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Homeopathy is a type of therapy based on the idea that disease can be treated with minute doses of drugs that are thought to be capable of producing the same symptoms in healthy people as the disease itself. It was invented by German physician, Samuel Hahnemann during the late 18th and early 19th centuries. It became both refined and popularized courtesy of James Tyler Kent, an American physician .

Homeopathy is based on the idea that every naturally occurring element, plant, and mineral compound, when ingested or applied, will result in certain symptoms. Hahnemann believed that diluting the substances in a standardized manner, it was possible to reach the true essence of the substance. He described the process of dilution as “potentizing” the substance. The diluted amounts could then be used to treat the very symptoms they were known to produce.

Hahnemann and his students approached the treatment in a holistic way, in other words the whole of the body and spirit is dealt with, not just the localised disease. Hahnemann spent extensive periods of time with his patients, asking them questions that dealt with their particular symptoms or illness, aswell as questions about their daily lives. It is thought that homeopathy is a response to the violent forms of medicine used at the time.

Homeopathy teaches that symptoms are to be encouraged, by prescribing a “remedy” in minuscule doses that in large doses would produce the same symptoms seen in the patient this is because homeopathy is based on the idea that the symptoms are the body’s way of fighting disease, it is believed that the treatment is designed to simply stimulate the immune system to help cure the disease.

However there are those who think that homeopathy is useless and suggest that it is a load of nonsense, these views are quite clearly expressed in “Needed – irresponsible idiots to work with aids in Botswana”. This article is particularly good as it shows a case which homeopathy does seem rather ridiculous rather than just simply dismissing it they use the case study to support their argument. Further support that homeopathy is not a cure was recently in the news, Homeopathy not a cure.

So it would seem that there is alot of evidence to support the argument that it is useless. Some people use it as an alternative to conventional medicine while others use it as a last resort. The question is the people who claim it works is it simply psychological? The same could be argued for any form of treatment could all forms of treatment simply be placebos used to trick the brain into fighting diseases? Whatever your take on this these questions must crop up and there is no consistent answer it depends on the individual, although you will find that the vast majority will dismiss the idea that all forms of treatment are placebos purely on the basis that people who receive treatment don’t want to believe that the treatment is essentially useless.

Core Skills for the Clinical Service Lead

For those of you who don’t know the term clinical director can be divided into the categories lab director, medical director, chief of service, etc. Essentially it just means that they are Top Dog of a department in terms of the medical side of things. For those of you who are familiar with the TV Show “House” the title character Gregory House is a clinical director as are Cameron and Wilson.

National clinical directors and advisors who are sometimes called Tsars are experts that supervise the implementation of a national service framework (NSF) or major clinical or service strategy. Tsars are acting advocates for the NSF or strategies within the NHS. They work with policy and delivery teams to achieve joined up action.

As national clinical directors the role also involves:

  • visiting health and social care practitioners
  • chairing task forces with health and social care professionals and health service managers
  • working with the Royal Colleges to ensure that changes in health and social services are reflected in training and education
  • chairing task forces to develop national service frameworks that bring together health professionals, service users and carers, health service managers, partner agencies, and other advocates.

Despite being at the top of the employment ladder there is still plenty of room for learning and as a result there are plenty of courses for Clinical Directors. A particularly good one is Core Skills in Finance & Business Planning for Consultants & Clinical Leaders, provided by Medicology.

Statistics show that more than £600 million is the cost to the NHS for patients failing to keep hospital appointments. That’s enough to run two medium-size hospitals! The figures show that between 2007 and 2008 6.5 million patients missed appointments which cost hospitals £100 per patient in revenue. In order to compensate for this some places are overbooking to compensate for people not attending, however there are drawbacks with this idea such as disadvantaging patients if 100% attendance occurs. Young males appear to make up the biggest portion of those that don’t attend appointments. At the opposite end of the scale people aged between 70 and 74 were the most conscientious in terms of attending appointments. However it isn’t all doom and gloom, over the past few years the attendance figures have improved slightly in England, Northern Ireland and Wales. Unfortunately the same can’t be said about Scotland where figures have increased.

