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20 - Public Health and Local Government in Wales: Every Policy A Health Policy – A Collaborative Agenda
- Edited by Adrian Bonner, University of Stirling
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- Book:
- Local Authorities and the Social Determinants of Health
- Published by:
- Bristol University Press
- Published online:
- 25 March 2021
- Print publication:
- 14 October 2020, pp 385-400
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Summary
Introduction
This chapter focuses on public health in Wales and the context within which it is delivered. As a devolved service, health policy and the wider public policy legislative framework are the responsibility of the devolved Welsh Government tasked under the Government of Wales Act 2006 with developing and implementing policy, exercising executive functions and making subordinate legislation. Focusing on public health, part two of the chapter outlines the organisations involved and the context of the policy in Wales. It also explores the political drive for more collaboration between different organisations as a mechanism for the delivery of better services. Part three examines a unique piece of legislation in Wales, the Well-Being of Future Generations Act 2015 (WFG Act), and identifies how this may influence the work of local authorities and other organisations in relation to health and its social determinants. In part four, we draw on the available evidence on how this is working so far and focus on two key policy areas jointly driven by the Cymru Well Wales partnership – ‘Adverse Childhood Experiences’ (ACEs) and ‘The first 1,000 days’. Finally, our conclusions indicate that regardless of where public health is located, the policy context in Wales is quite different, and the key issue is whether this will lead to improved public health outcomes for everyone in Wales.
Public health in Wales
The onset of devolution of health services across the United Kingdom (UK) has seen significant divergence through an asymmetric process where distinctive national characteristics of public services delivery have emerged (Bevan et al, 2014). Prior to this, as McClelland (2002, p 325) states, the National Health Service (NHS) in Wales was perceived as ‘forming an adjunct to the English health service’. Since 1999, legislative and policy frameworks have been viewed by the predominantly Welsh Labour-led devolved governments as a mechanism to assert political demarcation from Westminster. This was famously encapsulated in the term ‘clear red water’ set out in a speech delivered by the First Minister Rhodri Morgan in December 2002 (Morgan, 2017). While this philosophy was originally constructed in differentiating Welsh Labour from the marketisation strategies of New Labour in London, it grew in contextual importance.
Mechanisms of Tumor-Associated Edema: A Review
- Rolando F. Del Maestro, Joseph F. Megyesi, Catherine L. Farrell
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 17 / Issue 2 / May 1990
- Published online by Cambridge University Press:
- 18 September 2015, pp. 177-183
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An understanding of the mechanisms responsible for tumor-associated edema involves the elucidation of the role played by a number of intra-related processes. These include (i) the permeability of new tumor microvessels that are associated with tumor angiogenesis; (ii) alterations in microvascular permeability due to factors secreted by tumor cells; (iii) immunological mechanisms and (iv) increased microvessel permeability associated with inflammation. The rationale for a role for inflammatory processes in tumor-associated edema has been outlined and the role of non-steroidal anti-inflammatory drugs in modulating experimental and human tumor-associated edema has been explored.
Contributors
