Full Text Available The Republic of Kazakhstan is one of the largest and fastest growing post-Soviet economies in Central Asia. Despite recent improvements in health care in response to Kazakhstan 2030 and other state-mandated policy reforms, Kazakhstan still lags behind other members of the Commonwealth of Independent States of the European Region on key indicators of health and economic development. Although cardiovascular diseases are the leading cause of mortality among adults, HIV/AIDS, tuberculosis, and blood-borne infectious diseases are of increasing public health concern. Recent data suggest that while Kazakhstan has improved on some measures of population health status, many environmental and public health challenges remain. These include the need to improve public health infrastructure, address the social determinants of health, and implement better health impact assessments to inform health policies and public health practice. In addition, more than three decades after the Declaration of Alma-Ata, which was adopted at the International Conference on Primary Health Care convened in Kazakhstan in 1978, facilitating population-wide lifestyle and behavioral change to reduce risk factors for chronic and communicable diseases, as well as injuries, remains a high priority for emerging health care reforms and the new public health. This paper reviews the current public health challenges in Kazakhstan and describes five priorities for building public health capacity that are now being developed and undertaken at the Kazakhstan School of Public Health to strengthen population health in the country and the Central Asian Region.
Forsman, Anna K; Wahlbeck, Kristian; Aarø, Leif Edvard
BACKGROUND: The ROAdmap for MEntal health Research in Europe project aimed to create an integrated European roadmap for mental health research. Leading mental health research experts across Europe have formulated consensus-based recommendations for future research within the public mental health...... experts were involved in the priority setting process. RESULTS: Twenty priorities for public mental health research were identified through the consensus process. The research priorities were divided into summary principles-encompassing overall recommendations for future public mental health research...... in Europe-and thematic research priorities, including area-specific top priorities on research topics and methods. The priorities represent three overarching goals mirroring societal challenges, that is, to identify causes, risk and protective factors for mental health across the lifespan; to advance...
McCarthy, Mark; Harvey, Gabrielle; Conceição, Claudia; la Torre, Giuseppe; Gulis, Gabriel
Despite improving trends, countries in Europe continue to face public-health challenges. This study investigated the priorities of stakeholders for research to meet these challenges. Public-health research includes population-level and health-system research, but not clinical or biomedical research. The study drew on data from three surveys undertaken through collaboration in SPHERE (Strengthening Public Health Research in Europe). There was participation of ministries in 18 of 28 (64% response) European countries, from 22 of 39 (56% response) member national associations of the European Public Health Association, and from 80 civil society health organisations (53% of members of the European Public Health Alliance) Public-health research fields included disease control, health promotion and health services. Ministries of health, rather than ministries of science or education, mostly took responsibility for public-health research: they reported varied but well-defined areas for research in relation to national health plans and programmes. National public health associations reported research priorities across most fields of public health, although with some European regional differences. Civil society health organisations prioritised health promotion research nationally, but also health services research internationally. There was less research reported on methods, such as modelling and economic analysis, wider determinants of health, and public-health interventions. Systematic collaboration between stakeholders across European countries would enhance knowledge and promote innovation to address contemporary public-health challenges.
la Torre Giuseppe
Full Text Available Abstract Background Despite improving trends, countries in Europe continue to face public-health challenges. This study investigated the priorities of stakeholders for research to meet these challenges. Methods Public-health research includes population-level and health-system research, but not clinical or biomedical research. The study drew on data from three surveys undertaken through collaboration in SPHERE (Strengthening Public Health Research in Europe. There was participation of ministries in 18 of 28 (64% response European countries, from 22 of 39 (56% response member national associations of the European Public Health Association, and from 80 civil society health organisations (53% of members of the European Public Health Alliance Results Public-health research fields included disease control, health promotion and health services. Ministries of health, rather than ministries of science or education, mostly took responsibility for public-health research: they reported varied but well-defined areas for research in relation to national health plans and programmes. National public health associations reported research priorities across most fields of public health, although with some European regional differences. Civil society health organisations prioritised health promotion research nationally, but also health services research internationally. There was less research reported on methods, such as modelling and economic analysis, wider determinants of health, and public-health interventions. Conclusion Systematic collaboration between stakeholders across European countries would enhance knowledge and promote innovation to address contemporary public-health challenges.
Makenzius, Marlene; Wamala, Sarah
We evaluated the Swedish National Public Health Policy to determine its impact on public health priorities and practice at regional and local levels between 2004 and 2013. We conducted a survey by questionnaire in February 2013 among Swedish county councils/regions (n=19/21), and municipalities (n=219/290). The National Public Health Policy facilitated systematic public health practice, particularly for planning, for high priority concerns, including conditions during childhood and adolescence, physical activity, and tobacco prevention. Respondents expressed need for a comprehensive monitoring system with comparable indicators nationwide and explicit measurable objectives. To ensure effective monitoring and follow-up, the measurable outcomes need direct relevance to decision making and high-priority public health issues addressing Sweden's "overarching public health goal" - to create societal conditions for good health on equal terms for the entire population.
Members of the public can adopt any one of at least three roles when providing input to public decision-making: taxpayer, collective community decision-maker, or patient. Each of these potential roles can be mapped onto three areas of public policy decision-making in health care: funding levels and organization for the system, the services we choose to offer under public funding, and the characteristics of those who should receive the offered services. The increasing desire to involve the public across the spectrum of health care decision-making has yet to result in a clear delineation of either which of the areas are most appropriate for public input or which of the roles we wish individual participants to adopt. The average citizen (as opposed to the self-interested patient, the provider or the manager) has so far shown little interest in contributing and rarely has the requisite skills for most of the tasks asked of him or her. The widespread motivation of governments and others for seeking public input appears to be to get the public to take or share ownership in the tough rationing choices consequent on fiscal retrenchment in health care. Evaluation of existing literature leads to the conclusion that there are only limited areas where we might wish to obtain significant public input if we adopt this widespread policy motivation. Specifically, the general public should be asked to give input to, but not determine, priorities across the broad service categories that could potentially be publicly funded. Members of the public have neither the interest nor the skills to do this at the level of specific services. The role expected of such members of the public should be made explicit and should focus on collective views of the community good rather than self-interested views of individual benefit. Groups of patients, however, should be the source of input when socio-demographic characteristics are being used to decide who should receive offered services. The role
Dartigues, J F; Helmer, C; Dubois, B; Duyckaerts, C; Laurent, B; Pasquier, F; Touchon, J
Alzheimer's Disease is a major Public Health problem for many reasons. First, it is a frequent disease since, in France, the prevalence was estimated at about 400.000 cases, and the annual incidence at 100.000 cases. The frequency of the disease increases, in particular due to the ageing of the population. This disease has major consequences on the life of the patient and his/her caretaker. The cost of the disease is important, estimated at about 50 milliards of French francs. Pharmaceutical treatment and other interventions are possible in particular to delay the nursing home placement. On the other hand, this disease is often ignored, under-diagnosed, underestimated and exposed to inequality in resorting to care. In summary, Alzheimer's Disease (AD) has all the criteria required for a major public health problem. In spite of this observation, AD is not yet considered as a priority for health authorities, although attitudes are changing.
Antunes, José Leopoldo Ferreira; Toporcov, Tatiana Natasha; Bastos, João Luiz; Frazão, Paulo; Narvai, Paulo Capel; Peres, Marco Aurélio
ABSTRACT This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field. PMID:27598787
José Leopoldo Ferreira Antunes
Full Text Available ABSTRACT This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field.
Antunes, José Leopoldo Ferreira; Toporcov, Tatiana Natasha; Bastos, João Luiz; Frazão, Paulo; Narvai, Paulo Capel; Peres, Marco Aurélio
This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field. RESUMO Este estudo descreve a produção científica sobre saúde bucal veiculada na Revista de Saúde Pública, nos cinquenta anos de sua publicação. Foi realizado estudo de revisão narrativa, utilizando o PubMed como mecanismo de busca que indexa todos os fascículos da revista. De 1967 a 2015, foram publicados 162 manuscritos com foco específico em temas de saúde bucal. Essa temática esteve presente em todos os volumes da revista, com participação crescente ao longo dos anos. Cárie dentária foi o tema mais estudado, marcando presença constante na revista desde seu primeiro fascículo. Doença periodontal, fluorose, oclusopatias e outros temas emergiram antes mesmo do declínio dos indicadores de cárie. Políticas de saúde bucal é o tema mais recorrente nas duas últimas décadas. A Revista de Saúde Pública tem sido importante veículo de divulgação, comunicação e reflexão sobre saúde bucal, contribuindo de modo relevante para a interação técnico-científica entre os
Gulis, Gabriel; Garrido-Herrero, Lara; Katreniakova, Zuzana; Harvey, Gabrielle; McCarthy, Mark
Public health research is concerned with population health, determinants of health, health systems research, health promotion, environmental health, health protection, disease prevention and research in other fields of public health. During the last decades, non-governmental organisations (NGOs) are more often entering the field of public health research. This paper presents results of work within SPHERE (Strengthening Public Health Research in Europe), a European Commission funded study aimed to gather information and produce knowledge on the state of public health research in Europe. A questionnaire survey was developed and conducted among NGOs enrolled in a database held by the European Public Health Alliance (EPHA). There were 80 replies, and the response rate for NGOs that were members of EPHA was 53%. There were no significant statistical differences in the responses when analysed for three European groups ['old' member states (EU 15), accession members states in 2004 (EU 10) and EU-associated countries]. The NGOs reported a relatively large international experience, expressed by participation in international public health research, and more often practice work. The main research priorities reported were general public health, environmental health, ADHD, obesity, nutrition, tobacco control. NGOs showed low correlation between their work field and their proposed public health research priorities. There are growing numbers of NGOs in Europe concerned with public health. This survey indicates their interest also in public health research priorities.
Beck, Christina S; Aubuchon, Stellina M; McKenna, Timothy P; Ruhl, Stephanie; Simmons, Nathaniel
This article explores the functions of personal celebrity health narratives in the public sphere. This study examines data about 157 celebrities, including athletes, actors, musicians, and politicians, who have shared private information regarding a personal health situation (or that of a loved one) with others in the public domain. Part of a larger project on celebrity health narratives, this article highlights three key functions that celebrity health narratives perform--education, inspiration, and activism--and discusses the implications for celebrities and for public conversations about health-related issues.
