Public-Private health sector mix- way forward | Buso | South African ...

African Journals Online (AJOL)

The debate on Public-Private mix has been around in South Africa (SA) for the past ten years. The debate arose out of a realisation of the weaknesses in the public health parallel with the ever-increasing private sector worldwide. The concept has been referred to in different terminologies, public-private mix, public private ...

East African Journal of Public Health: Submissions

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Author Guidelines; » Copyright Notice; » Privacy Statement ... and noncommunicable diseases, health leadership and management issues. ... current scientific and policy debates, including methodological issues in public health research.

Globalisation and public health.

Science.gov (United States)

Bettcher, D; Lee, K

2002-01-01

At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

The nuclear debate from the standpoint of public health

International Nuclear Information System (INIS)

Pellerin, Pierre

1980-01-01

After surveying the sources of exposure to ionizing radiation to which man is subjected in modern life, the author assesses the health consequences of radiation caused by the nuclear industry. Specific attention is given to the contention that nuclear energy must entail unacceptable hazards on public health by discussing the issues to cancer and leukemia, genetic hazards, radioactive 'reconcentration', plutonium, radioactive waste and nuclear accidents [fr

Bioterrorism, public health, and the law.

Science.gov (United States)

Bayer, Ronald; Colgrove, James

2002-01-01

The controversy over the Model State Emergency Health Powers Act has underscored the enduring tension in public health between guarding the common welfare and respecting individual liberty. The current version of the act, crafted in response to extensive public commentary, attempts to strike a balance between these values but has failed to allay the concerns of many civil libertarians and privacy advocates. Although the debates over the model act have been triggered by the threat of bioterrorism, they illustrate broader philosophical differences, with profound implications for all realms of public health policy.

Interdisciplinary debate in the teaching-learning process on bioethics: academic health experiences.

Science.gov (United States)

Campos Daniel, Jéssica; Dias Reis Pessalacia, Juliana; Leite de Andrade, Ana Flávia

2016-06-01

The study aimed to understand the health of student experiences to participate in interdisciplinary discussions in bioethics and know the contributions of interdisciplinary methodological resource for the teaching-learning process at graduation. Descriptive study of qualitative approach in a public higher education institution of Divinópolis, Minas Gerais, Brazil. Three categories of analysis were identified: ''active methodologies in the training of a professional critic,'' ''interdisciplinary debate as facilitator reflection of bioethics'' and ''feelings and attitudes caused by the interdisciplinary debate.'' Discussion. There was a lack of approach of bioethical contents in the health curriculum, and the adoption of active methodologies provides a better reflection in bioethics, but that requires changing paradigms of teachers and educational institutions.

A calf is born : a reconstruction of the public debate on animal biotechnology

NARCIS (Netherlands)

Theune, E.

2001-01-01

'How should public debates be understood?' is the central question of this study. And it is answered by reconstructing a single public debate, namely the debate about the transgenic bull Herman. Herman the bull was created by Gene Pharming in 1989. An extra gene has been inserted in his genome as to

The Debate over eHealth

CERN Document Server

Gaddi, Antonio Vittorino

2014-01-01

The future of eHealth and telemedicine has recently become a much debated and controversial subject. It is widely believed that eHealth will play an increasingly important role in shaping healthcare systems in the twenty-first century. The rising burden of chronic diseases and the potential of eHealth for cutting costs and improving quality and safety of health services make eHealth a great opportunity for providing more efficient health care.

Institutional research on public opinion and participative devices. From polls to public debate

Directory of Open Access Journals (Sweden)

Mañas, Beatriz

2012-12-01

Full Text Available Considering that the methods and techniques implemented in social research entail a certain definition of the concepts studied, it seems relevant to reflect on the possibilities of devices other than polls when studying “public opinion” as a sociological concept. Two arguments for such approach can be highlighted: the qualitative and discursive nature of public opinion, and polls’ difficulties for being collectively perceived as a reliable and interesting way to express points of view about public matters. The French CNDP (Commission Nationale du Débat Public is conceived for encouraging national, regional or local debates about political decisions which involve an important governmental investment. Taking into account that deliberative polling has probably been the most systematized among numerous research devices which have tried to implement the premises of deliberative/participative democracy, we will explore the possibilities of a different and wider representation of “public opinion” from the analysis of the dynamics generated by the institutional device of Public Debate.

Sosteniendo la hipótesis de que los métodos y técnicas utilizadas para el estudio de los conceptos de interés sociológico tienen cierta influencia en la definición de los mismos, este artículo plantea una reflexión sobre las posibilidades e implicaciones de dispositivos diferentes a las encuestas para la investigación de la opinión pública. La aproximación a este enfoque se realizará desde dos argumentaciones: por un lado, sosteniendo la naturaleza cualitativa y discursiva de la opinión pública y, por otro, mostrando la dificultad de los sondeos para ser percibidos colectivamente como un medio confiable e interesante para expresar y registrar puntos de vista sobre los asuntos públicos. La CNDP (Comisión Nacional de Debate Público es una institución pública francesa creada para animar debates nacionales, regionales o locales

Global public health today: connecting the dots

Directory of Open Access Journals (Sweden)

Marta Lomazzi

2016-02-01

Full Text Available Background: Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design: A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results: Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions: The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the

Global public health today: connecting the dots

Science.gov (United States)

Lomazzi, Marta; Jenkins, Christopher; Borisch, Bettina

2016-01-01

Background Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the global level and should lead

Entrainement au Debat Public et a la Negociation d'Affaires en Anglais (Training in Public Debate and Business Negotiation in English)

Science.gov (United States)

Rivas, Michele

1975-01-01

This article describes a program designed to give native French speakers who already speak English further skills in oral presentation, public debate, and the language of business negotiations. (Text is in French.) (CLK)

Technical Versus Public Spheres: A Feminist Analysis of Women's Rhetoric in the Twilight Sleep Debates of 1914-1916.

Science.gov (United States)

Johnson, Bethany; Quinlan, Margaret M

2015-01-01

Twilight Sleep (TS) describes the delivery, via an injection, of an amnestic drug cocktail to a parturient woman throughout labor. In order to understand the development of modern-day rhetoric surrounding childbirth methods and procedures, this article explores the debate over TS between the public and technical sphere in New York City between 1914 and 1916 and examines the ways in which this debate altered obstetric health care for middle- and upper-class White women. The public response to this campaign posed a direct challenge to male obstetricians in New York City, many of whom were ill-equipped, both literally and figuratively, to use this procedure. Using a feminist rhetorical criticism, we examined the pro-TS rhetoric of women writers in New York City, the methods they borrowed from the women's movement, and the ensuing dialogue between the public and technical spheres. For this study, we analyzed journal and newspaper articles, a pamphlet, a collection of pro-TS organizational documents, letters to the editor, and books published about TS and the history of birth. Lastly, we analyzed theoretical notions of childbirth in women's health and communication studies. After examining the TS debate, we found that birth practices for middle- and upper-class women in New York City shifted and the obstetric community gained ascendancy over female midwifery. We also found that in certain instances, the rhetoric of pro-TS activists was more technically accurate than the rhetoric of some physicians. Hence the TS debate emerged from an argument over the right to use technical language in the technical and/or the public sphere. Conclusions and implications offered by this historical, feminist analysis question our current understanding of women's health and birthing practices, doctor-patient communication, and patient empowerment and access to technical knowledge.

Why media representations of corporations matter for public health policy: a scoping review

Directory of Open Access Journals (Sweden)

Heide Weishaar

2016-08-01

Full Text Available Abstract Background Media representations play a crucial role in informing public and policy opinions about the causes of, and solutions to, ill-health. This paper reviews studies analysing media coverage of non-communicable disease (NCD debates, focusing on how the industries marketing commodities that increase NCD risk are represented. Methods A scoping review identified 61 studies providing information on media representations of NCD risks, NCD policies and tobacco, alcohol, processed food and soft drinks industries. The data were narratively synthesized to describe the sample, media depictions of industries, and corporate and public health attempts to frame the media debates. Results The findings indicate that: (i the limited research that has been undertaken is dominated by a focus on tobacco; (ii comparative research across industries/risk-factors is particularly lacking; and (iii coverage tends to be dominated by two contrasting frames and focuses either on individual responsibilities (‘market justice’ frames, often promoted by commercial stakeholders or on the need for population-level interventions (‘social justice’ frames, frequently advanced by public health advocates. Conclusions Establishing the underlying frameworks is crucial for the analysis of media representation of corporations, as they reflect the strategies that respective actors use to influence public health debates and decision making. The potential utility of media research lies in the insights that it can provide for public health policy advocates about successful framing of public health messages and strategies to counter frames that undermine public health goals. A better understanding of current media debates is of paramount importance to improving global health.

Conflict of interest: A tenacious ethical dilemma in public health ...

African Journals Online (AJOL)

In addition to the ethical practice of individual health professionals, bioethical debate about conflict of interest (CoI) must include the institutional ethics of public policy-making, as failure to establish independence from powerful stakeholder influence may pervert public health goals. All involved in public policy processes are ...

Public debate about the EPR nuclear power plant at Flamanville; Debat public sur la centrale nucleaire EPR a Flamanville

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

The project of building of he EPR reactor at Flamanville (Manche, France) has been submitted to the public debate. This document includes a presentation of the project and of the rules of the public debate, a synthesis of the file made by the prime contractor (EDF), a synthesis of the collective book of national actors concerned by the project (a group of associations for environment protection, Areva company, the ministries of economy and ecology, Global Chance, association of pro-nuclear ecologists (AEPN), 'Sortir du Nucleaire' (out-of nuclear) network, group of scientists for the information about nuclear (GSIEN), association for the promotion of the Flamanville site (Proflam), French nuclear energy society (SFEN) in association with 'Sauvons le Climat' (let's save climate), regional collective association 'EPR non merci, ni ailleurs, ni ici' (EPR, no thanks, neither elsewhere, nor here), NegaWatt), and 5 detailed books of actors: ACRO (association for the control of radioactivity in Western France), CFDT and CGT syndicates, the economic and social council of Basse Normandie region, and Proflam. (J.S.)

Public debate about the EPR nuclear power plant at Flamanville; Debat public sur la centrale nucleaire EPR a Flamanville

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

The project of building of he EPR reactor at Flamanville (Manche, France) has been submitted to the public debate. This document includes a presentation of the project and of the rules of the public debate, a synthesis of the file made by the prime contractor (EDF), a synthesis of the collective book of national actors concerned by the project (a group of associations for environment protection, Areva company, the ministries of economy and ecology, Global Chance, association of pro-nuclear ecologists (AEPN), 'Sortir du Nucleaire' (out-of nuclear) network, group of scientists for the information about nuclear (GSIEN), association for the promotion of the Flamanville site (Proflam), French nuclear energy society (SFEN) in association with 'Sauvons le Climat' (let's save climate), regional collective association 'EPR non merci, ni ailleurs, ni ici' (EPR, no thanks, neither elsewhere, nor here), NegaWatt), and 5 detailed books of actors: ACRO (association for the control of radioactivity in Western France), CFDT and CGT syndicates, the economic and social council of Basse Normandie region, and Proflam. (J.S.)

Review: Questioning Ireland: debates in political philosophy and public policy

OpenAIRE

Sheehan, Helena

2000-01-01

This is a review of a collection of essays entitled Questioning Ireland: debates in political philosophy and public policy, edited by Joseph Dunne, Attracta Ingram and Frank Litton, published in Dublin by the Institute of Public Administration in 2000.

Framing the policy debate over spirits excise tax in Poland.

Science.gov (United States)

Zatonski, Mateusz; Hawkins, Benjamin; McKee, Martin

2018-06-01

Industry lobbying remains an obstacle to effective health-oriented alcohol policy. In 2013, an increase in excise tax on spirits was announced by the Polish government. This article presents a qualitative analysis of the public debate that ensued on the potential economic, health and social effects of the policy. It focuses on how competing groups, including industry actors, framed their position and sought to dominate the debate. Online archives of five Polish national newspapers, two spirits trade associations, and parliamentary and ministerial archives were searched. A thematic content analysis of the identified sources was conducted. The overall findings were compared with existing research on the framing of the Minimum Unit Pricing (MUP) debate in the UK. A total of 155 sources were analysed. Two main frames were identified: health, and economic. The spirits industry successfully promoted the economic frame in their own publications and in the media. The debate was dominated by arguments about potential growth of the grey market and losses in tax revenue that might result from the excise tax increase. The framing of the debate in Poland differed from the framing of the MUP debate in the United Kingdom. The Polish public health community was unsuccessful in making health considerations a significant element of the alcohol policy debate. The strategies pursued by UK health advocates offer lessons for how to make a more substantial impact on media coverage and promote health-oriented legislation.

E-networks for improving public health education and practice in low and middle income countries: Introducing public health global network

OpenAIRE

Manu Raj Mathur; Priyanka Chaman; Vijayluxmi Bose

2012-01-01

This paper introduces a knowledge exchange portal called the Public Health Global network (www.publichealthglobal.org). Evolution of the portal as a medium for promoting dialogue and exchange within the community of public health practice and its functions ─ showcasing successes, discussing challenges and focussing on debates around research, curricula, training needs and capacity-building interventions are described. Several challenges to setting up and running such a portal are highlighted ...

Education for public health in Europe and its global outreach

Science.gov (United States)

Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert

2014-01-01

Introduction At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice. PMID:24560263

Consumer-mediated health information exchanges: the 2012 ACMI debate.

Science.gov (United States)

Cimino, James J; Frisse, Mark E; Halamka, John; Sweeney, Latanya; Yasnoff, William

2014-04-01

The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: "Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure." Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately each discussant recognizes that there are many sides to this complex issue, each followed the debater's tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. Published by Elsevier Inc.

Mapping the scope and opportunities for public health law in liberal democracies.

Science.gov (United States)

Magnusson, Roger S

2007-01-01

The two questions, "What is public health law?" and "How can law improve the public's health?" are perennial ones for public health law scholars. This paper proposes a framework for conceptualizing discussion and debate about the scope and opportunities for public health law within liberal democracies. Part 2 of the paper draws selectively on this framework in order to highlight some areas where law's potential role deserves greater acknowledgment and exploration.

Public health terminology: Hindrance to a Health in All Policies approach?

Science.gov (United States)

Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

2018-02-01

National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

Radioactive wastes management. The consequences of the public debate; Gestion des dechets radioactifs. Les suites du debat public

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

The French law from December 30, 1991 has defined an ambitious 15 years program of researches in order to explore the different possible paths for the long-term management of long-lived high and intermediate level radioactive wastes. The law foresees also that at the end of the 15 years research program, in 2006, a project of law will be prepared by the French government and transmitted to the European parliament. A public debate has been organized and emceed in 2005 in order dialogue with the general public and to gather its questions, remarks and fears. This document presents the decisions that the government wishes to take according to the different points discussed during the debate: implementing a national waste management policy for the overall radioactive materials and wastes, reinforcing the tools of this national policy, confirming the prohibition of storing foreign wastes, broadening ANDRA's missions, continuing and reinforcing researches evaluation, creating an independent nuclear safety authority, securing the financing of nuclear charges, sharing information with the public, reinforcing the role of the local information and follow-up committee, institutionalizing the local information commissions, reinforcing nuclear transparency, defining a waste disposal reference solution (long-duration reversible storage), continuing the researches along the three paths defined, defining a decision process, implementing a progressive and monitored disposal solution, sustaining economically the regions which have endorsed the setting up of a nuclear facility in their territory. Some pedagogical files about the research programs, the inventory of wastes, the separation-transmutation, the underground disposal and the sub-surface storage are attached at the end of the document. (J.S.)

Academic advocacy in public health: Disciplinary 'duty' or political 'propaganda'?

Science.gov (United States)

Smith, K E; Stewart, E A

2017-09-01

The role of 'advocacy' within public health attracts considerable debate but is rarely the subject of empirical research. This paper reviews the available literature and presents data from qualitative research (interviews and focus groups conducted in the UK in 2011-2013) involving 147 professionals (working in academia, the public sector, the third sector and policy settings) concerned with public health in the UK. It seeks to address the following questions: (i) What is public health advocacy and how does it relate to research?; (ii) What role (if any) do professionals concerned with public health feel researchers ought to play in advocacy?; and (iii) For those researchers who do engage in advocacy, what are the risks and challenges and to what extent can these be managed/mitigated? In answering these questions, we argue that two deeply contrasting conceptualisations of 'advocacy' exist within public health, the most dominant of which ('representational') centres on strategies for 'selling' public health goals to decision-makers and the wider public. This contrasts with an alternative (less widely employed) conceptualisation of advocacy as 'facilitational'. This approach focuses on working with communities whose voices are often unheard/ignored in policy to enable their views to contribute to debates. We argue that these divergent ways of thinking about advocacy speak to a more fundamental challenge regarding the role of the public in research, policy and practice and the activities that connect these various strands of public health research. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Application of scientific criteria to food allergens of public health importance.

Science.gov (United States)

Chung, Y J; Ronsmans, S; Crevel, R W R; Houben, G F; Rona, R J; Ward, R; Baka, A

2012-11-01

Scientific criteria for identifying allergenic foods of public health importance (Björkstén, B., Crevel, R., Hischenhuber, C., Løvik, M., Samuels, F., Strobel, S., Taylor, S.L., Wal, J.-M., Ward, R., 2008. Criteria for identifying allergenic foods of public health importance. Regulatory Toxicology and Pharmacology 51(1), 42-52) have been further refined to incorporate an assessment of the strength of available scientific evidence (van Bilsen, J.H., Ronsmans, S., Crevel, R.W., Rona, R.J., Przyrembel, H., Penninks, A.H., Contor, L., Houben, G.F., 2011. Evaluation of scientific criteria for identifying allergenic food of public health importance. Regulatory Toxicology and Pharmacology 60, 281-289). A multi-disciplinary group was invited to critically test the refined approach. They independently evaluated selected publications on coconut, soy and/or peanut allergy, scored them using the newly developed level of evidence criteria, and debated proposed approaches for combining and utilising the scores to measure the overall impact of an allergen in public health impact assessments. The evaluation of selected publications using the modified criteria produced a relatively consistent result across the experts. These refined criteria were judged to be a way forward for the identification of allergenic foods of public health importance, and for prioritisation of allergen risk management and future data gathering. The debate to combine available evidence when assessing whether an allergenic food is of sufficient public health importance to warrant active management led to proposals on how to weight and combine evidence on allergen severity, potency and prevalence. The refined criteria facilitate a debate to find a meaningful sequence of steps to summarise the available information in relation to a food allergen. Copyright © 2012 ILSI Europe. Published by Elsevier Inc. All rights reserved.

Putting the public (back) into public health: leadership, evidence and action.

Science.gov (United States)

South, J; Connolly, A M; Stansfield, J A; Johnstone, P; Henderson, G; Fenton, K A

2018-03-13

There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.

E-cigarettes: a need to broaden the debate.

Science.gov (United States)

Latif, E; Nair, M

2016-11-01

The unregulated market for e-cigarettes continues to grow, with debates on their efficacy and impact on global public health. E-cigarettes, or electronic nicotine delivery systems (ENDs), are marketed as a 'safe' alternative to tobacco products and a tool for 'harm reduction'. Some public health experts are calling it a 'game changer' and favour the 'harm reduction' strategy, while others dispute this claim. In our opinion, the debate needs to be broadened to encompass other related concerns and effects on non-users and affected stakeholders. As with tobacco control, a holistic approach is needed to build a raft of policies that effectively address the issue from all angles and look beyond the direct health implications of e-cigarette use to explore the social, economic, political and environmental aspects of this debate, putting 'harm reduction' in context.

Consumer-Mediated Health Information Exchanges: The 2012 ACMI Debate

Science.gov (United States)

Cimino, James J.; Frisse, Mark; Halamka, John; Sweeney, Latanya; Yasnoff, William

2017-01-01

The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: “Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure.” Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately, each discussant recognizes that there are many sides to this complex issue, each followed the debater’s tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. PMID:24561078

The emergency of concept global health: perspectives for the field of public health

Directory of Open Access Journals (Sweden)

João Roberto Cavalcante Sampaio

2016-12-01

Full Text Available In recent years, we have witnessed the emergence of new terms in the academic and political debate of public health, such as ‘’global health’’, ‘’global public goods’’, ‘’global health governance’’, ‘’global public health’’, ‘’health diplomacy’’, 'international cooperation’’. In this study, we aimed to analyze the historical development of the concept of ‘global health’, as well as the prospects of this new concept in the research and public health practice. A comprehensive literature review was performed in Pubmed, Scielo, Scopus, and BVS. We also analyzed documents obtained from the websites of international health organizations. 514 publications were retrieved and 36 were selected for this study. In general, the concept of "global health" refers to health as a transnational phenomenon linked to globalization, which has as main challenge to think public health beyond international relations between countries. International health organizations are particularly important in the development of the concept of "global health" and its new application prospects in the field of public health are health diplomacy, international cooperation and global health governance.

The political debate as public patrimony

Directory of Open Access Journals (Sweden)

Dr. José Cisneros Espinosa

2006-01-01

Full Text Available The following article establishes a critique to the prevalent conception of political communication by focusing on the concept of collective democracy, which is drawn from English political theory. This approach, proposed by David Mena PhD., a researcher from Universidad de las Americas, Puebla, in Mexico, is applied here to contrast the concept of political marketing with the notion of communication as a model for political participation through collective decision-making. Finally, in the conclusive section, the author emphasizes two ideas pointed out by Mena: first, the design of political campaigns as education promotion, and second, the notion of the political debate as a public good.

Debated agronomy: public discourse and the future of biotechnology policy in Ghana.

Science.gov (United States)

Braimah, Joseph A; Atuoye, Kilian N; Vercillo, Siera; Warring, Carrie; Luginaah, Isaac

2017-01-01

This paper examines the highly contested and ongoing biotechnology (Bt) policy-making process in Ghana. We analyse media content on how Bt is viewed in the context of Ghana's parliamentary debate on the Plant Breeders Bill and within the broader public policy-making literature. This paper does not seek to take a position on Bt or the Bill, but to understand how policy actors influence the debate with political and scientific rhetoric in Ghana. The study reveals that in the midst of scientific uncertainties of Bt's potential for sustainable agriculture production and food security, policy decisions that encourage its future adoption are heavily influenced by health, scientific, economic, environmental and political factors dictated by different ideologies, values and norms. While locally pioneered plant breeding is visible and common in the Ghanaian food chain, plant breeding/GMOs/Bt from international corporations is strongly resisted by anti-GMO coalitions. Understanding the complex and messy nature of Bt policy-making is critical for future development of agricultural technology in Ghana and elsewhere.

National Debate and Public Confidence in Sweden

International Nuclear Information System (INIS)

Lindquist, Ted

2014-01-01

Ted Lindquist, coordinator of the Association of Swedish Municipalities with Nuclear Facilities (KSO), closed the first day of conferences. He showed what the nuclear landscape was in Sweden, and in particular that through time there has been a rather good support from the population. He explained that the reason could be the confidence of the public in the national debate. On a more local scale, Ted Lindquist showed how overwhelmingly strong the support was in towns where the industry would like to operate long-term storage facilities

Debate on GMOs health risks after statistical findings in regulatory tests.

Science.gov (United States)

de Vendômois, Joël Spiroux; Cellier, Dominique; Vélot, Christian; Clair, Emilie; Mesnage, Robin; Séralini, Gilles-Eric

2010-10-05

We summarize the major points of international debate on health risk studies for the main commercialized edible GMOs. These GMOs are soy, maize and oilseed rape designed to contain new pesticide residues since they have been modified to be herbicide-tolerant (mostly to Roundup) or to produce mutated Bt toxins. The debated alimentary chronic risks may come from unpredictable insertional mutagenesis effects, metabolic effects, or from the new pesticide residues. The most detailed regulatory tests on the GMOs are three-month long feeding trials of laboratory rats, which are biochemically assessed. The tests are not compulsory, and are not independently conducted. The test data and the corresponding results are kept in secret by the companies. Our previous analyses of regulatory raw data at these levels, taking the representative examples of three GM maize NK 603, MON 810, and MON 863 led us to conclude that hepatorenal toxicities were possible, and that longer testing was necessary. Our study was criticized by the company developing the GMOs in question and the regulatory bodies, mainly on the divergent biological interpretations of statistically significant biochemical and physiological effects. We present the scientific reasons for the crucially different biological interpretations and also highlight the shortcomings in the experimental protocols designed by the company. The debate implies an enormous responsibility towards public health and is essential due to nonexistent traceability or epidemiological studies in the GMO-producing countries.

Public deliberation in the function of overcoming the democratic deficit, public debate and delineation from public hearing

Directory of Open Access Journals (Sweden)

Vukadinović Slobodan

2016-01-01

Full Text Available The article analyses forms of direct democracy from its historical forms, in Ancient Greece, to the modern ones, in Switzerland and the USA. Pointing towards the modern flaws of representative democracy, which dominates the present world, the author explores the forms of citizen participation - from participation to influence, which assists the overcoming of the democratic deficit in practice. Besides the traditional (classical ones, the analysis also focuses on the innovative mechanisms, from informal to formal ones, from individual to collective mechanisms. The focus is on the procedures of direct citizen participation such as: elections, referendum (with its modalities, plebiscite and popular veto, citizens' initiatives, the right of legislative initiative, public meetings, as well as seeking new constructive solutions which enable the citizens not only to express their opinions through selecting the option for or against, but to actively participate and express their own opinions, positions, experiences and arguments - to participate in public deliberation. These are: public debate, public hearing, public consultations and public discussions, round tables and public presence in the form of mini-audiences, public opinion polls and participation in surveys, cooperation of state bodies with civil society organisations, public call for submission of proposals, remarks and petitions, public-private dialogue, focus groups, citizen panels, citizen conferences, citizens' advisory committees, town hall meetings, citizens juries, consensus conferences, the world cafe. In particular, the article points out that e-participation is nowadays utilised more often and gains significance, since it enables citizens to submit their proposals and remarks electronically, in the form of discussion and interaction via social networks and on-line dialogue platforms. It points towards the positive effects and advantages of direct involvement of citizens in the

Media debates and 'ethical publicity' on social sex selection through preimplantation genetic diagnosis (PGD) technology in Australia.

Science.gov (United States)

Whittaker, Andrea

2015-01-01

This paper offers a critical discourse analysis of media debate over social sex selection in the Australian media from 2008 to 2014. This period coincides with a review of the National Health and Medical Research Council's Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research (2007), which underlie the regulation of assisted reproductive clinics and practice in Australia. I examine the discussion of the ethics of pre-implatation genetic diagnosis (PGD) within the media as 'ethical publicity' to the lay public. Sex selection through PGD is both exemplary of and interconnected with a range of debates in Australia about the legitimacy of certain reproductive choices and the extent to which procreative liberties should be restricted. Major themes emerging from media reports on PGD sex selection in Australia are described. These include: the spectre of science out of control; ramifications for the contestation over the public funding of abortion in Australia; private choices versus public authorities regulating reproduction; and the ethics of travelling overseas for the technology. It is concluded that within Australia, the issue of PGD sex selection is framed in terms of questions of individual freedom against the principle of sex discrimination - a principle enshrined in legislation - and a commitment to publically-funded medical care.

The Struggle for the Soul of Public Health.

Science.gov (United States)

Wiley, Lindsay F

2016-12-01

Prevention has become a central focus for health care payers, providers, policy makers, and the general public. Given the centrality of prevention to public health science, practice, and law, it would seem that conditions are ripe for the public health law renaissance to expand beyond legal and scientific circles to permeate the general consciousness. Yet, public health law and policy interventions continue to face considerable political and legal opposition. The population perspective-which emphasizes the social determinants of health, collective action to create healthier communities, and communitarian rationales for prioritizing health-is as important to public health problem-solving as the prevention orientation. But it conflicts with the individualistic orientation that dominates American legal, cultural, and social discourse. This article suggests that public health law and policy debates offer important opportunities for public health advocates to reach across silos to promote the population perspective that unites the field. The article explores contrasting explanations for disease, injury, premature death, and health disparities offered by the population perspective and the individualistic orientation; political and cultural barriers that stand in the way of innovative law and policy interventions; and normative tensions between the communitarian population perspective and self-interested rationales for investment in prevention. Copyright © 2016 by Duke University Press.

Present day public space through the prism of resistance forms to participative injunction. The case of public debates on the electronuclear program

International Nuclear Information System (INIS)

Chambru, Mikael

2011-10-01

This paper proposes to analyze the types of commitments used in the public sphere by the anti-nuclear movements to resist the injunction of participatory public debates. These debates, related to the nuclear power policy, are implemented under the aegis of the National Commission of Public Debate (CNDP). Using a socio-historical approach, we contextualize the implementation of participative tools and the forms of resistance against them in a longer perspective and beyond these institutional participative mechanisms. Analyzing this form of communication and the information issues at stake, the social processes and the political strategies of actors constitute the next step in our work. Doing so enables us to improve the common understanding, through the prism of activist commitment, of the modern transformations of the public sphere. (author)

Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana.