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- By Jane E. Adcock, Yahya Aghakhani, A. Anand, Eva Andermann, Frederick Andermann, Alexis Arzimanoglou, Sandrine Aubert, Nadia Bahi-Buisson, Carman Barba, Agatino Battaglia, Geneviève Bernard, Nadir E. Bharucha, Laurence A. Bindoff, William Bingaman, Francesca Bisulli, Thomas P. Bleck, Stewart G. Boyd, Andreas Brunklaus, Harry Bulstrode, Jorge G. Burneo, Laura Canafoglia, Laura Cantonetti, Roberto H. Caraballo, Fernando Cendes, Kevin E. Chapman, Patrick Chauvel, Richard F. M. Chin, H. T. Chong, Fahmida A. Chowdhury, Catherine J. Chu-Shore, Rolando Cimaz, Andrew J. Cole, Bernard Dan, Geoffrey Dean, Alessio De Ciantis, Fernando De Paolis, Rolando F. Del Maestro, Irissa M. Devine, Carlo Di Bonaventura, Concezio Di Rocco, Henry B. Dinsdale, Maria Alice Donati, François Dubeau, Michael Duchowny, Olivier Dulac, Monika Eisermann, Brent Elliott, Bernt A. Engelsen, Kevin Farrell, Natalio Fejerman, Rosalie E. Ferner, Silvana Franceschetti, Robert Friedlander, Antonio Gambardella, Hector H. Garcia, Serena Gasperini, Lorenzo Genitori, Gioia Gioi, Flavio Giordano, Leif Gjerstad, Daniel G. Glaze, Howard P. Goodkin, Sidney M. Gospe, Andrea Grassi, William P. Gray, Renzo Guerrini, Marie-Christine Guiot, William Harkness, Andrew G. Herzog, Linda Huh, Margaret J. Jackson, Thomas S. Jacques, Anna C. Jansen, Sigmund Jenssen, Michael R. Johnson, Dorothy Jones-Davis, Reetta Kälviäinen, Peter W. Kaplan, John F. Kerrigan, Autumn Marie Klein, Matthias Koepp, Edwin H. Kolodny, Kandan Kulandaivel, Ruben I. Kuzniecky, Ahmed Lary, Yolanda Lau, Anna-Elina Lehesjoki, Maria K. Lehtinen, Holger Lerche, Michael P. T. Lunn, Snezana Maljevic, Mark R. Manford, Carla Marini, Bindu Menon, Giulia Milioli, Eli M. Mizrahi, Manish Modi, Márcia Elisabete Morita, Manuel Murie-Fernandez, Vivek Nambiar, Lina Nashef, Vincent Navarro, Aidan Neligan, Ruth E. Nemire, Charles R. J. C. Newton, John O'Donavan, Hirokazu Oguni, Teiichi Onuma, Andre Palmini, Eleni Panagiotakaki, Pasquale Parisi, Elena Parrini, Liborio Parrino, Ignacio Pascual-Castroviejo, M. Scott Perry, Perrine Plouin, Charles E. Polkey, Suresh S. Pujar, Karthik Rajasekaran, R. Eugene Ramsey, Rahul Rathakrishnan, Roberta H. Raven, Guy M. Rémillard, David Rosenblatt, M. Elizabeth Ross, Abdulrahman Sabbagh, P. Satishchandra, Swati Sathe, Ingrid E. Scheffer, Philip A. Schwartzkroin, Rod C. Scott, Frédéric Sedel, Michelle J. Shapiro, Elliott H. Sherr, Michael Shevell, Simon D. Shorvon, Adrian M. Siegel, Gagandeep Singh, S. Sinha, Barbara Spacca, Waney Squier, Carl E. Stafstrom, Bernhard J. Steinhoff, Andrea Taddio, Gianpiero Tamburrini, C. T. Tan, Raymond Y. L. Tan, Erik Taubøll, Robert W. Teasell, Mario Giovanni Terzano, Federica Teutonico, Suzanne A. Tharin, Elizabeth A. Thiele, Pierre Thomas, Paolo Tinuper, Dorothée Kasteleijn-Nolst Trenité, Sumeet Vadera, Pierangelo Veggiotti, Jean-Pierre Vignal, J. M. Walshe, Elizabeth J. Waterhouse, David Watkins, Ruth E. Williams, Yue-Hua Zhang, Benjamin Zifkin, Sameer M. Zuberi
- Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
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- Book:
- The Causes of Epilepsy
- Published online:
- 05 March 2012
- Print publication:
- 14 April 2011, pp ix-xvi
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seven - The consumer in education
- Edited by Richard Simmons, Martin Powell, Ian Greener
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- Book:
- The Consumer in Public Services
- Published by:
- Bristol University Press
- Published online:
- 22 January 2022
- Print publication:
- 15 April 2009, pp 119-136
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Summary
Introduction
The consumer role in education is one that has historically existed prior to legislative reform. Parents have always had choices about ‘which school’ in terms of private or state school, religious or non-religious, and also choices about where they live and, by implication, where their children go to school. It is now almost 30 years since the introduction of legislative reforms promoting additional elements of choice in the UK education service. Following the reforms put in place during the 1980s, parents, pupils and users have been empowered to participate further in the selection of services. In addition to the consumer-oriented reforms, elements of the reform agenda have also stressed the involvement of citizens in education and there are now opportunities for parents and users to have an input into the management and leadership of schools. Using the ‘voice’, ‘choice’ and ‘exit’ framework, the aim of this chapter is to discuss the consumer in education. It is divided into three parts. Part one focuses on the involvement of citizens, consumers and parents in education. In part two, the mechanisms of consumption are reviewed. The use of the market, catchment areas and also the allocation of school places by lottery are each investigated. Part three outlines the different faces of consumerism and citizen participation in education. Conclusions are drawn about the involvement of citizen-consumers in education services.
