Public health
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To obtain insight into the involvement of a patient's social network in the process leading to the administration of euthanasia and assisted suicide (EAS). ⋯ To a large extent the social network was involved in the patient's request for EAS, the doctor's intention to administer EAS and the actual administering of EAS. This seems to be important both for good decision-making with regard to EAS and for helping relatives to come to terms with the loss of a dear one.
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There have been enormous changes in general practice over the past couple of decades but we are now in danger of seriously overloading the system with continuous change. Public health practitioners have a role in recognising the contribution of personal and primary care to the delivery of health care and should work with general practice to ensure a creative partnership.
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Civilian violence has become an increasing problem in the industrial world. Gunshot wounds, fatal or non-fatal, are often considered as acute trauma episodes. However, our previous study, based on 820 firearm injuries, showed that this group of patients was characterized by a high mortality rate and a pronounced involvement in criminality when compared to a control group. ⋯ It is probable that this "syndrome' also exists in other groups of trauma patients. Since hospitalization affords a unique opportunity of reaching patients who have a "chronic trauma syndrome' risk profile, we believe, that these patients should not only be treated for their acute injuries, but that they should be offered help in order to change their destructive life-style. Research should be undertaken to evaluate whether an intervention program, such as counseling, could have an effect on morbidity and injury recurrence for these patients.
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Road traffic accidents cause several thousand deaths each year in England and Wales. One approach to reducing this toll is to ensure that services are planned to achieve early response of ambulances to accident victims and their rapid conveyance to a hospital with good accident and emergency facilities. In order to undertake medical care of the highest quality, there has been a policy of concentrating such facilities in large units. ⋯ Regression analysis was used to analyse the factors affecting the odds of death versus serious injury for each individual. An elevated probability of death was found among the old, pedestrians, casualties involved in multiple accidents, and casualties on roads with higher speed limits. However, no relationship was found between outcome and the estimated time taken to reach victims and to convey them to hospital, either before or after adjustment for other factors.(ABSTRACT TRUNCATED AT 250 WORDS)
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The National Health Service reforms revitalized the national emphasis on the public's health and health needs assessment. In Scotland, in contrast with England, there was no central investment in the development of methods and programmes for needs assessment in the context of the new NHS. To achieve a concerted effort, therefore, a self-help network--the Scottish Needs Assessment Programme (SNAP)--was created by the Scottish Forum for Public Health Medicine. This paper describes its evolution to the point where it is now supported as part of a national network of information for purchasing.