Oxford University Press's
Academic Insights for the Thinking World
In early 2011, Jon Underwood decided to develop a series of projects about death – one of which was to focus on talking about death. Jon read about the work of Bernard Crettaz, the pioneer of Cafes Mortéls which were themselves inspired by the cafes and coffeehouses of the European Enlightenment. Motivated by Bernard’s work, Jon immediately decided to use a similar model for his own project, and Death Cafe was born.
Death and dying surrounds us, yet many of us see it as an uncomfortable taboo subject. As part of a series of articles on encouraging an open dialogue around death and dying, we asked various healthcare professionals, academics, and members of the public who have experienced palliative care the following question: How important is it that we as a society are open to discussing death and dying?
It has been known for centuries that bacteria tend to adhere to solid surfaces, forming a slimy and slippery layer known as biofilm. Bacterial biofilms are complex microbial communities protected by an extracellular matrix composed of polysaccharides, proteins, and nucleic acids. The extracellular matrix improves biofilm cohesion and its adhesion to surfaces.
When orthopaedic surgeon, Dr. William H Harris discovered massive bone destruction around a total hip replacement that he had implanted, he was startled and dismayed. In fact, he had identified a new condition, “periprosthetic osteolysis”, which came to be the leading factor in failure of total hip replacement (THR) surgery. While THR surgery dramatically reversed severe arthritis of the hip, the same operation simultaneously created a relentless “particle generator” in the body.
Over the last decade or so, patients have been encouraged to think ahead, and make clear their wishes and plans for a time when illness may render them unable to makes decisions about their care for themselves. This process we know as Advance Care Planning (ACP). Intuitively, as a hospice physician trained in Palliative Medicine, ACP seems to me like a good thing to do, with those patients who are willing to do it.
Whether you are approaching retirement, or are a few years or decades away from thinking about leaving the workforce, it is likely that you will be affected by the changing nature of retirement. Maybe it’s not your own retirement that is on the forefront of your mind, but your spouse or partner’s. Perhaps your parent or another family member is trying to navigate the complexities of their pension, all the while trying to decide whether and how to retire.
In November last year, after much debate over cost, the National Institute for Health and Care Excellence (NICE) approved two new drugs for treatment of breast cancer for use on the NHS. Although first approval happened some time ago, this decision to make palbociclib and ribociclib available on the NHS, gives thousands more people access.
Palliative care is now a cemented service offered by health care services globally, and in the United Kingdom the hospice care sector provides support to 200,000 people each year. The care given to the terminally ill, as well as their family and friends is vital in supporting individuals through what is, for most, the most challenging time of their lives. This care ranges from clinical medical practice to spiritual support, and aims to put individuals in as much comfort as is possible.
Images of a Loa Loa worm crawling across a woman’s eye, a man’s leg swollen, unrecognizability from filariasis, a child comatose from malaria: these are the images often used to start a lecture on global health. The people suffering from these exotic maladies are undoubtedly of people of color who hail from communities and countries impoverished by a succession of geopolitical forces in direct opposition to human rights.
Defined as “the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health”, the field of epidemiology is a widely-encompassing field. Issues under this branch range from incarceration and health to environmental issues to gun violence. In recent years, global outbreaks have also brought epidemiology to the forefront with the reemergence of infectious diseases such as Ebola and Zika.
Retail thinking is spreading quickly in health care. It promises greater convenience and speed for delivering basic health care services — but it isn’t what patients really want. Retail thinking views patients as consumers: faceless targets for buying services and products that aren’t always health-related. It’s the thinking behind technology-assisted health care services, like ZocDoc, Amwell, and One Medical, which quickly triage symptoms or serve up medical advice.
With his right arm extended – pausing for just a moment – Senator John McCain flashed a thumbs-down and jarred the Senate floor. Audible gasps and commotion followed. At 1:29 am on 28 July, Senator McCain had just supplied the decisive “Nay” vote to derail the fourth and final bill voted on that night. With that, a seven-year pursuit to undo the Affordable Care Act had collapsed.
At the time of writing, many Australians are preoccupied with the recent result of the same-sex marriage survey (with 61.6% voting in favour of marriage equality). The survey’s result is indicative of a shift in the thinking about ‘rights’ in general, but also about ‘equality’ and what it means in practice. Unsurprisingly also, and as evidenced throughout the public and social media, all those who advocate for more open and inclusive society are pleased by what looks like a public surge for a social change.
When drafts of Sustainability and Transformation Plans (STP) for the 44 “footprints” of the NHS in England began to surface last year, a phrase caught my eye: “Championing the NHS Right Care approach to others within commissioner and provider organizations and building a consensus within the teams of those organizations”. This was the first bullet point for clinical leadership, from the 30 June 2016 version of the Cheshire and Merseyside STP.
Virtual Reality. Augmented Reality. Gamified Learning. Blended Learning. Mobile Learning. The list of technologies that promise to revolutionise medical education (or education in general) could go on, creating an exciting yet daunting task for the course leaders and educators who have to evaluate them.
Policy makers, organization, and governments have worked side-by-side with people living with AIDS as part of a global social movement for three decades. The success of the movement for HIV treatment access not only garnered billions of dollars of new money for HIV treatment, but also served to shift the public health paradigm from prevention-only to the provision long-term treatment.