Science.gov (United States)

Atuoye, Kilian Nasung; Vercillo, Siera; Antabe, Roger; Galaa, Sylvester Zackaria; Luginaah, Isaac

2016-11-01

Policy makers in low and middle-income countries are frequently confronted with challenges of increasing health access for poor populations in a sustainable manner. After several years of trying out different health financing mechanisms, health insurance has recently emerged as a pro-poor health financing policy. Capitation, a fixed fee periodically paid to health service providers for anticipated services, is one of the payment policies in health insurance. This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana's National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Learning outcomes in public health education in Poland according to international settlements].

Science.gov (United States)

Cianciara, Dorota

2009-01-01

The essential functions of the Polish public health system have never been officially defined and some approaches are visible. In the article existing foreign catalogues of essential public health functions (services) and core competences for public health professionals and students are presented. They were confronted with students' final skills in public health field of study, described in formal Polish educational standards. It was claimed that graduates' competencies in Poland do not cover the full range of public health functions and skills defined in different countries. In the 2nd cycle of study an emphasis is put down on education for the managers of health care. An urgent need of change of educational standards for public health field of study was underlined. This is closely related to the need of national debate on public health functions.

[Body, rights and comprehensive health: Analysis of the parliamentary debates on the Gender Identity and Assisted Fertilization Laws (Argentina, 2011-2013)].

Science.gov (United States)

Farji Neer, Anahí

2015-09-01

In this paper we present an analysis of the parliamentary debates of the Gender Identity Law (No. 26743) and the Assisted Fertilization Law (No. 26862) carried out in the Argentine National Congress between 2011 and 2013. Using a qualitative content analysis technique, the stenographic records of the debates were analyzed to explore the following questions: How was the public problem to which each law responds characterized? How was the mission of each law conceptualized? To what extent did those definitions call into question ideas of health and illness, in including in the public health system coverage for certain medical treatments of body optimization or modification? In the process of sanctioning both laws, the concepts of health and disease were put into dispute as moral categories. In this context, an expanded concept of comprehensive health arose, in which desires regarding reproduction and the body were included.

Rethinking schools of public health: a strategic alliance model.

Science.gov (United States)

Moloughney, Brent W; Skinner, Harvey A

2006-01-01

Canada is in the midst of rejuvenation of public health organizations, mandates and infrastructure. Major planning exercises are underway regarding public health human resources, where academic institutions have a key role to play. To what extent could schools of public health be part of the solution? Many universities across Canada are considering or in the process of implementing MPH programs (some 17 programs planned and/or underway) and possible schools of public health. However, concerns are raised about critical mass, quality and standards. We encourage innovation and debate about ways to enhance collaborative and structural arrangements for education programs. A school of public health model might emerge from this, but so too might other models. Also, novel types of organizational structure need consideration. One example is a "strategic alliance" model that is broad-based, integrative and adaptive--building on the interdisciplinary focus needed for addressing public health concerns in the 21st century. From our perspective, the central question is: what (new) types of organizational structures and, equally important, collaborative networks will enable Canada to strengthen its public health workforce so that it may better address local and global challenges to public health?

Vitalism and the Darwin Debate

Science.gov (United States)

Henderson, James

2012-01-01

There are currently both scientific and public debates surrounding Darwinism. In the scientific debate, the details of evolution are in dispute, but not the central thesis of Darwin's theory; in the public debate, Darwinism itself is questioned. I concentrate on the public debate because of its direct impact on education in the United States. Some…

Public health aspects of food irradiation

International Nuclear Information System (INIS)

Kampelmacher, E.H.

1982-01-01

The author debates public health aspects of food irradiation. The effect of food irradiation as a convenience to the consumer is discussed, i.e. the prevention of food deterioration and also the prevention of disease that could be passed on to the consumer by ingestion. On the other hand, the effects that could possibly be created by the application of radiation are also evaluated using toxicological and microbiological considerations. (Auth.)

Public debate about the EPR nuclear power plant at Flamanville

International Nuclear Information System (INIS)

2005-01-01

The project of building of he EPR reactor at Flamanville (Manche, France) has been submitted to the public debate. This document includes a presentation of the project and of the rules of the public debate, a synthesis of the file made by the prime contractor (EDF), a synthesis of the collective book of national actors concerned by the project (a group of associations for environment protection, Areva company, the ministries of economy and ecology, Global Chance, association of pro-nuclear ecologists (AEPN), 'Sortir du Nucleaire' (out-of nuclear) network, group of scientists for the information about nuclear (GSIEN), association for the promotion of the Flamanville site (Proflam), French nuclear energy society (SFEN) in association with 'Sauvons le Climat' (let's save climate), regional collective association 'EPR non merci, ni ailleurs, ni ici' (EPR, no thanks, neither elsewhere, nor here), NegaWatt), and 5 detailed books of actors: ACRO (association for the control of radioactivity in Western France), CFDT and CGT syndicates, the economic and social council of Basse Normandie region, and Proflam. (J.S.)

Debated agronomy: public discourse and the future of biotechnology policy in Ghana

OpenAIRE

Braimah, Joseph A.; Atuoye, Kilian N.; Vercillo, Siera; Warring, Carrie; Luginaah, Isaac

2017-01-01

ABSTRACT This paper examines the highly contested and ongoing biotechnology (Bt) policy-making process in Ghana. We analyse media content on how Bt is viewed in the context of Ghana’s parliamentary debate on the Plant Breeders Bill and within the broader public policy-making literature. This paper does not seek to take a position on Bt or the Bill, but to understand how policy actors influence the debate with political and scientific rhetoric in Ghana. The study reveals that in the midst of s...

Is globalization really good for public health?

Science.gov (United States)

Tausch, Arno

2016-10-01

In the light of recent very prominent studies, especially that of Mukherjee and Krieckhaus (), one should be initially tempted to assume that nowadays globalization is a driver of a good public health performance in the entire world system. Most of these studies use time series analyses based on the KOF Index of Globalization. We attempt to re-analyze the entire question, using a variety of methodological approaches and data. Our re-analysis shows that neoliberal globalization has resulted in very important implosions of public health development in various regions of the world and in increasing inequality in the countries of the world system, which in turn negatively affect health performance. We use standard ibm/spss ordinary least squares (OLS) regressions, time series and cross-correlation analyses based on aggregate, freely available data. Different components of the KOF Index, most notably actual capital inflows, affect public health negatively. The "decomposition" of the available data suggests that for most of the time period of the last four decades, globalization inflows even implied an aggregate deterioration of public health, quite in line with globalization critical studies. We introduce the effects of inequality on public health, widely debated in global public health research. Our annual time series for 99 countries show that globalization indeed leads to increased inequality, and this, in turn, leads to a deteriorating public health performance. In only 19 of the surveyed 99 nations with complete data (i.e., 19.1%), globalization actually preceded an improvement in the public health performance. Far from falsifying globalization critical research, our analyses show the basic weaknesses of the new "pro-globalization" literature in the public health profession. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Trade liberalization and the diet transition: a public health response.

Science.gov (United States)

Rayner, Geof; Hawkes, Corinna; Lang, Tim; Bello, Walden

2006-12-01

Trade liberalization remains at the forefront of debates around globalization, particularly around the impact on agriculture and food. These debates, which often focus on how poorer countries can 'trade their way' out of poverty, pay limited attention to dietary health, especially in the light of the WHO's Global Strategy for Diet, Physical Activity and Health (2004), which warned that future health burdens will be increasingly determined by diet-related chronic diseases. This article examines the diet transition as the absent factor within debates on liberalizing trade and commerce. We describe the evolution of trade agreements, noting those relevant to food. We review the association between trade liberalization and changes in the global dietary and disease profile. We illustrate some of the complex linkages between trade liberalization and the 'diet transition', illustrated by factors such as foreign direct investment, supermarketization and cultural change. Finally, we offer three scenarios for change, suggesting the need for more effective 'food governance' and engagement by public health advocates in policy making in the food and agriculture arena.

Proceedings of the public debate on the general options of management of high and intermediate activity and long-lived radioactive wastes; Compte-rendu du debat public sur les options generales en matiere de gestion des dechets radioactifs de haute activite et de moyenne activite a vie longue

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-01-15

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprised 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is a summary of the main questions tackled during this debate from its preparation to its closing meeting and dealing with: the acceptation of the debate, the progress of the debate, the socio-technical problem of gathering the different points to be debated with respect to the different areas in concern, the general questions about the overall nuclear wastes and materials (radioactivity, health, radioprotection, management, reprocessing, control, actors organization, knowledge sharing, perenniality of the financing), the specific questions about long-lived wastes (inventory, separation-transmutation feasibility, nuclear energy and energy policy, management solutions, storage and geologic disposal feasibility, impact of debates on the 2006 law, long-lived waste territories), the conclusions for the 2006 law: mastering the overall nuclear wastes and materials and step-by-step building up of a solution for long-lived wastes (difficulties, lessons learnt from foreign experience, first draft of the 2006 law). Some opinions expressed by some participants about these proposals conclude

[Targeted public funding for health research in the Netherlands].

Science.gov (United States)

Viergever, Roderik F; Hendriks, Thom C C

2014-01-01

The Dutch government funds health research in several ways. One component of public funding consists of funding programmes issued by the Netherlands Organisation for Health Research and Development (ZonMw). The majority of ZonMw's programmes provide funding for research in specific health research areas. Such targeted funding plays an important role in addressing knowledge gaps and in generating products for which there is a need. Good governance of the allocation of targeted funding for health research requires three elements: a research agenda, an overview of the health research currently being conducted, and a transparent decision-making process regarding the distribution of funds. In this article, we describe how public funding for health research is organized in the Netherlands and how the allocation of targeted funds is governed. By describing the questions that the current model of governance raises, we take a first step towards a debate about the governance of targeted public funding for health research in the Netherlands.

Proceedings of the public debate on the general options of management of high and intermediate activity and long-lived radioactive wastes

International Nuclear Information System (INIS)

2006-01-01

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprised 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is a summary of the main questions tackled during this debate from its preparation to its closing meeting and dealing with: the acceptation of the debate, the progress of the debate, the socio-technical problem of gathering the different points to be debated with respect to the different areas in concern, the general questions about the overall nuclear wastes and materials (radioactivity, health, radioprotection, management, reprocessing, control, actors organization, knowledge sharing, perenniality of the financing), the specific questions about long-lived wastes (inventory, separation-transmutation feasibility, nuclear energy and energy policy, management solutions, storage and geologic disposal feasibility, impact of debates on the 2006 law, long-lived waste territories), the conclusions for the 2006 law: mastering the overall nuclear wastes and materials and step-by-step building up of a solution for long-lived wastes (difficulties, lessons learnt from foreign experience, first draft of the 2006 law). Some opinions expressed by some participants about these proposals conclude

Belgian nuclear forum - launching the public debate on nuclear energy

International Nuclear Information System (INIS)

Leclere, Robert; Van Landeghem, Yves

2010-01-01

In the past decades, public opinion on nuclear power was dominated by a 'sleeping', indifferent majority. Nothing moved until (a minority of) opponents began to stir. Their activism strongly contrasted with the low-profile attitude of the nuclear players and pushed a considerable part of the indifferent majority towards a more negative attitude. A 2007 opinion poll (IFOP) confirmed this trend. The poll also revealed a major lack of objective and factual information. Incorrect and incomplete arguments tended to demonize nuclear energy, and 'nuclear' became a brand polarizing public opinion. This had a negative impact on decision-makers and culminated in the Belgian phase-out law of 2003. Based on the opinion poll, the members of the Belgian Nuclear Forum decided to launch a public information campaign, which they would jointly finance, with these goals: - In 3 to 4 years time, create greater public awareness on energy matters and move public opinion towards a more positive attitude. - Gain recognition of nuclear energy's legitimate place in the mix, and of the importance of peaceful nuclear applications. - Attract attention to the Belgian know-how and the importance of the industry on the scientific and economical level. - Optimize conditions for important nuclear issues such as long-term operation of NPPs, new nuclear research projects (MYRRHA),.. A 'push-pull' approach was adopted: push communication to the public (campaign) to pull (involve) decision-makers and get nuclear back on the political agenda. The Forum also opted for a sustained, long-term effort based on public campaigning, public relations and public affairs. Considering its long-time absence from the public debate, the Forum and its agency Saatchi and Saatchi agreed upon the following principles to underpin the campaign: - No 'pro-campaign'; that would be highly unrealistic and have a negative effect; - No taboos: bring up both the pros and cons; - No emotions: bring reason into a mainly emotional

Project of a radioactive waste deep reversible disposal centre in Meuse / Haute-Marne (Cigeo) - From May 15 to December 15 2013. Report established by the Chairman of the public debate specific commission. Assessment of the public debate. Project of a radioactive waste deep reversible disposal centre in Meuse / Haute-Marne (Cigeo) - From May 15 to December 15 2013, elaborated by the Chairman of the national public debate Commission

International Nuclear Information System (INIS)

Leyrit, Christian

2014-01-01

After a recall of the French legal background for a public debate as a general issue and, more specifically, for a sustainable management of radioactive materials and wastes, the first report describes the preparation, process and context of the public debate about the Cigeo project. Then, it discusses lessons learned from this debate on various issues (types of wastes, ethical aspects, project safety and reversibility, transports, local transformations and land planning, costs and funding, decision process and governance). The second report proposes an assessment of this public debate, and thus discusses and comments the debate content regarding these issues. It briefly presents the Cigeo project, outlines some difficulties faced during the debate, notably about the agenda, indicates measures implemented in 2013 to change the debate approach. It discusses the division between those in favour and those against this deep deposit project, outlines the importance given by the public to the types of wastes which are to processed in Cigeo, the importance of an ethical approach (by taking future generations into consideration, maintaining a site memory, considering funding, research and communication issues), and the concerns related to risk management. Other important concerns deal with reversibility and parcel retrievability, transport safety, the unknown costs and funding, impacts on the area, and a governance reform

A Proposed Collaboration Against Big Tobacco: Common Ground Between the Vaping and Public Health Community in the United States.

Science.gov (United States)

Wagener, Theodore L; Meier, Ellen; Tackett, Alayna P; Matheny, James D; Pechacek, Terry F

2016-05-01

An unfortunate conflict is underway between the public health community and the vaping community over e-cigarettes' harmfulness or lack thereof. This conflict is made worse by an information vacuum that is being filled by vocal members on both sides of the debate; a perceived lack of credibility of public health officials by those in the vaping community; the tobacco industry's recent involvement in e-cigarettes; and the constant evolution of different styles and types of e-cigarettes. This conflict is avoidable; common ground exists. If both groups rally around what is in their own and the public's best interest-the end of combustible tobacco--all will benefit significantly. If not, the result may be missed opportunities, misguided alliances, and--ultimately-poorer public health. This study brings light to the contentious debate between the vaping and public health communities. It addresses how both sides are responsible for bringing misleading information to the public and vocal leaders on both sides are unknowingly intensifying and polarizing the debate-likely at the expense of public health. It also describes how this conflict is avoidable, and provides a starting point for potential positions of common ground against Big Tobacco. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cultural and Normative Imaginaries in Parliamentary and Public Debates on Social Egg Freezing in Denmark

DEFF Research Database (Denmark)

Herrmann, Janne Rothmar; Kroløkke, Charlotte

Widely known as a global exporter of cryopreserved sperm, Danish women’s eggs follow very different trajectories. This paper identifies the cultural and normative imaginaries, which are expressed in parliamentary and public debates on social egg freezing in Denmark. We use the concept of sociotec......Widely known as a global exporter of cryopreserved sperm, Danish women’s eggs follow very different trajectories. This paper identifies the cultural and normative imaginaries, which are expressed in parliamentary and public debates on social egg freezing in Denmark. We use the concept...... of sociotechnical imaginaries (Jasanoff, 2015) to demonstrate how imaginaries are not merely hoped-for-futures but also embedded within the nexus of cultural, legal, and political milieus. To expound on what imaginaries has shaped the Danish regulation on the cryopreservation of eggs, we trace the bills...... differ or are consistent with the general perception in law, parliamentary, and public debate. Relying on welfare state theory, we discuss why reproduction in the Danish context is seen as a legitimate and appropriate sphere to regulate, while we turn to feminist theorizing to discuss their gendered...

Science and social responsibility in public health.

Science.gov (United States)

Weed, Douglas L; McKeown, Robert E

2003-01-01

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to public health as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession. PMID:14602514

WHO's role in the global health system: what can be learned from global R&D debates?

Science.gov (United States)

Moon, Suerie

2014-02-01

Recent global debates on the research and development (R&D) of health technologies, such as drugs, diagnostics and vaccines, can be seen as a microcosm of discussions on the role of the World Health Organization (WHO) in the global health system more broadly. The global R&D system has come under heightened scrutiny with the publication of a 2012 report by the WHO Consultative Expert Working Group on Research and Development (CEWG), which made a number of recommendations to more equitably meet global health needs. The CEWG report followed a decade-long process of debate at the WHO on the weaknesses of the global R&D system, which include problems of affordability, limited research where market returns are small or uncertain (such as the 'neglected diseases' that predominantly affect the world's poorest), inefficient overlap of research efforts, and overuse of medicines such as antibiotics. The CEWG report called on WHO Member States to develop a global framework to improve monitoring, coordination and financing of R&D efforts through the establishment of a Global Health R&D Observatory and the negotiation of a binding treaty on R&D. While the treaty option has been put on the back-burner for several years, Member States nevertheless agreed at the 2013 World Health Assembly (WHA) on concrete steps towards a global framework. Progress at the 2013 WHA reaffirmed the central role of WHO as a convener, and the WHA's decision to create the Observatory within the WHO Secretariat underscored the organization's role as a source of strategic knowledge in the global health system. However, despite WHO's constitutional mandate as the 'directing and coordinating authority on international health work', in reality it faces major challenges in coordinating autonomous R&D actors such as states, firms and foundations in the global system. Strengthening its ability to do so requires, at a minimum, reforming its financing arrangements to provide it with a greater degree of

Belgian nuclear forum - launching the public debate on nuclear energy

Energy Technology Data Exchange (ETDEWEB)

Leclere, Robert [Belgian Nuclear Forum, Gulledelle, 1200 Brussels (Belgium); Van Landeghem, Yves [Saatchi and Saatchi Belgium, Avenue Rogier, 1030 Brussels (Belgium)

2010-07-01

In the past decades, public opinion on nuclear power was dominated by a 'sleeping', indifferent majority. Nothing moved until (a minority of) opponents began to stir. Their activism strongly contrasted with the low-profile attitude of the nuclear players and pushed a considerable part of the indifferent majority towards a more negative attitude. A 2007 opinion poll (IFOP) confirmed this trend. The poll also revealed a major lack of objective and factual information. Incorrect and incomplete arguments tended to demonize nuclear energy, and 'nuclear' became a brand polarizing public opinion. This had a negative impact on decision-makers and culminated in the Belgian phase-out law of 2003. Based on the opinion poll, the members of the Belgian Nuclear Forum decided to launch a public information campaign, which they would jointly finance, with these goals: - In 3 to 4 years time, create greater public awareness on energy matters and move public opinion towards a more positive attitude. - Gain recognition of nuclear energy's legitimate place in the mix, and of the importance of peaceful nuclear applications. - Attract attention to the Belgian know-how and the importance of the industry on the scientific and economical level. - Optimize conditions for important nuclear issues such as long-term operation of NPPs, new nuclear research projects (MYRRHA),.. A 'push-pull' approach was adopted: push communication to the public (campaign) to pull (involve) decision-makers and get nuclear back on the political agenda. The Forum also opted for a sustained, long-term effort based on public campaigning, public relations and public affairs. Considering its long-time absence from the public debate, the Forum and its agency Saatchi and Saatchi agreed upon the following principles to underpin the campaign: - No 'pro-campaign'; that would be highly unrealistic and have a negative effect; - No taboos: bring up both the pros and cons; - No

Liking the pieces, not the package: contradictions in public opinion during health reform.

Science.gov (United States)

Brodie, Mollyann; Altman, Drew; Deane, Claudia; Buscho, Sasha; Hamel, Elizabeth

2010-06-01

Public opinion played a prominent role during the recent health care reform debate. Critics of reform pointed to poll results as evidence that a majority of Americans opposed sweeping changes. Supporters cited polls showing that people favored many specific aspects of the legislation. A closer examination of past and present polling shows that opinion tracked with historic patterns and was relatively stable, even if the contentious public debate suggested a volatile public mood in 2009 and 2010. Going forward, the public will begin reacting to reform implementation, primarily by judging it in terms of their perceptions of and experiences with what the new law does and does not do for people. These opinions could in turn influence implementation or future legislation.

Debating death: religion, politics, and the Oregon Death With Dignity Act.

Science.gov (United States)

Purvis, Taylor E

2012-06-01

In 1994, Oregon passed the Oregon Death With Dignity Act, becoming the first state in the nation to allow physician-assisted suicide (PAS). This paper compares the public discussion that occurred in 1994 and during the Act's implementation in 1997 and examines these debates in relation to health care reform under the Obama administration. I argue that the 1994 and 1997 Oregon PAS campaigns and the ensuing public debate represent the culmination of a growing lack of deference to medical authority, concerns with the doctor-patient relationship, and a desire for increased patient autonomy over decisions during death. The public debate over PAS in Oregon underscored the conflicts among competing religious, political, and personal interests. More visible and widespread than any other American debate on PAS, the conflict in Oregon marked the beginning of the now nationwide problem of determining if and when a terminally ill person can choose to die.

Medicine and public health in a multiethnic world.

Science.gov (United States)

Bhopal, Raj

2009-09-01

Achievement of medical and public health goals requires mutual understanding between professionals and the public, a challenge in diverse societies. Despite their massive diversity humans belong to one species, with race and ethnicity used to subgroup/classify humans and manage diversity. Classifications are contextual and vary by time, place and classifier. As classifications show major variations in health status, and risk factors, research using race and ethnicity has accelerated. Medical sciences, including epidemiology, are learning fast to extract value from such data. Among the debatable issues is the value of the relative risk versus absolute risk approaches (the latter is gaining ground), and how to assess ethnicity and race (self-assignment is favoured in the UK and North America, country of birth in continental Europe). Racial and ethnic variations in disease and risk factors are often large and usually unexplained. There is a compelling case for ethnic monitoring, despite its difficulties, for tackling inequalities and as a foundation for research. Medical and public health goals require good data collected in a racism-free social environment. Health professionals need to find the benefits of exploring differences while avoiding social division. Advances in health care, public health and medical science will follow.

Representation or reason: consulting the public on the ethics of health policy.

Science.gov (United States)

Mullen, Caroline

2008-12-01

Consulting the public about the ethical approaches underlying health policies can seem an appealing means of addressing concerns about limited public participation in development of health policy. However ambiguity surrounds questions of whether, or how consultation can really contribute to more defensible decisions about ethical aspects of policy. This paper clarifies the role and limits of public consultation on ethics, beginning by separating different senses of defensibility in decisions on ethics. Defensibility of ethical decisions could be understood either in the sense of legitimacy in virtue of reflecting the opinions of the public whose interests are affected, or in the sense of being able to withstand and respond to challenges presented in ethical debate. The question then is whether there are forms of consultation which have the potential to realise more defensible decisions in either of these senses. Problems of adequately accounting for the views of those affected by policy decisions casts doubt on the plausibility of using consultation as a means of determining the opinions of the public. Consultation can have a role by bringing new ideas and challenges to debate, although it is uncertain whether this will increase the defensibility of any decision on ethics.

Violence in Mexico: A social or public health problem?

Science.gov (United States)

Casas Patiño, Donovan; Rodríguez Torres, Alejandra; Salazar Morales, Mario Rodolfo

2016-03-08

This article seeks to explain the importance of violence as a social phenomenon and public health, trying to envision this issue not only from a curative approach to health, but from the social determinants of health, such as economics, politics and the administration of justice. Here, the younger population lacks real opportunities with an “absent State” that fails to provide structure. These frameworks play a fundamental role in the manifestation of violence. Thus, the debate for addressing and resolving violence opens the way to new perspectives regarding social factors as part of a public health, which cannot be oblivious to the state of the collective. Thus, the analysis of this situation shows that we cannot keep overlooking the whole picture of the real problem in the social health of our world instead of focusing on its discordant parts.

Public opinion and the politics of the killer robots debate

Directory of Open Access Journals (Sweden)

Michael C Horowitz

2016-02-01

Full Text Available The possibility that today’s drones could become tomorrow’s killer robots has attracted the attention of people around the world. Scientists and business leaders, from Stephen Hawking to Elon Musk, recently signed a letter urging the world to ban autonomous weapons. Part of the argument against these systems is that they violate the public conscience provision of the Martens Clause due to public opposition, making them illegal under international law. What, however, does the US public think of these systems? Existing research suggests widespread US public opposition, but focused on support for autonomous weapons in a vacuum. This paper uses two survey experiments to test the conditions in which public opposition rises and falls. The results demonstrate that public opposition to autonomous weapons is contextual. Fear of other countries or non-state actors developing these weapons makes the public significantly more supportive of developing them. The public also becomes much more willing to actually use autonomous weapons when their use would protect US forces. Beyond contributing to ongoing academic debates about casualty aversion, the microfoundations of foreign policy, and weapon systems, these results suggest the need for modesty when making claims about how the public views new, unknown technologies such as autonomous weapons.

The nuclear industry and public hearings; L'industrie nucleaire et le debat public

Energy Technology Data Exchange (ETDEWEB)

Mansillon, Y. [Commission Nationale du Debat Public, 75 - Paris (France)

2007-02-15

Major decisions about the French nuclear industry have been made, it is often said, without sufficiently informing and consulting the population. Laws in 1995 and 2002 provide for public hearings in order to inform the public and obtain its reactions to big projects of national interest. The responsibility for organizing a hearing is vested in an independent administrative authority, the National Commission of Public Debate (CNDP). Within 2 years, 5 issues related to the nuclear industry have been referred to it: 1) the ITER project at Cadarache in april 2003, 2) the George-Besse-II project to replace the present uranium enrichment plant at Tricastin in april 2004, 3) the research reactor Jules-Horowitz project at Cadarache in july 2004, 4) the EPR project at Flamanville in november 2004, and 5) the management of radioactive wastes in february 2005. The hearings already represent a fundamental innovation compared with earlier practices.

Draft Public Health Statement on the U.S.-Central American Free Trade Agreement (CAFTA).

Science.gov (United States)

2004-01-01

The U.S. is rapidly negotiating a raft of new regional and bilateral trade agreements. The most recent agreement, with Central America, [was to] come before Congress for a vote as soon as late May. There is growing concern that international trade agreements threaten health care and the health of communities. . . . The Draft Public Health Statement on the U.S.-Central American Free Trade Agreement (CAFTA), developed by CPATH which planned a campaign around the issues, analyzes key provisions from the perspective of public health and suggests reframing the trade debate in terms of health.

Utilization of debate as an educational tool to learn health economics for dental students in Malaysia.

Science.gov (United States)

Khan, Saad A; Omar, Hanan; Babar, Muneer Gohar; Toh, Chooi G

2012-12-01

Health economics, a special branch of science applying economic principles to the health delivery system, is a relatively young subdiscipline. The literature is scanty about teaching health economics in the medical and dental fields. Delivery methods of this topic vary from one university to another, with lectures, seminars, and independent learning reported as teaching/learning tools used for the topic. Ideally, debates should foster the development of logical reasoning and communication skills. Health economics in dentistry is taught under the community oral health module that constitutes part of an outcome-based dental curriculum in a private dental school in Kuala Lumpur, Malaysia. For this study, the students were divided into two groups: active participants (active debaters) and supporting participants (nonactive debaters). The debate style chosen for this activity was parliamentary style. Active and nonactive debaters' perceptions were evaluated before and after the activity through a structured questionnaire using a five-point rating scale addressing the topic and perceptions about debate as an educational tool. Cronbach's alpha coefficient was used as a measure of internal consistency for the questionnaire items. Among a total of eighty-two third-year dental students of two successive cohorts (thirty-eight students and forty-four students), seventy-three completed the questionnaire, yielding a response rate of 89 percent. Students' responses to the questionnaire were analyzed with the Kruskal-Wallis analysis of variance test. Results revealed that the students felt that their interest in debate, knowledge of the topic, and reinforcement of the previous knowledge had improved following participation in the debate. Within the limitations of this study, it can be concluded that debate was a useful tool in teaching health economics to dental students.

[International cooperation at Public Health: proposals to a debate].

Science.gov (United States)

Loyola, Maria Andréa; Corrêa, Marilena Cordeiro Dias Villela; Guimarães, Eduardo Ribas De Biase

2010-07-01

In the available literature, there is no study devoted to international cooperation in public health. This paper aims to partly fill this gap, raising and examining the state of art in this area as well as how it interferes in the evaluation of post-graduate programs. The study used secondary data available at CAPES "Indicators Journals", during the years of 1998 to 2006. It also analyzes foreign scholarships and special programs of cooperation of CAPES from 2005 to 2009 through a quantitative descriptive methodology. It shows that international cooperation in the area is relatively developed in a variety of themes and diverse partnerships, focusing in the United States. It is observed a positive correlation between the number of international cooperation and a high-concept program into the evaluation of CAPES, the last triennium of evaluation. The sub-areas where there is more cooperation are, in order: epidemiology; planning, and others. There is a variety of institutions, themes and subareas involved in international cooperation that could be a positive indicator in the evaluation, but as far as was possible to infer, no significant correlation in this direction was found.

