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Purpose: The purpose of the paper "Bibliometric Analysis of ChatGPT's Applications in Medicine: A Comprehensive Assessment of its Impact and Potential" is to conduct a systematic evaluation of how ChatGPT, an AI language model, has been applied in the field of medicine. The study aims to assess the impact of ChatGPT's applications in medicine and explore its potential contributions to the healthcare domain. Materials and Methods: The Scopus database was selected and the search query (All (ChatGPT AND Medicine) was developed on 11, July 2023 to retrieve all the bibliographic records on the domine of interest. From each record, we retrieved data on the title, author, organizations, journals, publications type, source, country, collaboration, etc. They were exported to MS-Excel for bibliometric analysis and VOSviewer software was used for analyzing Co-Occurrence networks and the data and descriptive analysis were classified, collected one by one, and loaded into the Bibliometric R-package program to create science maps and statistical graphs. Results: ChatGPT - related Medicine papers in the Scopus database constitute 532 papers. these publications received 1046 citations, these authored by 1771 authors published 203 article type and etc. Average citations per document 1966 received and 111 (20.86%) received extremal funding support from 62+ research agencies supporting research in this area. selected 65 significant keywords appearing in ChatGPT and Medicine. USA and UK were contributed the highest papers. Medicine is the broad subject of the study were published highest number of papers (312). Conclusion: The findings from this study can help researchers, practitioners, and policymakers better understand the impact and potential of ChatGPT in advancing medical knowledge, patient care, and healthcare practices. Additionally, the paper may contribute to identifying knowledge gaps and guide further research in this rapidly evolving field at the intersection of AI and medicine. [ABSTRACT FROM AUTHOR]

Presents tips of writing a medical paper in Great Britain. Identification of writing the concluding part as a helpful step for an easy paper formulation; Disadvantages of concentrating on the introductory part of the paper; Significance of formulating an interesting title.

The article presents abstracts on medical topics which include the gastroscopy rate in general practitioner practice populations in Great Britain, randomised prospective trial of transnasal and standard upper diagnostic endoscopy under local anesthetic, and guidelines on the endoscopic assessment of gastric polyps.

Reports on the importance of the United Kingdom's Government's White Paper on Genetics. Efforts to control the line between enthusiasm for the benefits genetic medicine may bring and the danger of raising unrealistic expectations; Commitment made to improve awareness of genetic medicine.

Focuses on the use of computer system for the publication of the journal 'British Medical Journal' in Great Britain. Scheme on the use of computer system in the editorial office; Problems relating to computer systems; Advantage on the use of computer systems.

Background: The objective of this paper is to outline and compare the regulation of paid healthcare professions and associated support workers in international context, bringing out the lessons to be learned as appropriate. Modern neo-liberal societies have sought to enhance healthcare through greater professional regulation, albeit in different ways and at variable pace. This general trend is illustrated with reference to medicine in the UK. However, although such reforms have helpfully cascaded to other health professions, government policy in high-income countries has not yet adequately regulated the interrelated group of non-professionalised health support workers who form the largest and least recognised part of the workforce. Nonetheless, in low- and middle-income (LMIC) countries-aside from the greater need for regulation of health professions-there is even more of an imperative to regulate the disparate, largely invisible support workforce.Methods: With reference to existing studies of the medical and wider health professions in the UK and selected other higher income societies, the importance of health professional regulation to the public is underlined in the Global North. The larger gap in the regulation of support workers in modern neo-liberal countries is also emphasised on a similar basis, with an increasingly ageing population and advances in healthcare. It is argued from the very limited patchwork of secondary literature, though, that policy-makers may want to focus even more on enhancing regulation of both the professional and non-professional workforce in LMIC societies centred mainly in the Global South, drawing on lessons from the Global North.Results/conclusions: Efforts to reform health professional regulatory approaches in more economically developed countries, while needing refinement, are likely to have had a positive effect. However, even in these societies there are still substantial shortfalls in the regulation of health support workers. There are even larger gaps in LMICs where there are fewer health professional staff and a greater dependence on support workers. With higher rates of morbidity and mortality, there is much more scope here for reforming health regulation in the public interest to extend standards and mitigate risk, following the pattern for healthcare professions in the Global North. [ABSTRACT FROM AUTHOR]

Reports developments related to medicine in Great Britain. Delay of the publication of the green paper report on general practice; Recommendation of the Social Services Select Committee for extra funding; Criticisms of the pharmaceutical price regulation scheme in the country.