Sampieri, Clara Luz; Mora, Mauricio
This study aimed review studies conducted on Mexican patients diagnosed with gastric cancer and/or diseases associated with its development, in which at least one Mexican institute has participated, and to assess their contributions to the primary and secondary prevention of this disease. A search of the Medline database was conducted using the following keywords: gastric/stomach cancer, Mexico. Studies of the Mexican population were selected in which at least one Mexican Institute had participated and where the findings could support public policy proposals directed towards the primary or secondary prevention of gastric cancer. Of the 148 studies found in the Medline database, 100 were discarded and 48 were reviewed. According to the analysis presented, these studies were classified as: epidemiology of gastric cancer (5/48); risk factors and protectors relating to gastric cancer (9/48); relationship between Helicobacter pylori and pathologies associated with gastric cancer and the development of the disease (16/48); relationship between the Epstein-Barr virus and pathologies associated with gastric cancer and the development of the disease (3/48); molecular markers for the development of diseases associated with gastric cancer and gastric cancer (15/48). Mexico requires a program for the prevention and control of gastric cancer based on national health indicators. This should be produced by a multidisciplinary committee of experts who can propose actions that are relevant in the current national context. The few studies of gastric cancer conducted on the Mexican population in national institutes highlight the poor connection that currently exists between the scientific community and the health sector in terms of resolving this health issue. Public policies for health research should support projects with findings that can be translated into benefits for the population. This review serves to identify national research groups studying gastric cancer in the Mexican
Sampieri, Clara Luz; Mora, Mauricio
This study aimed review studies conducted on Mexican patients diagnosed with gastric cancer and/or diseases associated with its development, in which at least one Mexican institute has participated, and to assess their contributions to the primary and secondary prevention of this disease. A search of the Medline database was conducted using the following keywords: gastric/stomach cancer, Mexico. Studies of the Mexican population were selected in which at least one Mexican Institute had participated and where the findings could support public policy proposals directed towards the primary or secondary prevention of gastric cancer. Of the 148 studies found in the Medline database, 100 were discarded and 48 were reviewed. According to the analysis presented, these studies were classified as: epidemiology of gastric cancer (5/48); risk factors and protectors relating to gastric cancer (9/48); relationship between Helicobacter pylori and pathologies associated with gastric cancer and the development of the disease (16/48); relationship between the Epstein-Barr virus and pathologies associated with gastric cancer and the development of the disease (3/48); molecular markers for the development of diseases associated with gastric cancer and gastric cancer (15/48). Mexico requires a program for the prevention and control of gastric cancer based on national health indicators. This should be produced by a multidisciplinary committee of experts who can propose actions that are relevant in the current national context. The few studies of gastric cancer conducted on the Mexican population in national institutes highlight the poor connection that currently exists between the scientific community and the health sector in terms of resolving this health issue. Public policies for health research should support projects with findings that can be translated into benefits for the population. This review serves to identify national research groups studying gastric cancer in the Mexican
Calabrese, Sarah K; Underhill, Kristen; Mayer, Kenneth H
Daily HIV preexposure prophylaxis (PrEP) is an effective form of HIV protection that remains unknown and inaccessible for many people in the United States despite receiving federal approval over five years ago. PrEP is supported by the public health community, but forgoing condoms while taking PrEP has proven controversial; this controversy may be contributing to the lag in PrEP uptake. We argue that limiting PrEP access based on anticipated or actual sexual behavior contradicts the goals of public health research and practice and is not scientifically justified. As evidence for the effectiveness of novel forms of biomedical HIV protection emerges, public health professionals need to accept new definitions of "protected sex" and ensure that their personal values do not override empirical evidence when determining public health priorities. (Am J Public Health. Published online ahead of print August 17, 2017: e1-e5. doi:10.2105/AJPH.2017.303966).
Hunter, David James; Kieslich, Katharina; Littlejohns, Peter; Staniszewska, Sophie; Tumilty, Emma; Weale, Albert; Williams, Iestyn
Purpose - The purpose of this paper is to reflect on the findings of this special issue and discusses the future challenges for policy, research and society. The findings suggest that challenges emerge as a result of legitimacy deficits of both consensus and contestatory modes of public involvement in health priority setting. Design/methodology/approach - The paper draws on the discussions and findings presented in this special issue. It seeks to bring the country experiences and case studies together to draw conclusions for policy, research and society. Findings - At least two recurring themes emerge. An underlying theme is the importance, but also the challenge, of establishing legitimacy in health priority setting. The country experiences suggest that we understand very little about the conditions under which representative, or authentic, participation generates legitimacy and under which it will be regarded as insufficient. A second observation is that public participation takes a variety of forms that depend on the opportunity structures in a given national context. Given this variety the conceptualization of public participation needs to be expanded to account for the many forms of public participation. Originality/value - The paper concludes that the challenges of public involvement are closely linked to the question of how legitimate processes and decisions can be generated in priority setting. This suggests that future research must focus more narrowly on conditions under which legitimacy are generated in order to expand the understanding of public involvement in health prioritization.
Health has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. I argue that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions.
“Personalised medicine” is currently attracting considerable attention and raising high hopes and expectations in modern medicine. The term “personalised medicine” denotes the use of genetic or other biomarker information, and it does not focus on a more personal patient-doctor relationship. Furthermore, personalised medicine is associated with ethical problems like priority setting and opportunity costs in solidarity-based public health care systems. Personalised medicine provides modern,...
Weale, Albert; Kieslich, Katharina; Littlejohns, Peter; Tugendhaft, Aviva; Tumilty, Emma; Weerasuriya, Krisantha; Whitty, Jennifer A
Purpose - The purpose of this paper is to introduce the special issue on improving equitable access to health care through increased public and patient involvement (PPI) in prioritization decisions by discussing the conceptualization, scope and rationales of PPI in priority setting that inform the special issue. Design/methodology/approach - The paper employs a mixed-methods approach in that it provides a literature review and a conceptual discussion of the common themes emerging in the field of PPI and health priority setting. Findings - The special issue focuses on public participation that is collective in character, in the sense that the participation relates to a social, not personal, decision and is relevant to whole groups of people and not single individuals. It is aimed at influencing a decision on public policy or legal rules. The rationales for public participation can be found in democratic theory, especially as they relate to the social and political values of legitimacy and representation. Originality/value - The paper builds on previous definitions of public participation by underlining its collective character. In doing so, it develops the work by Parry, Moyser and Day by arguing that, in light of the empirical evidence presented in this issue, public participatory activities such as protests and demonstrations should no longer be labelled unconventional, but should instead be labelled as "contestatory participation". This is to better reflect a situation in which these modes of participation have become more conventional in many parts of the world.
Theodorou, Mamas; Samara, Katerina; Pavlakis, Andreas; Middleton, Nikos; Polyzos, Nikos; Maniadakis, Nikos
The Greek public is currently not represented at any level of the healthcare system's organisational structure. This study aimed to investigate the opinions of Greek citizens as well as doctors regarding their representation in priority setting and to compare these two groups' preferences when prioritising competing resources. A sample of 300 citizens and 100 doctors were asked by means of a standardised questionnaire: (a) whether their views should inform healthcare decisions; (b) to rank in terms of importance other groups that should participate in the process; and (c) to allocate competing resources to a series of alternative prevention programmes, medical procedures or across different population groups. As many as 83% of the citizens stated that their opinions should inform decisions regarding prevention and population-group programmes, while a slightly lower 70% believed their opinions should also be heard regarding medical procedures. However, when asked to rank six different population groups in terms of their importance, the public ranked their role quite low. Generally, doctors and patients, and their families were ranked highest, while politicians were ranked last by both groups. Regarding allocation of funds, a remarkable consensus was observed between doctors and the public. This study documents for the first time in Greece the clear preference for active involvement of both the public and healthcare professionals in the process of priority setting and resource allocation. There is great urgency in complementing these findings with qualitative research methods, such as in-depth interviews and discussions with focus groups, so that a more democratic, participative and transparent process for healthcare priority setting can be initiated, based on the actual needs and health problems of the public.
Archambault, Philippe; Halpern, Benjamin S.; Stewart Lowndes, Julia S.; Côté, Isabelle M.
The Ocean Health Index (OHI) is a framework to assess ocean health by considering many benefits (called ‘goals’) provided by the ocean provides to humans, such as food provision, tourism opportunities, and coastal protection. The OHI framework can be used to assess marine areas at global or regional scales, but how various OHI goals should be weighted to reflect priorities at those scales remains unclear. In this study, we adapted the framework in two ways for application to Canada as a case study. First, we customized the OHI goals to create a national Canadian Ocean Health Index (COHI). In particular, we altered the list of iconic species assessed, added methane clathrates and subsea permafrost as carbon storage habitats, and developed a new goal, 'Aboriginal Needs', to measure access of Aboriginal people to traditional marine hunting and fishing grounds. Second, we evaluated various goal weighting schemes based on preferences elicited from the general public in online surveys. We quantified these public preferences in three ways: using Likert scores, simple ranks from a best-worst choice experiment, and model coefficients from the analysis of elicited choice experiment. The latter provided the clearest statistical discrimination among goals, and we recommend their use because they can more accurately reflect both public opinion and the trade-offs faced by policy-makers. This initial iteration of the COHI can be used as a baseline against which future COHI scores can be compared, and could potentially be used as a management tool to prioritise actions on a national scale and predict public support for these actions given that the goal weights are based on public priorities. PMID:28542394
Kaplan, Giora; Baron-Epel, Orna
Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.
Kimber, Christine; Abercrombie, Eydie; Epping, Jacqueline N; Mordecai, LeeAnn; Newkirk, Jimmy; Ray, Michael
Physical activity has emerged as a distinct area of public health practice. As this field evolved, the need for a professional organization for physical activity practitioners in public health became evident. A collaboration of several existing public health professional organizations formed to address this new area of public health practice. The collaboration laid the foundation to establish a professional organization. National Association of Physical Activity Practitioners in Public Health (NSPAPPH) was launched in April 2006. NSPAPPH accomplishments to date include convening a national meeting of physical activity practitioners, conducting strategic planning, adopting bylaws and core competencies for professional practice, developing a website and electronic newsletter, and establishing training opportunities for practitioners. Future plans for NSPAPPH include development of a professional certification for physical activity practitioners in public health; enhancement of training and professional development opportunities; recruitment of members from national, tribal, state, and local organizations working in public and private sectors; publications of journal articles, reports, and issue briefs; and development of a policy agenda. Implementing these plans will serve to strengthen public health infrastructure for physical activity, thus improving the physical activity behaviors of Americans and the health of the nation.