Working for the public health: politics, localism and epistemologies of practice.

Science.gov (United States)

Phillips, Gemma; Green, Judith

2015-05-01

The recent move of public health back to English local government has reignited debates about the role of a medicalised public health profession. The explicit policy rationale for the move was that local government is the arena in which the social determinants of health can be addressed, and that public health specialists could provide neutral evidence to support action on these. However, if a discourse of 'evidence-based' policy is in principle (if not practice) relatively unproblematic within the health arena, within the more overtly politicised local government space, rather different policy imperatives come to the fore. Responding to calls for research on evidence in practice, this article draws on ethnographic data of local authorities in the first year of the reorganised public health function. Focusing on alcohol policy, we explore how decisions that affect public health are rationalised and enacted through discourses of localism, empiricism and holism. These frame policy outcomes as inevitably plural and contingent: a framing which sits uneasily with normative discourses of evidence-based policy. We argue that locating public health in local government necessitates a refocusing of how evidence for public health is conceptualised, to incorporate multiple, and political, understandings of health and wellbeing. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Use of 'eradication' in HIV cure-related research: a public health debate.

Science.gov (United States)

Dubé, Karine; Luter, Stuart; Lesnar, Breanne; Newton, Luke; Galea, Jerome; Brown, Brandon; Gianella, Sara

2018-02-13

The landscape of Human Immunodeficiency Virus (HIV) research has changed drastically over the past three decades. With the remarkable success of antiretroviral treatment (ART) in decreasing AIDS-related mortality, some researchers have shifted their HIV research focus from treatment to cure research. The HIV cure research community often uses the term eradication to describe the science, and talks about eradicating the virus from the body. In public discourse, the term eradication could be conflated with disease eradication at the population level. In this paper, we call for a reframing of HIV cure research as control, as it is a more accurate descriptor and achievable goal in the foreseeable future. The properties of HIV are discordant with eradicability standards at both the individual level (as a clinical concept), and at the population level (as a public health concept). At the individual level, true eradication would necessitate absolute elimination of all latent HIV reservoirs from the body. Current HIV cure-related research strategies have proven unsuccessful at accurately quantifying, let alone eliminating these reservoirs. At the population level, eradication implies the permanent global reduction of HIV to zero new cases and to zero risk for future cases. Given the absence of an efficacious HIV vaccine and the impracticality and unethicality of eliminating animal reservoirs, global eradication of HIV is highly implausible. From a public health perspective, HIV eradication remains an elusive goal. The term 'eradication' is a misleading description of current HIV cure-related research. Instead, we call for the use of more realistic expressions such as 'sustained virologic HIV suppression (or control)' or 'management of HIV persistence' to describe HIV cure-related research. Using these terms reorients what HIV cure science can potentially achieve in the near future and avoids creating unrealistic expectations, particularly among the millions of people

It's no debate, debates are great.

Science.gov (United States)

Dy-Boarman, Eliza A; Nisly, Sarah A; Costello, Tracy J

A debate can be a pedagogical method used to instill essential functions in pharmacy students. This non-traditional teaching method may help to further develop a number of skills that are highlighted in the current Accreditation Council for Pharmacy Education Standards 2016 and Center for the Advancement of Pharmacy Education Educational Outcomes 2013. Debates have also been used as an educational tool in other health disciplines. Current pharmacy literature does illustrate the use of debates in various areas within the pharmacy curriculum in both required and elective courses; however, the current body of literature would suggest that debates are an underutilized teaching tool in pharmacy experiential education. With all potential benefits of debates as a teaching tool, pharmacy experiential preceptors should further explore their use in the experiential setting. Copyright © 2017 Elsevier Inc. All rights reserved.

[A Parliament debate regarding a scientific study].

Science.gov (United States)

Cervino, Marco; Mangia, Cristina; Gianicolo, Emilio Antonio Luca

2015-01-01

Publishing studies on the relationship between health and pollution provokes reactions and interest in the public opinion involved, the highest national institutions included. This commentary, aroused by a parliamentary debate, which also concerned one of our recent scientific papers published on Environmental Research about the association between congenital anomalies and maternal exposure to atmospheric pollutants in Brindisi (Apulia Region, Southern Italy), aims at contributing to reply the following questions: the type and quality of the data used in the estimates of exposure must be certified by institutional bodies? Adverse health effects in people exposed to pollutants at levels below the law limits can be excluded? Finally, we draw some remarks on measures to protect public health and on the relationship between the work of the researchers of public institutes and administrations.

Nanny or steward? The role of government in public health.

Science.gov (United States)

Jochelson, Karen

2006-12-01

The past year has witnessed contentious debates about public health in England around smoking bans, alcohol licencing, food labelling and junk food advertising. Some people argue that any government intervention in these areas is 'nanny statist'--an unnecessary intrusion into people's lives and what they do, eat and drink. Others argue that only the state can alter the environment that shapes people's decisions and behaviour. This paper suggests that there is a strong argument to be made for government intervention to safeguard public health. Legislation brings about changes that individuals on their own cannot, and sets new standards for the public good. Rather than condemning such activity as 'nanny statist', it might be more appropriate to view it as a form of 'stewardship'. The paper draws on international evidence about alcohol use, smoking and road safety to show how taxation, advertising bans, regulations proscribing behaviour and education create a public health framework and shape individual choices towards healthier and safer behaviour.

Testing the Flat World Thesis: Using a Public Dataset to Engage Students in the Global Inequality Debate

Science.gov (United States)

Arabandi, Bhavani; Sweet, Stephen; Swords, Alicia

2014-01-01

We present a learning module to engage students in the global inequality debate using Google Public Data World Development Indicators. Goals of this article are to articulate the importance and urgency of teaching global issues to American students; situate the central debate in the globalization literature, paying particular attention to global…

Television sex education panics? An analysis of three public debates in The Netherlands

NARCIS (Netherlands)

A.E. Mols (Anouk)

2016-01-01

textabstractIn 2013, television sex education show Dokter Corrie instigated a heated public debate in the Netherlands. This study places the Dokter Corrie uproar in a broader perspective and identifies the moral dimensions in the reactions to three Dutch television sex education shows: Open en Bloot

Can food be addictive? Public health and policy implications.

Science.gov (United States)

Gearhardt, Ashley N; Grilo, Carlos M; DiLeone, Ralph J; Brownell, Kelly D; Potenza, Marc N

2011-07-01

Data suggest that hyperpalatable foods may be capable of triggering an addictive process. Although the addictive potential of foods continues to be debated, important lessons learned in reducing the health and economic consequences of drug addiction may be especially useful in combating food-related problems. In the current paper, we review the potential application of policy and public health approaches that have been effective in reducing the impact of addictive substances to food-related problems. Corporate responsibility, public health approaches, environmental change and global efforts all warrant strong consideration in reducing obesity and diet-related disease. Although there exist important differences between foods and addictive drugs, ignoring analogous neural and behavioral effects of foods and drugs of abuse may result in increased food-related disease and associated social and economic burdens. Public health interventions that have been effective in reducing the impact of addictive drugs may have a role in targeting obesity and related diseases. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

[Forum: legitimacy, expansion, and sustainability of Social and Human Sciences in Public Health. Introduction].

Science.gov (United States)

Deslandes, Suely Ferreira

2012-12-01

The Forum debates current trends and challenges for teaching and research in this subfield and the prevailing criteria for evaluation of its academic output. The authors wager on the hypothesis that we are currently experiencing a clash between the consolidation of Social and Human Sciences in Public Health (with a well-defined identity, undeniable vigor in their research and proposals, and an important number of practitioners) and a bottleneck in training processes and iniquity and inadequacy in the institutional mechanisms for recognition of merit. The Forum presents four articles. The first, by Minayo, discusses the basic forms of knowledge for this training and those needed to analyze contemporary challenges in a globalized world, besides debating the interfaces and mediations between the biological and the social in a teaching proposal. The second, by Trad, provides a current portrait of the subfield's output. The third, by Deslandes & Iriart, presents theoretical and methodological trends in recently published studies, identifying their gaps and characteristics. Bosi, author of the fourth article, fuels the debate on the criteria for evaluation of academic output in the field and analyzes their consequences. The Postscript, by Nunes, reclaims and updates the debate on the construction of identities in the social and Human Sciences in Public Health.

Cancer registration, public health and the reform of the European data protection framework: Abandoning or improving European public health research?

Science.gov (United States)

Andersen, Mette Rye; Storm, Hans H

2015-06-01

The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in

Alcohol industry influence on UK alcohol policy: A new research agenda for public health.

Science.gov (United States)

Hawkins, Benjamin; Holden, Chris; McCambridge, Jim

2012-09-01

The British government has been criticised for according industry interests too much weight in alcohol policy-making. Consequently, it has been argued that alcohol strategy in the UK is built around policies for which the evidence base is weak. This has clear implications for public health. The purpose of this commentary is to map recent developments in UK alcohol policy and related debates within the alcohol policy literature, thus laying the foundations for a systematic examination of the influence of the alcohol industry on alcohol policy. It highlights the changing structure of the industry and summarises what is known about the positions and strategies of industry actors towards alcohol policy. In so doing, it aims to contribute not just to debates about alcohol policy, but to a broader understanding of health policy processes and the relationships between government and other stakeholders. It advances a new research agenda focused on the role of corporate actors in the field of alcohol policy and public health more broadly.

"Managed competition" for Ireland? The single versus multiple payer debate.

LENUS (Irish Health Repository)

Mikkers, Misja

2014-09-01

A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.

'Taking public health out of the ghetto': the policy and practice of multi-disciplinary public health in the United Kingdom.

Science.gov (United States)

Evans, David

2003-09-01

Until recently, a medical qualification was required for senior public health posts in the UK National Health Service. Since 1997, the new Labour government has expressed its intention to take public health 'out of the ghetto' and to develop multi-disciplinary public health. In particular, it has announced the creation of a new senior professional role of specialist in public health equivalent to the consultant in public health medicine, and open to a range of disciplines. This paper asks 'what is really going on with the policy and practice of multi-disciplinary public health in the UK?' The answer draws on recent debates in the sociology of the professions, in particular the theoretical perspectives of Freidson (Profession of Medicine: a Study of the Sociology of Applied Knowledge, Dodd, Mead & Co, New York, 1970; Professional Powers: a Study of the Institutionalization of Formal Knowledge, University of Chicago Press, Chicago, 1986) and Larson (The Rise of Professionalism: a Sociological Analysis, University of California Press, Berkeley, 1977) concerning the 'professional project', Foucault's (Ideol. Consciousness 6 (1979) 5) notion of 'governmentality' and Harrison and Wood's (Public Admin. 77 (1999) 751) concept of 'manipulated emergence'. Key characteristics of the professional project are 'autonomy', the profession's ability to control its technical knowledge and application, and 'dominance', control over the work of others in the health care division of labour. Although useful as an explanatory framework for the period 1972-1997, the concept of the professional project does not easily explain the process of change since 1997. Here Foucault's concept of governmentality is helpful. Governmentality entails all those procedures, techniques, mechanisms, institutions and knowledges that empower political programmes. Professions are part of the process of governmentality, and their autonomy is always contingent upon the wider political context. Thus public health

GENETICALLY MODIFIED FOOD CROPS AND PUBLIC HEALTH

Directory of Open Access Journals (Sweden)

Alejandro Chaparro Giraldo

2008-09-01

Full Text Available The progress made in plant biotechnology has provided an opportunity to new food crops being developed having desirable traits for improving crop yield, reducing the use of agrochemicals and adding nutritional properties to staple crops. However, genetically modified (GM crops have become a subject of intense debate in which opponents argue that GM crops represent a threat to individual freedom, the environment, public health and traditional economies. Despite the advances in food crop agriculture, the current world situation is still characterised by massive hunger and chronic malnutrition, representing a major public health problem. Biofortified GM crops have been considered an important and complementary strategy for delivering naturally-fortified staple foods to malnourished populations. Expert advice and public concern have led to designing strategies for assessing the potential risks involved in cultivating and consuming GM crops. The present critical review was aimed at expressing some conflicting points of view about the potential risks of GM crops for public health. It was concluded that GM food crops are no more risky than those genetically modified by conventional methods and that these GM crops might contribute towards reducing the amount of malnourished people around the world. However, all this needs to be complemented by effective political action aimed at increasing the income of people living below the poverty-line.

Status of the public debate on the general options of management of high and intermediate activity and long-lived radioactive wastes; Bilan du debat public sur les options generales en matiere de gestion des dechets radioactifs de haute activite et de moyenne activite a vie longue

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-01-15

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprised 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is a status of the general organisation and progress of the debate from its preparing to its end in mid-January 2006. It shows the challenges the CNDP had to take up to treat the scientifical and technical questions in an accessible way, allowing the participation and the hearing of the large public. A status is made of the deception and satisfaction of the public. A lack of confidence in public authorities and scientists has been expressed several times. No pro-nuclear/anti-nuclear shock has occurred and the debate has revealed a remarkable richness in its content. One contribution of the debate to the future project of law is its enlargement to the overall nuclear wastes and valorizable materials and not only to the high/intermediate-level and long-lived wastes. (J.S.)

An NTSB for health care: learning from innovation: debate and innovate or capitulate.

Science.gov (United States)

Denham, Charles R; Sullenberger, Chesley B; Quaid, Dennis W; Nance, John J

2012-03-01

Economic and medical risks threaten the national security of America. The spiraling costs of United States' avoidable healthcare harm and waste far exceed those of any other nation. This 2-part paper, written by a group of aviators, is a national call to action to adopt readily available and transferable safety innovations we have already paid for that have made the airline industry one of the safest in the world. This first part supports the debate for a National Transportation Safety Board (NTSB) for health care, and the second supports more cross-over adoption by hospitals of methods pioneered in aviation. A review of aviation and healthcare leadership best practices and technologies was undertaken through literature review, reporting body research, and interviews of experts in the field of aviation principles applied to medicine. An aviation cross-over inventory and consensus process led to a call for action to address the current crisis of healthcare waste and harm. The NTSB, an independent agency established by the United States Congress, was developed to investigate all significant transportation accidents to prevent recurrence. Certain NTSB publications known as "Blue Cover Reports" used by pilots and airlines to drive safety provide a model that could be emulated for hospital accidents. An NTSB-type organization for health care could greatly improve healthcare safety at low cost and great benefit. A "Red Cover Report" for health care could save lives, save money, and bring value to communities. A call to action is made in this first paper to debate this opportunity for an NTSB for health care. A second follow-on paper is a call to action of healthcare suppliers, providers, and purchasers to reinvigorate their adoption of aviation best practices as the market transitions from a fragmented provider-volume-centered to an integrated patient-value-centered world.

Status of the public debate on the general options of management of high and intermediate activity and long-lived radioactive wastes

International Nuclear Information System (INIS)

2006-01-01

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprised 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is a status of the general organisation and progress of the debate from its preparing to its end in mid-January 2006. It shows the challenges the CNDP had to take up to treat the scientifical and technical questions in an accessible way, allowing the participation and the hearing of the large public. A status is made of the deception and satisfaction of the public. A lack of confidence in public authorities and scientists has been expressed several times. No pro-nuclear/anti-nuclear shock has occurred and the debate has revealed a remarkable richness in its content. One contribution of the debate to the future project of law is its enlargement to the overall nuclear wastes and valorizable materials and not only to the high/intermediate-level and long-lived wastes. (J.S.)

Ethical issues in predictive genetic testing: a public health perspective.

Science.gov (United States)

Fulda, K G; Lykens, K

2006-03-01

As a result of the increase in genetic testing and the fear of discrimination by insurance companies, employers, and society as a result of genetic testing, the disciplines of ethics, public health, and genetics have converged. Whether relatives of someone with a positive predictive genetic test should be notified of the results and risks is a matter urgently in need of debate. Such a debate must encompass the moral and ethical obligations of the diagnosing physician and the patient. The decision to inform or not will vary depending on what moral theory is used. Utilising the utilitarian and libertarian theories produces different outcomes. The principles of justice and non-maleficence will also play an important role in the decision.

Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000-09.

Science.gov (United States)

Bradley, Elizabeth H; Canavan, Maureen; Rogan, Erika; Talbert-Slagle, Kristina; Ndumele, Chima; Taylor, Lauren; Curry, Leslie A

2016-05-01

Although spending rates on health care and social services vary substantially across the states, little is known about the possible association between variation in state-level health outcomes and the allocation of state spending between health care and social services. To estimate that association, we used state-level repeated measures multivariable modeling for the period 2000-09, with region and time fixed effects adjusted for total spending and state demographic and economic characteristics and with one- and two-year lags. We found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes. Our study suggests that broadening the debate beyond what should be spent on health care to include what should be invested in health-not only in health care but also in social services and public health-is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

Is violence a disease? Situating violence prevention in public health policy and practice.

Science.gov (United States)

Williams, D J; Donnelly, P D

2014-11-01

The paper provides a review of some of the thoughts, ideas, and opinions that pervade the public health literature concerning how to classify or conceptualise violence. It is argued that violence transcends classic distinctions between communicable and non-communicable diseases, distinguishes itself from the discipline of injury control, and is influenced by wider, social determinants. Through a discussion of these varied perspectives it is concluded that a fourth revolution in public health is needed - a 'change in scope' revolution - that recognizes the influence of social justice, economics, and globalization in the aetiology of premature death and ill health, into which violence fits. However, rather than be shackled by debates of definition or classification, it is important that public health acknowledges the role it can play in preventing violence through policy and practice, and takes unified action. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development.

Science.gov (United States)

Mereu, Alessandra; Sotgiu, Alessandra; Buja, Alessandra; Casuccio, Alessandra; Cecconi, Rosaria; Fabiani, Leila; Guberti, Emilia; Lorini, Chiara; Minelli, Liliana; Pocetta, Giancarlo; Contu, Paolo

2015-01-01

According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.

Cultural and Normative Imaginaries in Parliamentary and Public Debates on Social Egg Freezing in Denmark

DEFF Research Database (Denmark)

Herrmann, Janne Rothmar; Kroløkke, Charlotte

Widely known as a global exporter of cryopreserved sperm, Danish women’s eggs follow very different trajectories. This paper identifies the cultural and normative imaginaries, which are expressed in parliamentary and public debates on social egg freezing in Denmark. We use the concept...... of sociotechnical imaginaries (Jasanoff, 2015) to demonstrate how imaginaries are not merely hoped-for-futures but also embedded within the nexus of cultural, legal, and political milieus. To expound on what imaginaries has shaped the Danish regulation on the cryopreservation of eggs, we trace the bills......, their three readings in Parliament and the concurrent public and ethical debates that in time relaxed the legal limit for the cryopreservation of eggs from the initial proposed 1 year limit to the current 5 years and today ignite discussions on elective egg freezing. We then discuss how those imaginaries...

Conceptualising space and place : Lessons from geography for the debate on privacy in public

NARCIS (Netherlands)

Koops, Bert-Jaap; Galic, Masa; Timan, Tjerk; Newell, Bryce; Koops, Bert-Jaap

2017-01-01

This contribution aims to open up the rich literature on the conceptualisation of space and place, primarily from the field of geography, for scholars in other disciplines, in particular legal and governance scholars engaged in the debate on (the right to) privacy in public spaces. Although there is

International trade versus public health during the FCTC negotiations, 1999-2003.

Science.gov (United States)

Mamudu, Hadii M; Hammond, Ross; Glantz, Stanton A

2011-01-01

To examine why the Framework Convention on Tobacco Control did not include an explicit trade provision and delineate the central arguments in the debate over trade provision during the negotiations. Triangulate interviews with participants in the FCTC negotiations, the FCTC negotiations documents, and tobacco industry documents. An explicit FCTC trade provision on relation between international trade and public health became a contentious issue during the negotiations. As a result, two conflicting positions, health-over-trade and opposition to health-over-trade emerged. Opposition to explicit trade language giving health priority was by both tobacco industry and countries that generally supported strong FCTC provisions because of concerns over 'disguised protectionism' and setting a precedent whereby governments could forfeit their obligations under pre-existing treaties. Owing to lack of consensus among political actors involved in the negotiations, a compromise position eliminating any mention of trade emerged, which was predicated on belief among some in the public health community that public health would prevail in future trade versus health conflicts. The absence of an explicit FCTC trade provision was due to a political compromise rather than the impact of international trade agreements and decisions on public health and lack of consensus among health advocates. This failure to include an explicit trade provision in the FCTC suggests that the public health community should become more involved in trade and health issues at all levels of governance and press the FCTC Conference of the Parties for clarification of this critical issue.

ANCLI: white papers. Major contribution to public debate in France on nuclear waste policy

International Nuclear Information System (INIS)

Sene, M.

2006-01-01

Local Information Commissions (CLI) were first set up in autumn 1981 following the 'Mauroy circular' sent out by then Prime Minister, Pierre Mauroy. To date (2006), 30 CLIs have been set up. The status and funding for these CLIs have lacked consistency, subject to the good will of the political authorities. However, since being set up, the value of these commissions has become more and more apparent: the French now have somewhere where they can express their opinions. It is for this reason that, for almost ten years, the CLIs have called for a legislative framework in recognition of their existence: this has now been achieved, under the provisions of the Nuclear Transparency and Safety Act passed on 13 June 2006. It is a shame, however, that this Act does not explicitly recognize the existence of the National Association of Local Information Commissions (ANCLI), set up in 2000 and grouping together 20 CLIs (2006). When two public debates were announced, one on waste management and the other on the European Pressurized Reactor (EPR), ANCLI set up a working group to investigate the subject of 'Local Governance of nuclear sites' and which published its findings in May 2005. Thanks to the extremely positive reaction this Paper received, both on the part of the CLIs and within political circles, ANCLI initiated a study focused more directly on nuclear waste management. This working group's research has resulted in the publication of the 'Livre Blanc de l'ANCLI - Matieres et dechets radioactifs/territoires' - ANCLI's White Paper on radioactive materials and waste and local communities (June 2006).This Paper was published after the Act of 28 June 2006 relative to 'National policy on sustainable management of radioactive materials and waste' was passed. Members of the French parliament were informed of the key ideas it contains. This 'White Book' is a contribution to public debate on nuclear waste and on EPR. In a first approach, the ANCLI is not considered as a partner

Public health nihilism vs pragmatism: history, politics, and the control of tuberculosis.

Science.gov (United States)

Fairchild, A L; Oppenheimer, G M

1998-01-01

Tuberculosis (TB) began to decline in the Western world in the mid- to late 1800s. In the United States, the disease receded until the mid-1980s, when that trend was reversed. Although the TB epidemic in the United States subsided in response to public health interventions, it sparked a controversy regarding the relative value of targeted public health measures vs broad social reform. That controversy, which echoed earlier debates calling for structural reform over public health programs, was further strengthened by the historical and demographic studies of Thomas McKeown. His influential thesis maintains that clinical and primary prevention efforts had little effect on TB mortality. In this paper, the historical literature is used to examine whether public health had a significant impact on the decline of TB mortality rates in several countries. Specifically, the paper describes the arguments for and data affirming the efficacy of 2 major public health interventions over time: segregation of those infected with pulmonary TB and eradication of bovine TB. This review finds support for the hypothesis that public health measures, along with other factors, led to falling rates of TB mortality beginning in the late 19th century. Images FIGURE 3 p1112-a p1113-a PMID:9663166

Moving research beyond the spanking debate.

Science.gov (United States)

MacMillan, Harriet L; Mikton, Christopher R

2017-09-01

Despite numerous studies identifying a broad range of harms associated with the use of spanking and other types of physical punishment, debate continues about its use as a form of discipline. In this commentary, we recommend four strategies to move the field forward and beyond the spanking debate including: 1) use of methodological approaches that allow for stronger causal inference; 2) consideration of human rights issues; 3) a focus on understanding the causes of spanking and reasons for its decline in certain countries; and 4) more emphasis on evidence-based approaches to changing social norms to reject spanking as a form of discipline. Physical punishment needs to be recognized as an important public health problem. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Health services research for the public health service (PHS) and the public health system].

Science.gov (United States)

Hollederer, A; Wildner, M

2015-03-01

There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

Farmers' suicide in India: implications for public mental health.

Science.gov (United States)

Das, Anindya

2011-01-01

Farmers' suicide in India is a cause of concern and government figures, though conservative, predict an impending epidemic. Various measures to curb this calamity are being made in a piecemeal manner. Considering it as an issue of social and mental health concern, this article attempts to evaluate the situation based on the tenet that health and illness are the result of a complex interplay between biological, psychological, social, environmental, economic and political factors. Thus in India the agrarian crisis, among other causes, has been largely debated as the major reason for the current state of farmers. It is important that (psychiatric) epidemiology and public mental health try to evolve mechanisms to understand and implement measures, and take this into consideration when attempting health promotion and prevention.

Financiando o SUS: algumas questões para o debate Funding the Brazilian National Health Service (SUS: some issues for the debate

Directory of Open Access Journals (Sweden)

Ruben Araujo de Mattos

2003-09-01

Full Text Available Este debate discute questões relacionadas ao financiamento do Sistema Único de Saúde (SUS. Na primeira parte, Ruben de Mattos defende a criação de dispositivos para a elevação progressiva dos gastos públicos em saúde. Segundo o debatedor, o maior desafio do governo será viabilizar - e sustentar - um sistema que garanta, de fato, o acesso universal e igualitário. Mattos também destaca a importância dos repasses federais entre os níveis de governos, por vê-los como instrumentos capazes de reduzir as desigualdades entre as regiões e incentivar políticas que contribuam para a consolidação do SUS. Na segunda parte, Nilson do Rosário afirma que o ajuste fiscal da década de 1990, conseqüência da política de estabilização monetária, limitou a capacidade de financiamento governamental na atenção à saúde, gerando efeitos perversos devido à ampliação da desigualdade social. A seguir, explica como o setor saúde respondeu às exigências de ajuste macroeconômico nas despesas públicas através de estratégias substitutivas, contexto em que o Programa de Saúde da Família (PSF se expandiu rapidamente, tornando-se estratégico na agenda da ampliação da atenção ambulatorial básica do país.This work discusses some of the issues related to the funding of the Brazilian National Health Service (SUS. In the first part of the paper, Ruben de Mattos advocates the creation of devices to guarantee a progressive increase in the public health budget. In the debater's view, the greatest challenge facing the government is the development - and the maintenance - of a system that can de facto guarantee universal and equalitarian access. Mattos also emphasizes the importance of the federal government's transfers of funds to local governments since the latter are seen as instrumental in the attempts to reduce inequality between regions and to encourage policies that will contribute to the SUS' consolidation. In the second part, Nilson

Paternalism & Its Discontents: Motorcycle Helmet Laws, Libertarian Values, and Public Health

Science.gov (United States)

Jones, Marian Moser; Bayer, Ronald

2007-01-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists’ advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering. PMID:17194856

Public challenge and endorsement of sex category ambiguity in online debate: 'The sooner people stop thinking that gender is a matter of choice the better'.

Science.gov (United States)

Sweeting, Helen; Maycock, Matthew William; Walker, Laura; Hunt, Kate

2017-03-01

Despite academic feminist debate over several decades, the binary nature of sex as a (perhaps the) primary social classification is often taken for granted, as is the assumption that individuals can be unproblematically assigned a biological sex at birth. This article presents analysis of online debate on the BBC news website in November 2013, comprising 864 readers' responses to an article entitled 'Germany allows 'indeterminate' gender at birth'. It explores how discourse reflecting Western essentialist beliefs about people having one sex or 'the other' is maintained in debates conducted in this online public space. Comments were coded thematically and are presented under five sub-headings: overall evaluation of the German law; discussing and disputing statistics and 'facts'; binary categorisations; religion and politics; and 'conversations' and threads. Although for many the mapping of binary sex onto gender was unquestionable, this view was strongly disputed by commentators who questioned the meanings of 'natural' and 'normal', raised the possibility of removing societal binary male-female distinctions or saw maleness-femaleness as a continuum. While recognising that online commentators are anonymous and can control their self-presentation, this animated discussion suggests that social classifications as male or female, even if questioned, remain fundamental in public debate in the early 21 st century. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

The pros and cons of human therapeutic cloning in the public debate.

Science.gov (United States)

Nippert, Irmgard

2002-09-11

Few issues linked to genetic research have raised as much controversial debate as the use of somatic cell nuclear transfer technology to create embryos specifically for stem cell research. Whereas European countries unanimously agree that reproductive cloning should be prohibited there is no agreement to be found on whether or not research into therapeutic cloning should be permitted. Since the UK took the lead and voted in favour of regulations allowing therapeutic cloning the public debate has intensified on the Continent. This debate reflects the wide spectrum of diverse religious and secular moralities that are prevalent in modern multicultural European democratic societies. Arguments range from putting forward strictly utilitarian views that weight the moral issues involved against the potential benefits that embryonic stem cell research may harbour to considering the embryo as a human being, endowed with human dignity and human rights from the moment of its creation, concluding that its use for research is unethical and should be strictly prohibited. Given the current state of dissension among the various European states, it is difficult to predict whether 'non-harmonisation' will prevail or whether in the long run 'harmonisation' of legislation that will allow stem cell research will evolve in the EU.

