Post-cure

The curative imaginary is a powerful driver of hope and investment in medicine, often displacing attention and resources given to other illness-related fields of practice. Whereas cure implies an end to the sick role and the possibility of an absolute state of health, in practice those fields that are touted as having high curative potential grapple with the ongoing nature and incompleteness of post-cure care. By capturing the public imagination and channelling research and funding in particular directions, the motif of cure risks drawing resources away from other, less seductive forms of treatment, and towards the technological at the expense of the social. Drawing on our research into precision medicine and deep brain stimulation, we track how cure operates as a concept in these fields, and compare this to how medical practitioners actually care for patients. We argue that a critical engagement with post-cure possibilities offers an opportunity to challenge and rethink what constitutes good medical care, as well as the social, political, and economic underpinnings of medical innovation.

An Interdisciplinary Model of Treatment of Children with Cerebral Palsy in Poland. Recommendations of the Paediatric Rehabilitation Section of the Polish Rehabilitation Society

Medical rehabilitation plays an important leading role in the treatment of children with cerebral palsy (CP). Collaboration between specialists in medical rehabilitation and the rehabilitation team is a prerequisite for good medical care. The quality of medical services for children with CP depends chiefly on the level of expertise of the treatment team. Through training of specialists and sharing of knowledge, we can help more patients. This idea was developed and implemented by Dr Ewa Kooyman-Piskorz, the founder and president of Wandafonds Foundation. Between 2003 and 2014, Dutch specialists working with children with CP conducted a number of training workshops in Poland under the supervision of the Polish Rehabilitation Society and Prof. Jules Becher, a world-famous expert in the rehabilitation of children. Based on these experiences, we present the recommendations of the Paediatric Rehabilitation Section of the Polish Rehabilitation Society regarding an interdisciplinary model of treatment of children with CP in Poland.

Recognition of One’s Own Mental State by Parents of Children-patients

In present article studied recognition of the situation of actualization of the mental state by child-patients parent's. The research was carried out in two stages. Sample: 70 mothers having children under the age of 7 years. Average age of mothers – 27 years. At the first stage by means of the technique "A relief of a mental state" (Prokhorov, 1998) were received estimates of mental states in the following situations: hospitalization of the child, "bad" medical care, troubles at work, "good" medical care, a usual (background) mental state. Based on the results of the first stage were two sets of descriptions were constructed. At the second stage, these sets were presented for recognition to the same sample. The first set of descriptions was constructed by the tequnique of the machine learning, the second set was constructed by the scheme of E.Yu. Artemyeva (1999). The results show the possibility of recognizing the situations of actualization of the mental state by the parents of child patients, which is limited by the emotional valence of the situation. Differentiation of situations of one valence is obstructed. The condition, actualized in one situation, can be extrapolated to other situations of similar emotional valence. The way to construct a description of the experienced mental state has a matter for recognition of the situation of actualization of a mental state. Funding This work was supported by grant RFH №15-06-10641.

The National Institute for Health and Clinical Excellence, and otolaryngology: review of the evidence

Background:The adoption of evidence-based practice is fundamental to good medical care; it ensures that intervention is clinically effective and safe. In a world of limited healthcare resources, consideration of cost-effectiveness must, unfortunately, restrict clinicians' choice. The National Institute for Health and Clinical Excellence has, for over 10 years, developed guidance to achieve a national consensus on best practice.Objectives:This review describes the Institute's methodology, examines guidance relevant to otolaryngology and presents more recent research to update the evidence.

Determinants of trust in the patient–oncologist relationship

ABSTRACTObjective:The relationship between the patient and physician is at the heart of good medical care, and trust is an essential component of this relationship. To enable the oncologist to better form a trusting relationship with the patient, this article describes four factors that influence patient trust.Methods:Thematic literature review and a clinical vignette.Results:The authors discuss four factors that influence patient trust. These factors are whether and how the oncologist (1) minimizes the potential for shame and humiliation during the medical encounter, (2) manages the power imbalance between doctor and patient without abuse or misuse, (3) demonstrates to the patient an appreciation of how he or she is suffering from experience of cancer, and (4) demonstrates to the patient how he or she is suffering from the treatment provided by the oncologist. The authors illustrate these factors with a clinical vignette.Significance of results:The cancer patient is best cared for by an oncologist who can not only understand disease and treat medical problems, but also accompany the patient through the illness experience. This requires an appreciation of the challenges to trust that are inherent in the special characteristics of the patient–physician interaction.