Mechanism and enlightenment of public participation in the NICE health technology assessment in England / 中国药房

OBJECTIVE To analyze the public participation mechanism of National Institute for Health and Care Excellence （NICE） health technology assessment in England and to provide experience for the dynamic adjustment of Chinese medical insurance catalog. METHODS By retrieving related literature and official websites， types and mechanisms of public participation （management organization， selection method， participation mode， evaluation feedback） in NICE health technology assessment were analyzed comprehensively； and based on this， suggestions were put forward to adjust the public participation in Chinese medical insurance catalog. RESULTS & CONCLUSIONS The current public participation types of NICE health technology assessment were patient and carer organizations， HTA committee lay members， patient expert and public observers. At the management level， NICE has set up a public participation team and made guidelines on public participation matters. For different public participation types， NICE has established different selection procedures， such as expression of interest， NICE invitation， open recruitment， nomination， NICE decision， etc. The public participation types are various and in the whole assessing process from the initial determination of the scope of the health technology assessment to the final appeal. Also， NICE has established a flexible and dynamic evaluation feedback system to optimize the way of public participation and the health technology assessment process； NICE has undertaken extensive international cooperation and exchanges to promote public participation at the national and international levels. It is suggested that our country should combine the national conditions， clarify the channel of public participation in health technology evaluation， set up a working group of public participation affairs， strengthen patients’ participation in evaluation and feedback， improve decision-making transparency， and improve the public participation mechanism of health technology evaluation from the aspects of channel opening， management mechanism， evaluation feedback， information disclosure and so on.

Cuidado e gratidão em relatos de parto de sites ingleses / Care and gratitude in birth stories in English websites

Resumo Neste trabalho, examino as percepções de mulheres sobre o cuidado recebido no parto através da presença ou ausência da gratidão em relatos de parto de dois sites ingleses. Nos relatos, nem sempre a gratidão é expressa e nem sempre ela se dirige à equipe de saúde - agradece-se às doulas ou aos próprios sites, cujos vídeos de preparação para o parto teriam sido importantes para uma experiência positiva. O bom cuidado no parto nesses relatos está associado a uma boa comunicação entre parturiente e midwife (parteira), especialmente nas informações recebidas sobre os procedimentos e sobre o que fazer ao longo do trabalho de parto. Assim, tanto nesses relatos quanto na literatura de saúde pública sobre o parto, a boa equipe é aquela que dá à mulher condições de tomar suas próprias decisões, de fazer suas escolhas informadas. Ao fazê-lo, empodera a mulher e reduz a assimetria na relação entre profissional e paciente. Ao contrário, informações contraditórias ou pouca informação podem produzir ansiedade e desconforto. Argumento, assim, que o sentimento de gratidão, ausente ou presente nos relatos de parto, ilumina as dinâmicas da assistência ao parto na Inglaterra, revelando o que se constitui um bom cuidado.

Abstract In this paper, I examine women´s perceptions of birth care through the presence or absence of gratitude in birth stories from two English websites. In these narratives, gratitude is not always expressed nor is it necessarily addressed to the health team - doulas or the websites themselves are thanked for helping prepare for childbirth and for a positive experience. Good birth care in these stories is associated with good communication between women and midwife, especially regarding the information they receive about the procedures and about what to do during labor. Thus, both in these narratives and in the public health literature on childbirth, a good care team is one that enables women to make their own decisions and informed choices. In doing so, it empowers women and reduces asymmetry in the professional-patient relationship. On the contrary, contradictory or little information can produce anxiety and discomfort. Therefore, I argue that the feeling of gratitude, absent or present in birth reports, illuminates the dynamics of childbirth care in England, revealing what constitutes good care.