[Personal genomics: are we debating the right Issues?].

Science.gov (United States)

Vayena, E; Mauch, F

2012-07-25

The debate about personal genomics and their role in personalized medicine has been, to some extent, hijacked by the controversy about commercially available genomic tests sold directly to consumers. The clinical validity and utility of such tests are currently limited and most medical associations recommend that consumers refrain from testing. Conversely, DTC genomics proponents and particularly the DTC industry argue that there is personal utility in acquiring genomic information. While it is necessary to debate risks and benefits of DTC genomics, we should not lose sight of the increasingly important role that genomics will play in medical practice and public health. Therefore, and in anticipation of this shift we also need to focus on important implications from the use of genomics information such as genetic discrimination, privacy protection and equitable access to health care. Undoubtedly, personal genomics will challenge our social norms maybe more than our medicine. Sticking to the polarization of «to have or not to have DTC genomics» risks to takes us away from the critical issues we need to be debating.

CNS members promoting nuclear energy in public debate - an example from Quebec

International Nuclear Information System (INIS)

Franta, J.; Sabourin, G.; Saint-Denis, M.

2006-01-01

For approximately two years, several members of the Quebec branch of the Canadian Nuclear Society have publicly expressed their views in favour of nuclear energy in Quebec. This paper summarizes their participation in the BAPE public hearings on the environment ('Bureau d'Audience Publique sur l'Environnement'), in the hearings of a Quebec Parliamentary Commission on economy and labour, and in the United Nations Conference on Climate Change in December 2005 in Montreal. The focus is mainly on a debate around the possible refurbishment of the Gentilly-2 nuclear power plant, the only operating nuclear plant in Quebec. Antinuclear groups are well organized and their message is transmitted loudly to the public by the mainstream media. Industry professionals must therefore express themselves publicly to counterbalance this biased message. In conclusion, we see a need for the formation of a coalition of all who support nuclear power in Quebec to support the refurbishment of Gentilly-2. (author)

CNS members promoting nuclear energy in public debate - an example from Quebec

Energy Technology Data Exchange (ETDEWEB)

Franta, J.; Sabourin, G.; Saint-Denis, M. [Atomic Energy of Canada Limited, Montreal, Quebec (Canada)

2006-07-01

For approximately two years, several members of the Quebec branch of the Canadian Nuclear Society have publicly expressed their views in favour of nuclear energy in Quebec. This paper summarizes their participation in the BAPE public hearings on the environment ('Bureau d'Audience Publique sur l'Environnement'), in the hearings of a Quebec Parliamentary Commission on economy and labour, and in the United Nations Conference on Climate Change in December 2005 in Montreal. The focus is mainly on a debate around the possible refurbishment of the Gentilly-2 nuclear power plant, the only operating nuclear plant in Quebec. Antinuclear groups are well organized and their message is transmitted loudly to the public by the mainstream media. Industry professionals must therefore express themselves publicly to counterbalance this biased message. In conclusion, we see a need for the formation of a coalition of all who support nuclear power in Quebec to support the refurbishment of Gentilly-2. (author)

Europeanization of National Public Spheres? Cross-National Media Debates about the EU's Socio-Economic Strategy

DEFF Research Database (Denmark)

Porte, Caroline de la; van Dalen, Arjen

2016-01-01

This paper studies the Europeanization of media coverage of the European Union's (EU) socio-economic strategy, which is a crucial building block for developing a European Public Sphere. As the EU level increasingly influences public policy in member states, there should correspondingly be a more...... intense and visible media debate with attention for EU-level and cross-national policies and developments. On the basis of a content analysis (2000–2010) in Denmark, France, Poland and the UK, we find that media attention for the EU's growth and jobs strategy is limited, that it does not increase over...... in terms of benchmarking and reporting on criticism and advice to member states. This criticism is more often diffuse than aimed at specific member states. Therefore, we conclude that media coverage of the EU's socio-economic strategy is Europeanized, but that it remains a debate by and for EU...

[The Danish debate on priority setting in medicine - characteristics and results].

Science.gov (United States)

Pornak, S; Meyer, T; Raspe, H

2011-10-01

Priority setting in medicine helps to achieve a fair and transparent distribution of health-care resources. The German discussion about priority setting is still in its infancy and may benefit from other countries' experiences. This paper aims to analyse the Danish priority setting debate in order to stimulate the German discussion. The methods used are a literature analysis and a document analysis as well as expert interviews. The Danish debate about priority setting in medicine began in the 1970s, when a government committee was constituted to evaluate health-care priorities at the national level. In the 1980s a broader debate arose in politics, ethics, medicine and health economy. The discussions reached a climax in the 1990s, when many local activities - always involving the public - were initiated. Some Danish counties tried to implement priority setting in the daily routine of health care. The Council of Ethics was a major player in the debate of the 1990s and published a detailed statement on priority setting in 1996. With the new century the debate about priority setting seemed to have come to an end, but in 2006 the Technology Council and the Danish Regions resumed the discussion. In 2009 the Medical Association called for a broad debate in order to achieve equity among all patients. The long lasting Danish debate on priority setting has entailed only very little practical consequences on health care. The main problems seem to have been the missing effort to bundle the various local initiatives on a national level and the lack of powerful players to put results of the discussion into practice. Nevertheless, today the attitude towards priority setting is predominantly positive and even politicians talk freely about it. © Georg Thieme Verlag KG Stuttgart · New York.

Ethical issues in predictive genetic testing: a public health perspective

Science.gov (United States)

Fulda, K G; Lykens, K

2006-01-01

As a result of the increase in genetic testing and the fear of discrimination by insurance companies, employers, and society as a result of genetic testing, the disciplines of ethics, public health, and genetics have converged. Whether relatives of someone with a positive predictive genetic test should be notified of the results and risks is a matter urgently in need of debate. Such a debate must encompass the moral and ethical obligations of the diagnosing physician and the patient. The decision to inform or not will vary depending on what moral theory is used. Utilising the utilitarian and libertarian theories produces different outcomes. The principles of justice and non‐maleficence will also play an important role in the decision. PMID:16507657

A path forward in the debate over health impacts of endocrine disrupting chemicals.

Science.gov (United States)

Zoeller, R Thomas; Bergman, Åke; Becher, Georg; Bjerregaard, Poul; Bornman, Riana; Brandt, Ingvar; Iguchi, Taisen; Jobling, Susan; Kidd, Karen A; Kortenkamp, Andreas; Skakkebaek, Niels E; Toppari, Jorma; Vandenberg, Laura N

2014-12-22

Several recent publications reflect debate on the issue of "endocrine disrupting chemicals" (EDCs), indicating that two seemingly mutually exclusive perspectives are being articulated separately and independently. Considering this, a group of scientists with expertise in basic science, medicine and risk assessment reviewed the various aspects of the debate to identify the most significant areas of dispute and to propose a path forward. We identified four areas of debate. The first is about the definitions for terms such as "endocrine disrupting chemical", "adverse effects", and "endocrine system". The second is focused on elements of hormone action including "potency", "endpoints", "timing", "dose" and "thresholds". The third addresses the information needed to establish sufficient evidence of harm. Finally, the fourth focuses on the need to develop and the characteristics of transparent, systematic methods to review the EDC literature. Herein we identify areas of general consensus and propose resolutions for these four areas that would allow the field to move beyond the current and, in our opinion, ineffective debate.

The Use of Social Marketing to Influence the Development of Problem Gambling in the UK: Implications for Public Health

Science.gov (United States)

Powell, Jane E.; Tapp, Alan J.

2009-01-01

In this paper the authors present and debate the theoretical case for the use of social marketing to help reduce problem gambling in the public health context of the UK. Is triangulated between the key theories and principles of social marketing, the key literature and its theoretical application to the debate about reducing problem gambling in…

Public health emergencies and the public health/managed care challenge.

Science.gov (United States)

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Training public health superheroes: five talents for public health leadership.

Science.gov (United States)

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Public Health, Embodied History, and Social Justice: Looking Forward.

Science.gov (United States)

Krieger, Nancy

2015-01-01

This essay was delivered as a commencement address at the University of California-Berkeley School of Public Health on May 17, 2015. Reflecting on events spanning from 1990 to 1999 to 2015, when I gave my first, second, and third commencement talks at the school, I discuss four notable features of our present era and offer five insights for ensuring that health equity be the guiding star to orient us all. The four notable features are: (1) growing recognition of the planetary emergency of global climate change; (2) almost daily headlines about armed conflicts and atrocities; (3) growing public awareness of and debate about epic levels of income and wealth inequalities; and (4) growing activism about police killings and, more broadly, "Black Lives Matter." The five insights are: (1) public health is a public good, not a commodity; (2) the "tragedy of the commons" is a canard; the lack of a common good is what ails us; (3) good science is not enough, and bad science is harmful; (4) good evidence--however vital--is not enough to change the world; and (5) history is vital, because we live our history, embodied. Our goal: a just and sustainable world in which we and every being on this planet may truly thrive. © The Author(s) 2015.

[Public health services between "new public health" and "new public management"].

Science.gov (United States)

Oppen, M

1996-04-01

Today, a substantial reorientation of the Public Health services in the Federal Republic of Germany is broadly seen necessary. Patterns of functional and organisational restructuring of Public Health services on the regional and the communal level are closely linked with concepts of prevention and health promotion. Hence, a number of agencies have already adopted new tasks and functions like comprehensive and transorganizational planning, coordination and evaluation as well as the establishment of new reporting systems. Presently, the transformation process from the bureaucratic mode of administering matters of health to a new Public Health orientation receives new impacts from the international "New Public Management" movement. Comparatively late, with the beginning of the 1990s, a growing number of German municipalities has introduced new concepts of administration. Local government administrations, of which the Public Health services are a part, follow the model of modern service organizations producing services in a more efficient, professionalized and consumer-oriented way. Specific elements of economising modernisation programmes like re-distribution of tasks, de-centralisation, extension of managerial capacities, setting of stimulating working conditions that provide employees with greater independence of action as well as career opportunities, are at the same time prerequisites for innovative strategies of health protection and coordination policies of Public Health services.

A path forward in the debate over health impacts of endocrine disrupting chemicals

DEFF Research Database (Denmark)

Zoeller, Robert T; Bergmann, Åke; Becher, Georg

2014-01-01

Several recent publications reflect debate on the issue of "endocrine disrupting chemicals" (EDCs), indicating that two seemingly mutually exclusive perspectives are being articulated separately and independently. Considering this, a group of scientists with expertise in basic science, medicine...

Fiscal versus social responsibility: how Philip Morris shaped the public funds divestment debate

Science.gov (United States)

Wander, N; Malone, R E

2006-01-01

Calls for institutional investors to divest (sell off) tobacco stocks threaten the industry's share values, publicise its bad behaviour, and label it as a politically unacceptable ally. US tobacco control advocates began urging government investment and pension funds to divest as a matter of responsible social policy in 1990. Following the initiation of Medicaid recovery lawsuits in 1994, advocates highlighted the contradictions between state justice departments suing the industry, and state health departments expanding tobacco control programmes, while state treasurers invested in tobacco companies. Philip Morris (PM), the most exposed US company, led the divestment opposition, consistently framing the issue as one of responsible fiscal policy. It insisted that funds had to be managed for the exclusive interest of beneficiaries, not the public at large, and for high share returns above all. This paper uses tobacco industry documents to show how PM sought to frame both the rhetorical contents and the legal contexts of the divestment debate. While tobacco stock divestment was eventually limited to only seven (but highly visible) states, US advocates focused public attention on the issue in at least 18 others plus various local jurisdictions. This added to ongoing, effective campaigns to denormalise and delegitimise the tobacco industry, dividing it from key allies. Divestment as a delegitimisation tool could have both advantages and disadvantages as a tobacco control strategy in other countries. PMID:16728755

Contesting Risk and Responsibility: European Debates on Food and Agricultural Governance of Avian Influenza

NARCIS (Netherlands)

Krom, de M.P.M.M.; Oosterveer, P.J.M.

2010-01-01

In August 2005, avian influenza entered European public arenas as the next food and agricultural risk. As the virus was detected close to Europe, questions arose whether measures were required to protect human health and secure European food supply. This article analyzes the public debates on the

Leprosy: International Public Health Policies and Public Health Eras

Directory of Open Access Journals (Sweden)

Niyi Awofeso

2011-09-01

Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

Paternalism and its discontents: motorcycle helmet laws, libertarian values, and public health.

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Jones, Marian Moser; Bayer, Ronald

2007-02-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists' advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering.

Drug consumption rooms: Comparing times, spaces and actors in issues of social acceptability in French public debate.

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Jauffret-Roustide, Marie; Cailbault, Isabelle

2018-06-01

In October 2016, the first French drug consumption room (DCR) opened in Paris. We propose to examine the process through which this issue has been framed as a matter of public concern, after being ignored for almost 20 years. Our analysis of the controversy on DCRs investigates how public conversations on harm reduction evolve according to the time period (from the 1990s to the present), scale of discourse (local vs. national), and involved actors (politicians, professionals, local residents, and drug users). Our methodology includes analyses of media content: we reviewed 1735 articles published between 1990 and 2017. Our theoretical approach is in line with the sociology "des épreuves" derived from pragmatic sociology and controversy analysis. This approach goes beyond interactionism by attempting to place situations back into broader sociological realities. We also pay special attention to governance, a political lens that focuses on local aspects of negotiations and on the implication of a variety of actors. While the current debate on DCRs in France draws on constraints and resources already present in the harm reduction debate of the 1980s, it also repositions itself by avoiding moral argumentation and featuring less confrontation in the professional sphere. Today, we can see that the center of this tense debate has shifted from the professional sphere to the political and residential spheres. Most often, residents advance concerns that are not directly related to drug users themselves, but that derive from their apprehension of living in a displaced and stranded neighborhood. The public conversation leaves little room for drug users, even though they are the primary stakeholders of harm reduction and play a crucial role in DCR advocacy. Our work reveals that the controversy about DCR is the product of complex interactions between different kinds of actors harm reduction professionals, political actors at the local and national levels, local residents, and

Freedom of conscience and health care in the United States of america: the conflict between public health and religious liberty in the patient protection and affordable care act.

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West-Oram, Peter

2013-09-01

The recent confirmation of the constitutionality of the Obama administration's Patient Protection and Affordable Care Act (PPACA) by the US Supreme Court has brought to the fore long-standing debates over individual liberty and religious freedom. Advocates of personal liberty are often critical, particularly in the USA, of public health measures which they deem to be overly restrictive of personal choice. In addition to the alleged restrictions of individual freedom of choice when it comes to the question of whether or not to purchase health insurance, opponents to the PPACA also argue that certain requirements of the Act violate the right to freedom of conscience by mandating support for services deemed immoral by religious groups. These issues continue the long running debate surrounding the demands of religious groups for special consideration in the realm of health care provision. In this paper I examine the requirements of the PPACA, and the impacts that religious, and other ideological, exemptions can have on public health, and argue that the exemptions provided for by the PPACA do not in fact impose unreasonable restrictions on religious freedom, but rather concede too much and in so doing endanger public health and some important individual liberties.

Toward understanding the active SETI debate: Insights from risk communication and perception

Science.gov (United States)

Korbitz, Adam

2014-12-01

Insights from the robust field of risk communication and perception have to date been almost totally absent from the policy debate regarding the relative risks and merits of Active SETI or Messaging to Extraterrestrial Intelligence (METI). For many years, the practice (or proposed practice) of Active SETI has generated a vigorous and sometimes heated policy debate within the scientific community. There have also been some negative reactions in the media toward the activities of those engaged in Active SETI. Risk communication is a scientific approach to communication regarding situations involving potentially sensitive or controversial situations in which there may be high public concern and low public trust. The discipline has found wide acceptance and utility in fields such as public health, industrial regulation and environmental protection. Insights from the scientific field of risk communication (such as omission bias, loss aversion, the availability heuristic, probability neglect, and the general human preference for voluntary over involuntary risks) may help those who have participated in either side of the debate over Active SETI to better understand why the debate has taken on this posture. Principles of risk communication and risk perception may also help those engaged in Active SETI to communicate more effectively with other scientists, the public, with the media, and with policy makers regarding their activities and to better understand and respond to concerns expressed regarding the activity.

Health insurance reform: labor versus health perspectives.

Science.gov (United States)

Ammar, Walid; Awar, May

2012-01-01

The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform plan. The Ministry of Public Health (MOPH) considers that health financing should be dealt with as part of a more comprehensive health reform plan that falls under its prerogatives. While a virulent political discussion is taking place, major stakeholders' inputs are very limited and civil society is totally put away from the whole policy making process. The role of the media is restricted to reproducing political disputes, without meaningful substantive debate. This paper discusses health insurance reform from labor market as well as public health perspectives, and aims at launching a serious public debate on this crucial issue that touches the life of every citizen.

The Public Debate about Roads on the National Forest: An Analysis of the News Media

Science.gov (United States)

David N. Bengston; David P. Fan

1999-01-01

Roads and road building on the US national forests have become the focus of intense public debate in recent years. Timber companies and others argued that forest roads are an essential transportation system for the production of commodities that society needs. Environmentalists and others reply that national forest roads constitute ecologically destructive "...

Making the case for a 'fifth wave' in public health.

Science.gov (United States)

Hanlon, P; Carlisle, S; Hannah, M; Reilly, D; Lyon, A

2011-01-01

This paper will argue that the UK has seen several phases of public health improvement since the Industrial Revolution, and that each of these can be linked to major shifts in thinking about the nature of society and health itself. The authors are not, however, attempting to delineate firm sequences of events (or imply causality) as this would require a level of analysis of the relationship between economy, society and culture which is beyond the scope of this paper. Rather, it is suggested that each phase of health improvement can be thought of in metaphorical terms as a 'wave'. The first wave is associated with great public works and other developments arising from social responses to the profound disruptions which followed the Industrial Revolution. The second wave saw the emergence of medicine as science. The third wave involved the redesign of our social institutions during the 20th Century and gave birth to the welfare state. The fourth wave has been dominated by efforts to combat disease risk factors and the emergence of systems thinking. Although a trough of public health activity continues from each wave, none exerts the same impact as when it first emerged. This paper will discuss the complex challenges of obesity, inequality and loss of wellbeing, together with the broader problems of exponential growth in population, money creation and energy usage. As exponential growth is unsustainable on a finite planet, inevitable change looms. Taken together, these analyses suggest that a fifth wave of public health development is now needed; one which will need to differ radically from its forerunners. The authors invite others to join them in envisioning its nature and in furthering the debate about future public health. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Gender perspectives on access to public debate: reflecting on the evening news contents

Directory of Open Access Journals (Sweden)

Rosa Cabecinhas

2013-06-01

Full Text Available The present article aims to analyze the reception of media content within a gender perspective. The women’s full exercise of citizenship and access to public debate depends greatly on the way media presents them to the world. This study considers that balanced representation of men and women in the news is an important criterion to take into account in order to produce quality journalism. Considering the various television news programs, the evening news is definitely one of the most important and, yet, one of the less studied. Daily broadcast on a prime time schedule, it is considered to be an important source of information through which citizens acknowledge themain events of the news agenda and, also, their social roles and responsibilities. Therefore, several focus groups have been organized with the purpose of debating news contents and understanding how gender meanings are negotiated by audiences. The analysis of these debates displayed important gender perspectives among focus groups participants. Its outputs allowed a better understanding of how audiences interpret gender meanings in the media and emphasized the need to develop alternative proposals of journalistic practices capable of promoting a critical, balanced and diversified gender perspective within the audiences.

Partners in Public Health: Public Health Collaborations With Schools of Pharmacy, 2015.

Science.gov (United States)

DiPietro Mager, Natalie A; Ochs, Leslie; Ranelli, Paul L; Kahaleh, Abby A; Lahoz, Monina R; Patel, Radha V; Garza, Oscar W; Isaacs, Diana; Clark, Suzanne

To collect data on public health collaborations with schools of pharmacy, we sent a short electronic survey to accredited and preaccredited pharmacy programs in 2015. We categorized public health collaborations as working or partnering with local and/or state public health departments, local and/or state public health organizations, academic schools or programs of public health, and other public health collaborations. Of 134 schools, 65 responded (49% response rate). Forty-six (71%) responding institutions indicated collaborations with local and/or state public health departments, 34 (52%) with schools or programs of public health, and 24 (37%) with local and/or state public health organizations. Common themes of collaborations included educational programs, community outreach, research, and teaching in areas such as tobacco control, emergency preparedness, chronic disease, drug abuse, immunizations, and medication therapy management. Interdisciplinary public health collaborations with schools of pharmacy provide additional resources for ensuring the health of communities and expose student pharmacists to opportunities to use their training and abilities to affect public health. Examples of these partnerships may stimulate additional ideas for possible collaborations between public health organizations and schools of pharmacy.

The ethics of limiting informed debate: censorship of select medical publications in the interest of organ transplantation.

Science.gov (United States)

Potts, Michael; Verheijde, Joseph L; Rady, Mohamed Y; Evans, David W

2013-12-01

Recently, several articles in the scholarly literature on medical ethics proclaim the need for "responsible scholarship" in the debate over the proper criteria for death, in which "responsible scholarship" is defined in terms of support for current neurological criteria for death. In a recent article, James M. DuBois is concerned that academic critiques of current death criteria create unnecessary doubt about the moral acceptability of organ donation, which may affect the public's willingness to donate. Thus he calls for a closing of the debate on current death criteria and for journal editors to publish only critiques that "substantially engage and advance the debate." We argue that such positions as DuBois' are a threat to responsible scholarship in medical ethics, especially scholarship that opposes popular stances, because it erodes academic freedom and the necessity of debate on an issue that is literally a matter of life and death, no matter what side a person defends.

Problem drug use the public health imperative: what some of the literature says.

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Bevan, Gez

2009-12-16

With more than 200,000 problem drug users is contact with structured treatment services in England the public health imperative behind drug treatment is great. Problem drug use for many is a chronic and relapsing condition, where "cure" is often neither a reasonable or appropriate expectation and it can further be argued that in these circumstances problem drug use is no different from any number of chronic and enduring health conditions that are managed in the health care system and therefore should be conceptualised as such. A public health approach to drug treatment emphasises the need for drug users in or accessing treatment, to reduce their harmful drug use, reduce drug use related risks such as sepsis and overdose and stay alive for longer. However a public health perspective in relation to problem drug use isn't always either apparent or readily understood and to that end there is still a significant need to continue the arguments and debate that treatment and interventions for problem and dependent drug users need to extend beyond an individualistic approach. For the purposes of discussion in this article public and population health will be used interchangeably. A recognition and acceptance that a public and population health approach to the management of problem drug users is sound public health policy also then requires a long term commitment in terms of staffing and resources where service delivery mirrors that of chronic condition management.

The debate over weight- versus price-based taxation of snuff in the United States' state legislatures.

Science.gov (United States)

Timberlake, David S; Sami, Mojgan; Patel, Sonam; Thiagarajan, Shamili; Badiyan, Ramin; Willard, Shay

2014-08-01

Discount snuff, known for its cheap price, high nicotine content, and popularity among youth, has increased substantially in market share in the United States. As a likely result, the leading manufacturer of premium snuff has supported legislation changing the basis for taxing snuff from price to weight. To determine which public health issues arose in legislative debates, we transcribed 17 of 52 bills from US state legislatures and coded for arguments broadly categorized into public health, fair taxation, tax revenue, tax efficiency, and anti-competitiveness. State legislators expressed frustration that equitable taxation, revenue generation, and prevention of youth tobacco use were frequently conflated in the debates. Public health advocates expressed concerns over youths' incentives to purchase low-weight snuff, but seldom discussed youths' growing preference for discount snuff. The evolving market of moist snuff is a critical consideration for US state legislators as well as policy makers from other countries who may evaluate taxation methods for alternate tobacco products.

Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

Science.gov (United States)

Hilton, Warren

2013-01-01

This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

Keeping the "public" in schools of public health.

Science.gov (United States)

Freudenberg, Nicholas; Klitzman, Susan; Diamond, Catherine; El-Mohandes, Ayman

2015-03-01

In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation's public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities.

[Glass ceiling and slippery stairs? Gender inequalities and strategies for change in the Spanish Society of Public Health and Health Services Administration].

Science.gov (United States)

Colomer Revuelta, C; Peiró Pérez, R

2002-01-01

In scientific societies, as in other social fields, women's participation in decision making is lower than that of men. We describe the situation in SESPAS (Spanish Society of Public Health and Health Services Administration) where, despite representing a 40% of its members, very few women have been in positions in which decisions are taken or in those of professional recognition. The process of change implemented during recent years and some of the effects of the actions taken are presented. Making the existing inequalities known has generated debate and interest in the intervention. A gender and public health working group was set up. In the last two years more women have been promoted to more senior positions in SESPAS.

[Poverty, public transfers and health: An analysis on self-rated health of social benefit recipients in Germany].

Science.gov (United States)

Pförtner, T-K; Schumann, N

2016-09-01

Prevention and reduction of poverty are key elements of social welfare policy in Germany. This study is the first analysis of self-rated health of individuals that escape poverty by benefiting form public transfers. Analyses are based on the German Socio-economic Panel (GSOEP) of 2010. Self-rated health was based on subjective assessment of general health status. Subjects were directly asked about receipt of public transfers. Income poverty was based on the equalized disposable income and is applied to a threshold of 60% of the median-based average income. We analyzed the association between self-rated health and pre- and post-transfer poverty by means of descriptive analyses and binary logistic regression. After adjusting for age, we found a significantly higher risk of poor self-rated health among those who escaped income poverty due to the receipt of social transfers compared to others (ORWomen: 1.85; 95%-CI: 1.27-2.69; ORMen: 2.57; 95%-CI: 1.63-4.05), in particular to those at risk of post-transfer poverty. These poverty-related inequalities in health were predominantly explained by nationality, occupational status, household type and long-term care within the household. This study provides first evidence that the receipt of public transfers is associated with increased risk of poor health in the light of impending income-poverty. This study adds to the current debate about the social and health implications of public transfers in the relationship between poverty and health. © Georg Thieme Verlag KG Stuttgart · New York.

[Evaluation of scientific production in different subareas of Public Health: limits of the current model and contributions to the debate].

Science.gov (United States)

Iriart, Jorge Alberto Bernstein; Deslandes, Suely Ferreira; Martin, Denise; Camargo, Kenneth Rochel de; Carvalho, Marilia Sá; Coeli, Cláudia Medina

2015-10-01

The aim of this study was to discuss the limits of the quantitative evaluation model for scientific production in Public Health. An analysis of the scientific production of professors from the various subareas of Public Health was performed for 2010-2012. Distributions of the mean annual score for professors were compared according to subareas. The study estimated the likelihood that 60% of the professors in the graduate studies programs scored P50 (Very Good) or higher in their area. Professors of Epidemiology showed a significantly higher median annual score. Graduate studies programs whose faculty included at least 60% of Epidemiology professors and fewer than 10% from the subarea Social and Human Sciences in Health were significantly more likely to achieve a "Very Good" classification. The observed inequalities in scientific production between different subareas of Public Health point to the need to rethink their evaluation in order to avoid reproducing iniquities that have harmful consequences for the field's diversity.

Who needs 'pukka anthropologists'? A study of the perceptions of the use of anthropology in tropical public health research.

Science.gov (United States)

Napolitano, Dora A; Jones, Caroline O H

2006-08-01

Over the past 50 years, there have been considerable changes both in how medical anthropologists view their relationship to tropical public health and in how tropical public health professionals view the role of anthropologists. In particular, in recent decades critical currents have emerged from an anthropology of medicine, calling for an examination of biomedicine and its conceptualisation of public health. There are parallel debates in public health about a narrow disease-focused or broader socio-cultural approach to improving population health. Based on a review of the literature and a qualitative study of the views of public health professionals and anthropologists working in tropical public health, the data presented in this paper suggest that public health professionals remain unaware of many of the contributions anthropology could make to tropical public health theory and practice. However, the objectives of a critical social science are not dissimilar to those of the broader concept of public health. We suggest that there are grounds for optimism. For those of us concerned not just with disease but also with inequities in health, the challenge is to work towards a critical tropical public health which draws as much from social science as from biomedicine, in theory and practice.

The influence of global warming on natural disasters and their public health outcomes.

