Hodges' Model: Welcome to the QUAD: screening

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label screening. Show all posts
Showing posts with label screening. Show all posts

Friday, March 13, 2026

'GlobalMinds' - NHS study severe mental health problems

Together we can change lives

Depression, bipolar, schizophrenia and related conditions affect millions of people around the world.

Yet mental health receives less than 1% of global research funding. 

This has left healthcare for these conditions stuck in the past:

Cross icon

Diagnosis can take years

Cross icon

Treatments target symptoms, not underlying causes

Cross icon

Half of the prescribed drugs cause severe side effects

GlobalMinds is a major research programme seeking to advance the understanding of mental health conditions and improve lives.

 



My source: 
News, NHS study to transform mental health treatment, The Times, 14 February, 2026, p.6

Sunday, September 10, 2023

When 'containment' and 'protection' meet injury


INDIVIDUAL
|
     INTERPERSONAL    :     SCIENCES               
HUMANISTIC --------------------------------------  MECHANISTIC      
SOCIOLOGY  :   POLITICAL 
|
GROUP
"MANUEL SUFFERED two serious brain injuries as a child in Denver, Colorado." p.54.
The function of the skull is . . ?

"Brain injuries affect about 8.5% of the general population but rates among prisoners are far higher. Kim Gorgens, a neuropsychologist at the University of Denver, reckons that between 50% and 80% of prisoners and those on parole in America have brain injuries. A review of research in America, Australia and Europe suggests that the average reported rate is around 46%. Research conducted in 2010 by Huw Williams of the University of Exeter put the rate among men in British prisons at 65%. A study published in 2017 found that nearly half of all prisoners in New Zealand had been hospitalised for a traumatic brain injury before committing their crime. Researchers suspect that the numbers may be even higher in poorer countries because road-traffic accidents and violence are generally more common." p.54.
 
"A report in 2016 by the Centre for Mental Health estimated that in Britain the cost of traumaic brain injury in a 15-year old who goes on to offend is around £345,000 ($475,000). The cost to those affected and society more widely - is incalcuable." p.55.
The function of prison is . . ?

"They are more troublesome while in prison and more likely to reoffend on release. This is especially true for those, like Manuel, who are injured as children." p.54.

"Acknowledging the link between brain injuries and criminal behaviour is not to excuse lawbreaking. Most people with such injuries are capable of taking responsibility for their actions. However, it is easier to curb crime if you understand the factors that make it more likely, of which neurodisabilities are an important and neglected one." p.13.



Banged up. International, The Economist, March 27th 2021. pp.54-55;
And: Leaders. Knocked out and locked up. 438:9238, p.13.

See also:

UK Prisons Strategy White Paper

Headway: Brain injury and the criminal justice system

Wednesday, June 16, 2021

Preventing Overdiagnosis 2022

 

Dear Colleague,

We are extremely pleased and excited to confirm that Preventing Overdiagnosis Evidence, Equity and Post Pandemic Health Care will be hosted by the University of Calgary, Alberta, Canada 9-12 June 2022.
 
We are accepting abstracts against the following themes, however this list is by no means exhaustive and we welcome submissions on all aspects of preventing Overdiagnosis:
 

  • Equity & Equality: disparities in healthcare provision, marginalized populations, conflicts of interest driving inequity
  • Sustainability and lessons learned from COVID-19: repurposing healthcare after a pandemic
  • Medicalizing citizens: the harms of screening, disease thresholds, industry influences, the role of media
  • The role of specialists in generating Overdiagnosis and their efforts to mitigate it
  • Clinical Practice: Other dimensions of ODx, overtesting and the harms of too much medicine
Oral abstracts can also be submitted for virtual presentation in September 2021, November 2021, January 2022 and March 2022.  
 
Submissions will be graded approximately six weeks prior to the session date.  Offering four deadlines e.g. the deadline for September 2021 virtual presentation will be sometime in July 2021.
Please choose Virtual Presentation prior to Calgary 2022 as your preferred means of presentation.
 
NB: Abstracts already submitted can change preferred means of presentation by logging back into the submission portal.
 
Virtual and face to face events will bring you a number of lively plenary debates about controversial and timely issues involving high-profile players from across the healthcare landscape.  
Registration is open

We are also bringing you the Lisa M Schwartz Scholarship an opportunity that provides awardees with PODC registration, funding toward travel and accommodation and the opportunity to present at the conference.

Submissions (made through the abstracts postal) should address an issue of relevance to Dr Schwartz work and interests, and be consistent with the vision and values Dr Schwartz championed in the communication of risk. 
 
Thank you for your patience, keep well.

Conference Scientific Committee 
www.preventingoverdiagnosis.net 
Tw: @PreventingODx

Sunday, March 07, 2021

WHO: 1 in 4 people projected to have hearing problems by 2050

"When unaddressed, hearing loss impacts many aspects of life at individual level"

 and collective too.


individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

"Communication and speech

Cognition  

Education and Employment: In developing countries, children with hearing loss and deafness often do not receive schooling. Adults with hearing loss also have a much higher unemployment rate. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce."