Saúde e pesquisas domiciliares no Brasil e Inglaterra: a Pesquisa Nacional de Saúde e a Health Survey for England / Health and household surveys in Brazil and England: The National Health Survey and the Health Survey for England

Resumo O objetivo do artigo é analisar as características das pesquisas nacionais de saúde realizadas no Brasil e na Inglaterra pelos seus respectivos institutos de Estatística. No Brasil foi considerada a Pesquisa Nacional de Saúde (PNS) e na Inglaterra, a Health Survey for England (HSE). Para tanto, apresenta-se inicialmente um panorama sobre os distintos perfis populacionais dos países. Passa-se, então, a um breve histórico das pesquisas, evidenciando inclusive as temáticas comuns que são abordadas na PNS e na HSE que favorecem análises comparativas. Por fim, apresenta-se uma comparação, a título de exemplo, acerca das desigualdades no acesso e na utilização dos serviços de saúde no Brasil e na Inglaterra. Os resultados evidenciam inúmeras possiblidades de análises comparativas em temáticas como percepção de saúde, tabagismo, consumo de bebidas alcoólicas, diabetes e hipertensão. Entretanto, salienta-se a necessidade de atentar para especificidades do perfil populacional de cada país e às características metodológicas das pesquisas.

Abstract This paper aims to analyze the characteristics of national health surveys conducted in Brazil and England by their respective Statistics institutes. For Brazil, the National Health Survey (PNS) was considered, and the Health Survey for England (HSE) for England. To this end, we show a preliminary overview of the different population profiles of the two countries. Then, a brief historical background is presented, including the common themes that are addressed in the PNS and HSE that favor comparative analyses. Finally, we compared, for example, the inequalities in access to and use of Brazilian and English health services. The results show several possibilities for comparative analysis on topics such as health perception, tobacco use, alcohol consumption, diabetes, and hypertension. However, the need to consider the specificities of the population profile of each country and the methodological characteristics of the surveys is emphasized.

O Serviço Social na Inglaterra: a experiência de um estágio de pesquisa / The Social Work in England: the experience of a research internship

Resumo: Este artigo é resultado de estágio de pesquisa no exterior realizado na Universidade de Essex - Inglaterra, nos meses de outubro e novembro do ano de 2019. Objetiva apresentar algumas aproximações sobre o debate do Serviço Social inglês, especialmente no que diz respeito às tendências do Serviço Social Radical e Neoliberal, bem como apontar alguns dados levantados em visitas institucionais e em entrevistas realizadas com assistentes sociais desse país.

Abstract: This paper is about a research internship abroad held at the University of Essex - England, for a period of two months, October and November 2019. Its purpose is to present some approaches on British Social Work, especially related to Radical and Neoliberal Social Work, as well as pointing out some data collected during institutional visits and interviews with social workers in this country.

Comparison of hierarchical management core competence training of ICU nurses in China and England / 中国实用护理杂志

ICU nursing is a vitalpartof the development of specialized nursing in China, and the standardized training of the corecompetence of ICU nurses is the primary goal of the development of ICU nursing. This paper took the First Affiliated Hospital of Sun Yat-sen University in China and the Royal Free Hospital in London, the United Kingdom as example, and compared the hierarchical management and core competencies training status of ICU nurses in China and England to find out the similarities and differences, and then to put forward valuable suggestions for hierarchical management and the core competence training of ICU nurses in China.

Mais Médicos (More Doctors) Program: a view from England / Programa Mais Médicos: um ponto de vista desde a Inglaterra

The Programa Mais Medicos (PMM) is a national strategy to increase the numbers of Brazilian trained doctors entering primary care and is possibly the most significant human resource intervention in Latin America in recent years. From an English perspective, there are clearly opportunities to learn the PMM. First, PAHO’s role in the PMM provides an exemplar for an overarching human resource migration and recruitment role throughout the EU. The role of the WHO in influencing and overseeing the recruitment of doctors throughout the EU could be an opportunity for improved distribution, avoiding a reliance on market forces. Secondly, a centrally-coordinated and governed process following well-established criteria and guidance laid out in law has helped to ensure that doctors are allocated to regions of the greatest need. Finally, the deployment of primary care doctors to ensure that the needs of the whole population are met, including in hard-to-reach areas. However, Brazil should not fall into the trap of doing much, and evaluating little. Brazil is in an exciting position to conduct robust before-after studies regarding the improvement in access, outcomes and equity that the ESF has already been credited with. Evaluation must include the impact of the PMM on Cuba.