Science.gov (United States)

Diaz, James H

2007-01-01

With a documented increase in average global surface temperatures of 0.6 degrees C since 1975, Earth now appears to be warming due to a variety of climatic effects, most notably the cascading effects of greenhouse gas emissions resulting from human activities. There remains, however, no universal agreement on how rapidly, regionally, or asymmetrically the planet will warm or on the true impact of global warming on natural disasters and public health outcomes. Most reports to date of the public health impact of global warming have been anecdotal and retrospective in design and have focused on the increase in heat-stroke deaths following heat waves and on outbreaks of airborne and arthropod-borne diseases following tropical rains and flooding that resulted from fluctuations in ocean temperatures. The effects of global warming on rainfall and drought, tropical cyclone and tsunami activity, and tectonic and volcanic activity will have far-reaching public health effects not only on environmentally associated disease outbreaks but also on global food supplies and population movements. As a result of these and other recognized associations between climate change and public health consequences, many of which have been confounded by deficiencies in public health infrastructure and scientific debates over whether climate changes are spawned by atmospheric cycles or anthropogenic influences, the active responses to progressive climate change must include combinations of economic, environmental, legal, regulatory, and, most importantly, public health measures.

Democratizing the world health organization.

Science.gov (United States)

van de Pas, R; van Schaik, L G

2014-02-01

A progressive erosion of the democratic space appears as one of the emerging challenges in global health today. Such delimitation of the political interplay has a particularly evident impact on the unique public interest function of the World Health Organization (WHO). This paper aims to identify some obstacles for a truly democratic functioning of the UN specialized agency for health. The development of civil society's engagement with the WHO, including in the current reform proposals, is described. The paper also analyses how today's financing of the WHO--primarily through multi-bi financing mechanisms--risks to choke the agency's role in global health. Democratizing the public debate on global health, and therefore the role of the WHO, requires a debate on its future role and engagement at the country level. This desirable process can only be linked to national debates on public health, and the re-definition of health as a primary political and societal concern. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Insolvency risk in health carriers: innovation, competition, and public protection.

Science.gov (United States)

Akula, J L

1997-01-01

This paper reviews the framework of regulatory and managerial devices that have evolved in response to the special dangers to the public posed by insolvency of health carriers. These devices include "prudential" measures designed to decrease the likelihood of insolvency, and measures to "protect enrollees" in the event that insolvency occurs nevertheless. It also reviews the current debate over how this framework should be adapted to new forms of risk-bearing entities, especially provider-sponsored networks engaged in direct contracting with purchasers of coverage. Parallels to solvency concerns in the banking industry are explored.

Does corruption undermine trust in health care? Results from public opinion polls in Croatia.

Science.gov (United States)

Radin, Dagmar

2013-12-01

Health and health care provision are one of the most important topics in public policy, and often a highly debated topic in the political arena. The importance of considering trust in the health care sector is highlighted by studies showing that trust is associated, among others, with poor self-related health, and poorer health outcomes. Similarly, corruption has shown to create economic costs and inefficiencies in the health care sector. This is particularly important for a newly democratized country such as Croatia, where a policy responsive government indicates a high level of quality of democracy (Roberts, 2009) and where a legacy of corruption in the health care sector has been carried over from the previous regime. In this study, I assess the relationship between health care corruption and trust in public health care and hypothesize that experience with health care corruption as well as perception of corruption has a negative effect on trust in public care facilities. Data were collected in two surveys, administered in 2007 and 2009 in Croatia. Experience with corruption and salience with corruption has a negative effect on trust in public health care in the 2007 survey, but not in the 2009 survey. While the results are mixed, they point to the importance of further studying this relationship. Copyright © 2013 Elsevier Ltd. All rights reserved.

Public debate on the general options relative to the management of high-medium activity and long-lived radioactive wastes; Debat public sur les options generales en matiere de gestion des dechets radioactifs de haute activite et de moyenne activite a vie longue

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-09-15

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. This document presents the organizational aspects of the debate: origin, organization committee (mission, members, commitments), framework (the December 31, 1991 law, technical enlargement, society aspects), topics (summary of the debate in ten questions), organization modalities (4 main steps, schedule, venues), objectives and perspectives (sharing information, decision making processes to be implemented by 2006). (J.S.)

How did the public respond to the 2015 expert consensus public health guidance statement on workplace sedentary behaviour? A qualitative analysis

Directory of Open Access Journals (Sweden)

Benjamin Gardner

2017-02-01

Full Text Available Abstract Background In June 2015, an expert consensus guidance statement was published recommending that office workers accumulate 2–4 h of standing and light activity daily and take regular breaks from prolonged sitting. This paper describes public responses to media coverage of the guidance, so as to understand public acceptability of the recommendations within the guidance, and perceptions of sitting and standing as health behaviours. Methods UK news media websites that had reported on the sedentary workplace guidance statement, and permitted viewers to post comments responding to the story, were identified. 493 public comments, posted in a one-month period to one of six eligible news media websites, were thematically analysed. Results Three themes were extracted: (1 challenges to the credibility of the sedentary workplace guidance; (2 challenges to the credibility of public health; and (3 the guidance as a spur to knowledge exchange. Challenges were made to the novelty of the guidance, the credibility of its authors, the strength of its evidence base, and its applicability to UK workplaces. Public health was commonly mistrusted and viewed as a tool for controlling the public, to serve a paternalistic agenda set by a conspiracy of stakeholders with hidden non-health interests. Knowledge exchanges focused on correcting others’ misinterpretations, raising awareness of historical or scientific context, debating current workplace health policies, and sharing experiences around sitting and standing. Conclusions The guidance provoked exchanges of health-promoting ideas among some, thus demonstrating the potential for sitting reduction messages to be translated into everyday contexts by lay champions. However, findings also demonstrated confusion, misunderstanding and misapprehension among some respondents about the health value of sitting and standing. Predominantly unfavourable, mistrusting responses reveal significant hostility towards

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

Science.gov (United States)

Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-01-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

Saúde Pública e Colonização da Natureza Public Health and Colonization of Nature

Directory of Open Access Journals (Sweden)

Áurea Maria Zöllner Ianni

2009-01-01

Full Text Available Este trabalho apresenta algumas questões sobre as quais o campo da Saúde Pública/Coletiva no Brasil precisa se reposicionar. Tomando por referência a concepção de biológico e social que se consolidou no campo a partir da década de 1970, discute-se a concepção de natureza e cultura que subsidiou o debate. Mostra como esse debate foi circunstanciado historicamente, por isso mesmo merecendo uma revisão, tendo em vista o contexto das sociedades modernas contemporâneas. As práticas biotecnológicas são objeto da análise na medida em que, além do seu uso intensivo pela saúde, carregam consigo as características de articular o biológico e o social num mesmo objeto, de transformar e criar seres vivos e de atuar na diversidade biológica. Este cenário coloca, à Saúde Pública/Coletiva, a imperiosa necessidade de rever seus marcos teórico-epistemológicos.This paper presents some issues on which the field of Public/Collective Health in Brazil needs to reposition. Based on the design of biological and social consolidated in the field from the 1970s, it discusses the concept of nature and culture that has supported the debate. It shows how this debate has been historically positioned, so it deserves to be reviewed, given the context of contemporary modern societies. Biotechnology practices are the subject of analysis in that, in addition to their intensive use by health, hold the characteristics of joining biological and social factors in the same object, transforming and creating living beings and working in the biodiversity. This scenario requires from the Public/Collective Health the urgent need to review their theoretical and epistemological marks.

Debating Diversity: Ethics and Controversial Public Issues

Science.gov (United States)

Darr, Christopher R.

2016-01-01

Courses: Ethics, Organizational Communication, Political Communication. Objectives: After completing this unit activity, students should be able to (1) apply multiple ethical perspectives to real-world diversity issues in a debate format, and (2) explain the role of informational and social category diversity in current controversies.

[Brazilian bibliographical output on public oral health in public health and dentistry journals].

Science.gov (United States)

Celeste, Roger Keller; Warmling, Cristine Maria

2014-06-01

The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on public health and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in public health, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in public health and key words about public health in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in public health journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral health publications in dentistry journals, though not in public health journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of public health, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

Public debate on the general options relative to the management of high-medium activity and long-lived radioactive wastes

International Nuclear Information System (INIS)

2005-09-01

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. This document presents the organizational aspects of the debate: origin, organization committee (mission, members, commitments), framework (the December 31, 1991 law, technical enlargement, society aspects), topics (summary of the debate in ten questions), organization modalities (4 main steps, schedule, venues), objectives and perspectives (sharing information, decision making processes to be implemented by 2006). (J.S.)

The history of a movement: Saúde em Debate magazine and Brazilian health reform.

Science.gov (United States)

Amarante, Paulo; Rizzotto, Maria Lucia Frizon; Costa, Ana Maria

2015-07-01

This article traces significant moments in the history of the magazine Saúde em Debate - sourcing references and information from documents, historical studies, editions of the magazine, academic work and interviews with physicians and writers who contributed to its creation. In its 39 years of existence, although there may have been variations in the magazine's editorial policy, its role as a means for exchange of ideas and debate on critical health thinking, and making a contribution by in some way intervening in the Brazilian political process, has not changed. The magazine established itself with a firm reputation as a vehicle of scientific communication especially in the areas of health policy and management, expanding the scope of subjects over time. Among the challenges it has faced, as well as that of financial sustenance, has been its role as an instrument for dissemination of Latin American thinking in the field of health.

Opportunities for Public Relations Research in Public Health.

Science.gov (United States)

Wise, Kurt

2001-01-01

Considers how communication researchers have developed a solid body of knowledge in the health field but know little about the activities of public relations practitioners in public health bodies. Suggests that public relations scholarship and practice have much to offer the field of public health in helping public health bodies meet their…

[Interadministrative collaboration for public health management in municipalities with less than 10,000 residents].

Science.gov (United States)

Alabert López, Marc; Arbussà Reixach, Anna; Sáez Zafra, Marc

This study analyses which administrative body local councils use to carry out their basic public health responsibilities. The study sample includes data from municipalities with less than 10,000 residents, which we believe is a first for studies published in academic journals in Spain. The data used was obtained by means of a survey administered by trained personnel. 93.7% of all the municipalities in the province of Girona, the area under study, responded to the survey. The analysis shows that there is a statistically significant difference between municipalities with more and less than 10,000 residents with regards to which administrative body local councils use for managing public health responsibilities. The results of this study suggest that in the ongoing debate over the streamlining of local government, the current situation regarding public health responsibilities in municipalities with less than 10,000 residents needs to be taken into account. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

The role played by stakeholders in the public debate that brought Italy out of the club of nuclear energy producers.

Science.gov (United States)

Cantone, Marie Claire; Sturloni, Giancarlo; Brunelli, Giancarlo

2007-10-01

In 1964, Italy was the fourth largest world producer of electricity generated by nuclear reactors, second in Europe only to United Kingdom. In subsequent years, various controversial political events contributed towards drastically slowing down the development of the Italian national nuclear program. The 1986 Chernobyl Nuclear Power Plant accident, which caused a public outcry all over Europe, had particularly serious repercussions in Italy. In a controversial referendum, held in November 1987, Italian citizens voted to repeal three laws promoting the installation of nuclear power plants (NPP) on Italian soil and allowing the National Institute for Electrical Energy (ENEL) to participate in the construction of NPP's abroad. This work analyzes the reasons for that decision and the communication strategies of the stakeholders that took part in the public debate on nuclear energy during the weeks following the Chernobyl accident. Drawing from the methodologies used in media studies, a quantitative and qualitative analysis of two leading Italian newspapers was performed. The results reveal that a variety of stakeholders, upholding different values and interests, took part in the debate. There being no tradition of a public dialogue and participation in Italy, the debate was polarized to a "yes/no choice," which eventually caused Italy to abandon the production of nuclear power for civilian use.

CIGEO public debate. Presentation of the Citizens' Conference - Press file. Presentation of the citizens panel opinion

International Nuclear Information System (INIS)

Hermitte, Marie-Angele; Bedu, Clemence; Besnus, Francois; Brom, Jean-Marie; Grambow, Bernd; Ruedinger, Andreas; Fourniau, Jean-Michel; Bobbio, Luigi; Blatrix, Cecile

2013-01-01

After a presentation of the organisation and implementation of the Citizens' Conference, a presentation of the members of the steering committee and of the assessment committee of this conference, this document presents the opinion of the citizen panel in the framework of the public debate on the Cigeo project of deep underground disposal of radioactive wastes. This opinion notably outlines the waste issue as an inter-generational issue, comments the calendar and condition of the Cigeo project, states the panel opinion on risks which are specific to the Cigeo project, discusses the issue of recoverability and reversibility, discusses the issue of site memory, evokes the possibility of exploitation of geothermal energy, outlines the importance of health and environmental monitoring, comments opportunities for local development, and discusses cost and financing assessments. An appendix presents the different training programmes proposed during the citizens' conference

Analysis of Arguments in the Public Debate on the Alphabet Change in bilingual Kazakhstan

Directory of Open Access Journals (Sweden)

Lyazzat Kimanova

2011-12-01

Full Text Available By focusing on an example of a public social debate on language policy, this article aims at showing the relevant contribution of argument analysis to the understanding of such debates. Argumentative discourse constitutes an essential condition for real democratic practice. Perelman & Olbrechts-Tyteca (1958: 73 point out that the commitment to argumentative practice offers an alternative to the use of violence. The relationship between argumentation and a democratic society is fundamental: argumentation is the substance of democracy, which differs from other social systems in that the only legitimate power is the power of the word. It is free will, which builds on the word alone, that enables us to live together in freedom. An important aspect of democracy, being based on a dialectic ideal, is its uncertain outcome: van Eemeren (2002: 71 characterizes democracy as «institutionalized uncertainty». Thus, insight into the functioning of argumentation contributes significantly to the understanding of democratic processes

Gun Control: The Debate and Public Policy.

Science.gov (United States)

Watkins, Christine

1997-01-01

Provides an overview and background information on the debate over gun control, as well as several teaching ideas. Handouts include a list of related topics drawn from various disciplines (economics, U.S. history), seven arguments for and against gun control, and a set of policy evaluation guidelines. (MJP)

Publicity, news content, and cultural debate

DEFF Research Database (Denmark)

Nørgaard Kristensen, Nete; From, Unni

2015-01-01

Taking our point of departure in mediatization theory (Hjarvard, 2013; Lundby, 2009; Schulz, 2004), we analyse the interwoven communicative forms of the film industry and the printed press as they are expressed in the coverage of three blockbusters in Danish newspapers – Ben-Hur (1959/62); Batman...... stimulate socio-cultural debate, at the same time as the portrayal of blockbuster movie events and their directors and actors at-tracts media audiences, serving as entertainment, service as well as enlightenment....

Ethics in public health research: privacy and public health at risk: public health confidentiality in the digital age.

Science.gov (United States)

Myers, Julie; Frieden, Thomas R; Bherwani, Kamal M; Henning, Kelly J

2008-05-01

Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies.

[Terrorism, public health and health services].

Science.gov (United States)

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Genetics, health care, and public policy: an introduction to public health genetics

National Research Council Canada - National Science Library

Stewart, Alison

2007-01-01

... initiative About this book Further reading and resources Principles of public health The emergence of public health genetics The human genome project and 'genomic medicine' Community genetics Current developments in public health genetics Genomics and global health 2 Genetic science and technology Basic molecular genetics Genes and the geno...

[Determination or determinants? A debate based on the Theory on the Social Production of Health].

Science.gov (United States)

Rocha, Patrícia Rodrigues da; David, Helena Maria Scherlowski Leal

2015-02-01

This article aims to discuss the concepts of Social Determination of Health and Social Determinants of Health, by establishing a comparison between each of their guiding perspectives and investigating their implications on the development of health policies and health actions. We propose a historical and conceptual reflection, highlighting the Theory on the Social Production of Health, followed by a debate on the concepts, with a comparative approach among them.

Culture as Cure: Civil Society and Moral Debates in KwaZulu-Natal ...

African Journals Online (AJOL)

The paper addresses the nature of 'really existing' civil society and the workings of the public sphere in informal urban settlements on the outskirts of Durban. It focuses on debates over morality and the health of the community which have emerged locally in the context of the HIV/AIDS epidemic, and highlights the positions ...

Why do health workers in rural Tanzania prefer public sector employment?

Science.gov (United States)

Songstad, Nils Gunnar; Moland, Karen Marie; Massay, Deodatus Amadeus; Blystad, Astrid

2012-04-05

Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system

Towards a public health profession

DEFF Research Database (Denmark)

Foldspang, Anders

2015-01-01

in the theoretical as well as the practical potential of the public health professional. Thus, he and she must be able to perform, what WHO Europe has developed as Essential Public Health Operations (EPHOs).3 This, in turn, implies that the public health professional possesses the set of intellectual (knowledge...... endorsed by WHO Europe’s member states as the basis for the public health education in Europe.5 The sections of the lists include: Public health methods; Population health and: Its social and economic determinants, and: Its material environmental determinants; Man-made interventions and systems, namely...... Health policy, health economics, organizational theory, health legislation, and public health leadership and management; Health promotion—health education, health protection, disease prevention; public health ethics. This should form the central part of the basis for all public health professionals...

The Danish Biofuel Debate

DEFF Research Database (Denmark)

Hansen, Janus

2014-01-01

of biofuels enrol scientific authority to support their positions? The sociological theory of functional differentiation combined with the concept of advocacy coalition can help in exploring this relationship between scientific claims-making and the policy stance of different actors in public debates about...... biofuels. In Denmark two distinct scientific perspectives about biofuels map onto the policy debates through articulation by two competing advocacy coalitions. One is a reductionist biorefinery perspective originating in biochemistry and neighbouring disciplines. This perspective works upwards from...

[Public health as a subject for the Assembly].

Science.gov (United States)

Garces, S; Torres, R

1997-12-01

Six Ecuadorian political figures and physicians were interviewed on their opinions concerning the problems of the health sector and possible solutions. Ecuadorians anticipate that installation of the National Assembly will lead to diagnosis and reform of societal ills. Health has not been a high priority of political leaders. Only 10% of the population has access to the social security system. Infant mortality rates are very high in the rural sierra, and nearly 70% of indigenous sierra children suffer from chronic malnutrition. The need for broad reform of the health sector has been recognized. The interview subjects agreed that reforms are needed, especially in regard to the Ecuadorian Institute of Social Security, which all agreed had become weakened by excessive political patronage and presence of unqualified political appointees. They agreed that the nation's health is deteriorating each day, but they did not always agree on how to solve the crisis. Among the themes debated were the need for improved coordination of services, increased investment in health services, redefinition of the role of public and private services, participation of the population in the construction of health policy, the need for professional administration, whether the poor should be charged for services, and whether monopolies should be permitted in the field of health care.

The public debate about roads on the National Forests : an analysis of the new media : 1994-98

Science.gov (United States)

David N. Bengston; David P. Fan

1999-01-01

Roads and road building on the US national forests have become the focus of intense public debate in recent years. Timber companies and others argue that forest roads are an essential transportation system for the production of commodities that society needs. Environmentalists and others reply that national forest roads constitute ecologically destructive "...

Pigs in Public Health

DEFF Research Database (Denmark)

Svendsen, Mette N.

2017-01-01

of public health, made me re-evaluate both what ‘public’ and what ‘health’ means in public health. In this commentary I provide a short personal account of that intellectual journey. I argue that entanglements between species make it urgent that public health scholars investigate the moral, socio......Animals are rare topics in public health science texts and speech despite the fact that animal bodies and lives are woven into the health of human populations, and vice versa. Years of ethnographic and documentary research – following pigs and their humans in and out of biomedical research – made......-economic, material, and bacterial passages between humans and animals that constitute the various publics of public health and profoundly shape the health of human and animal populations in a globalized world....

Institutional public private partnerships for core health services: evidence from Italy

Directory of Open Access Journals (Sweden)

Longo Francesco

2011-04-01

Full Text Available Abstract Background Public-private partnerships (PPPs are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. Methods A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN. The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4 currently in force in one Italian region as the unit of analysis: (i a rehabilitation hospital, (ii, an orthopaedic-centre, (iii a primary care and ambulatory services facility, and (iv a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Results Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i a strategic market orientation to a specialised service area with sufficient potential demand, (ii the allocation of public capital assets and the consistent financial involvement of the private partner, (iii the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv clear regulation of the workforce to align the contracts with the organisational culture. Conclusions Findings

Institutional public private partnerships for core health services: evidence from Italy.

Science.gov (United States)

Cappellaro, Giulia; Longo, Francesco

2011-04-19

Public-private partnerships (PPPs) are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN). The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4) currently in force in one Italian region as the unit of analysis: (i) a rehabilitation hospital, (ii), an orthopaedic-centre, (iii) a primary care and ambulatory services facility, and (iv) a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i) a strategic market orientation to a specialised service area with sufficient potential demand, (ii) the allocation of public capital assets and the consistent financial involvement of the private partner, (iii) the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv) clear regulation of the workforce to align the contracts with the organisational culture. Findings suggests that institutional PPPs enable national health

Determination or determinants? A debate based on the Theory on the Social Production of Health

Directory of Open Access Journals (Sweden)

Patrícia Rodrigues da Rocha

2015-02-01

Full Text Available This article aims to discuss the concepts of Social Determination of Health and Social Determinants of Health, by establishing a comparison between each of their guiding perspectives and investigating their implications on the development of health policies and health actions. We propose a historical and conceptual reflection, highlighting the Theory on the Social Production of Health, followed by a debate on the concepts, with a comparative approach among them.

Profile of Public Health Leadership.

Science.gov (United States)

Little, Ruth Gaskins; Greer, Annette; Clay, Maria; McFadden, Cheryl

2016-01-01

Public health leaders play pivotal roles in ensuring the population health for our nation. Since 2000, the number of schools of public health has almost doubled. The scholarly credentials for leaders of public health in academic and practice are important, as they make decisions that shape the future public health workforce and important public health policies. This research brief describes the educational degrees of deans of schools of public health and state health directors, as well as their demographic profiles, providing important information for future public health leadership planning. Data were extracted from a database containing information obtained from multiple Web sites including academic institution Web sites and state government Web sites. Variables describe 2 sets of public health leaders: academic deans of schools of public health and state health directors. Deans of schools of public health were 73% males and 27% females; the PhD degree was held by 40% deans, and the MD degree by 33% deans. Seventy percent of deans obtained their terminal degree more than 35 years ago. State health directors were 60% males and 40% females. Sixty percent of state health directors had an MD degree, 4% a PhD degree, and 26% no terminal degree at all. Sixty-four percent of state health directors received their terminal degree more than 25 years ago. In addition to terminal degrees, 56% of deans and 40% of state health directors held MPH degrees. The findings call into question competencies needed by future public health professionals and leadership and the need to clarify further the level of public health training and degree type that should be required for leadership qualifications in public health.

Submission of the national commission of the public debate on the options concerning the long life high and medium activity radioactive wastes management

International Nuclear Information System (INIS)

2006-01-01

This document deals with the presentation of a public debate on the radioactive wastes management and the opportunities of its organization. It presents successively the long life high and medium activity radioactive wastes, the today radioactive wastes management policy and some questions and topics which could be discussed during the debate. (A.L.B.)

Public Health Departments

Data.gov (United States)

Department of Homeland Security — State and Local Public Health Departments in the United States Governmental public health departments are responsible for creating and maintaining conditions that...

Partisan Responses to Public Health Messages: Motivated Reasoning and Sugary Drink Taxes.

Science.gov (United States)

Gollust, Sarah E; Barry, Colleen L; Niederdeppe, Jeff

2017-12-01

This study examines the public's motivated reasoning of competitive messages about sugary drink taxes, a public health policy approach attempted with some recent success in the United States. In an experiment embedded in a nationally representative survey fielded in the fall of 2012, we randomized participants ( N  = 5,147) to receive one of four messages: control, a strong protax message, a two-sided message, or a message refuting arguments made in soda company antitax messages. The protax message showed no effects on tax support, while the two-sided message depressed Republicans' support. The refutation message boosted independents' support but produced backlash among Republicans. This motivated response was pronounced among Republicans who were plausibly previously exposed to the sugary drink tax debate. These findings reinforce the communication challenges in an increasingly politicized US health policy discourse. Copyright © 2017 by Duke University Press.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

Science.gov (United States)

Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

Directory of Open Access Journals (Sweden)

Cameron Lister

2017-08-01

Full Text Available Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

Science.gov (United States)

Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

2017-12-11

To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems

Directory of Open Access Journals (Sweden)

Marleen Kraaij-Dirkzwager

2017-12-01

Full Text Available To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS, and concerns about the process to control the risks. The notions of ‘trust’ and ‘scientific uncertainty’ appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS, and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

Feminism and public health nursing: partners for health.

Science.gov (United States)

Leipert, B D

2001-01-01

It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

Jump Horse Safety: Reconciling Public Debate and Australian Thoroughbred Jump Racing Data, 2012-2014.

Science.gov (United States)

Ruse, Karen; Davison, Aidan; Bridle, Kerry

2015-10-22

Thoroughbred jump racing sits in the spotlight of contemporary welfare and ethical debates about horse racing. In Australia, jump racing comprises hurdle and steeplechase races and has ceased in all but two states, Victoria and South Australia. This paper documents the size, geography, composition, and dynamics of Australian jump racing for the 2012, 2013, and 2014 seasons with a focus on debate about risks to horses. We found that the majority of Australian jump racing is regional, based in Victoria, and involves a small group of experienced trainers and jockeys. Australian jump horses are on average 6.4 years of age. The jump career of the majority of horses involves participating in three or less hurdle races and over one season. Almost one quarter of Australian jump horses race only once. There were ten horse fatalities in races over the study period, with an overall fatality rate of 5.1 fatalities per 1000 horses starting in a jump race (0.51%). There was significant disparity between the fatality rate for hurdles, 0.75 fatalities per 1000 starts (0.075%) and steeplechases, 14 fatalities per 1000 starts (1.4%). Safety initiatives introduced by regulators in 2010 appear to have significantly decreased risks to horses in hurdles but have had little or no effect in steeplechases. Our discussion considers these Animals 2015, 5 1073 data in light of public controversy, political debate, and industry regulation related to jump horse safety.

Mediation misgivings: ambiguous clinical and public health interpretations of natural direct and indirect effects.

Science.gov (United States)

Naimi, Ashley I; Kaufman, Jay S; MacLehose, Richard F

2014-10-01

Recent methodological innovation is giving rise to an increasing number of applied papers in medical and epidemiological journals in which natural direct and indirect effects are estimated. However, there is a longstanding debate on whether such effects are relevant targets of inference in population health. In light of the repeated calls for a more pragmatic and consequential epidemiology, we review three issues often raised in this debate: (i) the use of composite cross-world counterfactuals and the need for cross-world independence assumptions; (ii) interventional vs non-interventional identifiability; and (iii) the interpretational ambiguity of natural direct and indirect effect estimates. We use potential outcomes notation and directed acyclic graphs to explain 'cross-world' assumptions, illustrate implications of this assumption via regression models and discuss ensuing issues of interpretation. We argue that the debate on the relevance of natural direct and indirect effects rests on whether one takes as a target of inference the mathematical object per se, or the change in the world that the mathematical object represents. We further note that public health questions may be better served by estimating controlled direct effects. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

A political dimension of public budget: the councils of rights as a space for collective and plural debate

Directory of Open Access Journals (Sweden)

Valdir Anhucci

2013-12-01

Full Text Available The consolidation of the political dimension of the Councils of Rights is linked to its understanding as plural public spaces, divergence and the constant struggle of ideas. The political dimension becomes crucial, especially in the process of defining and managing the public budget for both planning and to expand the debate on the allocation of financial resources for the implementation of public policies. It is this space that the different interests manifest themselves, becoming a field of political struggle for the appropriation of public resources in ensuring the rights and social protection of the most disenfranchised segments of society. The public budget in the spaces of advice gained a political dimension, the prospect of mere instrument accounting

Submission of the national commission of the public debate on the options concerning the long life high and medium activity radioactive wastes management; Saisine de la commission nationale du debat public sur les options generales en matiere de gestion des dechets radioactifs de haute activite et de moyenne activite a vie longue

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

This document deals with the presentation of a public debate on the radioactive wastes management and the opportunities of its organization. It presents successively the long life high and medium activity radioactive wastes, the today radioactive wastes management policy and some questions and topics which could be discussed during the debate. (A.L.B.)

The next public health revolution: public health information fusion and social networks.

Science.gov (United States)

Khan, Ali S; Fleischauer, Aaron; Casani, Julie; Groseclose, Samuel L

2010-07-01

Social, political, and economic disruptions caused by natural and human-caused public health emergencies have catalyzed public health efforts to expand the scope of biosurveillance and increase the timeliness, quality, and comprehensiveness of disease detection, alerting, response, and prediction. Unfortunately, efforts to acquire, render, and visualize the diversity of health intelligence information are hindered by its wide distribution across disparate fields, multiple levels of government, and the complex interagency environment. Achieving this new level of situation awareness within public health will require a fundamental cultural shift in methods of acquiring, analyzing, and disseminating information. The notion of information "fusion" may provide opportunities to expand data access, analysis, and information exchange to better inform public health action.

Feminism and public health ethics.

Science.gov (United States)

Rogers, W A

2006-06-01

This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

Public health and Plowshare

Energy Technology Data Exchange (ETDEWEB)

Terrill, Jr, J G [Consumer Protection and Environmental Health Service, U.S. PubIic Health Service, Washington, DC (United States)

1969-07-01

The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

Public health and Plowshare

International Nuclear Information System (INIS)

Terrill, J.G. Jr.

