Collaborative care of hypertensives,using a shared record.

A shared hospital-GP record for control of hypertension was studied in a sample of 60 patients. Over 80% of patients brought the record to hospital duly completed. Two-thirds of GPs, and the hospital staff, assessed the record as a useful aid in the care of hypertensives. It is still employed enthusiastically, three years after its introduction.     

Computers a cornerstone of evidence-based care,conference told.

Computers are poised to become key players in the delivery of health care, but are physicians ready for them? A recent conference on medical communication in the electronic era examined the potential of computers to assist in diagnosis, provide continuing medical education, disseminate evidence and research findings, and simplify practice management. However, delegates were told that even though many medical practices are computerized, it is often staff members and not physicians who use the technology. For computers to gain wider acceptance for medical purposes, physicians need to be made comfortable with their use at an early stage of training.     

Dental care for a captive killer whale,Orcinus orca

The crowns of several teeth of a captive killer whale, particularly on the mandible, were worn to the level of the pulp cavities by biting a cement structure in the pool. Food plugging partially vacant pulp cavities created intense vascularization, inflammation, and eventually a systemic focus for infection. This trauma correlated with an elevated white blood cell count. Haematology was restored to normal following regular care for the worn teeth. Patent drainage of the pulp cavity was maintained through routine brushing with a large-scale toothbrush. Administration of antibiotics was not necessary in controlling the white blood cell count.     

Health care as a right, fairness and medical resources

Our intention in the following is to use the WHO declaration as a basis for considering the allocation of resources in health care. We shall first argue that most of the criteria suggested as grounds for fair allocation of scarce medical resources have their difficulties if one tries to apply them one by one to medical practices. We shall then go on to claim that, if we take the right of all human beings to health or health care even moderately seriously, increasing the resources would in most cases be more ethical than attempting to allocate them 'fairly'.     

Emergency care,triage, and fairness

Triage is a widespread principle for prioritizing patients in emergency departments. The purpose of triage is to ensure that in emergency situations, whenever medical demand exceeds medical supply, limited resources should be directed to the case with the greatest clinical need. Triage fulfills this purpose by ranking patients according to how acute their condition is and then giving priority to the most acute ones. In this paper, I argue that this current practice of triage needs to be supplemented. Contemporary triage is based on a principle of preserving patients’ core capabilities, which is relevant when it comes to prioritizing acute patients above sub-acute ones, but not for prioritizing among sub-acute patients, which is the largest group of emergency patients. Henceforth, I propose to supplement triage with what I term the real dialogue model, a framework that, when combined with enhanced professional autonomy for clinical decision-makers, enables fair prioritizing among sub-acute patients.