Citizens, consumers and parents in education
Prior to 1979, the language used in all public services to describe those receiving them was centred around notions of professional autonomy and the dependency of clients (Clarke and Newman, 1997). Words including ‘patients’, ‘parents’, ‘pupils’, ‘prisoners’, ‘tenants’ and ‘clients’ each suggest users who were the recipients of public services. Further, they suggest users who are having services provided to them with little activity or participation on their behalf. Le Grand (2003) argues that these users were considered to be passive. Le Grand (2003, p 6) elaborates further in relation to patients:
Patients were supposed to live up to their appellation and be patient. They were to wait patiently in queues at general practitioners’ surgeries or at outpatient clinics; if they needed further treatment they had to be prepared to wait their turn on hospital waiting lists.
List of Contributors
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- By Ruth A. Berman, Douglas Biber, Jens Brockmeier, A.-M. Chartier, Karine Chemla, Stephen Chrisomalis, Peter T. Daniels, Teresa M. Dobson, Nicholas Everett, Joseph P. Farrell, Alison F. Garton, James Paul Gee, Usha Goswami, Niloofar Haeri, Roy Harris, Bruce D. Homer, Martin Ingvar, Lisbeth Larsson, Elizabeth Long, Heather Murray, Stephen P. Norris, David R. Olson, Karl Magnus Petersson, Linda M. Phillips, Chris Pratt, Dorit Ravid, Alexandra Reis, Catherine E. Snow, Carolyn Steedman, Thomas G. Sticht, Brian Street, Rosalind Thomas, Liliana Tolchinsky, Nancy Torrance, Yaching Tsai, Paola Uccelli, Frits Van Holthoon, Daniel A. Wagner, Feng Wang, William S.-Y. Wang, John Willinsky
- Edited by David R. Olson, University of Toronto, Nancy Torrance, University of Toronto
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- Book:
- The Cambridge Handbook of Literacy
- Published online:
- 05 June 2012
- Print publication:
- 09 February 2009, pp ix-xii
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Stimulant medication in ADHD: what do children and their parents say?
- Catherine McElearney, Carol Fitzpatrick, Niamh Farrell, Mary King, Bryan Lynch
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- Journal:
- Irish Journal of Psychological Medicine / Volume 22 / Issue 1 / March 2005
- Published online by Cambridge University Press:
- 13 June 2014, pp. 5-9
- Print publication:
- March 2005
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Objectives: The prescription of stimulant medication to children with attention deficit hyperactivity disorder remains topical. Few reports target children's views about taking long-term medication. The aim was to assess child and parent views of stimulant medication. To compare attitudes to medication between two groups of children, those with attention deficit hyperactivity disorder taking stimulant medication and those with epilepsy taking anti-epileptic medication.
Method: Forty children (n = 40) with attention deficit hyperactivity disorder on stimulant medication, and 40 children (n = 40) with epilepsy on anti-epileptic medication formed the study population. A semi-structured interview was carried out with each child and parent. Each parent completed the Dosage and Side-effects Questionnaire and the Attitude to Medication Questionnaire. Each child completed the Attitude to Medication Questionnaire.
Results: Sixty per cent of children (n = 24) with attention deficit hyperactivity disorder and 62.5% (n = 25) of those with epilepsy knew the name and purpose of their medication. Forty per cent (n = 16) of children in the stimulant group and 32.5% (n = 13) in the anti-epileptic group reported themselves as being non-compliant with medication. In both groups children reported positive aspects to taking medication. More children with epilepsy reported negative aspects. Only 32.5% (n = 13) of children with attention deficit hyperactivity disorder said that they would tell a friend about their medication, while 55% (n = 22) of the children with epilepsy indicated that they would do so. In both groups parents were better informed than their children were about the purpose of the medication. Parents of children with attention deficit hyperactivity disorder tended to be more positive about medication than their children and than the parents in the comparison group.
Conclusions: The majority of children and their parents express positive views about the stimulant medication. Children's views about medication compliance and side-effects should be sought, as they may differ significantly from those of their parents. Where parents have noticed positive changes, but children have not, this information can be used therapeutically to help children feel more in control of their behaviour.