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1

Personal health budgets – should patients be able to manage their care in a way that suits them? A concise narrative review.

100%

Tomaszewski K. A.

Horyzonty Wychowania

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2017

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vol. 16

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issue 40

147-157

EN

RESEARCH OBJECTIVE: The aim of this concise review is to both demonstrate the pros and cons in regards to personal health budgets (PHBs), as well as critically evaluate their performance and possibilities. Another purpose of this paper is to familiarize the wider public with the concept of PHBs. THE RESEARCH PROBLEM AND METHODS: The reason behind introducing PHBs and direct payments was to bring social care and long-term healthcare “closer” to the patients in order to personalize treatment and support. By “personalization” we understand the possibility of choosing services that best meet the unique and individual needs of a specific person. However, the tempting concept of PHBs carries with itself both pros and cons. This qualitative, comprehensive narrative review brings to light the current state of knowledge and different parties’ opinions on PHBs. THE PROCESS OF ARGUMENTATION: A PHB is an allocation of public/private financial resources used to identify and meet the health-related needs of a specific person. Such a resolution should potentially lead to new and innovative ways of spending the available funds, outside what traditional services offer, in order to personalize healthcare, increase its effectivity, and decrease the cost/benefit ratio. However, PHB’s are not all-inclusive but cater to needs easily overlooked in the traditional healthcare system. RESEARCH RESULTS: The described PHB organization combines the best available clinical experience with the cumulated health- and care-related experience of the patients. This way both long-term and new short-term needs can be addressed and the intervention that has begun can last as long as the patient needs it. CONCLUSIONS, INNOVATIONS AND RECOMMENDATIONS: The healthcare system faces difficult times, and PHBs may be a potential solution to at least a part of the problems. The only question is will they be implemented correctly becoming a positive driver of change or will they become the anchor that pulls down a sinking ship?

2

Pathogenesis of selected multiple primary neoplasms

75%

Witek M. K., Skrzynecka S., Bartoszek M., Michalik J., Pudźwa J.

European Journal of Clinical and Experimental Medicine

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2023

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issue 3

605-616

EN

Introduction and aim. Multiple primary tumors are defined as having more than one primary tumor in a different organ location in the same person. Therefore, it is important to know pathogenesis of multiple primary neoplasms to discover new forms of primary prevention and secondary prevention, especially connected with genetic tests which are important for the future of medicine as a part of personalized medicine. The aim of the study is to present selected aspects of the pathogenesis of multiple primary neoplasms. Material and methods. PubMed databases and Google Scholar were searched. Analysis of the literature. The rising risk of developing multiple primary cancers is a consequence of the progressive growth and ageing of the population and development of cancer in patients previously treated for cancer. The formation of secondary neoplasms may be multifactorial – to a large extent it is associated with genetic factors that may facilitate neoplastic transformation, for example as a result of radiation therapy, chemotherapy, inherited syndromes, environmental factors such as tobacco or alcohol, sometimes random somatic mutations. Conclusion. Knowledge of the pathogenesis of multiple primary tumors can contribute to a better understanding of the problem, as well as help in the prevention or early diagnosis of multiple primary tumors (primary and secondary prevention)

3

Genetyka, prywatyzacja ryzyka i polityka kozła ofiarnego

51%

Domaradzki J.

Diametros

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2012

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issue 32

1-18

PL

Koncepcja ryzyka należy do podstawowych kategorii współczesnej medycyny. Wskazując na trzy typy ryzyka: środowiskowe, związane ze stylem życia i genetyczne, medycyna podkreśla zarazem osobistą odpowiedzialność za zdrowie i zarządzanie ryzykiem. Efektem jest redukcja złożonych problemów społecznych do perspektywy jednostkowej. Taka polityka kozła ofiarnego jest wzmacniana przez genetykę, która kreuje swoistą „optykę molekularną”. Akcentuje ona genetyczne predyspozycje chorób organicznych, zaburzeń psychicznych i zachowań ludzkich, przerzucając odpowiedzialność za zdrowie z państwa na jednostki. Twierdzi bowiem, że zdrowie czy choroba zależą zarówno od praw biochemicznych i genetycznych, jak i od osobistych wyborów. Powszechność informacji sprawia, że trudno być nieświadomym ryzyka, zaś bierność i obojętność uznaje się za przejaw nieodpowiedzialności. I tak medycyna szerzy ideę, że choroby można uniknąć, i obliguje w ten sposób jednostki do poszukiwania wiedzy i niwelacji ryzyka. Odwraca to jednak uwagę od społecznych uwarunkowań chorób i maskuje konieczność reform.

EN

The concept of risk is one of the key categories of modern medicine. By stressing its three types, environmental risk, risk associated with lifestyle and genetic risk, medicine emphasizes personal responsibility for health and the management of risk. This results in bringing complex social problems down to the personal level. Such politics of “victim blaming” is reinforced by genetics, which emphasizes inherited predispositions to diseases, thus shifting responsibility for health from the government toward the individual. Medicine argues that health and illness depend on biochemical laws and personal lifestyle. Because information regarding risks is omnipresent it is impossible to be unaware of them. Ignorance and negligence are treated as irresponsibility. Consequently, medicine promotes the idea that disease can be prevented. It obliges individuals to look for information and to manage personal risk. Yet, it masks the social determinants of health and the necessity of social reforms.

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Personal health budgets – should patients be able to manage their care in a way that suits them? A concise narrative review.

Pathogenesis of selected multiple primary neoplasms

Genetyka, prywatyzacja ryzyka i polityka kozła ofiarnego