Aims Newly graduated doctors write a large proportion of prescriptions in UK hospitals but recent studies have shown that they frequently make prescribing errors. The prescribing safety assessment (PSA) has been developed as an assessment of competence in relation to prescribing and supervising the use of medicines. This report describes the delivery of the PSA to all UK final-year medical students in 2016 (PSA2016). Methods The PSA is a 2-hour online assessment comprising eight sections which cover various aspects of prescribing defined within the outcomes of undergraduate education identified by the UK General Medical Council. Students sat one of four PSA 'papers', which had been standard-set using a modified Angoff process. Results A total of 7343 final-year medical students in all 31 UK medical schools sat the PSA. The overall pass rate was 95% with the pass rates for the individual papers ranging from 93 to 97%. The PSA was re-sat by 261 students who had failed and 80% of those candidates passed. The internal consistency (Cronbach's alpha) of the four papers ranged from 0.74 to 0.77 (standard error of measurement 4.13-4.24%). There was a statistically significant variation in performance between medical school cohorts (F = 32.6, P < 0.001) and a strongly positive correlation in performance for individual schools between PSA2015 and PSA2016 ( r = 0.79, 95% CI 0.61-0.90; P < 0.01). Conclusions PSA2016 demonstrated the feasibility of delivering a standardized national prescribing assessment online. The vast majority of UK final-year medical students were able to meet a prespecified standard of prescribing competence. [ABSTRACT FROM AUTHOR]

Presents information on the apparent decline in clinical medicine in Britain, one of Britain's traditional strengths. Analysis by the Institute for Scientific Information (ISI); Clinicians staying out of research because of decline in salaries; Increase in `soft money' from drug companies and small charities accounting for drop in quality and jump in output, according to Edinburgh gastroenterologist Ian Bouchier.

Recently there has been renewed interest in basing teachers’ professional learning on medically derived models. This interest has included clinical practice models and evidence-based teaching as well as the use of various forms of ‘Rounds’ which claim to derive from medical rounds. However, many arguing for these approaches may well not have a detailed knowledge of the actuality of professional learning in medicine but may be basing their ideas on idealised models drawn from popular conceptions. In addition, the model used by some calling for medically derived teacher learning is biomedicine, an area in which parallels with Education are difficult. This paper argues that mental health and public health provide a better analogue for Education than biomedicine. It considers some of the lessons that can be drawn from research on evidence-based practice in these areas. The paper concludes that a way forward is neither uncritically to assume the superiority of medical models of professional learning nor to rely only on empirical evidence from Education, but rather to enter into dialogue with colleagues in mental and public health about shared concerns and experiences in professional learning. [ABSTRACT FROM PUBLISHER]

Reports developments related to medicine in Great Britain. Uses of a plastic drip set; Usefulness of waste papers; Preference to live in Africa.

Objective: This paper aims to demonstrate that any suggestion that there is a need for specific innovation laws is flawed. Innovation is central to good medical practice and is adequately supported by current law. Methods: The paper reviews the nature of medical innovation and outlines recent attempts in the UK to introduce specific laws aimed at 'encouraging' and 'supporting' innovation. The current legal framework is outlined and the role of the law in relation to medical innovation explored. Results: The analysis demonstrates the cyclic relationship between medical advancement and the law and concludes that there is no requirement for specific innovation laws. Conclusions: The law not only supports innovation and development in medical treatment but encourages it as central to a functioning medical system. There is no need to introduce specific laws aimed at medical innovation; to do so represents an unnecessary legal innovation and serves to complicate matters. [ABSTRACT FROM AUTHOR]

Through an examination of the extensive papers, manuscripts and correspondence of American physician Benjamin Rush and his friends, this article argues that it is possible to map a network of Scottish-trained physicians in the late eighteenth and early nineteenth-century Atlantic world. These physicians, whose members included Benjamin Rush, John Redman, John Morgan, Adam Kuhn, and others, not only brought the Edinburgh model for medical pedagogy across the Atlantic, but also disseminated Scottish stadial theories of development, which they applied to their study of the natural history and medical practices of Native Americans and slaves. In doing so, these physicians developed theories about the relationship between civilization, historical progress and the practice of medicine. Exploring this network deepens our understanding of the transnational intellectual geography of the eighteenth and early nineteenth century British World. This article develops, in relation to Scotland, a current strand of scholarship that maps the colonial and global contexts of Enlightenment thought. [ABSTRACT FROM AUTHOR]

The last two hundred years or so have seen the transformation of medical practice from a clinical art to the application of science to the diagnosis and treatment of disease. There has been a historical debate about how the use of technology and discoveries of the laboratory have become integrated within medical practice. In trying to understand the evolution of “scientific medicine,” this has generally focused on the tensions between the differing cultures, persons, and professions of the “laboratory” and “clinic” and sought to explain how they were resolved within specific institutions. This paper looks again at the “Glasgow School” (the subject of a number of seminal papers on this subject) and the forces that shaped it, by exploring the career of Leonard Findlay, whose training in Glasgow, and in Berlin (where he worked in a department in which science and medicine were integrated), defined a style of clinical medicine that formed the model for a new sort of university department of medicine in which clinicians and scientists worked side by side, albeit under the leadership of the former. As a clinician exposed in Berlin to the emerging new sciences of nutrition, microbiology, and immunology, which were particularly relevant to the care of sick children, Findlay created in Glasgow a department of medical pediatrics, which owed less to local factors, figures, and forces and more to his experience in Germany. [ABSTRACT FROM PUBLISHER]

