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Biomedical subjects

Stephen Gillam

Publications and source records attributed to Stephen Gillam.

8 recordsLinked to original sources
PubMed2006

Undergraduate public health education in UK medical schools - struggling to deliver.

INTRODUCTION: Recent policy initiatives in the United Kingdom (UK) have underlined the importance of public health education for health care professionals. We aimed to describe teaching inputs to medical undergraduate curricula, to identify perceived challenges in the delivery of public health teaching and strategies that may overcome them. METHODS: We undertook a cross-sectional survey; questionnaires were sent electronically to 28 teaching leads in academic departments of public health in UK medical schools. These were followed-up by telephone interviews. RESULTS: We obtained a 75% response rate. We found a great deal of variability between schools in teaching methods, curricular content and resources used. In 76% of medical schools, public health and clinical teaching were integrated to some extent. The proportion of teaching delivered as lectures is decreasing and that of self-directed learning is increasing. A range of methods is used to assess students and in 33% of schools these assessments contributed to final Medical School marks. More than half the medical schools had difficulty finding teachers and staffing levels had deteriorated in 55% of schools. Many interviewees felt that their contributions were undervalued. Few were aware of the level of funding received to support teaching. DISCUSSION: There is a need to increase the supply of well-trained and motivated teachers and combine the best traditional teaching methods with more innovative, problem-based approaches. Faculties need to share 'learning about what works' and teaching resources across medical schools as well as addressing a culture of neglect of teaching in some departments. Suggestions are made as to how undergraduate public health teaching can be strengthened.

Cross-Sectional Studies↗
PubMed2003

Do people with type 2 diabetes and their carers lose income? (T2ARDIS-4).

T(2)ARDIS is a study of the full costs of care for a sample of people with type 2 diabetes in the UK. This paper reports on individual earnings lost by patients (n=653) and carers (n=253) aged <65 years, based on 1998 values. Mean annual lost earnings are calculated on three different bases. Across the total survey population aged <65 years, mean lost earnings are estimated at pound 869 (S.D. pound 4109) per patient and pound 1300 (S.D. pound 4093) per carer. However, for the sub-set of respondents who actually lose earnings, the mean levels are pound 13841 (S.D. pound 9551) and pound 10960 (S.D. pound 6002), respectively. Patients and carers who lose earnings incur higher personal care-related expenditure than those who do not lose earnings (although for the patients this is not statistically significant). Patients who lose earnings also report poorer health-related quality of life and carers who lose earnings report higher levels of strain. Only one third of carers report receiving state benefits, and for both carers and patients the shortfall between reported benefits received and lost earnings is substantial. A strong association was found between patients' loss of earnings and the presence of diabetic complications (P<0.001), especially micro-vascular complications. Policy priorities should, therefore, include facilitating comprehensive access to state benefits (especially for carers) and a clear focus on reducing the incidence of diabetic complications.

Adult↗
PubMed2003

Back to the market: yet more reform of the National Health Service.

Yet more reform of the National Health Service in England has been announced by the Department of Health. In opposition, the Labour Party criticized the creation of an "internal market" for health care by the Conservative government, but five years into the Blair administration, market incentives are to be reinvigorated and the private sector is to be embraced in ways not seen hitherto. New guidance signals the introduction of competitive contracting using cost-per-case currencies, more choice for patients in where they will receive hospital treatment, and the freeing of NHS care providers from the direct political control of ministers. It is intended that the monopolistic features of the NHS in England should give way to greater pluralism, in particular through contracts with privately owned health care organizations. However, there is little evidence to suggest that these policies will be effective, and a number of practical problems may obstruct implementation.

Competitive Bidding↗
PubMed2002

The community-oriented primary care experience in the United kingdom.

The UK National Health Service has long delivered public health programs through primary care. However, attempts to promote Sidney Kark's model of community-oriented primary care (COPC), based on general practice populations, have made only limited headway. Recent policy developments give COPC new resonance. Currently, primary care trusts are assuming responsibility for improving the health of the populations they serve, and personal medical service pilots are tailoring primary care to local needs under local contracts. COPC has yielded training packages and frameworks that can assist these new organizations in developing public health skills and understanding among a wide range of primary care professionals.

Behavioral Risk Factor Surveillance System↗