Health has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. I argue that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions. PMID:15847685
Oussayef, Nadia L; Pillai, Satish K; Honein, Margaret A; Ben Beard, C; Bell, Beth; Boyle, Coleen A; Eisen, Lars M; Kohl, Katrin; Kuehnert, Matthew J; Lathrop, Eva; Martin, Stacey W; Martin, Rebecca; McAllister, Janet C; McClune, Elizabeth Pantino; Mead, Paul; Meaney-Delman, Dana; Petersen, Brett; Petersen, Lyle R; Polen, Kara N D; Powers, Ann M; Redd, Stephen C; Sejvar, James J; Sharp, Tyler; Villanueva, Julie; Jamieson, Denise J
The introduction of Zika virus into the Region of the Americas (Americas) and the subsequent increase in cases of congenital microcephaly resulted in activation of CDC's Emergency Operations Center on January 22, 2016, to ensure a coordinated response and timely dissemination of information, and led the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. During the past year, public health agencies and researchers worldwide have collaborated to protect pregnant women, inform clinicians and the public, and advance knowledge about Zika virus (Figure 1). This report summarizes 10 important contributions toward addressing the threat posed by Zika virus in 2016. To protect pregnant women and their fetuses and infants from the effects of Zika virus infection during pregnancy, public health activities must focus on preventing mosquito-borne transmission through vector control and personal protective practices, preventing sexual transmission by advising abstention from sex or consistent and correct use of condoms, and preventing unintended pregnancies by reducing barriers to access to highly effective reversible contraception.
Hills, Andrew P; Dengel, Donald R; Lubans, David R
Physical activity (PA) provides numerous physiological and psychosocial benefits. However, lifestyle changes, including reduced PA opportunities in multiple settings, have resulted in an escalation of overweight and obesity and related health problems. Poor physical and mental health, including metabolic and cardiovascular problems is seen in progressively younger ages, and the systematic decline in school PA has contributed to this trend. Of note, the crowded school curriculum with an intense focus on academic achievement, lack of school leadership support, funding and resources, plus poor quality teaching are barriers to PA promotion in schools. The school setting and physical educators in particular, must embrace their role in public health by adopting a comprehensive school PA program. We provide an overview of key issues and challenges in the area plus best bets and recommendations for physical education and PA promotion in the school system moving forward.
Newton Paul N
Full Text Available Abstract Background Plasmodium falciparum malaria remains a major public health problem. A vital component of malaria control rests on the availability of good quality artemisinin-derivative based combination therapy (ACT at the correct dose. However, there are increasing reports of poor quality anti-malarials in Africa. Methods Seven collections of artemisinin derivative monotherapies, ACT and halofantrine anti-malarials of suspicious quality were collected in 2002/10 in eleven African countries and in Asia en route to Africa. Packaging, chemical composition (high performance liquid chromatography, direct ionization mass spectrometry, X-ray diffractometry, stable isotope analysis and botanical investigations were performed. Results Counterfeit artesunate containing chloroquine, counterfeit dihydroartemisinin (DHA containing paracetamol (acetaminophen, counterfeit DHA-piperaquine containing sildenafil, counterfeit artemether-lumefantrine containing pyrimethamine, counterfeit halofantrine containing artemisinin, and substandard/counterfeit or degraded artesunate and artesunate+amodiaquine in eight countries are described. Pollen analysis was consistent with manufacture of counterfeits in eastern Asia. These data do not allow estimation of the frequency of poor quality anti-malarials in Africa. Conclusions Criminals are producing diverse harmful anti-malarial counterfeits with important public health consequences. The presence of artesunate monotherapy, substandard and/or degraded and counterfeit medicines containing sub-therapeutic amounts of unexpected anti-malarials will engender drug resistance. With the threatening spread of artemisinin resistance to Africa, much greater investment is required to ensure the quality of ACTs and removal of artemisinin monotherapies. The International Health Regulations may need to be invoked to counter these serious public health problems.
Full Text Available Abstract The 'global public good' (GPG concept has gained increasing attention, in health as well as development circles. However, it has suffered in finding currency as a general tool for global resource mobilisation, and is at risk of being attached to almost anything promoting development. This overstretches and devalues the validity and usefulness of the concept. This paper first defines GPGs and describes the policy challenge that they pose. Second, it identifies two key areas, health R&D and communicable disease control, in which the GPG concept is clearly relevant and considers the extent to which it has been applied. We point out that that, while there have been many new initiatives, it is not clear that additional resources from non-traditional sources have been forthcoming. Yet achieving this is, in effect, the entire purpose of applying the GPG concept in global health. Moreover, the proliferation of disease-specific programs associated with GPG reasoning has tended to promote vertical interventions at the expense of more general health sector strengthening. Third, we examine two major global health policy initiatives, the Global Fund against AIDS, Tuberculosis and Malaria (GFATM and the bundling of long-standing international health goals in the form of Millennium Development Goals (MDG, asking how the GPG perspective has contributed to defining objectives and strategies. We conclude that both initiatives are best interpreted in the context of traditional development assistance and, one-world rhetoric aside, have little to do with the challenge posed by GPGs for health. The paper concludes by considering how the GPG concept can be more effectively used to promote global health.
Okamoto, Janet; Buffington, Sandra de Castro; Cloum, Heather M; Mendenhall, Brett M; Toboni, Michael; Valente, Thomas W
Public opinion polls have historically indicated that the US public favours domestic over global priorities. It is not known what influence health knowledge has in shaping public opinion about domestic and global health policy. This study examines how knowledge of HIV/AIDS is related to the rated importance of domestic and global health issues. Participants were recruited to participate in an electronic survey (N = 995) and were predominantly White (86.3%), married (61.9%) and female (71.8%). HIV/AIDS knowledge was significantly associated with both domestic (β = 0.12, p research has implications for ways to gain support for implementation of public health policy through increasing health knowledge.
Flear, Mark L
The replacement of the European Union (EU) Clinical Trials Directive by the new Clinical Trials Regulation (CTR), which entered into force on 16 June 2014 but will not apply before 28 May 2016, provides an opportunity to review the legal and political context within which this important aspect of research law and policy sits and to reflect on the implications for public health. My aim in this article is to relate the context to the key purposes and aims of EU law and policy on clinical trials in order to explain and clarify its orientation. On that basis, I argue that the CTR and the changes it introduces to the law on clinical trials are part of the EU's continued focus on market optimisation. It is this focus that orients and directs the wider pharmaceutical development pipeline, but that undermines the achievement of key public health objectives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Humphreys, B L
Those seeking information in health policy and public health are not as well served as those seeking clinical information. Problems inhibiting access to health policy and public health information include the heterogeneity of professionals seeking the information, the distribution of relevant information across disciplines and information sources, scarcity of synthesized information useful to practitioners, lack of awareness of available services or training in their use, and lack of access to information technology or to knowledgeable librarians and information specialists. Since 1990, the National Library of Medicine and the National Network of Libraries of Medicine have been working to enhance information services in health policy and public health through expanding the coverage of the NLM collection, building new databases, and engaging in targeted outreach and training initiatives directed toward segments of the health policy and public health communities. Progress has been made, but more remains to be done. Recommendations arising from the meeting, Accessing Useful Information: Challenges in Health Policy and Public Health, will help NLM and the National Network of Libraries of Medicine to establish priorities and action plans for the next several years.
Muideen O. Bakare
Full Text Available Sub-Saharan African (SSA population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD. The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.
Nsabagasani, Xavier; Ogwal-Okeng, Jasper; Mbonye, Anthony;
priority medicines for diarrhea, sepsis, pneumonia and malaria. 81 health workers from the facilities reported what they prescribed for children with the above diseases. RESULTS: Oral rehydration salt (ORS) and zinc sulphate dispersible tablets for diarrhea were available in all HC IIs and IIIs and in only......OBJECTIVES: To explore the availability and utilization of the World Health Organization (WHO) recommended priority life-saving medicines for children under five in public health facilities in Uganda. METHODS: We conducted a cross sectional survey in 32 lower level public facilities in Jinja...... of the health workers reported prescribing zinc sulphate and ORS for diarrhea, 86% reported procaine benzyl penicillin injection powder for sepsis, and 57% reported amoxicillin dispersible tablets for pneumonia. None reported prescribing Artemether lumefantrine dispersible tablets and rectal artesunate...
Rogge, Jana; Kittel, Bernhard
The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens' attitudes towards three person-based priority criteria, patients' smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011) in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents' attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models.
Sierra Health Foundation, 2009
The primary goal of this study was to measure public perceptions, opinions and priorities as they pertain to youth issues in Sacramento for the purposes of further developing public and private youth programming and public policy in the Sacramento region. By presenting a "statistically reliable" profile of public opinion on youth issues,…
Issues pertaining to children often struggle to become public policy priorities. A clear demonstration of this phenomenon is the degree to which children are supported in the federal budget in comparison to other priorities. If issues pertaining to children struggle for the policy spotlight, subissues pertaining to them face an even greater…
Issues pertaining to children often struggle to become public policy priorities. A clear demonstration of this phenomenon is the degree to which children are supported in the federal budget in comparison to other priorities. If issues pertaining to children struggle for the policy spotlight, subissues pertaining to them face an even greater…
Rakhmanin, Yu A; Mikhaylova, R I
Contemporary environmental factors influencing the formation of the environment and public health have been analyzed The increasing chemical pollution of the environment (air water, soil, living environment), and the intensification of the impact of physical factors in the first place, "electromagnetic smog" associated with the widespread use of appliances and computer equipment, cellular threaten public health have been shown. In this connection, there were determined priorities and main directions of research in the platform "Preventive Environment", approved by Ministry of Health of Russia, which is based on the concept of the factor prevention of noninfectious diseases.
Gluskin, Rebecca Tave; Mavinkurve, Maushumi; Varma, Jay K
For nearly a decade, interest groups, from politicians to economists to physicians, have touted digitization of the nation's health information. One frequently mentioned benefit is the transmission of information electronically from laboratories to public health personnel, allowing them to rapidly analyze and act on these data. Switching from paper to electronic laboratory reports (ELRs) was thought to solve many public health surveillance issues, including workload, accuracy, and timeliness. However, barriers remain for both laboratories and public health agencies to realize the full benefits of ELRs. The New York City experience highlights several successes and challenges of electronic reporting and is supported by peer-reviewed literature. Lessons learned from ELR systems will benefit efforts to standardize electronic medical records reporting to health departments.
Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N.; Olalubi, Oluwasogo A.; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A.; Ngogang, Jeanne Y.
Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems. As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs. PMID:27508058
Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y
Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems. As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.
Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin-Nun, Gabi; Goffer, Ronen; Ben-Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz
In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care-related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. One hundred thirty-two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system's monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues.
Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict
Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting...... of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions....... is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience...
Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin‐Nun, Gabi; Goffer, Ronen; Ben‐Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz
Abstract Background In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care‐related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. Goals To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. Method One hundred thirty‐two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Outcomes Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system’s monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Conclusion Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues. PMID:18429997
Maluka, Stephen; Kamuzora, Peter; Sebastiån, Miguel San
care priorities in Mbarali district, Tanzania, and evaluates the descriptions against Accountability for Reasonableness. Key informant interviews were conducted with district health managers, local government officials and other stakeholders using a semi-structured interview guide. Relevant documents......Priority-setting has become one of the biggest challenges faced by health decision-makers worldwide. Fairness is a key goal of priority-setting and Accountability for Reasonableness has emerged as a guiding framework for fair priority-setting. This paper describes the processes of setting health...... not satisfy all four conditions of Accountability for Reasonableness; namely relevance, publicity, appeals and revision, and enforcement. This paper aims to make two important contributions to this problematic situation. First, it provides empirical analysis of priority-setting at the district level...
