Adjudicated health: incarcerated women and the social construction of health

Women in prison have been identified as one of the most vulnerable groups of women in society. This study examined the social construction of health through weekly interviews with 20 incarcerated women over 15 months. The study was grounded within a critical hermeneutic context using interpretive methods for data analysis. Adjudicated health reflects the social construction of health for women prior to and during imprisonment, and is dually grounded in protection and punishment — a construction in direct apposition to the department of correction's conceptualization of health. Implications for the health of women during imprisonment and post-release are discussed. This revised version was published online in July 2006 with corrections to the Cover Date.     

The health of health practitioners: remedial programs, regulation and the spectre of the law

The past two decades have seen an emerging awareness by regulators and some of the health professions about the phenomenon of the impaired practitioner. One response, particularly from the medical profession, has been to design various models of health programs principally to cater to psychiatrically unwell and substance dependent practitioners. However, the health conditions of practitioners are more diverse than these categories, particularly in the era of a stressed and ageing health care workforce. The potential exists for practitioners, their treaters and employers to be legally liable for foreseeable risks posed to patients and clients by practitioners whose health is problematic and/or deteriorating. There is much to be said for practitioners, health service administrators, educators and regulators dealing more effectively with all categories of impaired practitioners before the intervention of the civil law which may not be adequately informed or sophisticated and is most unlikely to be collaborative in its approach.     

Plato and the origin of mental health

This essay examines the history of the concept of mental health. Its origin can be traced to Plato, who argued that immorality is to the soul what disease is to the body. The purpose of this argument was to answer those who thought that morality is a set of social conventions, and in that sense, is contrary to nature. Plato responded by turning to those who made a systematic study of nature – the medical writers of his day – and claiming that if proper balance is needed to maintain a healthy body, the same is true of the soul. Thus the natural state of the soul is one in which the various parts agree on which should rule. This does not mean that Plato sought to excuse immoral behavior by treating it as a medical condition, only that he regarded immoral behavior as contrary to nature and thus treatable. Although later attempts to define mental health are not as rigid as Plato's, it is remarkable how many of his insights are still applicable, in particular the claim that morality and mental health, though not identical, are nonetheless linked. A case in point is the experience of wanting something but not liking the fact that you want it. Plato regarded internal conflict of this sort as a paradigm case of psychic dysfunction. I argue that we can regard it as either a moral failing or a mental one.     

Illuminating the health and safety of luminol

Luminol is a reagent that is used to enhance areas of non-visible bloodstaining and it is one of the most sensitive of such reagents available to the forensic scientist. However, its use, particularly within the UK and some other European countries, has been limited, predominantly due to concerns about the health and safety of the reagent. This paper reviews the literature currently available regarding the health and safety of luminol, and in the authors' view demonstrates that there are no significant health and safety concerns with the preparation of luminol solution and its application at the crime scene or in the laboratory, providing suitable precautions are taken.     

参与式教学法在卫生法学与卫生监督课程中的应用

目的:探讨参与式教学法在卫生法学与卫生监督课程中的实践应用及效果,以提升课堂质量,增强学生的理论实践水平。方法:抽取卫生法学与卫生事业管理两个专业正在讲授该课程的班级,由教师在课堂上应用参与式教学法进行教学,然后用自行设计的调查问卷对学生参与课题讲学的效果和问题进行调查。结果:通过参与式教学法,76.2%的学生认为个人学习的主动性增强;79.6%的学生认为个人对知识的掌握和吸收程度增强;74.6%的学生认为个人独立解决问题的能力增强。结论:卫生法学与卫生监督课程开展参与式教学法具有良好的教学效果。但是在具体实施过程中,教师还应注意努力激发学生的学习兴趣和参与热情,在实施参与式教学前向学生充分讲授基础知识,进行充分备课,拓展背景知识。     

Why public opinion changes: the implications for health and health policy

Research on stasis or change in public opinion toward health, health policy, and medical care tends to focus on short-term dynamics and to emphasize the impact of discrete messages communicated by individual speakers in particular situations. This focus on what we term "situational framing," though valuable in some respects, is poorly equipped to assess changes that may occur over the longer term. We focus, instead, on "structural framing" to understand how institutionalized public health and health care policies impact public opinion and behavior over time. Understanding the dynamics of public opinion over time is especially helpful in tracking the political effects of the Patient Protection and Affordable Care Act of 2010 as it moves from the debate over its passage to its implementation and operation.     