Schemes such as sending text message reminders are being rolled out by the Department of Health. Whilst some say that missing appointments is unforgivable Unison is saying that the patients are not to blame when appointments are arranged months in advance. Other initiatives such as the choose and book scheme have also been introduced in order to reduce the number of missed appointments.

It is common courtesy to inform the doctor that you won’t be able to make the appointment or that you no longer require their services. Obviously this can’t be done if you forget but simply not attending is just rude and also selfish as not only is it wasting health professionals’ time and money but it is also impacting on others such as those who are on waiting lists or need to make an appointment but are unable to get one because the doctors are fully booked.

Daniel Hannan, a Tory MEP (Member of European Parliament) who criticised the NHS on American TV was accused of being “unpatriotic” by Andy Burnham, who is the Health Secretary. He claimed that the NHS is unfair and outdated and should be scrapped. Hannan made a series of appearances on American television over several weeks, and was quoted as describing the NHS as “60 year mistake” and he “wouldn’t wish it on anyone”. This rather brutal attack on the NHS came about following Obama’s proposal to introduce a similar system in America. Mr Hannan has repeatedly stressed that the views he expressed on U.S TV were his own and not those of the party but that Roger Helmer, a fellow Tory MEP who reports claim he said on BBC Radio 4′s PM programme: “I think Dan has done us a service by raising these issues which need to be looked at”. Burnham said: “What has happened within the last 48 hours is what Cameron has feared most because it lays bare the Tories’ deep ambivalence towards the NHS.”

Daniel Hannan claims that: “If 80% of Americans are getting better health care than we are in the UK then we ought to ask why, and we ought to ask how are we going to deliver equally good results.” For those who are not particularly familiar with the current health care system in America see The Difference between USA healthcare and the NHS

Tory leader David Cameron, vows to protect health from spending cuts that have been predicted for 2011 if he comes to power, he reiterates his commitment to the NHS and has made it clear that he does not share Hannan’s views and has distanced himself from Hannan. Cameron claims:”We are the party of the NHS, we back it, we are going to expand it, we have ring-fenced it and said that it will get more money under a Conservative government, and it is our number one mission to improve it.” He goes on to say: “He (Hannan) does have some quite eccentric views about some things, and political parties always include some people who don’t toe the party line on one issue or another issue.”

There are some who feel that Daniel Hannan should be disciplined for his comments about the NHS. Mr Hannan’s words have been seized on by Labour and the Liberal Democrats who have questioned the party’s commitment to the NHS. His critics state that Hannan’s words were an “insult” to the 1.4m NHS workers and “he should not be voicing those views in the foreign media in my view”. John Prescott has recorded a message accusing Mr Hannan of “misrepresentation of the NHS here in Britain”. Even the Prime Minister has publicly joined those who support the NHS by joining the welovetheNHS Twitter campaign, that was set up defend the health service from US attacks.

It would seem that Hannan’s comment has stirred alot of unrest within the British public and alot of people are pledging their support to the NHS. One of those is the physicist Professor Stephen Hawking, who claims that he would not be alive without it: “I have received a large amount of high-quality treatment without which I would not have survived.” Hawking, who has Lou Gehrig’s disease, was in Washington to be awarded the America’s highest civilian honour, the Presidential Medal of Freedom. An American newspaper subsequently used Prof Hawking as an example of the deficiencies of the NHS. “People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless,” it claimed.

As with any big institution there will be a few that oppose it but for the vast majority of people the NHS does work and saves millions of lives. For those that don’t like the NHS the UK also has the option of private healthcare so if you don’t want to use the NHS go private. Simple.

