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There’s a lot of money to be made from telling healthy people they’re sick. Some forms of medicalising ordinary life may now be better described as disease mongering: widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments. 2 Pharmaceutical companies are actively involved in sponsoring the definition(More)
This paper is written within the context of a relational data base model as presented by E. F. Codd in [1]. It also serves as a companion paper to his paper [2]. The central thesis is that a file operation should not produce unexpected 'side effects' in order to maintain a restriction (such as one-one, or many-one) on the file. Any file operation which(More)
Over time, the definition of prevention has expanded so that its meaning in the context of health services is now unclear. As risk factors are increasingly considered to be the equivalent of "diseases" for purposes of intervention, the concept of prevention has lost all practical meaning. This paper reviews the inconsistencies in its utility, and suggests(More)
Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a pervasive problem. Direct measurement of overuse through documentation of delivery of inappropriate services is challenging given the difficulty of defining appropriate care for patients with individual preferences and needs; overuse can also be(More)
All NHS patients who are suspected to have bowel cancer by their general practitioner should now be seen by a specialist within two weeks. The government introduced this policy in July 2000 in response to concerns that some patients had to wait too long for an outpatient appointment. However, this new policy could distort referral patterns either by(More)