This paper presents some of Santorio's marginalia to his Commentaria in primam fen primi libri Canonis Avicennae (Venice, 1625), which I identified in the Sloane Collection of the British Library in 2016, as well as the evidence for their authorship. The name of the Venetian physician Santorio Santori (1561–1636) is linked with the introduction of quantification in medicine and with the invention of precision instruments that, displayed for the first time in this work, laid down the foundations for what we today understand as evidence-based medicine. But Santorio's monumentale opus also contains evidence of many quantified experiments and displays his ideas on mixtures, structure of matter and corpuscles, which are in many cases clarified and completed by the new marginalia. These ideas testify to an early interest in chemistry within the Medical School of Padua which predates both Galileo and Sennert and which has hitherto been unknown. [ABSTRACT FROM AUTHOR]

Background: Debate is intensifying about how to assess the full range of impacts from medical research. Complexity increases when assessing the diverse funding streams of funders such as Asthma UK, a charitable patient organisation supporting medical research to benefit people with asthma. This paper aims to describe the various impacts identified from a range of Asthma UK research, and explore how Asthma UK utilised the characteristics of successful funding approaches to inform future research strategies. Methods: We adapted the Payback Framework, using it both in a survey and to help structure interviews, documentary analysis, and case studies. We sent surveys to 153 lead researchers of projects, plus 10 past research fellows, and also conducted 14 detailed case studies. These covered nine projects and two fellowships, in addition to the innovative case studies on the professorial chairs (funded since 1988) and the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma (the 'Centre') which together facilitated a comprehensive analysis of the whole funding portfolio. We organised each case study to capture whatever academic and wider societal impacts (or payback) might have arisen given the diverse timescales, size of funding involved, and extent to which Asthma UK funding contributed to the impacts. Results: Projects recorded an average of four peer-reviewed journal articles. Together the chairs reported over 500 papers. All streams of funding attracted follow-on funding. Each of the various categories of societal impacts arose from only a minority of individual projects and fellowships. Some of the research portfolio is influencing asthmarelated clinical guidelines, and some contributing to product development. The latter includes potentially major breakthroughs in asthma therapies (in immunotherapy, and new inhaled drugs) trialled by university spin-out companies. Such research-informed guidelines and medicines can, in turn, contribute to health improvements. The role of the chairs and the pioneering collaborative Centre is shown as being particularly important. Conclusions: We systematically demonstrate that all types of Asthma UK's research funding assessed are making impacts at different levels, but the main societal impacts from projects and fellowships come from a minority of those funded. Asthma UK used the study's findings, especially in relation to the Centre, to inform research funding strategies to promote the achievement of impact. [ABSTRACT FROM AUTHOR]

The discourses around globalisation and internationalisation within higher education to date have tended to focus on institutional change. While recognising the importance of these debates, this paper suggests that issues around curriculum change and teaching and learning through global professions such as health and engineering have so far been largely neglected. Using evidence from the UK and Ireland, the paper looks particularly at how students perceive the importance and value of global perspectives to their professions. It concludes by noting that there is evidence of interest in integrating global perspectives within health and engineering degree courses from students, but that this raises major challenges concerning discipline-based knowledge, valuing differing perspectives and approaches towards teaching and learning. [ABSTRACT FROM AUTHOR]

In this paper, we discuss findings from two studies designed to access and analyse the beliefs, attitudes, and behaviours of health-care professionals and scientists working in morally contested fields of biomedicine that involve the embryo. We seek to support the view that the embryo typically ‘matters’ to the people we interviewed and whose work we observed, even though it is impossible for them to agree in terms of why that is, and even though their work is of the type to which the moral guardians of the embryo object. In the first part of this paper, we touch on the policy and legal position in relation to embryos, noting Margot Brazier's account of the development of the relevant regulation in the UK and the importance of her claim that the embryo is widely thought to have an important symbolic value. We then turn to explore some of the views, attitudes, and work practices of those whose work involves the embryo, whether that be in relation to fertility treatment services, including IVF and PGD, or research that uses embryos. Our discussion shows the extent to which the embryo typically matters, in various ways, to those working in these fields. [ABSTRACT FROM AUTHOR]

The world in 2010 is a very different place to 1987 when Bhugra's paper on homophobia was published. Huge shifts have occurred in society's attitudes to gender, sex, sexuality and identity - notably by the internet, changes in HIV treatment, media representation of homosexuality and feminism and the role of women in society. This paper updates the literature review on homophobia revisiting society's assumptions about homosexuals. Changes are discussed in the context of definitions of homophobia, socio-cultural and politico-legal perspectives and homophobia and medicine. New current assumptions are drawn up and offered as a way of understanding both development and limitations - whilst there has been a reduction in the fear associated with gay men and women, discrimination remains. Newer issues such as internalised homophobia, globalisation and mainstream representations of homosexuality add complexity to this ongoing concern. [ABSTRACT FROM AUTHOR]

This paper is the start of a series on general medicine and surgery for dental practitioners. It follows on from a previous series, published in the British Dental Journal in 2003. The proportion of older people in the UK population has been on the increase for several years. Dental practitioners who treat the general public often see older patients on a regular basis. This paper considers aspects of clinical management in the older patient with particular reference to the presentation of disease and factors to be considered in prescribing medication. [ABSTRACT FROM AUTHOR]