During the early 20th Century an increased interest in leadership was noted, The early leadership theories focus on the qualities that distinguish leaders and followers. However subsequent theories explore other factors including situational factors and skill level. There are a number of leadership types the most common ones are:

  • The Great Man Theories:
    This theory assumes that leadership is hardwired, in other words people are born leaders rather than created. This theory portrays leadership primarily as a male quality.
  • Trait Theories:
    This theory has some ideas similar to those of the Great Man theory. Trait theory states that certain traits and qualities that make a better leader are inherited. This theory has one major flaw it can’t explain why some people have the qualities defined as leadership qualities but are not leaders; also it assumes that leadership runs in the family so what about the leaders from a family where none of the family members are leaders.
  • Contingency Theories:
    This theory focuses on environmental variables that determine what leadership style best suits the situation. It would seem that this is the most logical theory as it recognises that there is no single leadership style best suits a situation.
  • Situational Theories:
    According to this theory leaders base their decisions on situational variables. Different styles of leadership may be more appropriate for certain types of decision-making. This theory appears to be similar to the above theories.
  • The Behavioural Theory:
    This theory claims that leaders are created rather than it being innate qualities. In other words this theory is based on the actions of the individual rather than mental qualities or internal states. Behaviourists argue that people become leaders through teachings and observation.
  • The Participative Theory:
    The participative theory suggests the best leadership style is one which considers the input of others. Leaders that fit into this category encourage contribution from their group thus making others feel relevant and involved decision-making processes.
  • Management Theory:
    This theory is also known as the “Transactional theory” see the leaders role as one of supervision, organization, and optimising group performance. This theory sees the basis of leadership as one of reward and punishment. This is often the most common type of leadership found in business.
  • Relationship Theory:
    Also called the “Transformational theory” concentrates on the bonds between leaders and their followers. These leader often have high moral and ethical standards; they motivate or inspire people, they are very focused on the groups performance and want everyone to reach their full potential. A good example of this type of leader would be religious leaders such as priests.

So now that we have outlined the main leadership types which type are you? Who knows maybe you are a mixture of several.

The chemical DEET which is found in many insect repellent sprays has been shown to be toxic and can cause fits in children, the current advice is that it should not be used by pregnant women. In research studies DEET blocked the enzyme cholinesterase, which is essential for sending messages between the muscles and the brain which can cause muscle spasms and in severe cases death. Other side effects of DEET are excessive salivation and eye watering.

DEET, is also known as diethyl toluamide, and is used in a many repellent sprays. Initially it was thought that the DEET simply altered the insects sense of smell to prevent them from detected the smell of the human. However on further study it was found that it acts on the enzyme which is present in both insects and mammals. Therefore the idea that it simply modifies insect behaviour is false as it directly inhibits enzyme activity in both mammal and insect nerves, research also shows that DEET interacts and strengthens the toxicity of carbamates, a class of insecticides also known to block acetylcholinesterase.

This research raises questions with regards to the safety of insect repellents, however at present it is mainly based on theory and tests on animals if you are at all concerned speak to a pharmacist or a doctor. Alternatively try alternatives from your health food shop

Under a new Strategic Health Authority Initiative nurses will be able to compare the quality of patient care against other trusts in England. The initiative ‘Energise for Excellence in Care’ is designed to improve fundamental nursing care, it is hoped that the tool should be available on website for the NHS Institute for Innovation and Improvement after it has been adapted.

The new tool is based on the ‘acuity/dependency’ tool which was developed by the Association of UK University Hospitals, which helps to categorise patients depending on their conditions (for example ‘stable’ or ‘unstable’) which can then be used to help inform staffing levels, skill mix and workforce development needs.

It is hoped that the new tool will enable nurses to deliver evidence-based care, that will include the development of new services where appropriate. In order to improve quality patient care indicators are key according to Lord Darzi’s Next Stage Review of the NHS, which was published summer 2008. In May 2009 a list of over 200 indicators that could be used to improve services across the NHS was published by the Government.

The Chief Executive David Nicholson will take personal responsibility for the ‘quality, innovation, productivity and prevention’ (or QIPP). It is also the focus of the DH management board. The Department of Health funded initiative; “Energise for Excellence in Care” is being led by senior nurses. Although it is hoped that this initiative will help the QIPP initiative it is important to stress that it also has wider goals, such as getting the nurses to focus on the things that really matter to patients. The initiative is also designed to give nurses permission to say what needs to be done and encourage nurses to reflect on the quality of the care that they are providing.

