Oxford University Press's
Academic Insights for the Thinking World

The end-of-life sector needs concrete solutions to be truly person-centred

In recent years the language used to describe what constitutes good end-of-life care has changed. ‘Shared-decision making’, ‘patient autonomy’, ‘choice’ and ‘advance care planning’ have become buzzwords. This is to be welcomed, of course, but has the sector really changed in practice? According to several policy reports, in addition to feedback from people who use end-of-life services, not particularly.

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Sports impairment in youth with inflammatory bowel disease

Over 80,000 children and adolescents in the United States live with inflammatory bowel diseases (IBD), which includes Crohn’s Disease and Ulcerative Colitis. These are chronic autoimmune diseases that cause inflammation in the gastrointestinal tract.

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Global health as a social movement: Q&A with Dr. Joia Mukherjee

What is social entrepreneurship? In essence, it’s about using the tools of entrepreneurship—opportunity, resourcefulness, innovation—to address stubborn social and environmental problems. A defining feature of social entrepreneurship is the concept of systemic change; that is, change that addresses the underlying social, political, and economic forces that conspire to exclude the poor and marginalised from the opportunities that many of us take for granted.

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A good death beyond dignity?

According to the Australian euthanasia activist Philip Nitschke, to choose when you die is “a fundamental human right. It’s not just some medical privilege for the very sick. If you’ve got the precious gift of life, you should be able to give that gift away at the time of your choosing.” This view combines two extreme standpoints in the debate on euthanasia and assisted suicide.

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Crises and population health

On the day after the horrific shooting that claimed the lives of 17 students at Stoneman Douglas High School in Parkland, Florida, the local state representative predicted what would happen next. “Nothing.”

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Looking back at 100 years of flu [timeline]

This year is the centenary of the Spanish influenza pandemic of 1918. However, it was only by 2010 that the industry had started universal flu vaccine trials, following the Swine flu pandemic in 2009. Explore the last hundred years of flu, as we mark the Spanish flu centenary, from the four major pandemics to the medical advances along the way, with this interactive timeline.

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Improving care for the family and friends who care for cancer patients

Many individuals in the United States will receive a cancer diagnosis this year. Such a diagnosis is upsetting to those who receive it and overwhelming to those—relatives or friends—who love them. Cancer is rarely experienced in isolation. 

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Stroboscopic medicine

The stroboscope is an ingenious device of rapidly flashing lights that allows engineers and scientists to freeze motion and capture brief slices of time. The resulting image is akin to examining a single frame of a motion picture that provides a sharp image, albeit one without context and with neither past nor future. This is now, sadly, an apt metaphor for contemporary clinical encounters.

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Kidney transplants, voucher systems, and difficult questions

It is commonly said that necessity is the mother of invention, and this was certainly the case at UCLA Medical Center in 2014 . Howard Broadman, then aged 64 and a retired judge from San Diego County, California, was concerned that his grandson, Quinn Gerlach, would be unable to secure a transplant kidney when he needed one. And so began the first “voucher system” for kidney procurement.

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Mind-body connection: a psychosomatic approach to women’s health

For millennia, medicine has been applied towards three main areas of the human condition: the mind, the body, and the spirit. Traditional Chinese medicine was similar to ancient Indian medicine in that it sought to create a holistic approach to treating illness, and recognised the contributions of psychological and social aspects in disease management.

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How can research impact patients’ health in the “real world”?

As an academic researcher, my primary goal is to improve population health. I was trained in innovative study designs, rigorous analytic approaches, and taught that fidelity to the methods is of the utmost importance. However, it is just as important that patients actually use the programs that we design to improve their health. Unfortunately, the few health programs that actually make it into the community can take years—even decades—to get there.

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Does consolidation in health care mean patients suffer?

The recent news that US retail giant CVS Health will purchase insurance giant Aetna, in part to gain millions of new customers for its prescription drug and primary care businesses, is another ominous sign for patients. Consolidation often limits competition, and when that happens in market-based systems the result, says good research, is often that the cost of health care goes up.

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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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