Legislative restrictions on the sale of organs, gametes and surrogacy services are often seen as having no basis other than mere prejudice or taboo. This paper argues instead that they can be read as instances of a broader decommodification of healthcare provision established in Britain with the creation of the NHS in 1948. Restrictions on the marketisation of medicine were justified by Aneurin Bevan, the founder of the NHS, and by Richard Titmuss, one of its chief academic defenders, in distinctly utopian terms. On this vision, the NHS would function as a utopian enclave prefiguring an idealised non-capitalist future. This commonsense of post-war medicine was fatally destabilised by fiscal crisis and social critique in the 1970s. Influential commentators like Ian Kennedy developed an anti-utopian account of the real NHS and proposed legalistic and market-based reform. These reforms sought to dissolve the enclave, assimilating medical work and the NHS as a whole to broader systems of accounting and accountability. Insofar as they have been realised, they achieve a recommodification of medicine in Britain. The paper concludes by examining recent studies of the ‘new NHS’, which see in the latter-day idealisation of market processes a novel form of self-denying utopianism. [ABSTRACT FROM AUTHOR]

The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies. [ABSTRACT FROM AUTHOR]

After 1945, Western medicine was influenced mostly by investigations from Britain and the USA. This paper deals with the presentation of German medicine in the German weekly «Der Spiegel» between 1947 and 1955, when German society changed from a postwar community focussed on survival to a modern western society. The paper will particularly focus on medicine as a service, dealing not with diagnostic and therapeutic innovations, but with troublesome every-day problems of body and soul at the border of health and disease. The paper argues that »service medicine« was an important tool for German medicine to achieve social acceptance and to integrate itself into the new German democratic society with its private market economy. [ABSTRACT FROM AUTHOR]

This paper introduces the controversy surrounding active voluntary euthanasia and describes the legal position on euthanasia and assisted suicide in the UK. Findings from studies of the nurses' attitudes to euthanasia from the national and international literature are reviewed. There are acknowledged difficulties in carrying out research into attitudes to euthanasia and hence the review of findings from the published studies is followed by a methodological review. This methodological review examines the research design and data collection methods used in the published studies, problems with understanding definitions of euthanasia and the measurement of attitudes. The paper concludes with a discussion of how research in this area may influence nursing practice. [ABSTRACT FROM AUTHOR]

Medicine has changed dramatically in the past two decades. The traditional paternalism in the UK is waning and the relationship between the medical profession, government and patients has progressed from one where autonomy and respect could be assumed to patients now taking part in decisions about their healthcare. This paper explores different means of engaging patients and involving them in changes in service delivery. Engaging patients in this new world, where the management of chronic disease will become increasingly important, requires new skills. Representative patients who can participate in discussions without intimidation need to be developed and nurtured. Similarly, professionals who can work constructively with challenging patients and service users need to be cultivated. When these key ingredients come together, an organisation which listens is possible. This paper describes an organisational development initiative, the Patient Line of Sight, which set out to understand and thereby improve the experience of patients attending the hospital. The programme brought about changes in many areas in the hospital and gave the staff a greater sense of empowerment. There is a plethora of ways in which patients and the public can be engaged. The aim of this paper is to consider how patient involvement can move from a tick box alongside the development of services to an integral driver in the system. Patient engagement is about culture -- open, transparent organisations which can rise to this challenge are likely to be able to adopt change and continue to improve the services which they offer. [ABSTRACT FROM AUTHOR]

This paper provides a comparative historiographical framework within which to reconsider the history of nursing. It asks why nursing has remained largely sidelined within the history of medicine, while the latter has gained mainstream respectability in the wider field of historical research. Gender historians are challenged to look at the under-explored aspects of nursing's history such as pre-Nightingale nurses and nursing, and the multiple and international meanings of race, class and gender as experienced by this unique cohort of women and men. The paper draws upon key texts in the history of nursing and of medicine and includes a discussion about use of imagery within significant publications and what this says about intended readerships. It concludes that, unlike medicine, nursing professionals have to some extent hijacked the history of nursing, while the subject has been further hampered by Florence Nightingale's legacy and the subsequent emphasis on the professionalisation of nursing. [ABSTRACT FROM AUTHOR]

This paper presents an overview of several evidence-based medicine and patient information studies conducted across the UK health service over a 4 year period, investigating clinicians', managers', and patients' perceptions of digital resources (primarily digital libraries) in hospitals, Primary Care Trusts, NHS Direct (patient call centre) and patient groups. In-depth interviews and focus groups are analysed using grounded theory methodologies and through content analysis used to produce quantitative finding. The perceived impacts of three different methods employed for delivering health informatics are presented. The findings highlight some generic issues relevant for health informatics in the UK health sector as well as some specific issues for medical digital libraries. This paper reviews in more detail the issues of medical technology implementation (traditional implementation, on the wards, and intermediaries within in communities). A breakdown of the clinicians' and patients' information journey (information initiation, facilitation and interpretation) is also presented with regard to medical digital libraries and online resources. Broad guidelines derived from these findings are provided for health-informatics deployment. [ABSTRACT FROM AUTHOR]