"Nearly 2.5 billion people worldwide ─ or 1 in 4 people ─ will be living with some degree of hearing loss by 2050, warns the World Health Organization’s (WHO) first World Report on Hearing, released today. At least 700 million of these people will require access to ear and hearing care and other rehabilitation services unless action is taken."


"But the most glaring gap in health system capacity is in human resources. Among low-income countries, about 78% have fewer than one ear, nose and throat (ENT) specialist per million population; 93% have fewer than one audiologist per million; only 17% have one or more speech therapist per million; and 50% have one or more teacher for the deaf per million. This gap can be closed through integration of ear and hearing care into primary health care through strategies such as task sharing and training, outlined in the report."

"Impact on society and economy

Years Lived with Disability (YDLs) and Disability Adjusted Life Years (DALYs)

WHO estimates that unaddressed hearing loss poses an annual global cost of US$ 980 billion. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs. 57% of these costs are attributed to low- and middle-income countries."

Sources:

https://www.who.int/news/item/02-03-2021-who-1-in-4-people-projected-to-have-hearing-problems-by-2050

https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss

 

Dear colleagues,

We have recently published an article that presents some insights from Canada 

(full-text available from ResearchGate https://www.researchgate.net/publication/343400636_Here's_to_sound_action_on_global_hearing_health_through_public_health_approaches )

Shroff, F.M. and Jung, D. (2020), "Here's to sound action on global hearing health through public health approaches", International Journal of Health Governance, Vol. 25 No. 3, pp. 235-244. https://doi.org/10.1108/IJHG-01-2020-0004 

Abstract Purpose – A global pandemic, non-occupational noise-induced hearing loss (NIHL) is a completely preventable public health problem, which receives limited air time. This study has dual purposes: to contribute to scholarly literature that puts non-occupational NIHL on the global priority map and to effect change in the City of Vancouver’s policies toward noise. 

Design/methodology/approach – Experts in public health and hearing health were contacted in addition to a scoping literature search on PubMed. Information pertaining to both developed and developing countries was obtained, and comparison was made to Canada where possible. The authors met with elected officials at the City of Vancouver to inform them of the win–win aspects of policies that promoted better hearing.

Findings – Non-occupational NIHL is an underappreciated issue in Canada and many other countries, as seen by the lack of epidemiological data and public health initiatives. Other countries, such as Australia, have more robust research and public health programs, but most of the world lags behind. Better hearing health is possible through targeted campaigns addressing root causes of non-occupational, recreational noise–positive associations with loud noise. By redefining social norms so that soft to moderate sounds are associated with positive values and loud sounds are negatively attributed, the societies will prevent leisure NIHL. The authors recommend widespread national all-age campaigns that benefit from successful public health campaigns of the past, such as smoking cessation, safety belts and others. Soft Sounds are Healthy (SSH) is a suggested name for a campaign that would take many years, ample resources and sophisticated understanding of behavior change to be effective.

Research limitations/implications – A gap exists in the collection of non-occupational NIHL data. Creating indicators and regularly collecting data is a high priority for most nations. Beyond data collection, prevention of non-occupational NIHL ought to be a high priority. Studies in each region would propel understanding, partly to discern the cultural factors that would predispose the general population to change favorable attitudes toward loud sounds to associations of moderate sounds with positivity. Evaluations of these campaigns would then follow.

Practical implications – Everyday life for many people around the world, particularly in cities, is loud. Traffic, construction, loudspeakers, music and other loud sounds abound. Many people have adapted to these loud soundscapes, and others suffer from the lack of peace and quiet. Changing cultural attitudes toward loud sound will improve human and animal health, lessen the burden on healthcare systems and positively impact the economy. Social implications–Industries that create loud technologies and machinery ought to be required to find ways to soften noise. Regulatory mechanisms that are enforced by law and fines ought to be in place. When governments take up the banner of hearing health, they will help to set a new tone toward loud sounds as undesirable, and this will partially address the root causes of the problem of non-occupational NIHL.

Thanks

Irina Ibragimova, PhD

Co-editor, International Journal of Health Governance

HIFA profile: Irina Ibraghimova is a medical librarian, based in Croatia, and works with health care professionals in the countries of the Former Soviet Union, Central and Eastern Europe, and Africa. Her interests include evidence-based practice (both in health care and in library/informatics field). She is a HIFA Country Representative for Croatia. https://www.hifa.org/support/members/irina www.lrcnetwork.org www.healthconnect-intl.org ibra AT zadar.net

Source:

HIFA https://www.hifa.org/

(Posted a little late...)

Sunday, August 04, 2019

Pandemic Bonds: Beware perverse incentives and instruments?

individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population



Geography
Number of Countries
Number of fatalities
Instruments: Legal, Science, Social, Policy, Financial ... ?


"On Wednesday [24 July], the World bank said it  would give $300m in grants and loans to DRC to step up its aid response.

But funding connected to the World Bank's pandemic bonds, issued in 2017 have been less forthcoming. One relatively small slice - the so-called "cash" element - has delivered $31.4m to help with the crisis."