O Programa Mais Médicos (PMM) é uma estratégia nacional para aumentar o número de médicos brasileiros formados entrando na área de cuidados primários e é, sem dúvida, a intervenção de recursos humanos mais importante na América Latina nos últimos anos. De uma perspectiva inglesa, é evidente que existem oportunidades para aprender com o PMM. Em primeiro lugar, o papel da OPAS no PMM fornece um exemplo para um modelo de migração de recursos e recrutamento humano global em toda a UE. O papel da OMS em influenciar e fiscalizar o recrutamento de médicos em toda a UE poderia ser uma oportunidade para melhorar a distribuição, evitando a dependência nas forças de mercado. Em segundo lugar, um processo centralmente coordenada e governada de acordo com critérios bem estabelecidos e as orientações constantes da lei tem ajudado a garantir que os médicos sejam alocados em regiões de maior necessidade. Por fim, a implementação de médicos de cuidados primários garante que as necessidades de toda a população sejam atendidas, incluindo em áreas de difícil alcance. No entanto, o Brasil não deve cair na armadilha de avaliar pouco. O Brasil pode fazer estudos robustos sobre a melhoria do acesso pelos resultados e equidade com que a ESF já foi creditada. A avaliação deve incluir o impacto do PMM em Cuba.

Implementation of Integrated Care Pathways for Persons with Psychosis in Ontario, Canada: Barriers and Opportunities.

Currently there is an emphasis on developing Integrated Care pathways for mental health problems. The concept of pathways draws heavily from principles of lean thinking and is therefore based on improving the efficiency of the system to provide quality services to persons with health problems. Development of pathways for schizophrenia, along with depression and dementia is high priority in Ontario, Canada. This is an exciting development, especially as this might trigger radical changes in the health system to improve the care of those with schizophrenia. As the pathways are fully developed in England, we have tried to highlight the issues that can facilitate or hinder the development and implementation of the pathways in Ontario, compared with England. Development of pathways offers unique opportunities, that might lead to substantial improvement in care of persons with psychosis.

Internação Psiquiátrica Involuntária: estudo comparativo das Normas de Saúde Mental do Brasil e Inglaterra/País de Gales / Involuntary Psychiatric Admission: comparative study of Mental Health legislation from Brazil and England/Wales