A recent issue of this Journal published two papers on political issues facing the specialty of emergency medicine in the USA and in Canada. This paper continues the theme from a UK perspective. In recent years there has been significant change in the National Health Service, which has had (or will have) both direct and indirect consequences for the specialty of emergency medicine and the delivery of emergency care in the UK. This article describes some of the recent National Health Service initiatives and their implications for emergency medicine. [ABSTRACT FROM AUTHOR]

This paper reports the findings from an evaluation of a pilot interprofessional training ward project for pre-qualification medical, nursing, occupational therapy and physiotherapy students. This initiative required sustained collaboration from staff based in two National Health Service (NHS) trusts and four schools in three universities. The ward was based on a model of interprofessional education developed in Sweden, but adapted in the light of this experience and also to meet the needs and aspirations of the training ward stakeholders in London. The training ward was evaluated using a multi-method design. Data were collected from all participants involved in this pilot: students, facilitators and patients. The findings from the evaluation are presented and discussed. This paper pays particular attention to the collaborative experiences of the students, staff and institutions involved in this initiative. In addition, 1-year follow-up data collected from the students who had, by then, qualified as clinical practitioners are reported. The paper presents conclusions from the evaluation, and comments on the training ward's strengths, limitations and future development. [ABSTRACT FROM AUTHOR]

This paper briefly outlines health advisor L.W. Harrison's contribution to venereology or genitourinary (GU) medicine, and shows how his principles of good practice fulfil many of the principles of clinical governance. The paper then outlines some general principles of clinical governance and indicate how they relate to GU medicine. Harrison set up the specialty on a firm foundation of clinical excellence that fulfils many of the latest requirements. He would have been thrilled to see how the specialty has broadened and would have applauded the drive for excellence. However, he might have been concerned over the literature on clinical governance, reminding that the pursuit is excellence of clinical care for the patient, and that clinical governance must not become an end in itself.

This paper studies the rising use of commercial medical assistance in early modern England. We measure individual consumption of medical and nursing services using a new dataset of debts at death between ca. 1670 and ca. 1790. Levels of consumption of medical services were high and stable in London from the 1680s. However, we find rapid growth in the provinces, in both the likelihood of using medical assistance and the sums spent on it. The structure of medical services also shifted, with an increase in "general practice," particularly by apothecaries. The expansion in medical services diffused from London and was motivated by changing preferences, not wealth. [ABSTRACT FROM AUTHOR]

This paper reviews some key issues in risk analysis, management and communication. It concentrates on three areas: communication and choice with regard to clinical risks, risk communication and public health, and the relationship between scientific advice and public policy decisions. In each sphere, some longstanding concerns have recently come to have increased prominence, and the paper briefly reviews some ongoing responses to these. [ABSTRACT FROM AUTHOR]

Presents the medical studies featured in the 'British Medical Journal' in Great Britain. Focus of the majority of the papers on epidemiology; Number of citations received by the studies included in the list; Citation of pharmacologically oriented papers with the highest ratings. INSETS: 1940s;Concourse No 2;The BMJ's top 50.

In this paper, we trace how mathematical models are made 'evidence enough' and 'useful for policy'. Working with the interview accounts of mathematical modellers and other scientists engaged in the UK Covid-19 response, we focus on two weeks in March 2020 prior to the announcement of an unprecedented national lockdown. A key thread in our analysis is how pandemics are made 'big'. We follow the work of one particular device, that of modelled 'doubling-time'. By following how modelled doubling-time entangles in its assemblage of evidence-making, we draw attention to multiple actors, including beyond models and metrics, which affect how evidence is performed in relation to the scale of epidemic and its policy response. We draw attention to: policy; Government scientific advice infrastructure; time; uncertainty; and leaps of faith. The 'bigness' of the pandemic, and its evidencing, is situated in social and affective practices, in which uncertainty and dis-ease are inseparable from calculus. This materialises modelling in policy as an 'uncomfortable science'. We argue that situational fit in-the-moment is at least as important as empirical fit when attending to what models perform in policy. • Pandemics are performed as crises of uncertain yet catastrophic potential. • Mathematical models are forms of scalar narrative affording epidemics their scale. • Models and projections are made useful as evidence in their situated policy events. • Calculations are given agency as affects in the evidencing of pandemics. • Modelling pandemics is a site of 'uncomfortable science' and 'dis-ease'. [ABSTRACT FROM AUTHOR]