Pinder, Leeya F.; Nelson, Brett D.; Eckardt, Melody; Goodman, Annekathryn
African-born immigrants comprise one of the fastest growing populations in the U.S., nearly doubling its population size in recent years. However, it is also one of the most underrepresented groups in health-care research, especially research focused on gynecologic and breast malignancies. While the opportunity exists for access to an advanced health-care system, as immigrants migrate to the U.S., they encounter the same health-care inequalities that are faced by the native-born population based on ethnicity and social class, potentiated by limitations of health literacy and lack of familiarity with U.S. health systems. Given the continued influx of African-born immigrants in the U.S., we sought to understand the representation of this population in cervical and breast cancer research, recognizing the population’s high risk for these diseases at baseline while residing in their native countries. We determined that there is limited research in these diseases that disproportionately affect them; yet, there are identifiable and potentially modifiable factors that contribute to this paucity of evidence. This clinical commentary seeks to underscore the clear lack of research available involving African-born immigrants with respect to gynecologic and breast malignancies in the existing literature, demonstrate the need for more robust research in this population, and provide fundamental insights into barriers and solutions critical to the continued health of this growing population. PMID:27499654
Berg, van den A.E.
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 ad
Berg, van den A.E.
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
Glassman, Amanda; Giedion, Ursula; McQueston, Kate
The use of health technology assessment research in emerging economies is becoming an increasingly important tool to determine the uses of health spending. As low- and middle-income countries' gross domestic product grows, the funding available for health has increased in tandem. There is growing evidence that comparative effectiveness research and cost-effectiveness can be used to improve health outcomes within a predefined financial space. The use of these evaluation tools, combined with a systematized process of priority setting, can help inform national and global health payers. This review of country institutions for health technology assessment illustrates two points: the efforts underway to use research to inform priorities are widespread and not confined to wealthier countries; and many countries' efforts to create evidence-based policy are incomplete and more country-specific research will be needed. Further evidence shows that there is scope to reduce these gaps and opportunity to support better incorporation of data through better-defined priority-setting processes.
Hansen, Kristian Schultz
sector.A new health status indicator entitled Disability Adjusted Life Years (DALYs) was used to describe the level of ill health from the most common health problems in the Zimbabwean population in 1997. Epidemiological information was derived from multiple sources. The cause of death pattern...... by estimates from epidemiological studies from other settings if no Zimbabwean sources were available. Disease and public health experts were consulted about the identification of the best possible sources of information, the quality of these sources and the data adjustments made. Epidemiological information...... was utilised to calculate the burden of disease as measured by DALYs lost. HIV infection emerged from the information collected as the single most serious public health problem in Zimbabwe responsible for 49% of the total disease burden.In order to confirm some of the findings of the above study component...
Etchegary, Holly; Bishop, Lisa; Street, Catherine; Aubrey-Bassler, Kris; Humphries, Dale; Vat, Lidewij Eva; Barrett, Brendan
The vision of Canada's Strategy for Patient-Oriented Research is that patients be actively engaged as partners in health research. Support units have been created across Canada to build capacity in patient-oriented research and facilitate its conduct. This study aimed to explore patients' health research priorities in the province of Newfoundland and Labrador (NL). Eight town halls were held with members of the general public in rural and urban settings across the province. Sessions were a hybrid information-consultation event, with key questions about health research priorities and outcomes guiding the discussion. Sixty eight members of the public attended town hall sessions. A broad range of health experiences in the healthcare system were recounted. Key priorities for the public included access and availability of providers and services, disease prevention and health promotion, and follow-up support and community care. In discussing their health research priorities, participants spontaneously raised a broad range of suggestions for improving the healthcare system in our jurisdiction. Public research priorities and suggestions for improving the provision of healthcare provide valuable information to guide Support Units' planning and priority-setting processes. A range of research areas were raised as priorities for patients that are likely comparable to other healthcare systems. These create a number of health research questions that would be in line with public priorities. Findings also provide lessons learned for others and add to the evidence base on patient engagement methods.
Myocardial infarction and brain infarction are personally dramatic events. However, these cardiovascular events are also globally dramatic not just for being the first cause of death all over the world. In addition, their prevalence is increasing and the high economic cost of treatment - technological and pharmacological - is already inaccessible in many regions of the world. In light of the above, we have established an international foundation under the priority concept "Science, Health and Education" (SHE). This fundation is based in a new Spanish research and funding model, the "Nacional Cardiovascular Research Center (CNIC). The research aspect is geared towards promoting cardiovascular health and disease management both individually and among the population. Funding is public and private, excluding the fharmaceutical industry, wich thus prevents conflicts of interest. In the cardiovascular setting, the entity SHE as conceptual priority, and the CNIC as Scientific basis or model can be pilot or applicable to other health and disease issues in general.
Hansen, Kristian Schultz
There is not much knowledge at present of the relative cost-effectiveness of health services offered in the Zimbabwean public health care sector. In addition, the information on the relative importance of diseases is less than complete. Such information may however be useful for assessing...... was utilised to calculate the burden of disease as measured by DALYs lost. HIV infection emerged from the information collected as the single most serious public health problem in Zimbabwe responsible for 49% of the total disease burden.In order to confirm some of the findings of the above study component......, a small population survey was designed to estimate the population prevalence of serious health problems in an urban area of Zimbabwe through the application of verbal autopsy and morbidity interview techniques. The survey confirmed to some extent the pattern of diseases found in the nationwide study.Cost...
Full Text Available Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems. As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.
Wykes, Til; Haro, Josep Maria; Belli, Stefano R; Obradors-Tarragó, Carla; Arango, Celso; Ayuso-Mateos, José Luis; Bitter, István; Brunn, Matthias; Chevreul, Karine; Demotes-Mainard, Jacques; Elfeddali, Iman; Evans-Lacko, Sara; Fiorillo, Andrea; Forsman, Anna K; Hazo, Jean-Baptiste; Kuepper, Rebecca; Knappe, Susanne; Leboyer, Marion; Lewis, Shôn W; Linszen, Donald; Luciano, Mario; Maj, Mario; McDaid, David; Miret, Marta; Papp, Szilvia; Park, A-La; Schumann, Gunter; Thornicroft, Graham; van der Feltz-Cornelis, Christina; van Os, Jim; Wahlbeck, Kristian; Walker-Tilley, Tom; Wittchen, Hans-Ulrich
Mental and brain disorders represent the greatest health burden to Europe-not only for directly affected individuals, but also for their caregivers and the wider society. They incur substantial economic costs through direct (and indirect) health-care and welfare spending, and via productivity losses, all of which substantially affect European development. Funding for research to mitigate these effects lags far behind the cost of mental and brain disorders to society. Here, we describe a comprehensive, coordinated mental health research agenda for Europe and worldwide. This agenda was based on systematic reviews of published work and consensus decision making by multidisciplinary scientific experts and affected stakeholders (more than 1000 in total): individuals with mental health problems and their families, health-care workers, policy makers, and funders. We generated six priorities that will, over the next 5-10 years, help to close the biggest gaps in mental health research in Europe, and in turn overcome the substantial challenges caused by mental disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.
Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.
OCLC Online Computer Library Center, Inc., 2012
This new report details findings from a study OCLC conducted with libraries in mid-2011 to learn about their priorities, initiatives, thoughts on the future of their service points and the sources they use to keep up with developments in the library field. Most public library staff: (1) Anticipate that the top reason patrons are using their…
OCLC Online Computer Library Center, Inc., 2012
This new report details findings from a study OCLC conducted with libraries in mid-2011 to learn about their priorities, initiatives, thoughts on the future of their service points and the sources they use to keep up with developments in the library field. Most public library staff: (1) Anticipate that the top reason patrons are using their…
Tania Castaño Calduch
Full Text Available Objetivos: Valorar si el tabaco de liar supone un problema en materia de salud pública y consumo. Métodos: Se estudia el 70% del mercado español. En materia de salud pública, se analizan los contenidos de nicotina, alquitrán y monóxido de carbono del humo, y se comparan con los de los cigarrillos convencionales. En materia de consumo, se examina el etiquetado. Resultados: Los contenidos de nicotina, alquitrán y monóxido de carbono alcanzan valores de hasta el 70%, el 85% y el 84%, respectivamente, más de lo permitido para los cigarrillos convencionales. El 67% de las muestras no indican los contenidos de nicotina y alquitrán, y el 100% el monóxido de carbono. A pesar de la existencia de etiquetado, éste no garantiza una información suficiente al consumidor. Conclusiones: El tabaco de liar supone un problema tanto en materia de salud pública como en consumo. Por ello, sería necesaria alguna medida que permita resolver esta cuestión.Objectives: To study whether fine-cut tobacco poses a problem for public health and consumer affairs. Methods: We analyzed up to 70% of the fine-cut tobacco market in Spain. Regarding public health, the contents of nicotine, tar and carbon monoxide were analyzed and compared with levels in conventional cigarettes. Concerning consumer affairs, the labeling of samples was checked. Results: The contents of nicotine, tar and carbon monoxide reached values of 70%, 85% and 84%, respectively. These values are higher than those allowed in conventional cigarettes. A total of 67% of the samples analyzed did not show nicotine and tar contents on the labeling. None of the labels showed carbon monoxide contents. The presence of labeling per se did not guarantee sufficient information for consumers. Conclusions Fine-cut tobacco is a problem in both public health and consumer affairs. Solutions are required to resolve both problems.
Since 1999, Polish health policy has changed, the quality of services has increased, and also the level of financing, mainly from public benefits. Despite constant growth of indexes reflecting the health status of Polish society, such as life expectancy, quality of life, or decreasing index of deaths at birth, just as in the majority of European countries, in Poland the society is growing older, which implies the necessity to reorganize the system. In this paper, the author has described the most important factors that determine the operation of the health system in Poland, as well as presents the ways it was restructured over the last few years, taking into consideration the structural, legislative, financial, organizational, and quantitative aspects. Also, the latest trends in Polish health policy, which take into account new goals of the system, have been presented within.
