The Journal of the Royal Society for the Promotion of Health最新文献

Over the last 25 years there have been considerable advances in the treatment and technologies used in the care of newborn infants. Most of these advances are related to the care of the premature infants and there have been few changes in the management of conditions commonly seen in term infants. Neonatal jaundice is one of the commonest neonatal disorders and has been recognized since early history. Early neonatal jaundice is usually caused by the physiological destruction of red blood cells in the infant and its importance lies in the ability of the bilirubin pigment so produced to cross the blood brain barrier resulting in neurotoxicity. Prolonged neonatal jaundice (after 14 days of age) may be an indication of an underlying liver disorder. The approach to neonatal jaundice has remained largely unchanged over the last two to three decades. We continue to rely on visual inspection to assess the severity of early neonatal jaundice. We have technology that is effective in reducing the level of bilirubinaemia but in the UK there is no clear consensus as to the level at which jaundice should be treated. We do not have a standardized approach to the management of prolonged jaundice and there is potential for infants with significant liver problems to be diagnosed at a relatively late stage. Some countries (for example the US) have professional bodies who have introduced guidelines to ensure a standardized approach to the jaundice infant. We have little information about neonatal jaundice treatment in other parts of the developing world.

The claim is made by many that we have reached a point where we are exposed to too much information. This potential phenomenon is particularly prominent in the health field where there is a suggestion that the volume of available information has increased significantly and more importantly that such volume has had detrimental effects on both the overall quality of such information and the ability of people to process and use it. This paper explores the nature and validity of these claims. Within the context of the notion of an 'information society', it outlines a range of concerns that have been expressed in relation to this increase, including the simple problem of overload, the potential for less robust information to enter the system and thus the overall quality of available information to decline. This excess of information is seen to act against the benefits that are sought--information can be invalid and people may not have time to reflect and act on excessive information loads. This can result in irrationality or disinformation. The suggestion is made, however, that these concerns are largely unsupported by empirical evidence and are potentially the basis of a panic over the entry of alternative perspectives on health. The pessimistic perspectives are thus balanced by more constructive and optimistic views on this growth and opening up of information production and potential consumption. Seeing information creation as organic and pluralistic, it is suggested that increased information volume can actually be a constructive phenomenon. The paper concludes with the contention that it is unrealistic to expect a return to former circumstances of controlled and limited information flows. Rather, a series of more pragmatic suggestions is offered within existing circumstances, including differentiating between information rich and poor health areas, addressing structural issues like information access and health literacy, and working towards organizing health information so that it is of a high quality, is physically accessible, relevant to the needs and literacy of groups, and in a usable form.

This article examines the nature and role of Web 2.0 resources and their impact on health information made available though the Internet. The transition of the Web from version one to Web 2.0 is described and the main features of the new Web examined. Two characteristic Web 2.0 resources are explored and the implications for the public and practitioners examined. First, what are known as 'user reviews' or 'user testimonials', which allow people to comment on the health services delivered to them, are described. Second, new mapping applications that take advantage of the interactive potential of Web 2.0 and provide tools to visualize complex data are examined. Following a discussion of the potential of Web 2.0, it is concluded that it offers considerable opportunities for disseminating health information and creating new sources of data, as well as generating new questions and dilemmas.

The regulatory landscape of the health and adult social care system in England is constantly changing. The establishment of a new regulator, the Care Quality Commission (CQC), will help to integrate the regulation of the health and adult social care sector together and strengthen the safety and quality assurance for patients and service users. It will have the challenge of regulating a much bigger sector and wider variety of organizations than its predecessor bodies--i.e. Healthcare Commission, Commission for Social Care Inspection and Mental Health Act Commission. An effective and efficient regulatory approach is needed by the new regulator to achieve the objectives, without increasing the regulatory burden on the services. A risk-based regulatory approach may help to deal with those challenges by proactively identifying and assessing any key risks to the quality and safety of these services. There are a number of perceived benefits of adapting such a risk-based approach by the regulator, both in terms of effectiveness and efficiency, as experienced by many other regulators in the UK and abroad.