Oxford University Press's
Academic Insights for the Thinking World

The challenges of training future surgeons in the current NHS

Following the publication of the Government consultation Modernising Medical Careers in 2003, UK postgraduate medical training for doctors has been extensively reformed. These reforms have resulted in a competence-based training system, centred on a structured syllabus that defines the knowledge, professional behaviours, core clinical procedures, and clinical performance required for training.

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Five key underlying drivers of the opioid crisis

The War on Drugs got it wrong. When President Nixon launched the “War on Drugs” in 1971, he framed the way we would view drug epidemics moving forward: as a moral issue. The “war” cast people struggling with addiction as criminals and degenerates to be dealt with by the criminal justice system. But law enforcement solutions have failed to curb addiction, and have further contributed to harming communities already experiencing deep levels of trauma, particularly communities of color.

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The evolution of pain medicine adherence [extract]

Pain medicine adherence, the extent to which patients follow a treatment plan for managing pain, has remained a challenge to doctors and patients alike for millennia. Risks abound, from not taking enough medication, to taking too much and/or becoming dependent on it, with the current opioid epidemic in the United States providing a clear example […]

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Medical mycology: an introduction

The spectrum of fungal disease has evolved exponentially over the past four decades, and so has the emergence of fungal diseases as an increasingly important problem in global healthcare systems. If a medical mycologist who had retired in the 1970s returned to the discipline today, they would inevitably find it irrevocably changed—almost unrecognisable.

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Ten reasons to write in plain English [excerpt]

Medical science writing is important and writing in plain English (that being writing that conveys the right content, clearly, and concisely) is a skill honed by practice. Learning to express complex ideas succinctly is in no way a remedial skill. Rather, it can only be seen as a sign of mastery. This matters in the 21st century, as English is the global language of science.

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A step in the light direction for arrhythmia

Each successful beat of the heart is the result of a well-timed electrical orchestra, headed by a conductor tasked with tirelessly maintaining this life-sustaining rhythm. The conductor of this silent symphony is the heart’s natural pacemaker cells, which synchronize the muscular contractions necessary to pump blood throughout the body.

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Treating people with Alzheimer’s: The non-pharmacological approach.

On 2 January 2018, National Public Radio’s Terry Gross interviewed British neuroscientist Joseph Jebelli, who discussed Alzheimer’s disease and how “much better treatment” for the disease is about ten years away. The improved treatment to which Dr. Jebelli was referring was pharmaceutical/biomedical treatment. Indeed, the vast majority of stories in the mass media about treatment for Alzheimer’s focuses on the long hoped for biomedical treatment, emerging from drug trials or genetic approaches or both, that can stop the progress of the disease or prevent its occurrence. There is, however, a vast difference between treating a disease and treating people diagnosed with the disease — and this difference is especially critical where people diagnosed with Alzheimer’s and their families and friends are concerned.

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How will population ageing affect future end of life care?

Increasing population ageing means that deaths worldwide are expected to rise by 13 million to 70 million per year in the next 15 years. As a result, there is an urgent need to plan ahead to ensure we meet the growing end of life care needs of our population in the future. Understanding where people die, and how this could change in the future, is vital to ensuring that health services are equipped to support people’s needs and preferences at the end of life.

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Global Health Days – immunity and community

24 April marks the start of World Immunization Week – an annual campaign first launched in 2012. The week is one of 8 WHO international public health events, which include those targeting major infectious diseases – World AIDS day, World Tuberculosis (TB) day, World Malaria day, and World Hepatitis Day. These infections share a few features with each other which mean they all will continue to be global health threats.

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The road to safe drugs

Healthcare is expensive, and not just in high income countries. Those who are suffering or struck by illness in resource limited countries are often unable to afford services that can provide them the care they need. Inequitable access to health services continues to be among the greatest public health challenges of our time. Since becoming […]

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WANTED: An alternative to Competency-Based Medical Education

Nicaragua (1984): In a hospital—or at least what was labelled as a hospital—a physician receives an elderly woman in a hypertensive crises. He administers the only anti-hypertensive medication available—Reserpine—a drug that is now rarely used because of its side effects. To his profound dismay the patient suffers a stroke and dies a few hours later. There are no morgues in such rural hospitals. There are no ‘funeral parlours’ in the villages. Families take their departed loved ones home for burial.

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What can brain research offer people who stutter?

There’s something compelling about watching a person who stutters find a way to experience fluent speech. British TV viewers witnessed such a moment on Educating Yorkshire, back in 2013. When teenager Musharaf Asghar  listened to music through headphones during preparations for a speaking exam, he found that his words began to flow. Singers, like Mark Asari who is currently competing on The Voice UK, also demonstrate how using the voice in song, rather than speech, can result in striking fluency.

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We can predict rain but can’t yet predict chronic pain

Accurate weather forecasts allow us to prepare for rain, snow, and temperature changes. We can avoid driving on icy roads, pack an umbrella, or purchase sunblock, depending on what is predicted.  Forecasting also generates information trustworthy enough to evacuate a city at risk from a category 4 hurricane. Meteorology has come a long way; today satellite data inform sophisticated computer weather models. Unfortunately, the same can’t be said for forecasting chronic pain. In most cases, health care providers can’t anticipate early or accurately enough which patients might develop long-lasting pain.

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What’s the deal with genetically modified (GM) foods?

It’s complicated; but here is a quick summary of what the controversy over genetically modified foods is all about. GM engineering involves reconfiguring the genes in crop plants or adding new genes that have been created in the laboratory. Scientific modification of plants is not something new. Since time began, nature has been modifying plants and animals through natural evolution, meaning that the plants and ani­mals that adapt best to the changing environment survive and pass their genes on to their offspring. Those that are least fit do not survive.

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Better health care delivery: doing more with existing resources

The healthcare sector faces challenges which are constantly escalating. Populations are growing worldwide and so is the share of the elderly in society. There is a constant proliferation of new medications, diagnostic methods, medical procedures and equipment, and know-how. This huge progress greatly improves the quality of medical treatment but at the same time increases its costs. Governments and authorities are allocating ever growing budgets to healthcare systems but the increased budgets do not cover the increased costs of providing quality healthcare to the public.

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What causes oral cancer and how can we prevent it?

We know that excessive consumption of alcohol is detrimental to oral health, but why? We know that tobacco smoking, alcohol, and poor oral hygiene cause increased acetaldehyde levels in saliva. Alcohol itself is not carcinogenic, but it is metabolised to acetaldehyde which has been strongly implicated in the development of oral cancer. The variation between people in how they metabolize alcohol might explain why some are at greater risk of cancer than others.

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