If nurses are consistently providing high quality care it may reduce costs for the NHS as fewer mistakes will be made and morale will improve as it is well known that low morale is detrimental to productivity and in this case patients. For more information see How morale levels affect the workplace

If their mothers are obese the statistics show that the daughters are 10 times more likely to be overweight; with sons the chance is 6 times more likely that they will be overweight if their father is overweight.

These results came from a study into whether childhood obesity was linked to environmental influences instead of genetic ones. The study involved looking at BMI’s for 226 five-year-olds and their parents. The researchers noted a relationship between the BMI of the children and the same sex parent. However no link was found between the children and the parent of the opposite sex. This suggests that the link is environmental as if it was genetic it would be unlikely to be gender selective.

These findings are not really surprising as it is a logical step that the parents eating habits and lifestyle would influence the child but what is surprising is that it seems to be gender specific. One possible explanation for the relationship between children and same sex parents is that the children use their parents as role models and so model their behaviour on the parent of the same sex.

If this is the case you would have thought that the parents would ensure that they are a positive role model for their children. Also they should take into consideration that the “fat kids” are usually singled out by bullies and are more prone to health problems such as diabetes and heart problems, add into the mix the psychological problems such as low self esteem. It is also worth pointing out that your eating habits can be passed down through the generations so not only are your children affected but your grandkids and great….grandkids.

We all know that good communication is key but it is not always practised as the coroners reports are showing, there seems to be a high number of deaths which could have been avoided. Since the rules were changed last year, coroners have been able to write detailed reports following inquests that highlighted a risk of more deaths occurring. Coroners reported that better communication could reduce the number of deaths occurring in hospital.

Out 207 reports between July 2008 and March 2009, 58 arose from hospital deaths, 19 were classed as mental health related, 19 were associated with community healthcare and emergency services and 11 were linked to drugs and medication.

So what is good communication?
Good communication is sharing information is a clear and concise manner with everyone who is involved in the care of the patient, it is also ensuring that the patient fully understands what is going; obviously in emergency situations this is not always possible at the time but after the emergency has passed they need to be told what is going on. This will minimise the chance of the patient possibly taking the wrong medication or committing suicide because they become depressed.

There are a number of courses available which are designed to help improve communication skills. One particularly good one is done by Medicology, Communication Skills for Doctors.

There are claims that over half of the children taking Tamiflu to cure swine flu suffered side effects such as nausea, insomnia and nightmares. The statistics show that 1 in 5 children had a neuropsychiatric side effect, such as poor concentration, inability to think clearly, problems sleeping, and feeling dazed or confused. The research that was carried out was flawed as there was no control group therefore it is impossible to say whether the symptoms were a result of the drug or the virus; however, there were no serious long term side

Participants for the study were selected differently in the three schools. In two schools (one primary and one secondary school) the researchers selected all the classes who were offered prophylaxis, (age 4-11 years in the primary school), and all of one year group in the secondary school (age 13-14 years). In the other secondary school, the questionnaire was offered only to pupils in four of the classes in the year group (age range 11-13 years). This is a flawed sample as there is no fixed criteria for selecting the participants for the research.

Here are a few of the questions that were asked to the sample:

  • Whether children who had been offered Tamiflu had taken it?
  • How long they took it for?
  • Were they taking any other medication with Tamiflu?
  • Were there symptoms after taking Tamiflu (including specific gastrointestinal and neuropsychiatric symptoms)?

Out of 256 schoolchildren, 103 replied which is 40% of the participants. The number of responses from the secondary school were higher than those from the primary school. The results show that only 48% of the primary schoolchildren in comparison to the 76%of the secondary schoolchildren. The most common side effects were nausea and vomiting, followed by mild neuropsychiatric effects such as difficulty sleeping, nightmares and poor concentration.

It is worth pointing out that Tamiflu has not been withdrawn and is still used to treat swine flu. All drugs come with side effects and not everybody experiences them, thus suggesting that Tamiflu is no different to any other medicine.