1969-01-01

The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

The influence of violent media on children and adolescents:A public health approach

OpenAIRE

Browne, Kevin D.; Hamilton-Giachritsis, Catherine

2005-01-01

There is continuing debate on the extent of the effects of media violence on children and young people, and how to investigate these effects. The aim of this review is to consider the research evidence from a public-health perspective. A search of published work revealed five meta-analytic reviews and one quasi-systematic review, all of which were from North America. There is consistent evidence that violent imagery in television, film and video, and computer games has substantial short-term ...

The public health nutrition intervention management bi-cycle: a model for training and practice improvement.

Science.gov (United States)

Hughes, Roger; Margetts, Barrie

2012-11-01

The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. Education and practice settings. This model will have applications for educators and practitioners. Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.

Academic Debate: Publications Which Promote Political Agendas Have no Place in Scientific and Medical Journals, and Academics Should Refrain from Publishing in Such Journals.

Science.gov (United States)

Glick, Shimon; Clarfield, A Mark; Strous, Rael D; Horton, Richard

2015-01-01

This paper presents the full debate held on October 1, 2014, which focused on the following resolution: "Publications which promote political agendas have no place in scientific and medical journals, and academics should refrain from publishing in such journals." The debate moderator was Professor Shimon Glick. Taking the pro stance was Professor A. Mark Clarfield; the con stance was held by Professor Rael D. Strous. Following the first part of the debate, Dr Richard Horton, Editor-in-Chief of The Lancet, gave his thoughts on the topic. This was followed by the opportunity for rebuttal by Professors Clarfield and Strous. The debate was summarized and closed by Professor Glick. This paper provides a slightly edited text of the debate, for ease of reading.

Gambling and the Health of the Public: Adopting a Public Health Perspective.

Science.gov (United States)

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

Transversal Lines of the Debates

Directory of Open Access Journals (Sweden)

Yolanda Onghena

1998-12-01

Full Text Available The Transversal Lines of the Debates gathers for publication the presentations of the scholars invited to the seminar. In the papers, Yolanda Onghena observes that the evolution from the cultural to the inter-cultural travels along four axes: the relations between cultureand society; the processes of change within identity-based dynamics; the representations of the Other; and, interculturality. Throughout the presentations and subsequent debates, whenever the different participants referred to aspects of the cultural identity problematic--”angst”, “obsession”, “deficit”, manipulation”, and others, these same participants in the Transversal Lines of the Debates also showed that, in certain areas, an optimistic viewpoint is not out of the question.

Message design strategies to raise public awareness of social determinants of health and population health disparities.

Science.gov (United States)

Niederdeppe, Jeff; Bu, Q Lisa; Borah, Porismita; Kindig, David A; Robert, Stephanie A

2008-09-01

Raising public awareness of the importance of social determinants of health (SDH) and health disparities presents formidable communication challenges. This article reviews three message strategies that could be used to raise awareness of SDH and health disparities: message framing, narratives, and visual imagery. Although few studies have directly tested message strategies for raising awareness of SDH and health disparities, the accumulated evidence from other domains suggests that population health advocates should frame messages to acknowledge a role for individual decisions about behavior but emphasize SDH. These messages might use narratives to provide examples of individuals facing structural barriers (unsafe working conditions, neighborhood safety concerns, lack of civic opportunities) in efforts to avoid poverty, unemployment, racial discrimination, and other social determinants. Evocative visual images that invite generalizations, suggest causal interpretations, highlight contrasts, and create analogies could accompany these narratives. These narratives and images should not distract attention from SDH and population health disparities, activate negative stereotypes, or provoke counterproductive emotional responses directed at the source of the message. The field of communication science offers valuable insights into ways that population health advocates and researchers might develop better messages to shape public opinion and debate about the social conditions that shape the health and well-being of populations. The time has arrived to begin thinking systematically about issues in communicating about SDH and health disparities. This article offers a broad framework for these efforts and concludes with an agenda for future research to refine message strategies to raise awareness of SDH and health disparities.

Development of an online tool for public health: the European Public Health Law Network.

Science.gov (United States)

Basak, P

2011-09-01

The European Public Health Law Network was established in 2007 as part of the European Union (EU) co-funded Public Health Law Flu project. The aims of the website consisted of designing an interactive network of specialist information and encouraging an exchange of expertise amongst members. The website sought to appeal to academics, public health professionals and lawyers. The Public Health Law Flu project team designed and managed the website. Registered network members were recruited through publicity, advertising and word of mouth. Details of the network were sent to health organizations and universities throughout Europe. Corresponding website links attracted many new visitors. Publications, news, events and a pandemic glossary became popular features on the site. Although the website initially focused only on pandemic diseases it has grown into a multidisciplinary website covering a range of public health law topics. The network contains over 700 publications divided into 28 public health law categories. News, events, front page content, legislation and the francophone section are updated on a regular basis. Since 2007 the website has received over 15,000 views from 156 countries. Newsletter subscribers have risen to 304. There are now 723 followers on the associated Twitter site. The European Public Health Law Network has been a successful and innovative site in the area of public health law. Interest in the site continues to grow. Future funding can contribute to a bigger site with interactive features and pages in a wider variety of languages to attract a wider global audience. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Public health and peace.

Science.gov (United States)

Laaser, Ulrich; Donev, Donco; Bjegović, Vesna; Sarolli, Ylli

2002-04-01

The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

Public Health's Falling Share of US Health Spending.

Science.gov (United States)

Himmelstein, David U; Woolhandler, Steffie

2016-01-01

We examined trends in US public health expenditures by analyzing historical and projected National Health Expenditure Accounts data. Per-capita public health spending (inflation-adjusted) rose from $39 in 1960 to $281 in 2008, and has fallen by 9.3% since then. Public health's share of total health expenditures rose from 1.36% in 1960 to 3.18% in 2002, then fell to 2.65% in 2014; it is projected to fall to 2.40% in 2023. Public health spending has declined, potentially undermining prevention and weakening responses to health inequalities and new health threats.

Muslim dress and the head-scarf debate

NARCIS (Netherlands)

Moors, A.; Skov, L.

2010-01-01

Debates about the presence of students wearing head scarves in public schools in West Europe started in the late 1980s; about a decade later, the employment of women wearing head scarves also became the focus of attention. These debates need to be seen within a context in which a new generation of

Responsive partisanship: public support for the clinton and obama health care plans.

Science.gov (United States)

Kriner, Douglas L; Reeves, Andrew

2014-08-01

We examine the contours of support for the Clinton and Obama health care plans during the 1990s and 2000s based on our own compilation of 120,000 individual-level survey responses from throughout the debates. Despite the rise of the Tea Party, and the racialization of health care politics, opinion dynamics are remarkably similar in both periods. Party ID is the single most powerful predictor of support for reform and the president's handling of it. Contrary to prominent claims, after controlling for partisanship, demographic characteristics are at best weak predictors of support for reform. We also show that Clinton and Obama did not "lose" blacks, seniors, or wealthy voters over the course of the debate. The small and often nonexistent relationship between these characteristics and support for the plan are constant over time. Instead, the modest fluctuations in support for reform appear to follow the ebb and flow of elite rhetoric. Both mean levels of support and its volatility over time covary with elite partisan discourse. These findings suggest that presidents courting public opinion should seek consensus among their own party's elites before appealing to other narrower interests. Copyright © 2014 by Duke University Press.

Transportation and public health.

Science.gov (United States)

Litman, Todd

2013-01-01

This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

Reading and Writing with a Public Purpose: Fostering Middle School Students' Academic and Critical Community Literacies through Debate

Science.gov (United States)

Mirra, Nicole; Honoroff, Benjamin; Elgendy, Suzanne; Pietrzak, Gabriel

2016-01-01

Middle school is a crucial transition period for adolescents; in addition to beginning to grapple with the academic literacy demands of college and career readiness, they are working to find their place in public life and developing opinions about civic issues. This article presents debate as a literacy practice that is uniquely suited to helping…

Challenges to the census: international trends and a need to consider public health benefits.

Science.gov (United States)

Wilson, R T; Hasanali, S H; Sheikh, M; Cramer, S; Weinberg, G; Firth, A; Weiss, S H; Soskolne, C L

2017-10-01

The Canadian government decision to cancel the mandatory long-form census in 2010 (subsequently restored in 2015), along with similar discussions in the United Kingdom (UK) and the United States of America (USA), have brought the purpose and use of census data into focus for epidemiologists and public health professionals. Policy decision-makers should be well-versed in the public health importance of accurate and reliable census data for emergency preparedness planning, controlling disease outbreaks, and for addressing health concerns among vulnerable populations including the elderly, low-income, racial/ethnic minorities, and special residential groups (e.g., nursing homes). Valid census information is critical to ensure that policy makers and public health practitioners have the evidence needed to: (1) establish incidence rates, mortality rates, and prevalence for the full characterization of emerging health issues; (2) address disparities in health care, prevention strategies and health outcomes among vulnerable populations; and (3) plan and effectively respond in times of disaster and emergency. At a time when budget and sample size cuts have been implemented in the UK, a voluntary census is being debated in the US. In Canada, elimination of the mandatory long-form census in 2011 resulted in unreliable population enumeration, as well as a substantial waste of money and resources for taxpayers, businesses and communities. The purpose of this article is to provide a brief overview of recent international trends and to review the foundational role of the census in public health management and planning using historical and current examples of environmental contamination, cancer clusters and emerging infections. Citing a general absence of public health applications of the census in cost-benefit analyses, we call on policy makers to consider its application to emergency preparedness, outbreak response, and chronic disease prevention efforts. At the same time, we

Risk perceptions and public debates on climate change: a conceptualisation based on the theory of a functionally-differentiated society

Directory of Open Access Journals (Sweden)

Markus Rhomberg

2010-11-01

Full Text Available Mass media and its mechanisms of production and selection play a crucial role in the definition of climate change risks. Different form of logic in the political, scientific and media systems are vital aspects in the public debate on this issue. A theoretical analysis of these aspects needs a framework in terms of social theory: Luhmann’s concept of a functionally-differentiated society and the mechanisms of structural couplings could help to understand the relations and interplay of these systems in the climate-debate. Based on this framework and various empirical studies, this paper suggests: different logics lead to different climate-definitions in science, politics and mass media. Climate change became interesting, but not until it was located in the political decision-making process. Climate issues become publicly interesting, when they are clear, contentious and can be linked to Elite-Persons. In contrast to scientific communication, news media make great efforts to be clear and definite in their communications.

Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

Science.gov (United States)

Guyon, Ak'ingabe; Perreault, Robert

2016-10-20

Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

Systems science and systems thinking for public health: a systematic review of the field.

Science.gov (United States)

Carey, Gemma; Malbon, Eleanor; Carey, Nicole; Joyce, Andrew; Crammond, Brad; Carey, Alan

2015-12-30

This paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity. A systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health. 117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis. 4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health. There is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

On being a (modern) scientist: risks of public engagement in the UK interspecies embryo debate.

Science.gov (United States)

Porter, James; Williams, Clare; Wainwright, Steven; Cribb, Alan

2012-12-01

In 2006, a small group of UK academic scientists made headlines when they proposed the creation of interspecies embryos - mixing human and animal genetic material. A public campaign was fought to mobilize support for the research. Drawing on interviews with the key scientists involved, this paper argues that engaging the public through communicating their ideas via the media can result in tensions between the necessity of, and inherent dangers in, scientists campaigning on controversial issues. Some scientists believed that communicating science had damaged their professional standing in the eyes of their peers, who, in turn, policed the boundaries around what they believed constituted a "good" scientist. Tensions between promoting "science" versus promotion of the "scientist;" engaging the public versus publishing peer-reviewed articles and winning grants; and building expectations versus overhyping the science reveal the difficult choices scientists in the modern world have to make over the potential gains and risks of communicating science. We conclude that although scientists' participation in public debates is often encouraged, the rewards of such engagement remain. Moreover, this participation can detrimentally affect scientists' careers.

The making of a public health problem: multi-drug resistant tuberculosis in India.

Science.gov (United States)

Engel, Nora C

2013-07-01

This paper examines how actors construct the public problem of multi-drug resistant tuberculosis (MDR-TB) in India. MDR-TB has been framed by the World Health Organization as a pressing, global public health problem. The responses to MDR-TB are complicated as treatment takes longer and is more expensive than routine TB treatment. This is particularly problematic in countries, such as India, with high patient loads, a large and unregulated private sector, weak health systems and potentially high numbers of MDR-TB cases. This paper analyses how actors struggle for control over ownership, causal theories and political responsibility of the public problem of MDR-TB in India. It combines Gusfield's theory on the construction of public problems with insights from literature on the social construction of diseases and on medical social control. It highlights that there are flexible definitions of public problems, which are negotiated among actor groups and which shift over time. The Indian government has shifted its policy in recent years and acknowledged that MDR-TB needs to be dealt with within the TB programme. The study results reveal how the policy shift happened, why debates on the construction of MDR-TB as a public problem in India continue, and why actors with alternative theories than the government do not succeed in their lobbying efforts. Two main arguments are put forward. First, the construction of the public problem of MDR-TB in India is a social and political process. The need for representative data, international influence and politics define what is controllable. Second, the government seems to be anxious to control the definition of India's MDR-TB problem. This impedes an open, critical and transparent discussion on the definition of the public problem of MDR-TB, which is important in responding flexibly to emerging public health challenges.

Changing Policy Framing as a Deliberate Strategy for Public Health Advocacy: A Qualitative Policy Case Study of Minimum Unit Pricing of Alcohol

Science.gov (United States)

Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

2014-01-01

Context Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. Methods We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Findings Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Conclusions Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in

Changing policy framing as a deliberate strategy for public health advocacy: a qualitative policy case study of minimum unit pricing of alcohol.

Science.gov (United States)

Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

2014-06-01

Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. © 2014

Transitions in state public health law: comparative analysis of state public health law reform following the Turning Point Model State Public Health Act.

Science.gov (United States)

Meier, Benjamin Mason; Hodge, James G; Gebbie, Kristine M

2009-03-01

Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health.

A Case for Open Network Health Systems: Systems as Networks in Public Mental Health

Directory of Open Access Journals (Sweden)

Michael Grant Rhodes

2017-03-01

Full Text Available Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH services in the Netherlands. Decentralized under the (Community Participation Act (2014, local governments must find resources to compensate for reduced central funding to such services or “innovate.” But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional “health system” definitions, literature and narratives, and operating assumptions in public (mental health are ‘locked in’ constraining technical and organization innovations. If we view a “health system” as an adaptive system of economic and social “networks,” it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a “centralized hierarchical” or “tree” network. An overlooked alternative that breaks out of the established policy narratives is the view of a ‘health systems’ as a non-hierarchical organizational structure or �

Mountaintop removal mining: One coal company's response to the public debate

International Nuclear Information System (INIS)

Emerson, L.D.

1999-01-01

Mountaintop Mining has been practiced in West Virginia and surrounding Central Appalachian states for over twenty years. In recent months, however, media coverage and other events have increased public and regulatory scrutiny of the practice, which has led to mine permitting delays and employee layoffs. A law suit was filed in federal court alleging, among other things, that the construction of valley fills for excess spoil disposal is a violation of the Clean Water Act. West Virginia's Governor appointed a Task Force to study the issue and has made recommendations for further regulations. Arch Coal, Inc., operates four large surface mines in West Virginia, and many of it's mining subsidiaries have won federal and state honors for excellence in reclamation. Arch has also funded several studies that address many of the issues that have been at the core of the public debate. One study involves the assessment of the long term impact of large scale mining and valley fills on downstream water quality and aquatic life. Another evaluates the rate of forest plant invasion onto reclaimed lands. A third study compares the value of the wildlife habitats created on reclaimed lands relative to undisturbed ridge top and stream side habitats. The results of these studies show that mountaintop removal mining, when done responsibly, has minimal impacts on the environment, and can in fact provide valuable lands for future development. Arch Coal, Inc., has taken a leading role in addressing the scientific and public policy aspects of this controversial issue

Scaling up the health workforce in the public sector: the role of government fiscal policy.

Science.gov (United States)

Vujicic, Marko

2010-01-01

Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report.

Synthesizing evidences for policy translation: a public health discourse on rotavirus vaccine in India.

Science.gov (United States)

Panda, Samiran; Das, Aritra; Samanta, Saheli

2014-08-11

The debate on the relevance of rotavirus vaccine to immunization program in India, where 27 million children are born every year, rages on. We synthesized the issues raised during these debates and reviewed the current literature to identify themes that could inform public health policy decision. The paradigm we used integrated disease burden data, host and environmental factors, vaccine efficacy, immunization program issues, and economic considerations. Our synthesis reveals that substantive country specific information on disease burden and economic impact of rotavirus illness in India is constrained by lack of public discussion and qualitative studies on mothers' perceptions of the vaccine in concern. The need to improve the performance of current immunization program against six major vaccine preventable diseases (tuberculosis, diphtheria, tetanus, pertussis, polio, and measles) is often cited as a priority over introduction of rotavirus vaccine. Health in India being a state subject, we emphasize that the states which are in a position to reap the benefit of rotavirus vaccine, due to their good immunization program performance, should not be restrained from doing so. Meanwhile, the poorly performing states should step up their vaccination program and increase immunization coverage. Scientific, ethical and societal concerns captured through multiple sources indicate that the introduction of rotavirus vaccine would be a good investment for India. Copyright © 2014. Published by Elsevier Ltd.

Jump Horse Safety: Reconciling Public Debate and Australian Thoroughbred Jump Racing Data, 2012–2014

Science.gov (United States)

Ruse, Karen; Davison, Aidan; Bridle, Kerry

2015-01-01

Simple Summary This paper documents the dynamics of Australian thoroughbred jump racing in the 2012, 2013, and 2014 seasons with the aim of informing debate about risks to horses and the future of this activity. We conclude that the safety of Australian jump racing has improved in recent years but that steeplechases are considerably riskier for horses than hurdle races. Abstract Thoroughbred jump racing sits in the spotlight of contemporary welfare and ethical debates about horse racing. In Australia, jump racing comprises hurdle and steeplechase races and has ceased in all but two states, Victoria and South Australia. This paper documents the size, geography, composition, and dynamics of Australian jump racing for the 2012, 2013, and 2014 seasons with a focus on debate about risks to horses. We found that the majority of Australian jump racing is regional, based in Victoria, and involves a small group of experienced trainers and jockeys. Australian jump horses are on average 6.4 years of age. The jump career of the majority of horses involves participating in three or less hurdle races and over one season. Almost one quarter of Australian jump horses race only once. There were ten horse fatalities in races over the study period, with an overall fatality rate of 5.1 fatalities per 1000 horses starting in a jump race (0.51%). There was significant disparity between the fatality rate for hurdles, 0.75 fatalities per 1000 starts (0.075%) and steeplechases, 14 fatalities per 1000 starts (1.4%). Safety initiatives introduced by regulators in 2010 appear to have significantly decreased risks to horses in hurdles but have had little or no effect in steeplechases. Our discussion considers these data in light of public controversy, political debate, and industry regulation related to jump horse safety. PMID:26506396

The elite sport and Christianity debate: shifting focus from normative values to the conscious disregard for health.

Science.gov (United States)

Lee Sinden, Jane

2013-03-01

Scholars and theologians continue to debate whether or not God's intended purpose of elite sport violates the creational normativity for elite sport. However, while it is important to be aware of the contradictions between elite sport and Christianity, there is a need for more deep-seated discussions about emotions and health problems in elite sport and why so many Christian athletes continue to train for their sport at the expense of their health. This paper summaries the present debate regarding elite sport and Christianity and then shifts the reader to an exploration of the normalization of emotion, and the consequence of emotional suppression on athletes health. In doing so, the author presents the disregard of health problems as a more concrete measure of how far athletes should push themselves in elite sport. The author makes recommendations for emotion education and suggests directions for future research and practice.

Educating the future public health workforce: do schools of public health teach students about the private sector?

Science.gov (United States)

Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

2013-01-01

Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

Utilizing Team Debate to Increase Student Abilities for Mentoring and Critical Appraisal of Global Health Care in Doctor of Nursing Practice Programs.

Science.gov (United States)

Elliott, Naomi; Farnum, Karen; Beauchesne, Michelle

2016-01-01

Although graduates of doctor of nursing practice (DNP) programs are expected to demonstrate competence in advanced clinical scholarship, mentoring, and leadership, little is published about how team debate on a global health care topic supports DNP student learning and skill development. This article reports on an illuminative evaluation of DNP student learning experiences of team debate in the context of a 2-week international school program in Ireland. A focused illuminative evaluation approach involving a cohort of seven DNP students, who had participated in an international school team debate, was used. Data were collected using a Web-based qualitative questionnaire designed to elicit in-depth reflective accounts of DNP students' learning experiences. Content analysis revealed that team debate on a global health care topic enhanced learning in relation to fostering critical thinking and critical appraisal skills; encouraging teamwork; providing opportunities for mentoring, relationship building, and socialization into profession; and, from the DNP student perspective, increasing knowledge and global understanding of health care. This evaluation provides insights for nurse educators into the benefits of introducing team debate as a group activity to enhancing scholarly inquiry and mentoring skills of DNP students. Further research to evaluate team debate in other nurse education programs is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers.

Science.gov (United States)

Yeager, Valerie A; Wisniewski, Janna M; Amos, Kathleen; Bialek, Ron

2016-01-01

The public health workforce is critical to the functioning of the public health system and protection of the population's health. Ensuring a sufficient workforce depends on effectively recruiting and retaining workers. This study examines factors influencing decisions to take and remain in jobs within public health, particularly for workers employed in governmental public health. This cross-sectional study employed a secondary data set from a 2010 national survey of US public health workers. Survey respondents were included in this study if they responded to at least 1 survey item related to recruitment and retention. A total of 10 859 survey responses fit this criterion. Data examined demographics of public health workers and factors that influenced decisions to take jobs in and remain in public health. Job security (β = 0.42; 95% confidence interval [CI], 0.28-0.56) and competitive benefits (β = 0.49; 95% CI, 0.28-0.70) were significantly and positively associated with governmental employees' decisions to take positions with their current employers compared with public health workers employed by other types of organizations. The same finding held with regard to retention: job security (β = 0.40; 95% CI, 0.23-0.57) and competitive benefits (β = 0.53; 95% CI, 0.24-0.83). Two personal factors, personal commitment to public service (β = 0.30; 95% CI, 0.17-0.42) and wanted a job in the public health field (β = 0.44; 95% CI, 0.18-0.69), were significantly and positively related to governmental employees deciding to remain with their current employers. It is important to recognize the value of competitive benefits for both current and potential employees. Public health agencies should maintain these if possible and make the value of these benefits known to policy makers or other agencies setting these benefit policies. Job security associated with governmental public health jobs also appears to offer public health an advantage in recruiting and retaining employees.

Radioactive wastes: debated issues about the Cigeo project - White paper III by the ANCCLI

International Nuclear Information System (INIS)

2013-09-01

After a presentation of the interest of the ANCCLI in radioactive wastes, a presentation of the 2013 public debate as an administrative stage within a long process, a presentation of the chronology of the decision process regarding high-activity and medium-activity long-life wastes, and a discussion of a return on experience on the 2005 public debate, this publication discusses the main debated themes: waste warehousing, storage reversibility, ethical issues, the Cigeo inventory, and the impacts on the territory. The Aarhus convention (which addresses public debate) is given in appendix, as well as a contradictory overview of the history of high- and medium-activity long-life waste management

Public mental health.

Science.gov (United States)

Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

2017-10-01

Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Rationality and religion in the public debate on embryo stem cell research and prenatal diagnostics.

Science.gov (United States)

Myskja, Bjørn K

2009-06-01

Jürgen Habermas has argued that religious views form a legitimate background for contributions to an open public debate, and that religion plays a particular role in formulating moral intuitions. Translating religious arguments into "generally accessible language" (Habermas, Eur J Philos 14(1):1-25, 2006) to enable them to play a role in political decisions is a common task for religious and non-religious citizens. The article discusses Habermas' view, questioning the particular role of religion, but accepting the significance of including such counter-voices to the predominant views. Furthermore it is pointed out that not only religious but also numerous secular views stand in need of translation to be able to bear on policy matters. Accepting Habermas' general framework, I raise the question whether experts (such as clinicians working in relevant specialised areas of care) participating in political debates on biomedical issues have a duty to state their religious worldview, and to what extent the American government decision to restrict embryo stem cell research is an illegitimate transgression of the State-Church divide.

Jump Horse Safety: Reconciling Public Debate and Australian Thoroughbred Jump Racing Data, 2012–2014

Directory of Open Access Journals (Sweden)

Karen Ruse

2015-10-01

Full Text Available Thoroughbred jump racing sits in the spotlight of contemporary welfare and ethical debates about horse racing. In Australia, jump racing comprises hurdle and steeplechase races and has ceased in all but two states, Victoria and South Australia. This paper documents the size, geography, composition, and dynamics of Australian jump racing for the 2012, 2013, and 2014 seasons with a focus on debate about risks to horses. We found that the majority of Australian jump racing is regional, based in Victoria, and involves a small group of experienced trainers and jockeys. Australian jump horses are on average 6.4 years of age. The jump career of the majority of horses involves participating in three or less hurdle races and over one season. Almost one quarter of Australian jump horses race only once. There were ten horse fatalities in races over the study period, with an overall fatality rate of 5.1 fatalities per 1000 horses starting in a jump race (0.51%. There was significant disparity between the fatality rate for hurdles, 0.75 fatalities per 1000 starts (0.075% and steeplechases, 14 fatalities per 1000 starts (1.4%. Safety initiatives introduced by regulators in 2010 appear to have significantly decreased risks to horses in hurdles but have had little or no effect in steeplechases. Our discussion considers these Animals 2015, 5 1073 data in light of public controversy, political debate, and industry regulation related to jump horse safety.

Social media in public health.

Science.gov (United States)

Kass-Hout, Taha A; Alhinnawi, Hend

2013-01-01

While social media interactions are currently not fully understood, as individual health behaviors and outcomes are shared online, social media offers an increasingly clear picture of the dynamics of these processes. Social media is becoming an increasingly common platform among clinicians and public health officials to share information with the public, track or predict diseases. Social media can be used for engaging the public and communicating key public health interventions, while providing an important tool for public health surveillance. Social media has advantages over traditional public health surveillance, as well as limitations, such as poor specificity, that warrant additional study. Social media can provide timely, relevant and transparent information of public health importance; such as tracking or predicting the spread or severity of influenza, west nile virus or meningitis as they propagate in the community, and, in identifying disease outbreaks or clusters of chronic illnesses. Further work is needed on social media as a valid data source for detecting or predicting diseases or conditions. Also, whether or not it is an effective tool for communicating key public health messages and engaging both, the general public and policy-makers.

Implications for alcohol minimum unit pricing advocacy: what can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

Science.gov (United States)

Hilton, Shona; Wood, Karen; Patterson, Chris; Katikireddi, Srinivasa Vittal

2014-02-01

On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable

[Public-private relations in the Colombian health system from 1991 to 2015].

Science.gov (United States)

Cárdenas, William Iván López; Pereira, Adelyne Maria Mendes; Machado, Cristiani Vieira

2017-07-27

The case of Colombia's health system exemplifies the neoliberal reforms conducted in Latin America, characterized by the private sector's broad participation in the administration of resources and provision of health services. The system includes a set of benefits for persons that can afford to pay and a package of basic services with state financing for poor persons. This study aimed to analyze the public-private arrangements in the Colombian health system from 1991 and 2015, including the dimensions of insurance and financing. A case study was performed that included a literature review and analysis of documents and secondary data. The results suggest that the 1993 reform conceived of health as a public service to be provided by the market. There were changes in the state's role, delegating health care functions to the private sector through regulatory and contractual measures. Beginning in 2000, incremental reforms included instrumental changes in the system, while other initiatives aimed to expand the state's responsibilities in guaranteeing the right to health. In terms of health insurance, the main advances were the expansion of insurance coverage and harmonization of baskets of benefits between different insurance systems (although late). As for financing, there are important inequities in per capita spending between the different insurance systems and inefficiency in the financial intermediation. The Colombian case underscores the limits of structuring health systems with heavy market participation, and the study contributes to the debate on the challenges for social protection in health in Latin American countries.

Overcoming regulatory fear of public perceptions of mobile phone health risks

International Nuclear Information System (INIS)

Mercer, D.

2001-01-01

In the following discussion I will critique the images of the public, the mass media and science that permeate much of the regulatory discourse on RF and risk. These images are sometimes explicitly articulated but on other occasions merely implied. These images can be described as the mythical RF triad. Some examples are provided illustrating why the current approach represents a misleading oversimplification of the social and scientific context relevant to formulating a fair and scientifically accountable RF health policy. a number of suggestions are made for broadening the regulatory imagination and stimulate constructive debate on the RF question. Copyright (2001) Australasian Radiation Protection Society Inc

Nuclear safety and public debate

International Nuclear Information System (INIS)

Tanguy, P.