Austin, S Bryn
Public health attention to childhood obesity has increased in tandem with the growing epidemic, but despite this intense focus, successes in prevention have lagged far behind. There is a blind spot in our drive for childhood obesity prevention that prevents us from generating sufficiently broad solutions. Eating disorders and the constellation of perilous weight-control behaviors are in that blind spot. Evidence is mounting that obesity and eating disorders are linked in myriad ways, but entrenched myths about eating disorders undermine our ability to see the full range of leverage points to target in obesity preventive intervention studies. Our efforts to prevent childhood obesity can no longer afford to ignore eating disorders and the assemblage of related behaviors that persist unabated.
Global fiscal constraints mean that the UK healthcare system of the 21st century can no longer provide all possible services and treatment for all the people it serves. Currently, more than ever, there is a need to set priorities in terms of resources. The allocation of scarce healthcare resources will result in some care programmes being supported while others are not. Decision makers are increasingly engaging the public in policy making and priority-setting processes. Advocates of increased public engagement argue that public services are paid for by the people and, therefore, should be shaped more extensively by them, preferably by a fully representative sample. Central to the concept of public engagement is a desire for open dialogue and debate between groups that might not ordinarily have the channels to understand or speak to one another. Public engagement activities aim to link the healthcare community with the general public, community groups, civil society organisations and any other groups or communities in the outside world where healthcare decision-making gains its relevance. This article, therefore, aims to discuss the importance of promoting public engagement.
Full Text Available 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 leadership programs offered in various parts of the world, and suggests several principles to be taken into account for the development of public health leadership education in the future. A variety of educational programs in public health leadership are classified into several types in terms of their formats: degree programs offered by schools of public health or other programs of public health, those offered in partnership with public health agencies, and so on. All of these programs have important implications for the overall effectiveness of public health leadership education. For public health leadership education to be effective, the partnership between academia and public health agencies is vitally important. Programs should provide opportunities to learn on the basis of practical public health experience, a commitment to life-long learning, flexibility in design, and recognition of the diverse needs of individuals and communities. The application of distance learning methods is one of the options to make this possible.Keywords: public health leadership, public health professionals, school of public health
Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict; Byskov, Jens; Hurtig, Anna-Karin
Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions. Key informant interviews were conducted with the Council Health Management Team (CHMT), community representatives, namely women, youth, elderly, disabled, and people living with HIV/AIDS, and other stakeholders who participated in the preparation of the district annual budget and health plans. Additionally, minutes from the Action Research Team and planning and priority-setting meeting reports were analyzed. A number of benefits were reported: better identification of community needs and priorities, increased knowledge of the community representatives about priority setting, increased transparency and accountability, promoted trust among health systems and communities, and perceived improved quality and accessibility of health services. However, lack of funds to support the work of the selected community representatives, limited time for deliberations, short notice for the meetings, and lack of feedback on the approved priorities constrained the performance of the community representatives. Furthermore, the findings show the importance of external facilitation and support in enabling health professionals and community representatives to arrive at effective working arrangement. Community participation in
Full Text Available Background: Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions. Design: Key informant interviews were conducted with the Council Health Management Team (CHMT, community representatives, namely women, youth, elderly, disabled, and people living with HIV/AIDS, and other stakeholders who participated in the preparation of the district annual budget and health plans. Additionally, minutes from the Action Research Team and planning and priority-setting meeting reports were analyzed. Results: A number of benefits were reported: better identification of community needs and priorities, increased knowledge of the community representatives about priority setting, increased transparency and accountability, promoted trust among health systems and communities, and perceived improved quality and accessibility of health services. However, lack of funds to support the work of the selected community representatives, limited time for deliberations, short notice for the meetings, and lack of feedback on the approved priorities constrained the performance of the community representatives. Furthermore, the findings show the importance of external facilitation and support in enabling health professionals and community representatives to arrive at effective
Terry Robert F
Full Text Available Abstract Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.
Bartlett, Catherine; Wurtz, Rebecca
Twitter can serve as a powerful communication modality to both "push" and "pull" public health data; each user is a potential public health sensor and actor. However, in 2012, only 8% of local health departments had Twitter accounts. We outline how Twitter works, describe how to access public tweets for public health surveillance purposes, review the literature on Twitter's current and potential role supporting public health's essential services, summarize Twitter's limitations, and make recommendations for health department use.
Full Text Available Public transit priority is very important for relieving traffic congestion. The connotation of dynamic public transit priority and dynamic stochastic park and ride is presented. Based on the point that the travel cost of public transit is not higher than the travel cost of car, how to determine the level of dynamic public transit priority is discussed. The traffic organization method of dynamic public transit priority is introduced. For dynamic stochastic park and ride, layout principle, scale, and charging standard are discussed. Traveler acceptability is high through the analysis of questionnaire survey. Dynamic public transit priority with dynamic stochastic park and ride has application feasibility.
Dzau, Victor J; McClellan, Mark B; McGinnis, J Michael; Burke, Sheila P; Coye, Molly J; Diaz, Angela; Daschle, Thomas A; Frist, William H; Gaines, Martha; Hamburg, Margaret A; Henney, Jane E; Kumanyika, Shiriki; Leavitt, Michael O; Parker, Ruth M; Sandy, Lewis G; Schaeffer, Leonard D; Steele, Glenn D; Thompson, Pamela; Zerhouni, Elias
Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity. Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings. The US health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress. The action priorities and essential infrastructure needs represent major
Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
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.
Bennett Sara C
Full Text Available Abstract Health policy and systems research (HPSR has been identified as critical to scaling-up interventions to achieve the millennium development goals, but research priority setting exercises often do not address HPSR well. This paper aims to (i assess current priority setting methods and the extent to which they adequately include HPSR and (ii draw lessons regarding how HPSR priority setting can be enhanced to promote relevant HPSR, and to strengthen developing country leadership of research agendas. Priority setting processes can be distinguished by the level at which they occur, their degree of comprehensiveness in terms of the topic addressed, the balance between technical versus interpretive approaches and the stakeholders involved. When HPSR is considered through technical, disease-driven priority setting processes it is systematically under-valued. More successful approaches for considering HPSR are typically nationally-driven, interpretive and engage a range of stakeholders. There is still a need however for better defined approaches to enable research funders to determine the relative weight to assign to disease specific research versus HPSR and other forms of cross-cutting health research. While country-level research priority setting is key, there is likely to be a continued need for the identification of global research priorities for HPSR. The paper argues that such global priorities can and should be driven by country level priorities.
Defechereux, T.; Paolucci, F.; Mirelman, A.; Youngkong, S.; Botten, G.; Hagen, T.P.; Niessen, L.W.
BACKGROUND: Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and tr
Priority issues in tropical animal health management. ... based systems and ethno veterinary medical practices in solving their problems almost successfully. ... issues in the tropics must therefore take cognizance of these indigenous strategies.
Chalkidou, Kalipso; Glassman, Amanda; Marten, Robert; Vega, Jeanette; Teerawattananon, Yot; Tritasavit, Nattha; Gyansa-Lutterodt, Martha; Seiter, Andreas; Kieny, Marie Paule; Hofman, Karen; Culyer, Anthony J
Governments in low- and middle-income countries are legitimizing the implementation of universal health coverage (UHC), following a United Nation's resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost-effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities - implicitly or explicitly - it has not been made clear how priority-setting for UHC should be conducted. We provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC.
Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.
Prioridades de investigación en servicios sanitarios en el Sistema Nacional de Salud: Una aproximación por consenso de expertos Setting health services research priorities in the public health system: An approach through expert consensus
Technique features. Health Services Research Priorities were identified and scored (7 to 9, high relevance; 4 to 6 mild relevance and 1 to 3, low or no relevance. Results were sorted regarding the median score and its dispersion. Results: 53 research issues were identified. Strategies to improve effectiveness in health care, information to patients, health care quality and safety, equity, access and sustainability were considered of high priority and high consensus; just 4 items had remarkable dispersion (Intercuartile interval (ICI ≥ 2. Organizational improvement, productivity and efficiency enhancement, workforce and equipments were classified of mild priority. Additionally, this group of items reached very low consensus: 59% of them reached ICI ≥ 2. Conclusions: Our approach offers reference about priorities to Spanish health services researchers, and also, orientation to financers and users of this kind of research, though several limitations have been described.
Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L
Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.
Full Text Available Background: Setting research priorities is a scientific process to allocate resources to the best use. In low- and middle-income countries, allocation of limited resources to fundamental issues is more important. So, the present study was conducted to determine social health research priorities. Methods: In the first step, important issues and research topics of social health were extracted from documents and studies conducted at the national level.In qualitative phase, reciprocating questionnaires were sent and interviews were conducted with experts and stakeholders, social health issues (as members of Delphi. In the next step, the research topics extracted were discussed in small groups (suggested by Council on Health Research for Development to score the proposed priority topics by Delphi members. Finally, the list of priorities (titles that acquired more than 80% of the total score was sent to Delphi members for final approval. Results: During the study, 220 topics were obtained in four research domains: “description of the problem and its consequences”, “cause finding”, “intervention to eliminate or reduce problems”, and “Management-Policymaking”. Finally, 30 of these topics remained as priority topics. High priority research topics in social health were equity, happiness, economics, and ethics, respectively. Conclusion: The findings provide a list of research priorities that help researchers carrying out studies that will have the greatest social health impact. Some targeting areas such as happiness and ethics were identified as less attended subjects that need more investment in research policies, management, and governance.
Full Text Available Abstract This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.
tried herbal remedies for both of them for a week but without effect. The family permits her to travel with her child quite some distance to a fairly run down health centre ---- (Cont. with her meeting services, but going home unserved) WHAT ARE HEALTH SYSTEMS AND HEALTH SYSTEMS RESEARCH? Health systems...... and constraints. This effectively leaves policy-makers.without scientifically sound ideas of what they can and should actually strengthen within ever limited resources. Within such unmapped and misunderstood systems, interventions – even the very simplest – often fail to achieve their goals and no recommeded...
Harper, Sherilee L; Edge, Victoria L; Ford, James; Willox, Ashlee Cunsolo; Wood, Michele; McEwen, Scott A
This exploratory study used participatory methods to identify, characterize, and rank climate-sensitive health priorities in Nunatsiavut, Labrador, Canada. A mixed method study design was used and involved collecting both qualitative and quantitative data at regional, community, and individual levels. In-depth interviews with regional health representatives were conducted throughout Nunatsiavut (n = 11). In addition, three PhotoVoice workshops were held with Rigolet community members (n = 11), where participants took photos of areas, items, or concepts that expressed how climate change is impacting their health. The workshop groups shared their photographs, discussed the stories and messages behind them, and then grouped photos into re-occurring themes. Two community surveys were administered in Rigolet to capture data on observed climatic and environmental changes in the area, and perceived impacts on health, wellbeing, and lifestyles (n = 187). Climate-sensitive health pathways were described in terms of inter-relationships between environmental and social determinants of Inuit health. The climate-sensitive health priorities for the region included food security, water security, mental health and wellbeing, new hazards and safety concerns, and health services and delivery. The results highlight several climate-sensitive health priorities that are specific to the Nunatsiavut region, and suggest approaching health research and adaptation planning from an EcoHealth perspective.