Ebola's latest resurgence in central Africa has led to more than 1,700 fatalities. But for the insurance element of the bonds to pay out, the disease must cross an international border and there must be at least 20 fatalities in the second country.

The total possible insurance payout for Ebola is $150m and comes in three tranches: when 250, 750 and 2,500 people have died across at least two countries, $45m, $45m and $60m, respectively, will be disbursed."


Pandemic Bonds

World Bank:
Pandemic Emergency Financing Facility

DRC - Rwanda border


My source: Asgari, N. (2019) World Bank pandemic bonds spark Ebola anger, FT Weekend, 27-28 July, p.17.

Photograph - adapted from original by The Independent.

Monday, July 29, 2019

The number of pages count (in a medical MOT)

Received in the post: an invitation.

For a medical MOT that would cost me £129 - which is a saving of £141.

I am informed that a competitor charges £564 for a "360" Health Assessment and £424 for an "Essential" Health Assessment.

Recently I spoke to someone who had major surgery and they remarked on the lack of assessment not on the medical side, but the social, especially in relation to discharge and the circumstances they would be returning to.

This example of apparent disinterest in a social assessment contrasts with practice in the past - several decades ago.

Apart from an awareness of  'silver clouds' and rose-tinted glasses what struck me was securing a sale by a manifest of paper:


The various blood tests that would be completed are detailed using medical terminology across four A4 pages. Depending on age there is a free respiratory screening too.

The following quotations (Alber, et al., 2017) state clearly the risks:
"There is a growing awareness among clinicians and health care scientists, that medical overuse comprises unnecessary health care lacking benefit for patients [3] or putting them at risk of harm outweighing a potential benefit [4]. Moreover, unnecessary medicine adds to rising health care expenditures [5] and a misallocation of scarce resources [6]. Asymptomatic individuals are at risk of being labelled as patients, causing anxiety and affecting their quality of life [7]." ...

"Moreover, in secondary prevention, risk factors are increasingly treated as diseases [8]. There is a tendency to screen asymptomatic populations at low risk and to label pre-diseases as manifest diseases [1]. Serum cholesterol levels are a good example of threshold lowering by shifting the boundary between health and disease [9]."


Over-treatment is also a problem in two critical and concurrent senses, as follows:

Developed health
systems

Need to transform to
health promoting, educational, preventive,
self-caring systems.
Developing health
systems

Need to prevent the inheritance of commodified health care and over-treatment.*


Alber et al. also provide a useful diagram preceded with more background:
"In primary care, the “quaternary prevention concept” [11] was introduced (see Fig. 1 ) in order to protect individuals from unnecessary investigations and treatment. Quaternary prevention is a “new term for an old concept: first, do not harm” [12]. It refers to actions “taken to identify [a] patient at risk of overmedicalisation [= in the sense of medical overuse, author’s note], to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable” [13]."

Fig 1
The concept of quaternary prevention. Source: [11] Kuehlein T, Sghedoni D, Visentin G, Gérvas J, Jamoulle M. Quaternary prevention: a task of the general practitioner. PrimaryCare. 2010;10:350–4, and [12] Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag. 2015;4:61–4

Without being dismissive of screening and its relation to health and well-being, I have removed myself from this particular mailing list.

At some point I must really apply Hodges' model to this discussion. The model is ideally suited to navigating and arguing this debate; from self-care, primary care, prevention, population and global health. I have posted previously about the damaging ideal of the comprehensive health record and the way that records seem oriented to assessment and risk reduction with outcomes and relapse prevention an after-thought. This defensiveness is critical for public safety, professionalism and accountability, but as a thread on twitter shows it can have a negative impact too.


*There is an additional confounding factor at work in developing nations, the incursion of digital technologies from outside.


Alber, K., Kuehlein, T., Schedlbauer, A., & Schaffer, S. (2017). Medical overuse and quaternary prevention in primary care - A qualitative study with general practitioners. BMC family practice, 18(1), 99. doi:10.1186/s12875-017-0667-4

Tsoi, G.W.W. (2014). Update On Prevention - An Introduction to Quaternary Prevention, Medical Bulletin 19, 11, NOVEMBER 2014.

Ack.
I am subscribed to a mail list that is an invaluable resource on the status of medicine and health care, with contributors including, Mohammad Zakaria Pezeshki, Juan Gérvas, Karenleigh A. Overmann, Gene Tsoi and others.

MOT: Ministry of Transport test

Friday, May 16, 2014

If you must rumple the care domains - rumple them together

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

'A Man’s body and his mind, 
with the utmost reverence to both I speak it, 
are exactly like a jerkin, and a jerkin’s lining; – 
rumple the one – you rumple the other.’ 1





1 Sterne L. The Life and Opinions of Tristram Shandy, Gentleman (1761), vol. 3, ch. 4 (eds M New, J New). University of Florida Press, 1978.

Source: Royal College of Psychiatrists (2013) Whole-person care: from rhetoric to reality Achieving parity between mental and physical health. Occasional Paper 88, March 2013. p.2.