In his late historical and autobiographical writings (the late writings) Ernest Jones makes two interrelated claims. The first, which he passes off as an historical fact, is that by 1904 there were 'three sources of information available to [him]' about Freud (Jones, 1945b, p. 9). The second, which he makes by way of an autobiographical statement, is that he was already practising 'the new therapy' of psychoanalysis by 1906. Contemporaneous sources challenge the unspoken assumptions that run through Jones's late writings: that there was little or no discussion of Freud's ideas in Britain between 1904, when Jones claims he first started reading Freud, and November 1913 when he founded the London Psycho-Analytic Society. For reasons difficult to fathom Jones's version of history has been accepted almost without question. Lifting Jones's historical and autobiographical veils reveals a very different story: that when Jones first returned from Canada, in 1911, there was already a vibrant debate concerning the merits, or otherwise, of the new Freudian psychology and there were a number of doctors already treating patients with psychoanalysis or its variants. The paper concludes with a re-examination of Jones's relationship with M.D. Eder. [ABSTRACT FROM AUTHOR]

Background: Around 67 million pets are owned by households in the United Kingdom, and an increasing number of these are exotic animals. Approximately a third of pets are purchased through retail outlets or direct from breeders. A wide range of infections can be associated with companion animals. Objectives: This study uses a systematic literature review to describe the transmission of zoonotic disease in humans associated with a pet shop or other location selling pets (incidents of rabies tracebacks and zoonoses from pet food were excluded). Data sources: PubMed and EMBASE. Results: Fifty seven separate case reports or incidents were described in the 82 papers that were identified by the systematic review. Summary information on each incident is included in this manuscript. The infections include bacterial, viral and fungal diseases and range in severity from mild to life threatening. Infections associated with birds and rodents were the most commonly reported. Over half of the reports describe incidents in the Americas, and three of these were outbreaks involving more than 50 cases. Many of the incidents identified relate to infections in pet shop employees. Limitations: This review may have been subject to publication bias, where unusual and unexpected zoonotic infections may be over-represented in peer-reviewed publications. It was also restricted to English-language articles so that pathogens that are more common in non-Western countries, or in more exotic animals not common in Europe and the Americas, may have been under-represented. Conclusions/implications: A wide spectrum of zoonotic infections are acquired from pet shops. Salmonellosis and psittacosis were the most commonly documented diseases, however more unusual infections such as tularemia also appeared in the review. Given their potential to spread zoonotic infection, it is important that pet shops act to minimise the risk as far as possible. [ABSTRACT FROM AUTHOR]

The article features a set of abstracts of various research papers presented at the meeting of Royal Society of Medicine, London on November 23, 2003. Some of the papers presented are Sacral nerve stimulation (SNS) for faecal incontinence in the Great Britain; Fatigability of the external anal sphincter in faecal incontinence; Treatment of persistent perineal sinus with pedicled flap: experience of a single colorectal surgeon etc. SNS is safe effective in the medium to long term for treatment of faecal incontinence when conservative treatment has failed.

Background: The United Kingdom has led the world in the development of children's palliative care. Over the past two decades, the illness trajectories of children with life-limiting conditions have extended with new treatments and better home-based care. Future planning is a critically under-researched aspect of children's palliative care globally. This paper describes the development, implementation and evaluation of innovative child and parent-held palliative care planning resources. The resources were designed to facilitate parent and child thinking and engagement in future planning, and to determine care preferences and preferred locations of care for children with life-limiting conditions from diagnosis onwards. These resources fill a significant gap in palliative care planning before the end-of-life phase. Methods: Drawing on contemporaneous research on producing evidence-based children's health information, we collaborated with leading children's not-for-profit organisations, parents, children, and professionals. A set of resources (My Choices booklets) were developed for parents and children and evaluated using interviews (parents, children, professionals) and questionnaires (professionals) and an open web-based consultation. Results: Parents and children responded in three ways: Some used the booklets to produce detailed written plans with clear outcomes and ideas about how best to achieve desired outcomes. Others preferred to use the booklet to help them think about potential options. Remaining parents found it difficult to think about the future and felt there was no point because they perceived there to be no suitable local services. Professionals varied in confidence in their ability to engage with families to plan ahead and identified many challenges that prevented them from doing so. Few families shared their plans with professionals. Parents and children have far stronger preferences for home-care than professionals. Conclusion: The My Choices booklets were revised in light of findings, have been endorsed by Together for Short Lives, and are free to download in English and Welsh for use by parents and young people globally. More work needs to be done to support families who are not yet receptive to planning ahead. Professionals would benefit from more training in person-centred approaches to future planning and additional communications skills to increase confidence and ability to engage with families to deliver sensitive palliative care planning. [ABSTRACT FROM AUTHOR]

The field of personalised or stratified medicine is evolving alongside the formation of a plethora of public/private partnerships and collaborations. These new institutional forms, or ‘social technologies’, are varied and emerge in response to several drivers, including the need to draw on a broader base of data inputs relating to genomics, patient behaviour and healthcare system differentiation. This paper discusses some of these drivers of partnerships and collaborations. Although the number of such partnerships is growing, their rationale and basis for collaboration remains unclear. Public–private collaborations are at the core of the set of new life sciences policies in the UK but there is little indication in the policy documents of clear boundaries for these partnerships. In part, this is due to the lack of empirical evidence at the system level for conceptualising what is still a relatively new approach. The collection of evidence in the form of broad evaluations, rather than tightly focused theoretical studies, is more likely to be related back to systems and be of more use for formulating policy rationales. [ABSTRACT FROM AUTHOR]