A internação involuntária é uma medida controversa que pode levar a violação de vários direitos humanos. Nessa perspectiva, faz-se necessária uma legislação para definir e limitar as circunstâncias em que isso pode ocorrer. Políticas e leis bem formuladas podem promover o desenvolvimento de serviços acessíveis na comunidade, estimular campanhas de sensibilização e de educação, e estabelecer mecanismos legais e de supervisão para prevenir violações aos direitos humanos. Nesse contexto, este estudo descritivo-comparativo apresentou como objetivo analisar as semelhanças e diferenças entre as legislações em saúde mental relacionadas à internação psiquiátrica involuntária no Brasil e Inglaterra/País de Gales. Utilizou-se para o levantamento de dados de pesquisa bibliográfica e pesquisa documental. A análise foi realizada a partir da Lista de Checagem da Organização Mundial da Saúde (OMS) para a Legislação de Saúde Mental. Para a etapa de comparação dos dados das duas jurisdições, foi utilizado o método comparativo. Sobre os resultados da comparação da Lista de Checagem da OMS com as legislações do Brasil e Inglaterra/País de Gales, na legislação brasileira foram encontrados 52 (31,32%) dos 166 padrões da OMS, enquanto que na legislação da Inglaterra/País de Gales foram encontrados 90 (54,2%). A partir da análise foi possível concluir que: a legislação da Inglaterra/País de Gales traz procedimentos mais claros e detalhados sobre "internação involuntária" e possui "mecanismos de fiscalização" mais eficazes do que o Brasil; apesar das lacunas quanto aos procedimentos para apelações contra decisões de incapacidade e a revisão da necessidade de um tutor, a legislação apresenta uma boa cobertura sobre "competência, capacidade e tutela", tema de elevada importância, principalmente após a ratificação da CDPD, e que o Brasil não aborda em sua legislação; a legislação brasileira elenca um rol maior de "direitos fundamentais", porém não prevê "penalidades" quanto ao descumprimento desses direitos. Já a Inglaterra/País de Gales cobre amplamente essa questão. As principais semelhanças entre Brasil e Inglaterra/País de Gales referem-se aos padrões que necessitam de revisão: "Pacientes voluntários", situações de emergência", direitos econômicos e sociais", "questões civis" e "grupos vulneráveis". Ambas jurisdições também apresentam o mesmo nível de cobertura quanto a "pesquisa clínica e experimental", e "tratamentos especiais, isolamento e restrições". Em suma, a análise das legislações de saúde mental apresentada neste trabalho sugere que documentos internacionais de direitos humanos, como o Livro de Recursos OMS, são instrumentos importantes e que podem nortear a construção de legislações. É necessário também que a formulação de leis e políticas de saúde mental esteja articulada com os documentos internacionais de direitos humanos como a CDPD. Espera-se que o presente estudo traga a tona a reflexão das autoridades competentes sobre a necessidade de solicitar auditorias mais profundas no âmbito da legislação nacional de saúde mental, realizadas por comitês multidisciplinares, como recomendado pela OMS. A legislação de saúde mental deve estar num processo de constante evolução, centrada na busca da consolidação dos direitos das pessoas com transtornos mentais

Involuntary admission is a controversial measure that can lead to violation of various human rights. From this perspective, legislation must define and limit the circumstances in which this may occur. Well-formulated policies and laws can promote the development of accessible services in the community, stimulate awareness and education campaigns, and establish legal and supervisory mechanisms to prevent human rights violations. In this context, this descriptive- comparative aimed at analyzing the similarities and differences between the mental health' laws related to involuntary psychiatric admission in Brazil and England/Wales. In order to collect data, the author used bibliographic and documentary research. The analysis was based on the World Health Organization's Checklist on Mental Heallth Legislation. To compare data from the two jurisdictions, the author used the comparative method. Results comparing the WHO Checklist with the laws from Brazil and England/Wales showed that the Brazilian legislation meets 52 (31.32%) of the 166 WHO standards, while legislation in England/Wales meets 90 (54.2%). Some conclusions resulted from the analysis: the law from England/Wales establishes clearer and detailed procedures for "involuntary admissions" and has "oversight and review mechanisms" more effective than Brazil; despite the shortcomings in the procedures for appeals against disability decisions and the review of the need for a guardian, the legislation presents a medium compliance of "competence, capacity and protection", a subject of high importance, especially after the ratification of the CRPD, and Brazil does not address these issues in its legislation; Brazilian establishes a larger list of "fundamental rights", but does not provide "penalties" for the breach of those rights, while England/Wales meets WHO criteria in relation to this issue. The main similarities between Brazil and England/Wales refer to standards that require review: "voluntary patients", "emergency treatment", "economic and social rights", "civil issues" and "protection of vulnerable groups." Both jurisdictions also have the same level of compliance regarding "clinical and experimental research", and "special treatments, seclusion and restraint". In sum, the analysis of mental health legislation presented in this paper suggests that international human rights documents, such as the WHO Resource Book, are important tools which can guide the construction of legislation. It is also necessary that the formulation of mental health laws and policies are articulated with international human rights documents such as the CRPD. In this sense, this study may bring light for a reflection from competent authorities on the need to have audits for national mental health legislations, carried out by multidisciplinary committees, as recommended by WHO. Mental health legislation should be in a process of constant evolution, focusing on the search for the consolidation of rights of people with mental disorders