公共卫生框架下的卫生监督及其法制工作内涵简

卫生监督工作是公共卫生事业的一个组成部分,在实现公共卫生目标的同时,应当具备＂自我进化＂的能力。这种能力是公共卫生事业不断向高水平发展的重要因素,其动力来源在很大程度上依赖于卫生监督法制工作在正确的方向上有效运转。传统视角下对卫生监督法制工作内涵的解读有其局限性,本文在把握卫生监督与公共卫生之间的关系,以及重述、分析卫生监督过程的基础上,从解读立法、审视立法、反馈立法三个新的视角尝试探讨卫生监督法制工作的内涵。     

National health insurance and the new health occupations: nurse practitioners and physicians' assistants

This article considers a number of issues which might arise in formulating policy for new health occupations. Its particular focus is on nurse practitioners and physicians' assistants and their treatment under potential national health insurance arrangements. The development and expansion of these occupations are described, as is the evidence on their performance with respect to the quality of medical care provided, the impact on the cost of such care, and changes in access to care. We then discuss several issues which might arise in the context of national health insurance legislation, including reimbursement rates and methods, certification and licensure, training subsidies, deployment incentives, and compatibility with an increased supply of physicians.     

Tackling the health divide in europe: the role of the world health organization

Europe faces major health challenges in addition to its well-reported economic and financial difficulties. Despite the overall improvement in population health, significant inequalities remain, with a growing gap between rich and poor. WHO Europe, covering fifty-three member states, is committed to helping European governments meet the complex challenge posed by the "silent epidemic" of noncommunicable diseases. In September 2012 WHO launched Health 2020, an ambitious new health policy framework and strategy. Its success requires a whole-of-government and whole-of-society approach to improving health and well-being, informed by the latest evidence on cost-effective interventions. This review considers the prospects for success.     

Equity,health, and health care

Equity goals, such as equal treatment for equal need or equality of access, commonly take pride of place among the aims of health policy. But do these conceptions, or others derived from more fundamental philosophical systems such as those of the utilitarians or John Rawls, successfully capture the way in which the term equity is generally used? If not, is it possible to find some interpretation that can command a greater consensus? This paper answers no to the first question and yes to the second. It is argued that the standard conceptions of equity ignore the processes by which health states are determined and hence the extent to which they arise from factors beyond individual control. An alternative conception is proposed that directly incorporates these considerations.     

Empire and the business of health insurance.

I examine the development of privately provided insurance since World War II, giving special attention to Empire Blue Cross, and argue that the competition between employers and unions for the loyalty of workers after the passage of the Taft-Hartley Act helped diffuse private health insurance benefits already favored by federal policies. For-profit insurers did not challenge the privileged status of Blue Cross plans because they recognized the political benefits that the plans offered and because they did not wish to offend the plans' sponsors. A relatively easy and profitable business, health insurance has been greatly disturbed by the system inflation accompanying the introduction of Medicare and Medicaid programs. Now self-insurance and various managed-care schemes are major threats. The future may bring consolidation and the strengthening of pools, just the opposite of today's system fragmentation.     

Technology assessment and the sociopolitics of health technologies

In a growing number of countries, health technology assessment (HTA) has come to be seen as a vital component in policy making. Even though the assessment of the social, political, and ethical aspects of health technology is listed as one of its main objectives, in practice, the integration of such dimensions into HTA remains limited. Recent social scientific research on the inherently political nature of technology strongly supports such a comprehensive approach. The growing claims by and on behalf of consumer groups also suggest that HTA should be informed by a broader set of perspectives. Using the example of the cochlear implant in children, this essay compares the professed objectives of HTA with typical practice and explores possible explanations for the discrepancies observed. A second example, home telemonitoring for elderly persons, demonstrates how the types of evidence considered by HTA and the process through which assessments are produced may be reconsidered. We argue for the formal integration of the sociopolitical dimensions of health care technologies into assessments. The ability of HTA to more fully address important issues from a public policy point of view will increase by making explicit the sociopolitical nature of health care technologies.