The General Medical Council's call to modernize medical education prompted the University of Liverpool Medical School to develop a new undergraduate programme, integrating palliative medicine as 'core' curricula. Following successful piloting, the palliative medicine training programme was further developed and expanded. This paper examines whether the additional investment produces improved outcomes. In 1999, fourth year undergraduate medical students (Cohort 1, n=217) undertook a 2-week pilot education programme in palliative medicine. Subsequently, the training programme was refined and extended, incorporating advanced communication skills training, an ethics project and individual case presentations (Cohort 2, n=443). Congruent with the study's theoretical driver of self-efficacy, both cohorts were surveyed pre- and post-programme with validated measures of: (i) self-efficacy in palliative care scale; (ii) thanatophobia scale. No significant differences between cohorts' pre-programme scores were identified. Within each cohort, statistically and educationally significant post-education improvements were recorded in both scales. Further post-education analysis indicated that the extended programme produces significantly greater improvements in all domains of the self-efficacy in palliative care scale (communication, t=-7.28, patient management, t=-5.96, multidisciplinary team-working t=-3.77 at p<0.000), but not thanatophobia. Although improvements were recorded in both cohorts, participation in the extended education programme resulted in further statistically significant gains. Interpreted through the theoretical model employed, improved self-efficacy and outcome expectancies will result in behavioural change that leads to improved practice and better patient care. [ABSTRACT FROM AUTHOR]

Current veterinary history has not engaged significantly with patient histories. In many historical accounts of veterinary medicine, animal patients are backgrounded or completely invisible. Yet modern veterinary medicine, in its dominant form of companion animal practice, has become increasingly patient-centred. The modern animal patient is accorded something near full subject status in many veterinary clinical interactions. Embracing this raises issues of how to handle animals in veterinary history. Animals are the recipients of veterinary medicine, they exert agency in the clinic and field, yet they have remained problematical for the historian and sociologist, who have remained anthropocentric in orientation. This paper explores different constructions of the veterinary surgical patient in the 20th century in an attempt to begin examination of veterinary history as an animal-patient history "from below." In doing so, a trajectory of the development of British 20th-century veterinary medicine is presented which suggests the value of minding animals in historical accounts. Further interdisciplinary studies of veterinary procedures and practices are needed in order to foreground animals more and evaluate their subject status within historical and contemporary veterinary medicine. [ABSTRACT FROM AUTHOR]

For Freidson [(1985). The reorganisation of the medical profession. Medical Care Review, 42(1), 11–35], collegiality, or ostensible equal status amongst members of the medical profession, serves a dual purpose. It socialises members into an attitude of loyalty to colleagues and presents an image to those outside the profession that all its members are competent and trustworthy. However, Freidson saw the use of formal standards developed by one (knowledge) elite within medicine and enforced by another (administrative) elite as threatening collegiality and professional unity. Drawing on two studies in English primary medical care this paper reports the emergence of new strata or elites, with groups of doctors involved in surveillance of others and action to improve compliance in deficient individuals and organizations. Early indications are that these developments have not led to the consequences which Freidson predicted. The increasing acceptance of the legitimacy of professional scrutiny and accountability that we identify suggests that new norms are emerging in English primary medical care, the possibility of which Freidson''s analysis fails to take account. [Copyright &y& Elsevier]

Homoeopathy is one of the most widespread forms of complementary and alternative medicine (CAM) currently used in the UK. As an overtly holistic discipline, the homoeopathic consultation process is often regarded as being intrinsically patient-centred. This paper will argue that although an underlying mutualistic or collegial approach is often evident in homoeopathy, there are certain points in a consultation where these types of behaviour are more overt. It is suggested that these points are likely to be located where there is a predictable possibility of misalignment between letting the patient set the agenda, and the practical needs of the consultation process – ie the performance of certain essential consultation ‘tasks’. In order to illustrate this, one particular aspect of the homoeopathic consultation will be examined – the ‘treatment-giving’ phase. Four broad transitional formats will be proposed: categorical; open; deferred; and reversed. The relatively dynamic sequential positioning that the treatment phase occupies in the homoeopathic context will be highlighted, as will the implications that this may have in terms of encouraging patient / practitioner negotiation over treatment decisions. [ABSTRACT FROM AUTHOR]

Whilst there are not yet laws specifically relating to nanotechnology and its products in any country, the technology and its products are not unregulated. Regulatory frameworks created for conventional technologies and products will be expected to apply to nanotechnology and its products. For example, new medicines are regulated in Australia by the Therapeutic Goods Administration. If a new medicine incorporates nanotechnology, then it should still be regulated as a medicine. However, whether the expectation that pre-existing regulatory frameworks will apply is correct and, if so, whether the application of such frameworks is adequate are important issues to be answered. This paper considers these questions, drawing on lessons learnt from significant regulatory reviews undertaken in the United Kingdom, United States and Australia. [ABSTRACT FROM AUTHOR]