Disease and weight loss: a prospective study of middle-aged and older adults in Costa Rica and England / Enfermedad y pérdida de peso: un estudio prospectivo de adultos y adultos mayores en Costa Rica e Inglaterra

Objective. To determine whether disease predicts weight loss in population-based studies, as this may confound the relationship between weight and mortality. Materials and methods. We used longitudinal data from the Costa Rican Longevity and Healthy Aging Study (CRELES) and the English Longitudinal Study of Ageing (ELSA). We defined two overlapping outcomes of measured weight loss between waves: >1.0 point of body mass index (BMI) and >2.0 BMI points. Logistic regression models estimated the associations with disease, adjusting for age (range 52-79), sex, smoking, and initial BMI. Results. In ELSA, onset of diabetes, cancer, or lung disease is associated with loss >2.0 points (respectively, OR=2.25 [95%CI: 1.34-3.80]; OR=2.70 [95%CI: 1.49-4.89]; OR=1.82 [95%CI: 1.02-3.26]). In CRELES, disease-onset reports are not associated with weight loss at 5% significance, but statistical power to detect associations is poor. Conclusion. Although it is known that some diseases cause weight loss, at the population level these associations vary considerably across samples.

Objetivo. Determinar si las enfermedades predicen pérdida de peso a partir de encuestas poblacionales, debido a que esto podría confundir la relación entre peso y mortalidad. Material y métodos. Se utilizaron datos longitudinales de Costa Rica: Estudio de Longevidad y Envejecimiento Saludable (CRELES) y Estudio Longitudinal de Envejecimiento en Inglaterra (ELSA, por sus siglas en inglés). Se definieron dos indicadores de resultado no excluyentes de pérdida de peso entre rondas: >1.0 punto de índice de masa corporal (IMC) y >2.0 puntos de IMC. Las asociaciones de interés se estimaron con modelos de regresión logística, con controles para la edad (rango 52-79), sexo, tabaquismo actual e IMC inicial. Resultados. En el ELSA, la incidencia de diabetes, cáncer o enfermedad pulmonar está asociada con pérdida de >2.0 puntos de IMC (respectivamente: OR=2.25 [IC95%: 1.34-3.80]; OR=2.70 [IC95%: 1.49-4.89]; OR=1.82 [IC95%: 1.02-3.26]). En el CRELES, el reporte de diagnóstico de enfermedades no muestra asociación significativa a 5% con pérdida de peso, pero el poder estadístico de la muestra para detectar asociaciones es limitado. Conclusión. Aunque es conocido que ciertas enfermedades causan pérdida de peso, estas asociaciones a nivel poblacional varían considerablemente entre encuestas.

Ernst Hasenclever em Gongo-Soco: exploração inglesa nas minas de ouro em Minas Gerais no século XIX / Ernst Hasenclever in Gongo-Soco: English exploitation of the gold mines in the state of Minas Gerais in the nineteenth century

A partir do relato de Ernst Hasenclever sobre sua visita à mina de ouro de Gongo-Soco em 1839, o artigo procura compreender o sistema organizacional administrativo e de trabalho implementado pelas empresas inglesas de mineração de ouro em Minas Gerais, sobretudo na segunda metade do século XIX, período no qual o sistema escravista caminhava para seu final. Nosso objetivo é mostrar a continuidade do sistema administrativo e do uso da mão de obra escrava pelas empresas de capital inglês a partir da década de 1830 até o final do século, apesar da pressão exercida pela Inglaterra contra o tráfico transatlântico de escravos e da proibição aos súditos de sua majestade de possuir escravos em qualquer parte do mundo.