... Series Undergraduate Network Membership Contact Discover What is Public Health? Public health protects and improves the health of individuals, families, communities, and populations, locally and globally. Public health is personal. Public health professionals focus on preventing ...
Pronk, Nicolaas P; Baase, Catherine; May, Jeanette; Terry, Paul; Moseley, Karen
To explore factors that matter to business in making decisions regarding engagement in community health improvement efforts. Using qualitative methods, domains of interest were identified through literature reviews and expert interviews. Relevance of the domains in terms of potential priorities for action was tested through employer and community stakeholder interviews. Factors that employers considered important to sustained community collaboration as a business priority included (1) credibility of the convener, (2) broad representation of the community, (3) strong mission and goals, (4) individual commitment to health, (5) organizational commitment to health, and (6) demonstrated commitment from leadership. Priorities have been identified for engaging business in community health efforts. Implications for research, practice, and policy include the need for measurement, transparency in reporting, and agreement on principles for public-private partnership in this area.
Mental illness (especially depression and chronic anxiety) is the biggest single cause of misery in advanced countries. But only one quarter of those who are ill receive treatment. Mental health is crucial for wellbeing and there are modern evidence-based ways of treating mental health problems which have no net cost to the Exchequer. What are the most important factors affecting wellbeing in our society? And what low-cost ways do we have of improving wellbeing, when "all the money's gone"? T...
Sousa, Fábio Alexandre Melo do Rego; Goulart, Maria José Garcia; Braga, Antonieta Manuela dos Santos; Medeiros, Clara Maria Oliveira; Rego, Débora Cristina Martins; Vieira, Flávio Garcia; Pereira, Helder José Alves da Rocha; Tavares, Helena Margarida Correia Vicente; Loura, Marta Maria Puim
ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1) grouping by level of similarity, (2) classification according to epidemiological criteria, (3) ordering by experts, and (4) application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence). The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community. PMID:28273229
Fábio Alexandre Melo do Rego Sousa
Full Text Available ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1 grouping by level of similarity, (2 classification according to epidemiological criteria, (3 ordering by experts, and (4 application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence. The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community.
Paskins, Zoe; Jinks, Clare; Mahmood, Waheed; Jayakumar, Prakash; Sangan, Caroline B; Belcher, John; Gwilym, Stephen
This is the first national study of public and patient research priorities in osteoporosis and fracture. We have identified new research areas of importance to members of the public, particularly 'access to information from health professionals'. The findings are being incorporated into the research strategy of the National Osteoporosis Society. This study aimed to prioritise, with patients and public members, research topics for the osteoporosis research agenda. An e-survey to identify topics for research was co-designed with patient representatives. A link to the e-survey was disseminated to supporters of the UK National Osteoporosis Society (NOS) in a monthly e-newsletter. Responders were asked to indicate their top priority for research across four topics (understanding and preventing osteoporosis, living with osteoporosis, treating osteoporosis and treating fractures) and their top three items within each topic. Descriptive statistics were used to describe demographics and item ranking. A latent class analysis was applied to identify a substantive number of clusters with different combinations of binary responses. One thousand one hundred eighty-eight (7.4%) respondents completed the e-survey. The top three items overall were 'Having easy access to advice and information from health professionals' (63.8%), 'Understanding further the safety and benefit of osteoporosis drug treatments' (49.9%) and 'Identifying the condition early by screening' (49.2%). Latent class analysis revealed distinct clusters of responses within each topic including primary care management and self-management. Those without a history of prior fracture or aged under 70 were more likely to rate items within the cluster of self-management as important (21.0 vs 12.9 and 19.8 vs 13.3%, respectively). This is the first study of public research priorities in osteoporosis and has identified new research areas of importance to members of the public including access to information. The findings
... Published Books Fact Sheets Reports and Issue Briefs Advertising Public Health Buyers Guide Publications Contacts Professional Development ... Steps Challenge doubles its goal Apr 11 2017 Facebook Is your organization an APHA member? As an ...
Ierland, J. van & Schreuder, D.A.
The following topics; are discussed with respect to public health: - the effect of visible and ultraviolet radiation upon man. - vision with respect to lighting. interior lighting. - artificial lighting of work environments. - day light and windows. - recommendations for lighting. public lighting. -
Shawar, Yusra Ribhi; Crane, Lani G
Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community's ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical
de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela
Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.
Husting, P M; Alderman, M
Nurses' increasing age coupled with health care's rapidly changing environment moves succession planning, originally only a business sector tool, to a top administrative priority. Through active support of your facility's executive leadership and a clear linkage to long range organization objectives, you can implement this progressive procedure.
Jefferson, T O; Demicheli, V
We report on the application to the BFG Health Services Market Testing (MT) study of the response to a users' questionnaire and panel discussions to determine in which priority and how services should be provided. The questionnaire served to inform lay and health care panel members on users' views on the relative importance of future health services and the way they will be provided. Based on the questionnaire results and data contained in the BAOR Report of Public Health for 1992/93 the panel assigned the highest priorities to emergency services, followed by routine General Practitioner services and essential hospital services. The lowest ranking were non-essential hospital services, health care for children with special needs and provision of designated transport. There was a high consistency in views between the lay and health care members of the panel.
Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J
Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.
Public health is discussed departing from priorities related to the precautionary principle with special reference to air pollution from wood burning in individual stoves and the susceptibility of vulnerable groups, i.a. people with genetic predispositions for a lack of detoxifying capacity....
Public health is discussed departing from priorities related to the precautionary principle with special reference to air pollution from wood burning in individual stoves and the susceptibility of vulnerable groups, i.a. people with genetic predispositions for a lack of detoxifying capacity....
Svendsen, Mette N.
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...... me mindful and watchful of the porous passages between animal and human bodies and environments that do not confine themselves to ‘national health programs’ directed towards a specific (human) population. These unrecognized species encounters and relationships, which exceed the conventional framework...... 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...
Goddard, Maria; Hauck, Katharina; Smith, Peter C
Most countries face high demands on their health care systems and have limited resources with which to meet them. Priority setting seeks to address these problems by proposing rules to decide which groups of patients or disease areas should secure favoured access to limited health care resources. The economic approach towards priority setting, particularly in the form of cost-effectiveness analysis, is commonly advocated. However, despite many decades of refinement of the technical and methodological issues arising from the use of economic evaluation in priority setting, decision makers continue to diverge frequently from the principles of economic evaluation. Our approach in this paper is to highlight the potential contribution of models of political economy to understanding what constitutes rational behaviour when agents operate within political and institutional constraints. We argue that there may be potentially greater benefits to be gained from exploration and analysis of priority setting using models based on concepts such as median voter and competing interest groups, than from further efforts to refine the techniques of economic evaluation.
Silva Diego S
Full Text Available Abstract Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.
Heuer, Chelsea A.
Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health. PMID:20075322
Health care practitioners and researchers commonly call for greater reliance on evidence as a means to achieve improvement in quality of care. Systematic reviews provide a means to accelerate the use of evidence-based clinical interventions and public health practices. The extent to which these time- and resource-intensive systematic reviews currently address critical maternal health priorities in the intrapartum period is unclear. This analysis summarises key maternal health and research priorities, maps these priorities to existing reviews, identifies gaps in the literature that can be addressed with systematic reviews, and highlights key methodological concerns in conducting systematic reviews. The analysis draws on published data on maternal morbidities and an overview of 108 systematic reviews in Medline in the past 5 years using the MeSH terms 'Delivery, Obstetric,' to draw the links between health priorities, research priorities, existing evidence and missing evidence. Key causes of morbidity during labour and delivery in the United States include haemorrhage, pre-eclampsia and eclampsia, obstetric trauma and infection. Analyses of maternal morbidity and mortality suggest that key concerns include racial and ethnic disparities in health outcomes and the prevention of adverse events. Systematic reviews, however, generally tend to focus on the reduction of harms associated with interventions, are frequently limited to randomised designs, and do not address issues of health disparities. The results suggest that advances in evidence-based care in maternal health require that systematic reviews address issues of prevention of adverse events, include a larger variety of study designs when necessary and pay closer attention to health disparities.
Full Text Available Abstract Background Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles. Methods In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. Results The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Conclusions Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.
Full Text Available This paper examines existing methods of public debt management, features of their application, the problem of high levels of public debt and the efficiency of public debt management in Ukraine. Priorities debt policy of Ukraine in the context of the main methods are proposed for public debt management.
Fairbrother, Gerry; Dougherty, Denise; Pradhananga, Rosina; Simpson, Lisa A
Prior health services research (HSR) agendas for children have been published, but major ones are now over 15 years old and do not reflect augmented understanding of the drivers and determinants of children's health; recent changes in the organization, financing, and delivery of health care; a growing emphasis on population health; and major demographic shifts in the population. A policy-relevant research agenda that integrates knowledge gained over the past 2 decades is essential to guide future child HSR (CHSR). We sought to develop and disseminate a robust, domestically focused, policy-oriented CHSR agenda. The new CHSR agenda was developed through a series of consultations with leaders in CHSR and related fields. After each round of consultation, the authors synthesized the previous experts' guidance to help inform subsequent discussions. The multistep process in generation of the agenda included identification of major policy-relevant research domains and specification of high-value research questions for each domain. Stakeholders represented in the discussions included those with expertise in child and family advocacy, adult health, population health, community development, racial and ethnic disparities, women's health, health economics, and government research funders and programs. In total, 180 individuals were consulted in developing the research agenda. Six priority domains were identified for future research, including both enduring and emerging emphases: 1) framing children's health issues so that they are compelling to policy-makers; 2) addressing poverty and other social determinants of child health and wellbeing; 3) promoting equity in population health and health care; 4) preventing, diagnosing, and treating high priority health conditions in children; 5) strengthening performance of the health care system; and 6) enhancing the CHSR enterprise. Within these 6 domains, 40 specific topics were identified as the most pertinent for future research
Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.