1997-01-01

In this article are evoked the question of nuclear safety and the public opinion, from the beginning of nuclear power plants in 1954 where a peaceful use of nuclear energy is developed in minds. If the aim was to avoid any important accident, the Three Miles Island accident and more recently the Chernobyl accident provoked a shock in public opinion and marked a peak of nuclear controversy. From this point, the policy of transparence and a best information of the public taken as a partner are necessary to maintain the dialogue. (N.C.)

Assessing the public health impact of using poison center data for public health surveillance.

Science.gov (United States)

Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

2017-12-13

The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

Integrating Genetic Studies of Nicotine Addiction into Public Health Practice: Stakeholder Views on Challenges, Barriers and Opportunities

Science.gov (United States)

Dingel, M.J.; Hicks, A.D.; Robinson, M.E.; Koenig, B.A.

2011-01-01

Objective: Will emerging genetic research strengthen tobacco control programs? In this empirical study, we interview stakeholders in tobacco control to illuminate debates about the role of genomics in public health. Methods: The authors performed open-ended interviews with 86 stakeholders from 5 areas of tobacco control: basic scientists, clinicians, tobacco prevention specialists, health payers, and pharmaceutical industry employees. Interviews were qualitatively analyzed using standard techniques. Results: The central tension is between the hope that an expanding genomic knowledge base will improve prevention and smoking cessation therapies and the fear that genetic research might siphon resources away from traditional and proven public health programs. While showing strong support for traditional public health approaches to tobacco control, stakeholders recognize weaknesses, specifically the difficulty of countering the powerful voice of the tobacco industry when mounting public campaigns and the problem of individuals who are resistant to treatment and continue smoking. Conclusions: In order for genetic research to be effectively translated into efforts to minimize the harm of smoking-related disease, the views of key stakeholders must be voiced and disagreements reconciled. Effective translation requires honest evaluation of both the strengths and limitations of genetic approaches. PMID:21757875

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

Science.gov (United States)

Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

The public health leadership certificate: a public health and primary care interprofessional training opportunity.

Science.gov (United States)

Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

2014-03-01

This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

Public debate, collective learning process and soil-plant system expertise: when scientific knowledge becomes socially distributed

OpenAIRE

Cornélis, Jean-Thomas; Cornelis, Mathieu; International Symposium on Change in governance as collective learning

2009-01-01

Here, we aim to develop the conditions of possibility of a collective learning process for the forest ecosystem governance. We argue that stakeholders’ discussion and public debate should be intrinsically interconnected with the expertise of the soil-plant cycle. As Chris Argyris underlines, “[i]t is possible to develop knowledge, both valid and which can be “put into action” in everyday life” and which “provides an opportunity to test it in everyday life”. Primary forest is the most biolo...

Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

Directory of Open Access Journals (Sweden)

Abiiro Gilbert

2012-10-01

Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health

Directory of Open Access Journals (Sweden)

Carlos Castillo-Salgado

2015-11-01

Full Text Available Abstract Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health.

Science.gov (United States)

Castillo-Salgado, Carlos

2015-11-01

Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

Advances in dental public health.

Science.gov (United States)

Holt, R D

2001-07-01

Dental public health has been defined as 'the science and art of preventing oral diseases, promoting oral health and improving the quality of life through the organised efforts of society'. Dental practitioners most often have the oral health of individual patients as their primary focus but the aim of public health is to benefit populations. Early developments in dental public health were concerned largely with demonstrating levels of disease and with treatment services. With greater appreciation of the nature of oral health and disease, and of their determinants has come recognition of the need for wider public health action if the effects of prevention and oral health promotion are to be maximized.

Health needs and public health functions addressed in scientific publications in Francophone sub-Saharan Africa.

Science.gov (United States)

Benie-Bi, J; Cambon, L; Grimaud, O; Kivits, J; Alla, F

2013-09-01

To describe the reporting of public health research in Francophone sub-Saharan Africa (FSA). A bibliometric research study of scientific public health publications in FSA, which includes 24 countries and approximately 260 million people. Two researchers analysed original articles published in 2007 in the medical or social sciences fields and indexed in Scopus. At least one co-author of articles had to be based in FSA. The analysis focused on research field, public health function (WHO classification), FSA country author's affiliation, language, journal type and global burden of disease (WHO classification). Of 1047 articles retrieved by the search, 212 were from the public health field. The number of articles per country varied from 0 to 36. Public health functions examined were health service research (24.5%), health monitoring (27.4%), prevention (15%) and legislation (0.5%). The distribution of health needs described in the articles was close to that of the WHO data for Africa for 2004: infectious and parasitic diseases (70% vs 54%), maternal and perinatal conditions (15% vs 17%), non-communicable diseases (15.6% vs 21%), and injuries (0.5% vs 8%). The areas reported in published articles from sub-Saharan Africa reflect the health needs distribution in Africa; however, the number of publications is low, particularly for prevention. In light of the current focus on evidence-based public health, this study questions whether the international scientific community adequately considers the expertise and perspectives of African researchers and professionals. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Assessing entrepreneurship in governmental public health.

Science.gov (United States)

Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

2015-04-01

We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

Public health educational comprehensiveness: The strategic rationale in establishing networks among schools of public health.

Science.gov (United States)

Otok, Robert; Czabanowska, Katarzyna; Foldspang, Anders

2017-11-01

The establishment and continuing development of a sufficient and competent public health workforce is fundamental for the planning, implementation, evaluation, effect and ethical validity of public health strategies and policies and, thus, for the development of the population's health and the cost-effectiveness of health and public health systems and interventions. Professional public health strategy-making demands a background of a comprehensive multi-disciplinary curriculum including mutually, dynamically coherent competences - not least, competences in sociology and other behavioural sciences and their interaction with, for example, epidemiology, biostatistics, qualitative methods and health promotion and disease prevention. The size of schools and university departments of public health varies, and smaller entities may run into problems if seeking to meet the comprehensive curriculum challenge entirely by use of in-house resources. This commentary discusses the relevance and strength of establishing comprehensive curriculum development networks between schools and university departments of public health, as one means to meet the comprehensiveness challenge. This commentary attempts to consider a two-stage strategy to develop complete curricula at the bachelor and master's as well as PhD levels.

Qualidade de vida e saúde: um debate necessário Quality of life and health: a necessary debate

Directory of Open Access Journals (Sweden)

Maria Cecília de Souza Minayo

2000-01-01

Full Text Available Este trabalho traz para o debate as relações entre saúde e qualidade de vida. Busca situar os discursos que se constróem na área da saúde em outros setores e outras disciplinas. Trata de uma representação social criada a partir de parâmetros subjetivos (bem-estar, felicidade, amor, prazer, realização pessoal, e também objetivos, cujas referências são a satisfação das necessidades básicas e das necessidades criadas pelo grau de desenvolvimento econômico e social de determinada sociedade. Mostra os principais instrumentos construídos nos últimos anos para medir qualidade de vida e as discussões que provocam. Reflete, também, sobre o campo semântico em que se desenvolvem as representações e ações voltadas para a qualidade de vida, como as noções de desenvolvimento, democracia, modo, condições e estilo de vida. Na área da saúde, discute a tendência de se estreitar o conceito de qualidade de vida ao campo biomédico, vinculando-o à avaliação econômica. Apresenta os mais variados instrumentos criados para medi-la nessa referida concepção. Considera a proposta de promoção da saúde como a mais relevante estratégia do setor, para evitar o reducionismo médico e realizar um diálogo intersetorial. Argumenta, porém, que essa proposta ainda carece de aprofundamento e de ser testada nas práticas sanitárias.This paper discusses the relationships between quality of life and health by applying the discourses emerging in the health sector to other fields and other disciplines. These relationships constitute social representation based on subjective parameters (well-being, happiness, love, pleasure, personal satisfaction, and on objective ones such as satisfaction of basic needs and of the needs created by the degree of economical and social development of a given society. The text presents the main instruments which have been constructed during the last years for measuring quality of life, as well as the debate they

42 CFR 90.9 - Public health advisory.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

Huntington in Holland: The Public Debate on Muslim Immigrants in the Netherlands

NARCIS (Netherlands)

Vellenga, S.J.

2008-01-01

Since the beginning of this century, Muslim immigrants have become the subject of a heated debate in the Netherlands. This article examines and analyses this debate which is characterised by five distinctive elements: culturalisation, Islamisation, rejection of Islam, ‘new’ nationalism and the plea

Nuclear power debate and public opinion in Belarus: From Chernobyl to Ostrovets.

Science.gov (United States)

Novikau, Aliaksandr

2017-04-01

The Belarusian government's decision of the last decade to build a nuclear power plant near the city of Ostrovets, in northern Belarus, has proven to be controversial, resulting in a great deal of debate about nuclear energy in the country. The debate was inevitably shaped by the traumatic event that affected Belarus - the Chernobyl nuclear accident of 1986. The Belarusian authorities have consistently promoted a positive view of nuclear energy to the population in order to overcome the so-called 'Chernobyl syndrome' and deliberately shaped nuclear risk communication. As a result, the issue of trust remains crucial in all nuclear debates in Belarus.

The nuclear debate in Canada

International Nuclear Information System (INIS)

Macaulay, H.L.

1981-06-01

The author argues that the nuclear debate in Canada is concerned less with the safety of nuclear power plants and more with arguments of economics and social decision-making. The nuclear industry cannot afford to neglect the continuing need to inform the public about nuclear risks. But there is also a need to develop specific arguments to increase public acceptance of nuclear energy as an economic, democratic and equitable energy option

GIS and Public Health

Directory of Open Access Journals (Sweden)

Stefania Bertazzon

2014-06-01

Full Text Available This Special Issue on GIS and public health is the result of a highly selective process, which saw the participation of some 20 expert peer-reviewers and led to the acceptance of one half of the high-quality submissions received over the past year. Many threads link these papers to each other and, indeed, to our original call for papers, but the element that most clearly emerges from these works is the inextricable connection between public health and the environment. Indeed, GIS analysis of public health simply cannot disregard the geospatial dimension of environmental resources and risks. What consistently emerges from these analyses is that current geospatial research can only scratch the surface of the complex interactions of spatial resources, risks, and public health. In today’s world, or at least in the developed world, researchers and practitioners can count on virtually endless data, on inexpensive computational power, and on seamless connectivity. In this research environment, these papers point to the need for improved analytical tools, covering concepts, representation, modeling and reliability. These works are important contributions that help us to identify what advances in geospatial analysis can better address the complex interactions of public health with our physical and cultural environment, and bridge research and practice, so that geospatial analyses can inform public health policy making. [...

Recommendations from a Meeting on Health Implications of ...

African Journals Online (AJOL)

The Ghana Public Health Association organized a scientific seminar to examine the introduction of genetically modified organisms into public use and the health consequences. The seminar was driven by current public debate on the subject. The seminar identified some of the advantages of GMOs and also the health ...

Mental health in prisons: A public health agenda.

Science.gov (United States)

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Academic dental public health diplomates: their distribution and recommendations concerning the predoctoral dental public health faculty.

Science.gov (United States)

Kaste, L M; Sadler, Z E; Hayes, K L; Narendran, S; Niessen, L C; Weintraub, J A

1998-01-01

The purpose of this study was to assess the representation of academically based diplomates of the American Board of Dental Public Health (ABDPH) and to identify their perceptions on the training of dental public health predoctoral faculty. Data were collected by a mailed, self-administered, 13-item questionnaire. The population was the 48 diplomates of the ABDPH as of March 1997 associated with academic institutions. Twenty of the 55 US dental schools had a diplomate of the ABDPH with a mean of 1.8 diplomates per school with a diplomate. An average of 4.5 full-time faculty members per school were associated with teaching dental public health. A master's degree in public health (MPH) was the most frequently suggested educational requirement for dental public health faculty. Continuing education courses were training needs perceived for dental public health faculty. The lack of time, money, and incentives, along with perceived rigidity of requirements for board certification, were reported as major barriers for faculty becoming dental public health board certified. Numerous challenges confront the development of a strong dental public health presence in US dental schools. These challenges include, among others, insufficient numbers of academic dental public health specialists and insufficient motivations to encourage promising candidates to pursue specialty status.

[Debate and challenges on the topic of free medical care in Africa: "Back to the Future"?].

Science.gov (United States)

Ridde, Valéry; Blanchet, Karl

2009-01-01

In its 2008 annual report, WHO affirmed the importance of resisting the temptation to depend on direct payment for primary health care. Members of the WHO committee on the social determinants of health as well as of those at the conference on primary health care in Ouagadougou in 2008 reaffirmed the need to make access to health care systems more equitable. Several decades after imposition of direct payment began, convincing data clearly demonstrate its harmful effects on the basic fairness of access to care. Accordingly, the current debate in the field of financial support for health involves the elimination of payments. More precisely, we can finally say that this is a debate about a return to the free care that existed before the widespread implementation of "cost recovery" systems. Here we want to review these discussions and prepare the ground for a debate on possible effective strategies for making health care systems more equitable from the perspective of universal coverage. We will thus note that analyses today must certainly focus more on how to eliminate direct payments than on the reasons to do so, already amply demonstrated. The international community must now undertake to support governments that want to move in this direction and ensure that the process is thoroughly documented so that it can also produce useful knowledge for the formulation of fair public policies.

[Inequity in health: its historical development].

Science.gov (United States)

Salaverry García, Oswaldo

2013-01-01

Health inequity, main issue of contemporary debates on public health, is based on philosophical and historical concepts that date back to the idea of justice from classic Greece. The Aristotelian approach on distributive justice and its higher form, epiekeia or equity, has been reviewed, as well as how this evolves from the Middle Ages and modernity to the heart of the debate of a variety of thinkers such as liberal Rawls and Nobel laureate Amartya Sen. On this conceptual debate lies the World Health Organization version that links equity to health determinants and intends to make it operational through the equitable provision of health services.

Celebrating the work of Gavin Mooney: inclusiveness and involvement in global and public health issues.

Science.gov (United States)

McIntyre, Diane

2014-05-01

This paper considers Gavin Mooney's contributions to the research literature on inclusiveness in global and public health issues. Much of his contribution in this area stems from engaging with Indigenous people, which cemented his conviction that it is important to recognise the heterogeneity of groups in society, especially in relation to cultural differences. He believed that in order to develop appropriate equitable and efficient health and related policies, the preferences of citizens should be elicited. While this could feed into very specific policy decisions, such as how to allocate available resources within a particular community, more generally, community preferences should determine the core values that underpin a health system. He proposed that these values be documented in a 'constitution' and serve as the basis on which policy-makers and health managers make decisions. Preference elicitation has value in itself, as procedural justice allows for self-determination and contributes to empowerment. Further, engagement by citizens in deliberative processes can overcome polarisation. Health systems themselves, if developed as social institutions, can influence the nature of society and contribute to greater unity. Mooney raised similar concerns about policies arising from mono-cultural global perspectives and argued that, whether at the national or global level, values for health systems should be based on community preferences. He particularly highlighted the unequal distribution of benefits of neoliberal globalisation as the cause of growing health and wealth inequalities globally. There is resonance between Mooney's views on these issues and some of the contributions to the post-2015 development agenda debates. While it is unlikely that we have reached a point where the stranglehold of neo-liberal governments on key global institutions will be broken, the current debates nevertheless present an important window of opportunity to struggle for shifts in

Utility and justice in public health.

Science.gov (United States)

MacKay, Kathryn

2017-12-11

Many public health practitioners and organizations view themselves as engaged in the promotion or achievement of equity. However, discussions around public health frequently assume that practitioners and policy-makers take a utilitarian approach to this work. I argue that public health is better understood as a social justice endeavor. I begin by presenting the utility view of public health and then discuss the equity view. This is a theoretical argument, which should help public health to justify interventions for communicable and non-communicable diseases equally, and which contributes to breaking down the 'old/new' public health divide. This argument captures practitioners' views of the work they are engaged in and allows for the moral and policy justification of important interventions in communicable and non-communicable diseases. Systemic interventions are necessary to remedy high rates of disease among certain groups and, generally, to improve the health of entire populations. By viewing diseases as partly the result of failures of health protective systems in society, public health may justify interventions in communicable and non-communicable diseases equally. Public health holds a duty to improve the health of the worst-off in society; by prioritizing this group, the health of the whole community may improve. © The Author(s) 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Public health

NARCIS (Netherlands)

Berg, van den A.E.

2007-01-01

Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she

Critical perspectives in public health

National Research Council Canada - National Science Library

Green, Judith; Labonte, Ronald N

2008-01-01

... the contemporary roles of 'critical voices' in public health research and practice from a range of disciplines and contexts. The book covers many of the pressing concerns for public health practitioners and researchers, including: * * * * * the implications of new genetic technologies for public health; the impact of globalisation on local practice...

An EPR at Penly: an outline from the SFEN to feed the public debate

International Nuclear Information System (INIS)

Anon.

2010-01-01

Penly-3 is the project to build an EPR reactor as a third unit on the Penly site (France). The authors have reviewed 5 reasons to back it: 1) nuclear power is a useful source of energy at the world scale, 2) nuclear power is an adequate solution to meet our future needs of energy, 3) the EPR is at the top of today's nuclear technology, 4) nuclear power is an efficient tool to diminish CO 2 releases, and 5) The EPR is a valuable asset to maintain France in the top group of world actors in the nuclear sector. A public debate will be held soon concerning the Penly-3 project. (A.C.)

Development of Systematic Knowledge Management for Public Health: A Public Health Law Ontology

Science.gov (United States)

Keeling, Jonathan

2012-01-01

The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the public health system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

POBREZA Y DESIGUALDADES SOCIALES: UN DEBATE OBLIGATORIO EN SALUD ORAL POBREZA E DESIGUALDES SOCIAIS: UM DEBATE OBRIGATORIO EM SAUDE ORAL POVERTY AND INEQUALITIES: AN OBLIGATORY DENTAL HEALTH DEBATE

Directory of Open Access Journals (Sweden)

César Ernesto Abadía Barrero

2006-01-01

Full Text Available Las reformas al sector salud de las últimas décadas en Latinoamérica están fomentando la privatización de los servicios siguiendo principios de corte liberal. A diferencia de un sistema de medicina social, en sistemas privados el acceso de las personas a los servicios depende de la capacidad adquisitiva y su énfasis es más terapéutico que preventivo. El resultado es que personas con más recursos tienen menos riesgo de enfermar y de que sus enfermedades se agraven. De otro lado, quienes viven en la pobreza no solamente son más vulnerables a padecer enfermedades, sino que tienen menos acceso a los servicios de salud y, al no recibir tratamientos adecuados y oportunos, sus enfermedades se agravan. Esta situación es peor aún en temas de salud oral, donde se requiere un debate con la bioética como interlocutora para proponer sistemas de equidadAs reformas do setor saúde das últimas décadas na América Latina estão fomentando a privatização dos serviços, seguindo princípios de cunho liberal. Diferentemente de um sistema de medicina social, em sistemas privados, o acesso das pessoas aos serviços depende da capacidade de aquisiçãoe sua ênfase é mais terapêutica que preventiva. O resultado é que as pessoas com mais recursos tem menos risco de ficarem doentes e de que suas enfermidades se agravem. Por outro lado, as pessoas que vivem na pobreza, não somente são mais vulneráveis em sofrer enfermidades, mas também têm menos acesso aos serviços de saúde e, ao não receber tratamentos adequados e oportunos, suas enfermidades se agravam com o tempo. Esta situação se encontra agravada em temas de saúde oral, onde se exige um debate com a bioética como interlocutora para propor sistemas de equidadeLatinamerican last decades' health reforms have encouraged liberal principles where access to services depend on purchasing power, and where emphasis is placed more on therapeutics than on prevention. Therefore, people with high

A Case for Open Network Health Systems: Systems as Networks in Public Mental Health.

Science.gov (United States)

Rhodes, Michael Grant; de Vries, Marten W

2017-01-08

Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH) services in the Netherlands. Decentralized under the (Community) Participation Act (2014), local governments must find resources to compensate for reduced central funding to such services or "innovate." But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional "health system" definitions, literature and narratives, and operating assumptions in public (mental) health are 'locked in' constraining technical and organization innovations. If we view a "health system" as an adaptive system of economic and social "networks," it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a "centralized hierarchical" or "tree" network. An overlooked alternative that breaks out of the established policy narratives is the view of a 'health systems' as a non-hierarchical organizational structure or 'Open Network.' In turn, this opens new technological and

Public health leadership education in North America

OpenAIRE

Uno, Hideo; Zakariasen,Kenneth

2010-01-01

Hideo Uno, Kenneth ZakariasenDepartment of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, CanadaAbstract: Public health leadership is one of the priority disciplines public health professionals need to learn well if they are to deal with demanding public health issues effectively and efficiently. This article looks at the trends in public health leadership education by reviewing the literature and using the Internet to explore the public health leadershi...

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

OpenAIRE

Orvik, Arne

2016-01-01

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutio...

Gender blind? An analysis of global public-private partnerships for health.

Science.gov (United States)

Hawkes, Sarah; Buse, Kent; Kapilashrami, Anuj

2017-05-12

The Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power. Gender is an important determinant of health status, influencing differences in exposure to health determinants, health behaviours, and the response of the health system. We identified 18 GPPPH - defined as global institutions with a formal governance mechanism which includes both public and private for-profit sector actors - and conducted a gender analysis of each. Gender was poorly mainstreamed through the institutional functioning of the partnerships. Half of these partnerships had no mention of gender in their overall institutional strategy and only three partnerships had a specific gender strategy. Fifteen governing bodies had more men than women - up to a ratio of 5:1. Very few partnerships reported sex-disaggregated data in their annual reports or coverage/impact results. The majority of partnerships focused their work on maternal and child health and infectious and communicable diseases - none addressed non-communicable diseases (NCDs) directly, despite the strong role that gender plays in determining risk for the major NCD burdens. We propose two areas of action in response to these findings. First, GPPPH need to become serious in how they "do" gender; it needs to be mainstreamed through the regular activities, deliverables and systems of accountability. Second, the entire global health community needs to pay greater attention to tackling the major burden of NCDs, including addressing the gendered nature of risk. Given the inherent conflicts of interest in tackling the determinants of many NCDs, it is debatable whether the emergent GPPPH model will be an appropriate one for addressing NCDs.

Politics, Police Accountability, and Public Health: Civilian Review in Newark, New Jersey.

Science.gov (United States)

McGregor, Alecia

2016-04-01

Police brutality, a longstanding civil rights issue, has returned to the forefront of American public debate. A growing body of public health research shows that excessive use of force by police and racial profiling have adverse effects on health for African Americans and other marginalized groups. Yet, interventions to monitor unlawful policing have been met with fierce opposition at the federal, state, and local levels. On April 30, 2015, the mayor of Newark, New Jersey signed an executive order establishing a Civilian Complaint Review Board (CCRB) to monitor the Newark Police Department (NPD). Using a mixed-methods approach, this study examined how advocates and government actors accomplished this recent policy change in the face of police opposition and after a 50-year history of unsuccessful attempts in Newark. Drawing on official public documents, news media, and interviews conducted in April and May 2015, I propose that: (1) a Department of Justice investigation of the NPD, (2) the activist background of the Mayor and his relationships with community organizations, and (3) the momentum provided by the national Black Lives Matter movement were pivotal in overcoming political obstacles to reform. Examining the history of CCRB adoption in Newark suggests when and where advocates may intervene to promote policing reforms in other US cities.

Exploring the compassion deficit debate.

Science.gov (United States)

Stenhouse, Rosie; Ion, Robin; Roxburgh, Michelle; Devitt, Patric Ffrench; Smith, Stephen D M

2016-04-01

Several recent high profile failures in the UK health care system have promoted strong debate on compassion and care in nursing. A number of papers articulating a range of positions within this debate have been published in this journal over the past two and a half years. These articulate a diverse range of theoretical perspectives and have been drawn together here in an attempt to bring some coherence to the debate and provide an overview of the key arguments and positions taken by those involved. In doing this we invite the reader to consider their own position in relation to the issues raised and to consider the impact of this for their own practice. Finally the paper offers some sense of how individual practitioners might use their understanding of the debates to ensure delivery of good nursing care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Naturlighed, barnets tarv og kompensationsberettigelse i den politiske debat om kunstig befrugtning

DEFF Research Database (Denmark)

Nielsen, Lasse

2012-01-01

moral principles, the functioning based and the responsibility-sensitivity principle, that both independently and together support the conclusion that people suffering the disadvantage of being infertile is in fact entitled to public funded compensation. The article concludes that it is morally......This article provides a normative discussion of the political debate on public funded fertility-treatment in Denmark. It shows that especially three normative considerations attract attention in the debate. In the early part of the debate (1996) many Danish politicians weigh highly the moral......, and due to Parfit’s non-identity problem the interest of the child is irrelevant to such political debates. In the late part of the debate (2010) the question of whether infertility entails compensation-entitlement becomes crucial. Drawing on insights of political philosophy, the article suggests two...

PPACA and public health: creating a framework to focus on prevention and wellness and improve the public's health.

Science.gov (United States)

Majette, Gwendolyn Roberts

2011-01-01

PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health. © 2011 American Society of Law, Medicine & Ethics, Inc.

One Health Perspectives on Emerging Public Health Threats

Directory of Open Access Journals (Sweden)

Sukhyun Ryu

2017-11-01

Full Text Available Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm.

Climate Change and Public Health.

Science.gov (United States)

Ciesielski, Timothy

2017-05-01

It is clear that the public health community is concerned about the human health impacts of climate change, but are we inadvertently underestimating the scope of the problem and obfuscating potentially useful interventions by using a narrow intellectual frame in our discussions with policy makers? If we take a more holistic approach, we see that the public health impacts of climate change are only one subset of the enormous public health impacts of fossil fuel burning. This broader perspective can provide a more accurate and comprehensive assessment that is more useful for decision making in public policy settings.

Liberalism and Public Health Ethics.

Science.gov (United States)

Rajczi, Alex

2016-02-01

Many public health dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard public health interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in public health; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of public health ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in public health. © 2015 John Wiley & Sons Ltd.

[Regulatory policies on alcohol in Spain. Experience-based public health? 2008 SESPAS Report].

Science.gov (United States)

Villalbí, Joan R; Granero, Lluís; Brugal, M Teresa

2008-04-01

The present article reviews the proposal for alcohol regulation made in Spain in 2006 by the Ministry of Health and Consumer Affairs and dropped a few months later as adverse positions took over the debate in the political arena and the media. The background to these regulations, as well as their components, the process, and the actors involved are analyzed, and the factors leading to this outcome are discussed. A comparison is made with the tobacco regulation initiative in 2005, which resulted in a regulatory law with a highly favorable impact on public health. The actors interested in promoting alcohol consumption and opposed to any regulation have a privileged institutional presence, generating powerful resistance. Although these regulatory proposals would have marginal impacts on their trade, wine growers and wineries have been the most visible forces against regulation and have had the greatest political and media impact. Equally, manipulated messages on the health benefits of alcohol use have fed arguments against regulation. The lack of political and media consensus in this case stands in contrast with the tobacco regulation process, in which a certain political consensus had previously been reached and the smoking prevention movement had permeated the media with preventive messages, framing the issue in terms favorable for regulation. To gain ground, the sectors interested in expanding public policies for the prevention of the harm caused by alcohol need greater cohesion and organization. Professional public health organizations can substantially contribute to this field.

Enhancing crisis leadership in public health emergencies.

Science.gov (United States)

Deitchman, Scott

2013-10-01

Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

Approaches to Climate Change & Health in Cuba: Guillermo Mesa MD MPhil, Director, Disasters & Health, National School of Public Health. Paulo Ortiz MS PhD, Senior Researcher, Climate Center, Cuban Meteorology Institute.

Science.gov (United States)

Mesa, Guillermo; Ortiz, Paulo; Gorry, Conner

2015-04-01

The US National Institutes of Health predict climate change will cause an additional 250,000 deaths between 2030 and 2050, with damages to health costing US$2-$4 billion by 2030. Although much debate still surrounds climate change, island ecosystems-such as Cuba's-in the developing world are arguably among the most vulnerable contexts in which to confront climate variability. Beginning in the 1990s, Cuba launched research to develop the evidence base, set policy priorities, and design mitigation and adaptation actions specifically to address climate change and its effects on health. Two researchers at the forefront of this interdisciplinary, intersectoral effort are epidemiologist Dr Guillermo Mesa, who directed design and implementation of the nationwide strategy for disaster risk reduction in the Cuban public health system as founding director of the Latin American Center for Disaster Medicine (CLAMED) and now heads the Disasters and Health department at the National School of Public Health; and Dr Paulo Ortiz, a biostatistician and economist at the Cuban Meteorology Institute's Climate Center (CENCLIM), who leads the research on Cuba's Climate and Health project and is advisor on climate change and health for the UN Economic Commission for Latin America and the Caribbean (ECLAC).

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

DEFF Research Database (Denmark)

Orvik, Arne

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing...... as the disintegration of such values. Possible implications for public health management and leadership include four different forms. The application of the conceptual model can potentially draw attention to value conflicts and help to clarify contradictory, institutional logics. It can also potentially support health...... workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...

The 'Brain Drain' of physicians: historical antecedents to an ethical debate, c. 1960-79.