Based on the report of Ernst Hasenclever on his visit to the Gong-Soco gold mine in 1839, this article seeks to understand the labor and administrative organizational system implemented by the English gold mining companies in Minas Gerais, especially in the second half of the nineteenth century at a time when the slave-based system was in its final stages. Our objective is to show the continuity of the administrative system and the use of slave labor by the English companies from the 1830s until the end of the century, despite the pressure applied by England against the transatlantic slave trade and the prohibition of Her Majesty’s subjects to own slaves anywhere in the world.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5’s, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Characteristics and enlightenment of medical curriculum design in England / 中华医学教育探索杂志

The medical curriculum which is designed reasonable, plays a decisive role in the training specifications and quality of medical talents. The medical education in England is always in the world first column, and its medical curriculum is distinctive. The courses are mostly offered by the form of integration. They pay more attention to the setup of selective courses, humanities and social sciences courses, and they also put emphasis on the early clinical contact and early scientific research training. In addition, they are also outstanding in practice and internship. There is much beneficial enlightenment for our country's course reform from the British medical curriculum design, namely to establish integration courses which is interdisciplinary, to strengthen the humanistic quality's cultiva-tion, to advocate early clinical contact and early scientific research, and to strengthen cooperation and coordination between medical colleges and social organizations in all aspects.

Uma trajetória dos profissionais de saúde ingleses, 1815-1858 / A trajectory of British health professionals, 1815-1858

Relata a regulamentação das profissões de saúde na Inglaterra, de 1815 a 1858, momento em que também acontecia a reforma sanitária, decorrente das epidemias do período, e no qual os profissionais se dedicaram ao auxílio aos doentes. Na falta de clareza sobre as atribuições técnicas de cada profissional, o campo de práticas não regulamentadas ficou condicionado a dois papéis: fornecimento de conselhos médicos e/ou manuseio de fórmulas. Três importantes medidas modificaram o campo das práticas em medicina e em farmácia: o Ato dos Apotecários, de 1815, o Ato Farmacêutico, de 1852, e o Ato Médico, de 1858. Constatou-se a mistura de interesses do Estado, dos profissionais e da sociedade inglesa.

The article recounts the process of regulating the health professions in England from 1815 to 1858. Impelled by the period's epidemics, this was also the time of the sanitary reform, in which health professionals devoted themselves to aiding the ill. Since the technical attributions of each type of professional were not clearly defined, this field of un-regulated practices became divided into two areas: the provision of medical advice and the manipulation of formulas. Three important measures changed the field of medical and pharmacological practices: the Apothecaries Act (1815), the Pharmacy Act (1852), and the Medical Act (1858). These laws were a mixed reflection of the interests of the State, medical professionals, and British society.

O consumo de álcool segundo as gravuras Beer Street e Gin Lane de William Hogarth e as obras de John Wesley: convergências e diferenças / Alcohol consumption as portrayed in William Hogarth's prints Beer Street and Gin Lane and in the works of John Wesley: similarities and differences

Compara as gravuras Gin Lane e Beer Street, de William Hogarth, com textos do seu contemporâneo John Wesley, spiritus rector do movimento religioso metodista. Embora em algumas gravuras Hogarth tenha retratado o movimento metodista como perigosamente entusiasta, os dois defenderam uma agenda próxima quanto ao consumo de álcool. A semelhança entre as duas formas de compreender a questão é explicada por costumes culturalmente estabelecidos, e a diferença por uma perspectiva social distinta.

The article compares William Hogarth's Gin Lane and Beer Street with texts by his contemporary John Wesley, spiritus rector of the Methodist movement. Although Hogarth had portrayed the Methodist religious movement in some of his prints as dangerously enthusiastic, both men defended a similar agenda concerning alcohol consumption. The similarities in their two ways of understanding the issue can be explained by culturally established customs, while distinct social outlooks can account for their differences.