Abstract: This paper attempts to bring new insights to a long-standing historical debate over medical specialization by analyzing the formation of medical mycology, a somewhat marginal biomedical discipline that emerged in the mid-twentieth century around studies of fungal disease in humans. The study of fungi predates that of bacteria and viruses, but from the 1880s it became eclipsed by bacteriology. However, in the postwar period, there were moves to establish medical mycology as an independent speciality. I trace the processes that led to the launch of professional societies in the United States, Britain and Japan, three major players in medical mycology, and more broadly in biomedicine. The analysis of the three different national contexts illustrates how geographical, medico-technological, epidemiological, political and social conditions gave the specialty a distinctive character in each country; this was further complicated by the different and changing medical fields in which fungal diseases were studied and treated. The three case studies show medical specialization as a process that is not simply cumulative but responds to specific historical events and developments. [Copyright &y& Elsevier]

Abstract: The medical procedure of ‘feticide’ has been used in clinical practice since the early 1990s in the UK. The procedure constitutes a sensitive aspect of late termination of pregnancy (TOP), an issue that is in itself contentious. The procedure has attracted attention from academic and policy commentators, but recently the medical profession has expressed some uncertainty with respect to the legal position of live birth following TOP, and professional discretion in providing feticide. To understand the meaning of these comments better, we argue that it is helpful to acknowledge the rhetoric that shapes the academic discourse on feticide. In this paper, we review how feticide has been conceptualised within academic discourse, demonstrating that the concept has multiple meanings, some of which could be considered politically charged. We then consider some examples of the comments made about the legal uncertainties of feticide, highlighting assumptions made about the problematic nature of professional discretion. Ultimately, we suggest that a better understanding of the context of feticide is needed to ensure that future research in this area of health care engages adequately with issues of professional discretion. [Copyright &y& Elsevier]

This article argues that historians of medicine have, until very recently, misinterpreted the relationship of "science" and "the clinic" in the early twentieth century. It follows recent historiographic developments in focusing on the relationship in practice as exemplified by the development of a specific variety of collaborative clinical research using laboratory methods, ca. 1919-37, in a major British medical school. It suggests that it is such working hybrids that should be studied in order to understand fully the development of scientific medicines in the United Kingdom in this period. In Glasgow, it was the local medical culture's characteristic local subservience to clinical priorities that facilitated, in a particular kind of academic unit, a certain type of hierarchical teamwork between clinicians and laboratory workers; the paper reveals how and why this teamwork became, over time, more of an equal partnership. [ABSTRACT FROM AUTHOR]

From 1999 onwards most English NHS regions launched multidisciplinary public health training schemes. These schemes were open to those from backgrounds other than medicine and followed on from the announcement of a new multidisciplinary Public Health Specialist post--a post equivalent to the traditional medical Consultant in Public Health Medicine. This article documents the issues arising during the first few years of the multidisciplinary public health training schemes. It also includes a number of case studies from trainees who have passed through the training schemes, examining the positive and negative experiences of these trainees. The paper reveals how the schemes initially varied considerably by region, in respect of pay and other terms and conditions. The case studies from ex-trainees reveal a number of positive and negative features of the training schemes. [ABSTRACT FROM AUTHOR]

Objective The publication of information about the performance of health-care providers is regarded as central to promoting greater accountability and empowering patients to exercise choice. The evidence suggests that the public is not very interested in accessing or using current sources of information. This study aimed to explore the information needs of patients in the context of UK primary care and to develop an information source about general practice services, designed to be usable by and useful to patients. Design An action research study making use of data from formal and informal interviews, focus groups, participant observation and document review. Setting The geographical areas covered by two Primary Care Trusts in the north of England and two Local Health Boards in south Wales. Participants A partnership between 103 members of the public, general practice staff from 19 practices, NHS managers from four Primary Care Organizations and the research team. Results The public would like to know more about the quality and range of general practice services but current sources of information do not meet their needs. The public do not like league tables comparing the performance of practices and only a small number of people want to use comparative information to choose between practices. They seem to be more interested in the context and availability of services and the willingness of practices to improve, than in the practice's absolute or relative performance. They want to be clear about the source of the information so that they can make personal judgements about its veracity. Information is most likely to be useful if it adheres to the basic principles of cognitive science in terms of its structure, content and presentation format. Using these findings, paper and electronic prototype versions of a guide to general practice services have been developed. Conclusions In order to maximize the potential use of performance information by the public it is necessary to move beyond provider-led and professionally constructed approaches to information provision and ensure that the public is actively involved in the development of information sources. Such involvement produces a different kind of information to that currently available to the public. The findings of this study have important implications for policy. Most importantly, it seems that the traditional consumerist model underlying a policy of making comparative performance information available to the public to enable them to exercise choice between primary care providers may not be appropriate. An alternative model of information provision, which recognizes the public's commitment to their practice and is integrated with ‘soft’ sources of knowledge is more likely to engage and be of use to the public. [ABSTRACT FROM AUTHOR]