Public Health Medicine

The implications of the 1997 NHS (Primary Care) Act have been largely overlooked in the rush to establish Primary Care Groups. Allowing health authorities to develop local contracts for primary care has far-reaching implications and is an important departure from the national system of negotiation that has characterized general practice to date. This paper describes a content analysis of a sample of Personal Medical Services (PMS) pilot contracts. In the first year little attention has been given to achieving cost savings or greater efficiency and few contracts promote clinical guidelines. The difficulties of specifying services sensitive to local health needs are highlighted and the national Statement of Fees and Allowances (the 'Red Book') may not be swiftly supplanted. However, the pilots have introduced innovations such as salaried general practitioners, nurse-led services and NHS trust-managed care. The development of local contracts provides a valuable learning experie...

Background The aim of the study was to identify 'non-medical' datasets holding routinely collected information that might be used to measure and monitor the wider deter-minants of community health and well-being. Methods An expert panel discussion, involving public health and ...

One of the targets for the Health of the nation is to increase the proportion of women smokers who give up smoking at the start of their pregnancy, from a quarter to at least one-third, by the year 2000. This study uses a regional lifestyle survey to look at the characteristics of pregnant women who smoke. The lifestyle survey was based on a structured questionnaire which was sent by post to a systematic random sample of 60,000 adults across the North Western Region. A total of 513 respondents were pregnant; of these, 150 (29 per cent) reported that they smoked. The responses of pregnant smokers and non-smokers were compared to identify differences in age, demographic and social characteristics, mental distress and attitudes to lifestyle variables. Women in the North Western Region who smoked tended not to give up during pregnancy, but they did tend to smoke less. Smokers were more likely to be under 25 than non-smokers, less likely to be home-owners, and less likely to be living with a husband or partner. There was no difference in mental distress between smokers and ex-smokers, but they both experienced significantly greater mental distress than those who had never smoked. The difference between smokers and ex-smokers was in their type of occupation, housing tenure and whether they were living with a partner, ex-smokers being much more similar to non-smokers. More work needs to be done to improve the design of smoking cessation programmes, to make them more culturally appropriate for pregnant women who appear to be socially disadvantaged, have poor housing and lack a stable relationship.

Background Despite frequent calls to improve undergraduate medical public health teaching, little is known about whether curricula have changed. We report a survey of undergraduate public health teaching in UK medical schools in 1996. The survey aimed to assess whether the General Medical Council's 1993 recommendations to strengthen undergraduate medical education in public health have been implemented. Methods We asked heads of academic departments of public health at all 26 UK medical schools to ...

The specialty of family medicine is centered on lasting, caring relationships with patients and their families. Family physiciansintegrate the biological, clinical and behavioral sciences to provide continuing and comprehensive health care. The scope of family medicine encompasses all ages, sexes, each organ system and every disease entity. Read more about the history, scope and definition of family medicine by reviewing the following resources.



Public-health-family-medicine



Family medicine is a three-dimensional specialty, incorporating (1) knowledge, (2) skill and (3) process. At the center of the process element is the patient-physician relationship with the patient viewed in the context of the family. It is the extent to which this relationship is valued, developed, nurtured and maintained that distinguishes family medicine from all other specialties.



Family physicians integrate the biological, clinical and behavioral sciences to provide continuing and comprehensive health care. Family medicine encompasses all ages, sexes, each organ system and every disease entity. Family physicians also pay special attention to their patients' lives within the context of family and the community.

Adolescent Medicine
Geriatric Medicine
Pain Medicine
Sleep Medicine
Sports Medicine
Sexual Health
Geriatric Medicine
For more details, PS: https://clinicalcasereports.conferenceseries.com/events-list/case-reports-on-public-health-family-medicine

Background There is increasing interest in the health- promoting potential of physical activity in older adults. The objective of this study was to estimate the likely costs, health benefits and consequences for the National Health Service which might result from a publicly funded programme of regular exercise made available to a population of 10000 people over the age of 65.

Economic appraisal is increasingly being used to inform health care decision-making. To allow comparison, costs and benefits spread over time are weighted according to when they are experienced. The further in the future, the less heavily they are weighted or the more they are discounted. Traditional economic appraisal techniques are based on the view that social decisions should reflect private preferences. The practice of discounting future streams of costs and benefits is principally justified by the fact that individuals have a positive time preference, preferring consumption sooner rather than later. Discounting weights public decision-making in favour of interventions resulting in short-term benefits and against longer-term benefits. This discriminates against preventive and other public health programmes. This paper provides a critique of the foundations of discounting. It is argued that health policy should have a longer time horizon, reflecting social values rather than individual preferences. Factors which make discounting the future rational from the individual's point of view are shown to be irrelevant to a societal perspective. Although uncertainty about the effectiveness of interventions and technological change are good reasons for weighting some future benefits less highly, the routine use of a single discount rate for economic evaluations of health programmes is not justified.

General practice computers have been widely used in the United Kingdom for the last 10 years and there are over 30 different systems currently available. The commercially available databases are based on two of the most widely used systems – VAMP Medical and Meditel. These ...