Human Sociogenetics

In three cities of Chile (Santiago, Valparaiso, Valdivia) the A allele and phenotype (ABO blood group) are more frequent in the higher socioeconomic strata (SES) and the O allele and phenotype are in the lower ones. This constitutes a structured sociogenetic cline (SGC). The B allele and phenotypes (B+AB) present a rather erratic or contradictory distribution among SES. This SGC was also found in England. The standard interpretation of the origin and maintenance of this SGC in Chile is founded on socio-ethno-historic-cultural and drift factors followed by socioeconomic assortative mating that has occurred since the origin of Chileans by the admixture of Europeans and Amerindians. This interpretation is insufficient to explain the coincidence of the cline in England and Chile, and for some findings in Chile. 1) The A and Rh(-) frequencies of the highest SES in Chile are significantly higher than those found in Europeans. 2) The B gene and phenotypes (with AB) behave differently and in contradiction to the socio-ethno-cultural-historical process. 3) There is a significant interaction of the SGC with gender in Chile and England. There is not at present a putative relationship between ABO and psycho-social factors that could account for this sociogenetic interaction. This SGC seems to be present in societies with a hierarchical organization in relation to power, prestige, ownership, income and life style, and when sampling includes the most extreme SES. It has not been found in two samples from Ireland and in a sample from Chile taken from a public hospital, probably because those variables and conditions were not ascertained.

Guerra, formação do estado e identidade nacional nas franjas do mundo Atlântico / Guerre, formation de l'état et identité nationale dans lês franges du monde Atlantique / War, state formation, and national identity on the fringes of the Atlantic world

This paper deals with the impact of war on state formation in Ireland and England, focusing on the period from 1590 to 1691, the key turning point for the future development of the state in both countries. War played a vital role, but in a number of different ways, including in the ideological sphere, in a complex process, rather than simply causing a long-term expansion in army size and subsequent growth of the state. The author further emphasizes the dynamic nature of the state itself.

Dans cet article, on étudie l'impact de la guerre sur la formation de l'État en Irlande et en Angleterre, surtout dans la période de 1590 à 1691, période-clé pour le développement de l'État dans ces deux pays. La guerre y a joué un rôle très important sous plusieurs formes, et en particulier dans la sphère idéologique, au long d'un processus très complexe, au-delà de son rôle d'expansion et d'augmentation des armées et de sa conséquence, la croissance de l'État, dont il faut souligner la nature dynamique.

Efficacy of NETDC (New England Trophoblastic Disease Center) prognostic index score to predict gestational trophoblastic tumor from hydatidiform mole.

A prospective longitudinal analytic study assessing the efficacy of NETDC (New England Trophoblastic Disease Center) prognostic index score in predicting malignancy after hydatidiform mole had been performed. Of the parameter evaluated; age of patients, type of hydatidiform mole, uterine enlargement, serum hCG level, lutein cyst, and presence of complicating factors were significant risk factors for malignancy after hydatidiform mole were evacuated (p<0.032). The study were done on 50 women diagnosed with hydatidiform mole with 1 year observation (January 2001-December 2002) at the Department of Obstetrics and Gynecology, Mohammad Hoesin Hospital, Palembang. The results showed that the NETDC prognostic index score predicted malignancy in 50% of high risk group and 10% in low risk group (p<0.05). This showed a higher number than that found by the WHO (19%-30%). The risk for incidence of malignancy after hydatidiform mole in the high risk group is 9.0 times higher compared to that of the low risk group (CI: 1.769-45.786).

Analysis on the Support Mode of the AIDS Community in British / 中国医学伦理学

The care and support for the patient of AIDS is a vital content,we should enhance international collaboration and intercourse of information,which can promote efficiency.This text shows an analysis on the actuality and characteristic of the support mode of the AIDS community in British.Its purpose is to summarize the successful experience for china and improve the support mode for AIDS.