Nair, Manisha; Fellmeth, Gracia
As a reflection on the Edinburgh Declaration, this conceptual synthesis presents six important challenges in relation to the role of medical education in meeting current national health priorities. This paper presents a conceptual synthesis of current efforts in medical education to incorporate national health priorities as a reflection on how the field has evolved since the Edinburgh Declaration. Considering that health needs vary from country to country, our paper focuses on three broad and cross-cutting themes: health equity, health systems strengthening, and changing patterns of disease. Considering the complexity of this topic, we conducted a targeted search to broadly sample and critically review the literature in two phases. Phase 1: within each theme, we assessed the current challenges in the field of medical education to meet the health priority. Phase 2: a search for various strategies in undergraduate and postgraduate education that have been tested in an effort to address the identified challenges. We conducted a qualitative synthesis of the literature followed by mapping of the identified challenges within each of the three themes with targeted efforts. We identified six important challenges: (i) mismatch between the need for generalist models of health care and medical education curricula's specialist focus; (ii) attitudes of health care providers contributing to disparities in health care; (iii) the lack of a universal approach in preparing medical students for 21st century health systems; (iv) the inability of medical education to keep up with the abundance of new health care technologies; (v) a mismatch between educational requirements for integrated care and poorly integrated, specialised health care systems; and (vi) development of a globally interdependent education system to meet global health challenges. Examples of efforts being made to address these challenges are offered. Although strategies for combatting these challenges exist, the
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. [...
This article describes national level development towards a Health in All Policies approach in Finland over the past four decades. In the early 1970s, improving public health became a political priority, and the need to influence key determinants of health through sectors beyond the health sector became evident. The work began with policy on nutrition, smoking and accident prevention. Intersectoral health policy was developed together with the World Health Organization (WHO). When Finland joined the European Union in 1995, some competencies were delegated to the EU which complicated national intersectoral work. The priority in the EU is economy, but the Constitution's requirement to protect health in all policies gives legal backing for including health consideration in the EU-level work. To promote that, Finland adopted 'Health in All Policies' (HiAP) as the health theme for its EU Presidency in 2006. The intersectoral work on health has developed from tackling single health problems, through large-scale programmes, further to systematic work based on legislation and permanent structures. In the 2000s, work at local level was strengthened by introducing more focused and tighter legislation and by providing expert support for implementation. Recently, emphasis has been on broad objectives and Governmental intersectoral programmes, and actors outside the administrative machinery. Great improvements in the population health have been gained over the past few decades. However, health inequalities across social groups have remained unacceptably large. Major decisions on economic policy with varying impacts by the social groups have been made without health impact assessment, or ignoring assessments conducted.
Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G
Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as
Full Text Available Abstract Background Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA. Methods This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors' experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries. Results At the core of the PBMA approach is an advisory panel charged with making recommendations for resource re-allocation. The process can be supported by a range of 'hard' and 'soft' evidence, and requires that decision making criteria are defined and weighted in an explicit manner. Evaluating the process of PBMA using an ethical framework, and noting important challenges to such activity including that of organizational behavior, are shown to be important aspects of developing a comprehensive approach to priority setting in health care. Conclusion Although not without challenges, international experience with PBMA over the last three decades would indicate that this approach has the potential to make substantial improvement on commonly relied upon historical and political decision making processes. In setting out a step by step guide for PBMA, as is done in this paper, implementation by decision makers should be facilitated.
U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the National Priorities List (NPL) Publication Assistance Databsae (PAD), a Lotus Notes...
Zulu, Joseph M.; Michelo, Charles; Msoni, Carol
to enhance legitimate and fair PS was introduced by researchers and decision makers within the health sector in the EU funded research project entitled 'Response to Accountable priority setting for Trust in health systems' (REACT). The project aimed to strengthen fairness and accountability in the PS...... processes of health systems at district level in Zambia, Tanzania and Kenya. This paper focuses on local perceptions and practices of fair PS (baseline study) as well as at the evolution of such perceptions and practices in PS following an AFR based intervention (evaluation study), carried out at district...... administration, in non-governmental organizations (NGO) and in health facilities. RESULTS: During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported...
Full Text Available Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44 to 64% in the final round (n=34. The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH, governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.
Gelcich, Stefan; Buckley, Paul; Pinnegar, John K; Chilvers, Jason; Lorenzoni, Irene; Terry, Geraldine; Guerrero, Matias; Castilla, Juan Carlos; Valdebenito, Abel; Duarte, Carlos M
Numerous international bodies have advocated the development of strategies to achieve the sustainability of marine environments. Typically, such strategies are based on information from expert groups about causes of degradation and policy options to address them, but these strategies rarely take into account assessed information about public awareness, concerns, and priorities. Here we report the results of a pan-European survey of public perceptions about marine environmental impacts as a way to inform the formation of science and policy priorities. On the basis of 10,106 responses to an online survey from people in 10 European nations, spanning a diversity of socioeconomic and geographical areas, we examine the public's informedness and concern regarding marine impacts, trust in different information sources, and priorities for policy and funding. Results show that the level of concern regarding marine impacts is closely associated with the level of informedness and that pollution and overfishing are two areas prioritized by the public for policy development. The level of trust varies greatly among different information sources and is highest for academics and scholarly publications but lower for government or industry scientists. Results suggest that the public perceives the immediacy of marine anthropogenic impacts and is highly concerned about ocean pollution, overfishing, and ocean acidification. Eliciting public awareness, concerns, and priorities can enable scientists and funders to understand how the public relates to marine environments, frame impacts, and align managerial and policy priorities with public demand.
Full Text Available Abstract This commentary describes how the Brazilian Ministry of Health's (MoH research support policy fulfilled the National Agenda of Priorities in Health Research (NAPHR. In 2003, the MoH started a democratic process in order to establish a priority agenda in health research involving investigators, health managers and community leaders. The Agenda was launched in 2004 and is guiding budget allocations in an attempt to reduce the gap between scientific knowledge and health practice and activities, aiming to contribute to improving Brazilian quality of life. Many strategies were developed, for instance: Cooperation Agreements between the Ministry of Health and the Ministry of Science and Technology; the decentralization of research support at state levels with the participation of local Health Secretariats and Science and Technology Institutions; Health Technology Assessment; innovation in neglected diseases; research networks and multicenter studies in adult, women's and children's health; cardiovascular risk in adolescents; clinical research and stem cell therapy. The budget allocated by the Ministry of Health and partners was expressive: US$419 million to support almost 3,600 projects. The three sub-agenda with the higher proportion of resources were "industrial health complex", "clinical research" and "communicable diseases", which are considered strategic for innovation and national development. The Southeast region conducted 40.5% of all projects and detained 59.7% of the resources, attributable to the concentration of the most traditional health research institutes and universities in the states of São Paulo and Rio de Janeiro. The second most granted region was the Northeast, which reflects the result of a governmental policy to integrate and modernize this densely populated area and the poorest region in the country. Although Brazil began the design and implementation of the NAPHR in 2003, it has done so in accordance with the 'good
Norheim, Ole F
Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population's health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes.
Bonde, Lars Ole; Juel, Knud; Ekholm, Ola
Background: ‘Music and public health’ is a new field of study. Few scientific studies with small samples have documented health implications of musical participation. Research questions in this epidemiological study were: 1) Is there an association between self-rated health and active use of music...... in daily life? 2) What associations can be observed between musical background, uses and understanding of music as a health factor, and self-reported health? Method: Data came from the Danish Health and Morbidity Survey 2013, based on a simple random sample of 25.000 adult Danes (16+ years). Response rate......: 57%. Multiple logistic regression analyses were performed to investigate associations between musical background/activities and health-related indicators. Discussion: The study documents that a majority of informants use music to regulate physical and psychological states...
Nankinga, Ziadah; Kutyabami, Paul; Kibuule, Dan; Kalyango, Joan; Groves, Sara; Bollinger, Robert C; Obua, Celestino
Health research is critical to the institutional mission of the Makerere College of Health Sciences (MakCHS). Optimizing the alignment of health research capacity at MakCHS with the health needs and priorities of Uganda, as outlined in the country's Health Sector Strategic Plan (HSSP), is a deliberate priority, a responsibility, and a significant opportunity for research. To guide this strategic direction, an assessment of MakCHS's research grants and publication portfolio was conducted. A survey of all new and ongoing grants, as well as all publications, between January 2005 and December 2009 was conducted. Research, training, and education grants awarded to MakCHS' constituent faculties and departments, were looked for through financial records at the college or by contact with funding organizations. Published manuscripts registered with PubMed, that included MakCHS faculty authors, were also analyzed. A total of 58 active grants were identified, of which 18 had been initiated prior to 2005 and there were an average of about eight new grants per year. Most grants funded basic and applied research, with major focus areas being HIV/AIDS (44%), malaria (19%), maternal and child health (14%), tuberculosis (11%), mental health (3%), and others (8%). MakCHS faculty were identified as Principal Investigators (PIs) in only 22 (38%) active grants. Grant funding details were only available for one third of the active grants at MakCHS. A total of 837 publications were identified, with an average of 167 publications per year, most of which (66%) addressed the country's priority health areas, and 58% had MakCHS faculty or students as first authors. The research grants and publications at MakCHS are generally well-aligned with the Ugandan Health Ministry priorities. Greater efforts to establish centralized and efficient grants management procedures are needed. In addition, greater efforts are needed to expand capacity for MakCHS faculty leadership of grants, as well as to
Cromley, Ellen K
Authoritative and comprehensive, this is the leading text and professional resource on using geographic information systems (GIS) to analyze and address public health problems. Basic GIS concepts and tools are explained, including ways to access and manage spatial databases. The book presents state-of-the-art methods for mapping and analyzing data on population, health events, risk factors, and health services, and for incorporating geographical knowledge into planning and policy. Numerous maps, diagrams, and real-world applications are featured. The companion Web page provides lab exercises w
Bettcher, D; Lee, K
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.
Carter, Stacy M; Kerridge, Ian; Sainsbury, Peter; Letts, Julie K
Public health ethics has emerged and grown as an independent discipline over the last decade. It involves using ethical theory and empirical analyses to determine and justify the right thing to do in public health. In this paper, we distinguish public health ethics from clinical ethics, research ethics, public health law and politics. We then discuss issues in public health ethics including: how to weigh up the benefits, harms and costs of intervening; how to ensure that public health interventions produce fair outcomes; the potential for public health to undermine or promote the rights of citizens; and the significance of being transparent and inclusive in public health interventions. We conclude that the explicit and systematic consideration of ethical issues will, and should, become central to every public health worker's daily practice.
Garcia, Francisco A R; Freund, Karen M; Berlin, Michelle; Digre, Kathleen B; Dudley, Donald J; Fife, Rose S; Gabeau, Geralde; Geller, Stacie E; Magnus, Jeanette H; Trott, Justina A; White, Hilary F
Following the initial wave of federal support to address women's health, there is a need to assess successes and determine the next priorities to advance the health of women. The objective of this study was to systematically collect expert opinion on the major advances in women's health in the past decade and priorities for women's health research and service in the coming decade. We utilized a Delphi method to query the leadership from academic and community Centers of Excellence in Women's Health, as designated by the Department of Health and Human Services. Leaders from 36 of the 48 centers responded to a series of questions about the major advances and critical indicators to evaluate future needs in women's health. We utilized a social ecology model framework to organize the responses to each question. The experts identified increased health education for women and increased empowerment of women across multiple spheres as the major advances positively impacting the health of women. The experts selected the following areas as the most important indicators to measure the status of the health of women in the future: health education and promotion, rates and impact of interpersonal violence against women, and access to healthcare. The major advances and measures of the health of women did not focus on specific changes to individual women in illness management, clinical care, or individual behavioral change. As we move to address health reform, we must be able to recognize and incorporate a broad perspective on public health and policy initiatives critical to the health and wellness of women and girls and, therefore, central to the well-being of the nation.
