Global health priorities – priorities of the wealthy?

Health has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. I argue that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions.     

Dueling priorities

The Institute of Medicine report on medical errors and the resulting attention from the public and health care purchasers pushed patients safety to the forefront of providers' quality initiatives. Now, some health care leaders say the preoccupation with safety is wrongheaded and could detract from broad efforts to improve care.     

Trustees tackle priorities

Trustees at Michigan Hospital Association's member hospitals play a vital role in governing the many activities of Michigan hospitals. What are the top issues Michigan hospital trustees are addressing? Michigan Hospitals asked a variety of trustees and chief executives what those top issues would be.     

Childhood empyema in North-East Scotland over the past 15 years

INTRODUCTION: The incidence of paediatric empyema is rising in the United Kingdom and North America. The reasons for increasing admissions are unclear. Management in tertiary units is often required. We report our experience in North-East Scotland over the last 15 years. METHODS: Empyema patients <15 yrs admitted to the Royal Aberdeen Children's Hospital between 1 st January 1990 and 1st June 2006 were identified using discharge coding. Data was collated from case notes. Patient characteristics, microbiology results, hospital stay and management are studied. RESULTS: Twenty eight children (M:F = 1:1) were admitted. Mean age = 6.8 yrs. Twenty seven out of twenty eight presented with localising respiratory symptoms or signs. In 12/28 an organism was isolated. Streptococcus pneumoniae was the commonest isolate, and where polymerase chain reaction (PCR) testing was employed, 3/3 cases were serotype 1. Fourteen out of twenty eight required surgery: open (8/14) or thoracoscopic (6/14) decortication. Two thoracoscopic cases proceded to open decortication. No complications were observed. Mean hospital stay = 11.4 days. Twelve were managed in high dependency unit (HDU) with a mean stay of 7.1 days. DISCUSSION: We demonstrate similar trends in North-East Scotland to those reported elsewhere. Serotype 1 streptococcus pneumoniae is the most isolated. Multi-drug resistance is not seen in our population. A surveillance programme is now established and reasons for the increasing incidence should become apparent.