and emergence of more holistic, integrated approaches, a need for research investigating the process of policy implementation from launch to action arises. This paper aims to augment the empirical evidence on the implementation of integrated health promotion programs within a governmental setting using the case of Inuuneritta II. In this study, the constraining and enabling determinants of the implementation processes within and across levels and sectors were examined. Methods: Qualitative methods with a transdisciplinary approach were applied. Data collection consisted of six phases with different qualitative methods applied to gain a comprehensive overview and understanding of Inuuneritta II's implementation process. These methods included: observations and focus group discussions at the community health worker (CHW) conference, telephone interviews, document analysis, and a workshop on results dissemination. Results: Enabling determinants influencing the implementation process of Inuuneritta II positively were high motivation among adopters, local prevention committees supporting community health workers, and the initiation of the central prevention committee. In contrast, constraining determinants were ambiguous program aims, high turnovers, siloed budgets and work environments, and an inconsistent and neglected central prevention committee. Conclusion: Inuuneritta II provided a substantial framework for an integrated health policy approach. However, having a holistic and comprehensive program enabling an integrated approach is not sufficient. Inuuneritta II's integrated approach does not harmonise with the government's inflexible organisational structure resulting in insufficient implementation.

10.1186/s12879-018-3358-4 ; BMC Infectious Diseases ; 18 ; 1 ; 462

Background: European legislation prohibits direct-to-consumer advertising of prescription medicines, but allows drug manufacturers to provide information to the public on health and diseases. Our aim was to measure the frequency of disease awareness campaigns in Latvian media and assess their compliance with international and European standards. Methods: Materials on health/disease and treatments were collected between April and September 2015 from 12 newspapers and magazines and six online portals. Disease awareness campaigns were assessed using a previously developed instrument based on the WHO Ethical Criteria for Medicinal Drug promotion and European standards (EU law and pharmaceutical industry self-regulatory guidelines). Collected materials were used to examine the information provided on medical conditions and their diagnosis and treatment. The inter-rater reliability was calculated. Results: We collected 263 materials from print (n = 149) and online media (n = 114); 94 were news items and 169 were disease-awareness advertisements. Cancer, cardiovascular problems, allergies and respiratory diseases were common topics. Of the 157 campaigns assessed, non-compliance was identified in 149 cases (inter-rater reliability 90%), mainly due to misleading or incomplete information, lack of balance and the absence of a listed author/sponsor. Six disease awareness campaigns directly mentioned a pharmaceutical product by brand name and other four included the logo or name of a manufacturer, referred to a condition and indirectly mentioned a treatment, all in contravention with European law. Conclusions: The compliance of disease awareness campaigns in Latvian media with international and European standards is low. This raises concerns about the nature of information being conveyed. Through lack of balance, missing sponsorship information, and misleading or incomplete information, these campaigns could contribute to inaccurate self-diagnosis and generate demand among those who might not need medical treatment.

DOI: 10.3126/jnhrc.v7i1.2296 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 54-57

The Academy of Medical Sciences has matured quickly and found a distinctive niche amongst leading opinion formers and policy makers in healthcare and biomedical research. The Academy's 800 Fellows are the UK's leading medical scientists from hospitals, academia, public service and industry, and it is their expertise that gives the Academy its authority. The Academy campaigns vigorously to put science at the heart of the UK's public policy agenda in health, and to ensure that rapid advances in knowledge are translated as quickly as possible into benefits for patients. This paper briefly describes the work of the Academy and highlights the key achievements of the early years, particularly the Academy's role in drawing Government attention to the plight of academic medicine. The failure of clinical research to keep pace with scientific advances is now fully recognised and steps are being taken to establish new structures and to rebuild capacity in the UK.

A new masters-level course, 'Medicine and the Arts', will be offered in 2014 at the University of Cape Town, setting a precedent for inter-disciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

Fraudulent, harmful, or at best useless pharmaceutical and therapeutic approaches developed outside science-based medicine have boomed in recent years, especially due to the commercialisation of cyberspace. The latter has played a fundamental role in the rise of false health experts', and in the creation of filter bubbles and echo chambers that have contributed to the formation of highly polarised debates on non-science-based health practices--online as well as offline. By adopting a multidisciplinary approach, this edited book brings together contributions of international academics and practitioners from criminology, digital sociology, health psychology, medicine, law, physics, and journalism, where they critically analyse different types of non-science-based health approaches. With this volume, we aim to reconcile different scientific understandings of these practices, synthesising a variety of empirical, theoretical and interpretative approaches, and exploring the challenges, implications and potential remedies to the spread of dangerous and misleading health information. This edited book will offer some food for thought not only to students and academics in the social sciences, health psychology and medicine among other disciplines, but also to medical practitioners, science journalists, debunkers, policy makers and the general public, as they might all benefit from a greater awareness and critical knowledge of the harms caused by non-scientific health practices.

A new masters-level course, 'Medicine and the Arts', will be offered in 2014 at the University of Cape Town, setting a precedent for inter-disciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

Racial science and medical schools in early America -- The clinical-racial gaze -- Training on Black people's bodies -- Mastering anatomy -- Skull collecting, medical museums, and the international dimensions of racial science -- Jeffries Wyman, travel, and the rise of a racial anatomist -- Race, empire, and environmental medicine -- The afterlives of slavery and racial science in U.S. medical education.

Health and medical tourism is a complex area of study. Many governments, international agencies, private health providers and even some medical practitioners see it as a means of economic development that may cross-subsidise domestic health access. In contrast, others see it as part of a process of marketisation and economisation of public health services. It is hoped that this Tourism Review ebook makes at least a small contribution to a better understanding of the field