Science.gov (United States)

Wright, David; Flis, Nathan; Gupta, Mona

2008-11-10

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then deemed to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics.

Surfing the net for public health resources.

Science.gov (United States)

Angell, C; Hemingway, A; Hartwell, H

2011-08-01

To identify public health open educational resources (OER) available online, map the identified OER to The Public Health Skills and Career Framework (PHSCF), and triangulate these findings with public health practitioners. Systematic online search for public health OER. An online search was undertaken using a pre-defined set of search terms and inclusion/exclusion criteria. Public health OER were then mapped against the UK PHSCF. The findings of the search were discussed with public health specialists to determine whether or not they used these resources. A number of public health OER were identified, located on 42 websites from around the world. Mapping against the UK PHSCF demonstrated a lack of coverage in some areas of public health education. It was noted that many of the OER websites identified were not those generally used in practice, and those sites preferred by public health specialists were not identified by the online search. Public health OER are available from a number of providers, frequently universities and government organizations. However, these reflect a relatively small pool of original OER providers. Tagging of websites does not always identify their public health content. In addition, users of public health OER may not use search engines to identify resources but locate them using other means. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Intercultural competency in public health: a call for action to incorporate training into public health education

Directory of Open Access Journals (Sweden)

Julia eFleckman

2015-09-01

Full Text Available Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultural roles needs to be included in all processes of planning, implementation and evaluation. In focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt and strengthen intercultural competence education in public health educational institutions.

The State Public Health Laboratory System.

Science.gov (United States)

Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

2010-01-01

This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

Fatal exit the automotive black box debate

CERN Document Server

Kowalick, Tom

2005-01-01

"Fatal Exit: The Automotive Black Box Debate cuts through thirty years of political wrangling and institutional biases to provide an argument for the Motor Vehicle Event Data Recorder (MVEDR). This automotive equivalent of an airplane's flight recorder or black box is intended to solve the mysteries of car crashes and improve the safety of our roads. The reader is taken inside the automotive industry and the government highway safety establishment to foster an understanding of the politics and the positions on all sides of this safety debate. The author takes an unbiased approach, chronologically presenting each argument and uncovering the agendas and mandates of each of the stakeholders." "This publication is essential reading for all consumers who need to have their voices heard on this critical issue, as well as for attorneys, public safety advocates, public policy administrators, engineers, automotive professionals, journalists, and insurance executives."--Jacket.

Ethics in public health: call for shared moral public health literacy.

Science.gov (United States)

Maeckelberghe, Els L M; Schröder-Bäck, Peter

2017-10-01

Public Health (PH) in Europe has become much more vocal about its moral understandings since 1992. The rising awareness that PH issues were inseparable from issues of human rights and social justice almost self-evidently directed the agenda of EUPHA and the European Public Health (EPH)-conferences. Problems of cultural and behavioural change, and environmental issues on a global scale were also added. The Section Ethics in PH invited the EPH community to join in 'arm chair thinking': coming together at conferences not only to share the 'how' and 'what' of PH research, practices and policies but also the 'why'. Time has been reserved to genuinely discuss what moral values are at stake in the work of PH and to actively develop a moral language and framework for PH Ethics. The challenge for the next decades is to find ways to involve the general public in the cultivation of a shared moral PH literacy. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education.

Science.gov (United States)

Fleckman, Julia M; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C

2015-01-01

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions.

Conventional and ecological public health.

Science.gov (United States)

Rayner, G

2009-09-01

This paper suggests that current models of public health are no longer sufficient as a means for understanding the health challenges of the anthropogenic age, and argues for an alternative based upon an ecological model. The roots of this perspective originated within the Victorian era, although it found only limited expression at that time. Ecological thinking in public health has only been revived relatively recently. Derived from an analysis of obesity, this paper proposes the development of an approach to ecological public health based on four dimensions of existence: the material, the physiological, the social and the cultural-cognitive. The implications for public policy are considered.

Hearing of the public on September 19, 2005 at Cherbourg; Audition du public, Cherbourg, le 19 septembre 2005

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprises 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is the synthesis of the debates of the last public hearing at Cherbourg. This meeting gathers representatives of the different actors of the nuclear industry, ministers, public authorities, non governmental organizations who argue the questions asked by peoples from the audience. The topics concern the public health aspects and the risks linked with nuclear activities in general, the safety and security aspects of waste reprocessing and disposal facilities, and the technical feasibility of transmutation. (J.S.)

Why feminism in public health?

Science.gov (United States)

Hammarström, A

1999-12-01

The issues raised in this editorial and exemplified within a number of the studies reported in this issue indicate new directions for public health, directions which take feminist scholarship, both outside and within the medical framework, into account. The changing potential of feminist public health, as derived from the articles in this issue, can be summarised within the following issues: new research areas, positioning women as actors, development of theoretical frameworks, reflexive theory of science, interplay between sex and gender, gender-sensitive methods, diversities among women/men, pro-feminist research on men's health and using the results for change. Thus, feminist public health represents a shift towards the new public health, with holistic and multidisciplinary activities, based on theoretical pluralism, multiple perspectives and collective actions with the aim of improving the health of gender-subordinated groups.

The influence of violent media on children and adolescents:a public-health approach.

Science.gov (United States)

Browne, Kevin D; Hamilton-Giachritsis, Catherine

There is continuing debate on the extent of the effects of media violence on children and young people, and how to investigate these effects. The aim of this review is to consider the research evidence from a public-health perspective. A search of published work revealed five meta-analytic reviews and one quasi-systematic review, all of which were from North America. There is consistent evidence that violent imagery in television, film and video, and computer games has substantial short-term effects on arousal, thoughts, and emotions, increasing the likelihood of aggressive or fearful behaviour in younger children, especially in boys. The evidence becomes inconsistent when considering older children and teenagers, and long-term outcomes for all ages. The multifactorial nature of aggression is emphasised, together with the methodological difficulties of showing causation. Nevertheless, a small but significant association is shown in the research, with an effect size that has a substantial effect on public health. By contrast, only weak evidence from correlation studies links media violence directly to crime.

Education Improves Public Health and Promotes Health Equity.

Science.gov (United States)

Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

Applications of health information exchange information to public health practice.

Science.gov (United States)

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

Public health emergencies in urban India

Directory of Open Access Journals (Sweden)

Bhabani Prasad Acharya

2018-03-01

Full Text Available Public health emergencies in urban India can be caused by natural or man-made disasters. Occurrence of a public health emergency adds to the already stretched health system. This paper looks into the public health emergency conditions in urban India, and our preparedness to tackle them. To address this composite threat to nation’s health and development, a concerted public health response is needed, that can ensure efficient delivery in emergency situations Public health emergency is an occurrence or eminent threat of an illness or health condition caused by bio-terrorism, epidemic or pandemic disease, or novel and highly fatal infectious agent or biological toxin, that possess a substantial risk of a significant number of human facilities or incidents or permanent or long–term disability (1. It is a condition that requires the government to declare a state of public health emergency. The declaration of a state of public health emergency permits the government to suspend state regulations,and change the functions of state agencies (2. Term “Urban” refers to perplexing variety of environments.  Health circumstances of small cities and town differ in many ways from larger cities and metros. Within cities, change in lifestyle of residents is observed. The urban system is often present with full array of health providers ranging from traditional healer, street drug seller to highly –trained surgeons (3.

Influencing public health without authority.

Science.gov (United States)

Suresh, K

2012-01-01

This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.

Twitter and Public Health (Part 1): How Individual Public Health Professionals Use Twitter for Professional Development.

Science.gov (United States)

Hart, Mark; Stetten, Nichole E; Islam, Sabrina; Pizarro, Katherine

2017-09-20

The use of social networking sites is increasingly being adopted in public health, in part, because of the barriers to funding and reduced resources. Public health professionals are using social media platforms, specifically Twitter, as a way to facilitate professional development. The objective of this study was to identify public health professionals using Twitter and to analyze how they use this platform to enhance their formal and informal professional development within the context of public health. Keyword searches were conducted to identify and invite potential participants to complete a survey related to their use of Twitter for public health and professional experiences. Data regarding demographic attributes, Twitter usage, and qualitative information were obtained through an anonymous Web-based survey. Open-response survey questions were analyzed using the constant comparison method. "Using Twitter makes it easier to expand my networking opportunities" and "I find Twitter useful for professional development" scored highest, with a mean score of 4.57 (standard deviation [SD] 0.74) and 4.43 (SD 0.76) on a 5-point Likert scale. Analysis of the qualitative data shows the emergence of the following themes for why public health professionals mostly use Twitter: (1) geography, (2) continuing education, (3) professional gain, and (4) communication. For public health professionals in this study, Twitter is a platform best used for their networking and professional development. Furthermore, the use of Twitter allows public health professionals to overcome a series of barriers and enhances opportunities for growth. ©Mark Hart, Nichole E Stetten, Sabrina Islam, Katherine Pizarro. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.09.2017.

Public health challenges in sun protection.

Science.gov (United States)

Eide, Melody J; Weinstock, Martin A

2006-01-01

Sunscreens are a popular choice for protection from ultraviolet radiation, and hence, important components in the public health campaign to reduce the burden of skin cancer. Public health messages in skin cancer prevention have been used effectively in educational campaigns. The benefits of sunscreen extend beyond skin cancer prevention into other aspects of health and disease prevention: sunscreen decreases the risk for sunburn during physical activity outdoors and seems not to increase the risk for osteoporosis. Public health efforts have laid a solid foundation on which to face the continuing challenge of promoting and developing effective public health campaigns and health policies that encourage sunscreen use, sun protection, and the primary prevention of skin cancer. In this article, the controversies, concerns, and challenges of sunscreen use as it relates to public health are discussed.

Periodontal health and global public health

DEFF Research Database (Denmark)

Petersen, Poul E; Baehni, Pierre C

2012-01-01

Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing...... to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal....../oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging...

Public Health Autonomy: A Critical Reappraisal.

Science.gov (United States)

Zimmerman, Frederick J

2017-11-01

The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

(Public) Health and Human Rights in Practice.

Science.gov (United States)

Annas, George J; Mariner, Wendy K

2016-02-01

Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing. Copyright © 2016 by Duke University Press.

Primary health care and public health: foundations of universal health systems.

Science.gov (United States)

White, Franklin

2015-01-01

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

Public Debates over Islam and the Awareness of Muslim identity in the Netherlands

NARCIS (Netherlands)

Shadid, W.

2006-01-01

National and international events in which Muslims have been engaged have triggered heated debates on the integration of these groups in and their loyalty to Dutch society. In this regard, Dutch government has intervened, directly and indirectly, in Muslim religious affairs. The debates and the

Chiropractic care and public health

DEFF Research Database (Denmark)

Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

2012-01-01

The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession...

Public health medicine: the constant dilemma.

Science.gov (United States)

Eskin, Frada

2002-03-01

There is a well-known quotation by the nineteenth-century sociologist Virchow (quoted in Ref. 1) that aptly captures the dilemma that has confronted public health medicine since the specialty was created as a discrete entity in 1848. Virchow said: 'Medicine is politics and social medicine is politics writ large!' What does this mean in relation to effective public health medicine practice and how is it likely to affect its future? There is increasingly limited freedom of expression within the current context of political correctness, central control and a rapidly burgeoning litigious climate. The purpose of this paper is to explore these issues and to propose a means of maintaining public health medicine integrity within a working environment where action is becoming rapidly constrained by political rigidity. An additional factor to be included in the dialogue is the current context within which public health physicians work. Because the majority of public health doctors are employed within the National Health Service (NHS), they are finding themselves being expected to take on tasks and responsibilities marginal to their essential purpose and function. For example, public health physicians spend a great deal of time involved in detailed deliberations about health service provision. Although there is a great deal of evidence to show that good quality health care provision positively affects the health of the individual, there is no evidence to show that this activity has any effect on the population's health status. The essence of public health medicine practice is the prevention of ill-health and the promotion of the health of the population and, consequently, attention needs to be focused on the root causes of disease. However, as these are outside the aegis of the NHS, public health medicine involvement in such issues as education, nutrition, housing, transport and poverty is regarded as marginal to the NHS corporate agenda.

Child public health

National Research Council Canada - National Science Library

Blair, Mitch

2010-01-01

"Despite children making up around a quarter of the population, the first edition of this book was the first to focus on a public health approach to the health and sickness of children and young people...

The Atlanta Urban Debate League: Exploring the Making of a Critical Literacy Space

Science.gov (United States)

Cridland-Hughes, Susan

2016-01-01

The Atlanta Urban Debate League was established in 1985 as an after school program focused on providing debate outreach to high school students in the Atlanta public schools. Still in operation today, volunteers work with current students in public middle and high schools in Atlanta, supporting students as they practice reading, writing, speaking…

[Survey on public health nursing education-in the comparison of nursing education courses, universities, advanced courses for public health nurse with junior nursing colleges, and public health nursing school].

Science.gov (United States)

Hirano, Kayoko; Ikeda, Nobuko; Kanagawa, Katuko; Shiomi, Sigeki; Suzuki, Akira; Hirayama, Tomoko; Furuya, Akie; Ymazaki, Kyoko; Yasumura, Seiji

2005-08-01

Changes in public health nursing education have been consideration. Theses changes include a dramatic increase in the number of public health nurses (PHNs) who have enrolled for nursing courses at university. This study was conducted to assess the current status and future of public health nursing education as perceived by teachers and students at three types of schools: universities offering nursing courses, advanced courses for PHNs with junior nursing colleges, and public health nursing schools. Questionnaires were distributed to teachers and students by mail. The questions that were sent to teachers asked which subjects were required to become a certified PHN, which lecture methods were employed to teach public health-particularly community health assessment methods, and what was the level of awareness of the activities of PHNs. Students were asked about their motivation to be a PHN, their understanding of public health, their views of public health activities and their images of PHNs. Responses were analyzed and differences between questionnaires from different schools were noted. These included the number of subjects and the total number of hours spent doing practical training and field experience in universities and the other types of schools, and the number of teachers. Differences also were noted among students at three types of schools about their age, methods of public health activities, knowledge about activities undertaken by PHNs, and their images of PHNs. No differences were observed among the schools with respect to the students' conceptual understanding of public health. Student age, practical training and field experience were found to contribute to their level of understanding of public health and public health nursing. It is thus necessary to consider the teaching methods employed by universities that administer nursing courses and the effectiveness of courses offered by graduate schools.

Protecting Health and Saving Lives: The Part-Time/Internet-Based Master of Public Health Program at the Johns Hopkins Bloomberg School of Public Health

Science.gov (United States)

Bruce, Linda; Gresh, Kathy; Vanchiswaran, Rohini; Werapitiya, Deepthi

2007-01-01

This article discusses the part-time/Internet-based Master of Public Health (MPH) program at the Johns Hopkins Bloomberg School of Public Health (JHSPH). The Johns Hopkins Bloomberg School of Public Health was the first school of public health in the United States to offer a Master of Public Health program via the Internet. The JHSPH MPH Program…

The 'Brain Drain' of physicians: historical antecedents to an ethical debate, c. 1960–79

Science.gov (United States)

Wright, David; Flis, Nathan; Gupta, Mona

2008-01-01

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then deemed to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics. PMID:19000306

The 'Brain Drain' of physicians: historical antecedents to an ethical debate, c. 1960–79

Directory of Open Access Journals (Sweden)

Flis Nathan

2008-11-01

Full Text Available Abstract Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then deemed to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics.

Citizen Science for public health.

Science.gov (United States)

Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie

2016-12-23

Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for public health, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in public health might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants. © The Author 2016. Published by Oxford University Press.

77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

Science.gov (United States)

2012-06-27

... Prevention and Health Promotion, Division of Reproductive Health, Attn: National Public Health Action Plan... Disease Prevention and Health Promotion, Division of Reproductive Health, 4770 Buford Highway NE... topic's public health importance, existing challenges, and opportunities for action to decrease the...

Transexualidade e saúde pública no Brasil Transsexuality and public health in Brazil

Directory of Open Access Journals (Sweden)

Márcia Arán

2009-08-01

Full Text Available O artigo tem como objetivo discutir a transexualidade no contexto das políticas de saúde pública no Brasil. Para isto, num primeiro momento, problematiza-se a necessidade do diagnóstico de transtorno de identidade de gênero como condição de acesso ao tratamento na rede pública, buscando compreender de que forma se deu historicamente a patologização da transexualidade. Em seguida, analisa-se o debate sobre as políticas de saúde para transexuais, considerando o processo de legalização da cirurgia de transgenitalização no país, as resoluções do Conselho Federal de Medicina e os fóruns que se constituíram com representantes do Ministério da Saúde, profissionais da área e representantes do movimento social. Finalmente, tendo como referência trabalhos que se destacaram pela crítica à patologização da transexualidade nas áreas da saúde coletiva e das ciências sociais, pretende-se destacar a importância de compreendermos a diversidade de formas de subjetivação e de construção de gênero na transexualidade. Discute-se a questão da autonomia dos transexuais e sugerem-se políticas públicas que, embora sigam um protocolo de assistência, não tenham como única referência terapêutica a realização do diagnóstico e a cirurgia de transgenitalização.The article aims to discuss transsexuality in the context of the Brazilian public health policies. Firstly, it questions the necessity of the diagnosis of Gender Identity Disorder as a condition of access to treatment in the public health service, searching to understand the historical construction of transsexuality as a pathological phenomenon. After that, it analyzes the debate on public health policies for transsexuals, considering the process of legalization of the reassignment surgery in the country, the resolutions of the Federal Council of Medicine and the constitution of representative forums of the Health Ministry, as well as professionals of the area and

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Applications of health information exchange information to public health practice

DEFF Research Database (Denmark)

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.

2014-01-01

Health information exchange (HIE) can support several aspects of public health practice by increasing the availability, timeliness, and comprehensiveness individual-level patient information. The potential benefits to disease monitoring, disaster response, and other public health activities served...... as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using...... qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. We derived the codes for the template analysis through a literature review. HIE supported public health activities consistent with expectations in the literature...

Mind the public health leadership gap: the opportunities and challenges of engaging high-profile individuals in the public health agenda.

Science.gov (United States)

Shickle, Darren; Day, Matthew; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leadership has been criticized as being ineffective. The public health profession is relatively small. Critics have argued that there is over-emphasis on technical aspects and insufficient use of the 'community as a source of public health actions'. The paper analyses the resources, motivations and skills utilized by high-profile individuals who have made contributions to the public health agenda. The phenomenon of celebrity diplomacy is critiqued. Two exemplars are discussed: Jamie Oliver and Michael Bloomberg. The risks of involving celebrities are also considered. Leaders for public health demonstrate 'a paradoxical blend of personal humility and professional will' to make the 'right decisions happen'. While they may have ego or self-interest, in this context, at least, they channel their ambition for the public health cause, not themselves. Leaders from outside public health may have no understanding of what public health is nor consider their work as part of a wider public health agenda. It is important to understand why they become leaders for public health. This will inform a strategy for how others may be encouraged to collaborate for public health causes. Some key points for working with high-profile leaders for public health are identified. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Public Health and Unconventional Oil and Gas Extraction Including Fracking: Global Lessons from a Scottish Government Review.

Science.gov (United States)

Watterson, Andrew; Dinan, William

2018-04-04

Unconventional oil and gas extraction (UOGE) including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking and UOGE an immediate and long-term threat to global, national, and regional public health and climate. Rarely have governments brought together relatively detailed assessments of direct and indirect public health risks associated with fracking and weighed these against potential benefits to inform a national debate on whether to pursue this energy route. The Scottish government has now done so in a wide-ranging consultation underpinned by a variety of reports on unconventional gas extraction including fracking. This paper analyses the Scottish government approach from inception to conclusion, and from procedures to outcomes. The reports commissioned by the Scottish government include a comprehensive review dedicated specifically to public health as well as reports on climate change, economic impacts, transport, geology, and decommissioning. All these reports are relevant to public health, and taken together offer a comprehensive review of existing evidence. The approach is unique globally when compared with UOGE assessments conducted in the USA, Australia, Canada, and England. The review process builds a useful evidence base although it is not without flaws. The process approach, if not the content, offers a framework that may have merits globally.

News media coverage of a women's health contraversy: how newspapers and TV outlets covered a recent debate over screening mammography.

Science.gov (United States)

Steele, Whitney Randolph; Mebane, Felicia; Viswanath, K; Solomon, Janice

2005-01-01

Over the past decade, there have been several highly visible debates about mammography that have captured professional, public and media attention. This paper looks at newspaper and television news coverage of a controversial research letter in The Lancet by Gøtzsche and Olsen (2001) that concluded that screening mammography did not prevent deaths from breast cancer. The news pieces examined for this project were published between October 2001 and March 2002 in one of eight U.S. newspapers or aired on one of six national or cable news networks. The six-month period was divided into one-week segments; the numbers of articles published or stories aired in each week were graphed to examine patterns. Each newspaper article and television transcript was then reviewed to identify its main content area and the amount of coverage for each major event was quantified. The highest number of newspaper articles appeared to result from several events during the end of January through the beginning of February. These events included the publication of another meta-analysis of mammography that disputed the original letter's conclusion and a full-page New York Times advertisement paid for by major medical organizations stating their continued support for mammography. The greatest amount of television news coverage was devoted to the announcement of the official federal guidelines by the Secretary of Health and Human Services in late February. We conclude by discussing how the flow of news coverage of medical controversies can potentially impact the actions and reactions of the public, the medical community and health policy makers.

[PrEP Forum: an on-line debate on pre-exposure prophylaxis in Brazil].

Science.gov (United States)

Queiroz, Artur Acelino Francisco Luz Nunes; Sousa, Alvaro Francisco Lopes de

2017-11-21

This study aimed to identify health-promoting contents focused on HIV/Aids prevention in messages posted in a Facebook group for debates on the use of pre-exposure prophylaxis (PrEP). This was a prospective observational study using systematic non-participant observation. From July 2015 to June 2016, all the posts in the group were catalogued and formed a corpus. Everything was processed in IRaMuTeQ and analyzed by descending hierarchical classification. The collected data were grouped in three classes: (1) HIV/Aids prevention: discussing prophylaxis, treatment, target public, and side effects; (2) universal access to PrEP in Brazil: discussing government responsibilities; (3) on-line purchase of truvada: exposing a situation of vulnerability. The findings call attention to a potential public health problem and provide backing for understanding facilitators and barriers to the use of PrEP in Brazil through the identification of health-promoting content linked to individual, social, and institutional markers.

The Public Health Responsibility Deal: brokering a deal for public health, but on whose terms?

Science.gov (United States)

Panjwani, Clare; Caraher, Martin

2014-02-01

Coalitions of multinational food and drink businesses have pledged to reformulate their products and to market them responsibly. Largely business-led and self-regulated, the integrity of these voluntary initiatives has been questioned. The Public Health Responsibility Deal in England is an example of a voluntary initiative that is government-led. Does this approach provide evidence that with public leadership there is potential for voluntary actions to deliver meaningful results for public health? The subject of the research is the calorie reduction initiative of the Responsibility Deal. Source material was obtained primarily through a series of UK Freedom of Information requests and comprises previously unpublished Department of Health documentation relating to relevant meetings held during 2011 and 2012. The Responsibility Deal approach to calorie reduction deliberately involves the food industry in the specification of the measures it is to implement (reformulation and portion control). Finding the common ground between private and public interests has resulted in the deflection of public health objectives and the preclusion of adequate monitoring and evaluation. The Responsibility Deal approach is fundamentally flawed in its expectation that industry will take voluntary actions that prioritise public health interests above its own. Being government-led counts for little in the absence of sanctions to drive compliance. Instead the initiative affords private interests the opportunity to influence in their favour the public health policies and strategies that affect their products. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Public health legal preparedness in Indian country.

Science.gov (United States)

Bryan, Ralph T; Schaefer, Rebecca McLaughlin; DeBruyn, Lemyra; Stier, Daniel D

2009-04-01

American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective public health responses to emerging threats. To analyze how tribal laws support public health practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal public health law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable public health provisions. The public health-related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen public health legal foundations in tribal communities.

Systematic review of public health branding.

Science.gov (United States)

Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L

2008-12-01

Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

Risk tradeoffs and public health protection

International Nuclear Information System (INIS)

Charnley, G.

1998-01-01

Full text of publication follows: over the last 25 years, the traditional command-and-control, chemical-by-chemical environmental medium-by-environmental medium, risk-by-risk approach to protecting public health from environmental risks has worked well to greatly improve the quality of our food, air, water, and workplaces, but we are now left with the more complex problems, like urban air pollution or personal dietary behavior, that a chemical-by-chemical approach is not going to solve. Because current environmental regulatory programs have curbed the 'low-hanging fruit' and because of today's emphasis on achieving risk reductions cost-effectively, new and creative public health-based approaches to risk management are needed. Since public concern about pollution-related disease become serious in the 1960's and 1970's and regulatory agencies and laws began to proliferate, the public health goals of environmental protection have been obscured. As a society, we have made a tradeoff between environmental health and public health. The public health foundation of environmental health protection has been obscured by legalistic, technical, centralized decision-making processes that have often mistaken hazard for risk. A greater focus on public health would help us to assess aggregate risks and to target risk management resources by focusing on a problem and then identifying what is causing the problem as a guide to determining how best to solve it. Most of our current approaches start with a cause and then try to eliminate it without determining the extent to which it actually may contribute to a problem, making it difficult to set priorities among risks or to evaluate the impact of risk management actions on public health. (author)

How to characterize the public health workforce based on essential public health operations? environmental public health workers in the Netherlands as an example

NARCIS (Netherlands)

Jambroes, M.; van Honschooten, R.; Doosje, J.; Stronks, K.; Essink-Bot, M. L.

2015-01-01

Public health workforce planning and policy development require adequate data on the public health workforce and the services provided. If existing data sources do not contain the necessary information, or apply to part of the workforce only, primary data collection is required. The aim of this

Personalism for public health ethics

Directory of Open Access Journals (Sweden)

Carlo Petrini

2010-06-01

Full Text Available In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

Personalism for public health ethics.

Science.gov (United States)

Petrini, Carlo; Gainotti, Sabina; Requena, Pablo

2010-01-01

In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

Petroleum Scarcity and Public Health: Considerations for Local Health Departments

Science.gov (United States)

Parker, Cindy L.; Caine, Virginia A.; McKee, Mary; Shirley, Lillian M.; Links, Jonathan M.

2011-01-01

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and public health. Local health departments represent a critical yet highly vulnerable component of the public health infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local public health service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential Public Health Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts. PMID:21778471

Da teoria à formulação de uma Política Nacional de Avaliação em Saúde: reabrindo o debate From the theory to the formulation of a National Policy of Evaluation in Health: reopening the debate

Directory of Open Access Journals (Sweden)

Eronildo Felisberto

2006-09-01

Full Text Available O artigo propõe uma reflexão teórica e operacional, a ser enriquecida pelos debatedores convidados, sobre o significado de institucionalizar a avaliação a partir da perspectiva do gestor federal em induzir um "aculturamento" da avaliação, na rotina da atenção básica, considerada ação norteadora de uma política de saúde. A discussão se orienta por uma revisão sumária da literatura contextualizando dois debates anteriores que focalizaram a Institucionalização da Avaliação em Saúde e a Atenção Básica. Defende-se o princípio de que o ato de avaliar só agrega valor quando o conhecimento e o uso das informações produzidas geram aprimoramento institucional e profissional. Aborda-se ainda a necessidade de uma ampla ordem de ferramentas como: decisão político-institucional, recursos financeiros, mecanismos técnicos e estratégias organizacionais de qualificação de recursos humanos, adaptados às necessidades específicas decorrentes do processo de descentralização da gestão da atenção básica, demais diretrizes e princípios do SUS.This article proposes a theoretical and operational reflection, to be enriched by the invited debaters, about the significance of institutionalizing evaluation from the perspective of public management, by introducing a "culture" of evaluation in the routine of primary care as guiding element for a health care policy. The discussion is oriented by a summary revision of the literature contextualizing two previous debates that focalized the Institutionalization of Evaluation in Health and Primary Care. The article defends the principle that evaluation only aggregates value when the knowledge and information it produced come to generate institutional and professional improvement. Furthermore, it approaches the need for a broad range of tools including political-institutional decision-making, financial resources, technical mechanisms and organizational strategies for the qualification of

The Policy Debate on Pseudonymous Health Registers in Norway

Science.gov (United States)

Andresen, Herbjørn

Patient health data has a valuable potential for secondary use, such as decision support on a national level, reimbursement settlements, and research on public health or on the effects of various treatment methods. Unfortunately, extensive secondary use of data has disproportionate negative impact on the patients' privacy. The Norwegian health data processing regulation prescribes four different ways of organizing health registers (anonymous, de-identified, pseudonymous or fully identified data subjects). Pseudonymity is the most innovative of these methods, and it has been available as a legitimate means to achieve extensive secondary use of accurate and detailed data since 2001. Up to now, two different national health registers have been organized this way. The evidence from these experiences should be encouraging: Pseudonymity works as intended. Yet, there is still discernible reluctance against extending the pseudonymity principle to encompass other national health registers as well.