Ibrahim, Jennifer K; Burris, Scott; Hays, Scott
The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.
Contreras, Javier; Raventós, Henriette; Rodríguez, Gloriana; Leandro, Mauricio
The World Health Organization (WHO) Mental Health Action Plan 2013-2020 urges its Member States to strengthen leadership in mental health, ensure mental and social health interventions in community-based settings, promote mental health and strengthen information systems, and increase evidence and research for mental health. Although Costa Rica has strongly invested in public health and successfully reduced the burden of nutritional and infectious diseases, its transitional epidemiological pattern, population growth, and immigration from unstable neighboring countries has shifted the burden to chronic disorders. Although policies for chronic disorders have been in place for several decades, mental disorders have not been included. Recently, as the Ministry of Health of Costa Rica developed a Mental Health Policy for 2013-2020, it became evident that the country needs epidemiological data to prioritize evidence-based intervention areas. This article stresses the importance of conducting local epidemiological studies on mental health, and calls for changes in research funding priorities by public and private national and international funding agencies in order to follow the WHO Mental Health Action Plan.
Christiansen, Ask Vest
rad av världens främsta idrottsvetare och dopningsexperter hade mött upp för att presentera papers till en intresserad och engagerad publik. Temat för konferensen var "Doping and Public Health", och den aspekten behandlades också; dock tolkade flera presentatörer temat på sina egna vis, och hela...
Whelen, A Christian; Kitagawa, Kent; Maddock, Jay; Hayes, Donald; St John, Tonya Lowery; Rajan, Ranjani
Chronically understaffed public health laboratories depend on a decreasing number of employees who must assume broader responsibilities in order to sustain essential functions for the many clients the laboratories support. Prospective scientists considering a career in public health are often not aware of the requirements associated with working in a laboratory regulated by the Clinical Laboratory Improvement Amendments (CLIA). The purpose of this pilot internship was two-fold; introduce students to operations in a regulated laboratory early enough in their academics so that they could make good career decisions, and evaluate internship methodology as one possible solution to workforce shortages. Four interns were recruited from three different local universities, and were paired with an experienced State Laboratories Division (SLD) staff mentor. Students performed tasks that demonstrated the importance of CLIA regulations for 10–15 hours per week over a 14 week period. Students also attended several directed group sessions on regulatory lab practice and quality systems. Both interns and mentors were surveyed periodically during the semester. Surveys of mentors and interns indicated overall positive experiences. One-on-one pairing of experienced public health professionals and students seems to be a mutually beneficial arrangement. Interns reported that they would participate if the internship was lower paid, unpaid, or for credit only. The internship appeared to be an effective tool to expose students to employment in CLIA-regulated laboratories, and potentially help address public health laboratory staffing shortfalls. Longer term follow up with multiple classes of interns may provide a more informed assessment. PMID:23386992
Science for Alaska: Public Understanding of Science D. L. Campbell11University of Alaska Fairbanks, USA Around 200 people brave 40-below-zero temperatures to listen to university researchers and scientists give lectures about their work at an event called the Science for Alaska Lecture Series, hosted by the University of Alaska Fairbanks Geophysical Institute. It is held once a week, for six weeks during the coldest part of a Fairbanks, Alaska, winter. The topics range from space physics to remote sensing. The lectures last for 45 minutes with 15 minutes for audience questions and answers. It has been popular for about 20 years and is one of many public outreach efforts of the institute. The scientists are careful in their preparations for presentations and GI's Public Relations staff chooses the speakers based on topic, diversity and public interest. The staff also considers the speaker's ability to speak to a general audience, based on style, clarity and experience. I conducted a qualitative research project to find out about the people who attended the event, why they attend and what they do with the information they hear about. The participants were volunteers who attended the event and either stayed after the lectures for an interview or signed up to be contacted later. I used used an interview technique with open-ended questions, recorded and transcribed the interview. I identified themes in the interviews, using narrative analysis. Preliminary data show that the lecture series is a form of entertainment for people who are highly educated and work in demanding and stressful jobs. They come with family and friends. Sometimes it's a date with a significant other. Others want to expose their children to science. The findings are in keeping with the current literature that suggests that public events meant to increase public understanding of science instead draws like-minded people. The findings are different from Campbell's hypothesis that attendance was based
Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y
Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.
Llop Hernández, A
The author discusses the background for the idea of framing explicit policies on science and technology in the countries. She refers to the work of PAHO's Advisory Committee on Research (formerly Advisory Committee on Medical Research) and to statements made by governments on different occasions to the effect that the countries should establish their own research infrastructure. She mentions the basic elements and components of a national policy on science and technology, enunciates the principles that contribute to the establishment of a set of objectives, and states a number of premises that ensure the attainment of those objectives. She ends with some general observations on the criteria for the setting of priorities in health research.
Pratt, Bridget; Hyder, Adnan A
This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics - namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders' decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. © 2017 John Wiley & Sons Ltd.
Hayes, Donald K; Calhoun, Candice R; Joseph, Lin; Farnsworth, JoAnn Y; Arakaki, Kimberly B
The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, public health planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566
Torheim, Liv Elin; Birgisdottir, Bryndis Eva; Robertson, Aileen
Public Health Nutrition Education Liv Elin Torheim* 1, Bryndis Eva Birgisdottir2, 3, Inga Thorsdottir2, 3, Aileen Robertson4, Runa Midtvåge4, Chalida Mae Svastisalee4, Hanne Gillett4, Agneta Yngve5, Arja Erkkilä6 1Department of Nursing and Health Promotion, Oslo and Akershus University College......) and healthy aging. Unhealthy dietary patterns, high blood pressure and obesity are major risk factors for NCDs such as cancers, type 2 diabetes and cardiovascular diseases. There exists enormous potential to promote health and prevent diseases through targeting unhealthy life style, and it is crucial......, educational, social, economic, structural, political and/or legislative. The knowledge, skills, competencies and cultural heritage of the broader community should form a basis for all analyses and actions. The competencies required to be an effective PHN practitioner has been described by several scholars...
Sousa, Fábio Alexandre Melo do Rego; Goulart, Maria José Garcia; Braga, Antonieta Manuela Dos Santos; Medeiros, Clara Maria Oliveira; Rego, Débora Cristina Martins; Vieira, Flávio Garcia; Pereira, Helder José Alves da Rocha; Tavares, Helena Margarida Correia Vicente; Loura, Marta Maria Puim
To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1) grouping by level of similarity, (2) classification according to epidemiological criteria, (3) ordering by experts, and (4) application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence). The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community. Descrever a metodologia utilizada no processo de estabelecimento de prioridades em saúde para intervenção comunitária, numa comunidade idosa. Partindo dos resultados de um diagnóstico de saúde no âmbito da promoção do envelhecimento
Gambhir, Ramandeep Singh; Kaur, Amanpreet; Singh, Arshdeep; Sandhu, Anmol Rattan Singh; Dhaliwal, Angad Prakash Singh
Oral diseases are a major public health problem, and their burden is on increase in many low- and middle-income countries. Dental public health (DPH) aims to improve the oral health of the population through preventive and curative services. However, its achievements in India are being questioned probably because of lack of proficiency and skill among DPH personnel. The literature search for the present study was conducted utilizing various search engines and electronic databases such as PubMed and MEDLINE. Documents related to the Central and State Governments of India were also considered. Finally, 26 articles were selected for the present study from which relevant information can be extracted. The present study focuses on some of the important aspects relating to DPH in India such as priority for oral health, DPH workforce and curriculum, utilization of DPH personnel in providing primary oral health care, role of mobile dental vans, and research in DPH. It was concluded that more attention should be given toward preventive oral health care by employing more number of public health dentists in public sector, strengthening DPH education and research, and combining oral health programs with general health-care programs.
Wynia, Matthew K
Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust.
Borella, Laurent; Philip, Thierry
A recent report of the Senate revealed the difficulties of elaborating an effective cancer policy in France. Senators particularly pointed to the necessity of establishing cancer care priorities and to the tremendous need for medical coordination. This paper will develop the annual state debate on social security funding. The authors will show that health policy is entirely dependent on health economics. We believe that health priorities and health outcomes should be defined before any financial decision is made, this preliminary debate being an essential contribution to evidence-based policy-making in public health.
Michael, J M; Hayakawa, J M
In January 1984, the Asia-Pacific Academic Consortium for Public Health (APACPH) was established, bringing together 5 schools of public health with the objectives: to raise the quality of professional education in public health; to enhance the knowledge and skills of health workers through joint projects; to solve health problems through closer links with each other and with ministries of health; to increase opportunities for graduate students through curriculum development; and to make child survival a major priority. The Consortium now comprises 31 academic institutions or units in 16 countries, and is supported by UNICEF, The World Health Organization, the China Medical Board of New York, and the governments of Japan and Malaysia. During 1985-1992, it also received major support from the United States through the US Agency for International Development and the University of Hawaii. During the past 10 years, APACPH has carried out such activities as setting up a data bank on the programs of its members, assessing public health problems, designing new curriculum and systems for service delivery, facilitating information and faculty exchanges, and running workshops for academic administrators. It has also organized conferences on the impact of urbanization on health, aging, child survival, AIDS, and occupational health. Since 1987 it has published the Asia-Pacific Journal of Public Health, the only English language journal on public health issues in the Asia and Pacific region, which will feature work being done by non-English-speaking researchers. Emphasis in the coming years will be placed on setting common standards for teaching and research, so that members can make more use of each other's programs. It is hoped that membership of the Consortium will continue to expand. A particular concern will be to focus more resources on preventive care rather than curative.
Freire, R M
An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of public health, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greater proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development.(ABSTRACT TRUNCATED AT 250 WORDS)
Blaise, P; Dujardin, B; de Béthune, X; Vandenbergh, D
Health sector reform is a key priority of many governments throughout the world. Drug supply systems are a major element of public health policy design in Africa, where 90% of drugs are imported. The WHO Essential Drugs Program and the UNICEF sponsored Bamako Initiative have, since the late 1980s, promoted the rational use of essential drugs and attempted to ensure a sustainable drug supply through the implementation of cost recovery schemes and quality assurance mechanisms in public health services. A new market for drugs is emerging within this framework and there is growing competition for its control. Government medical stores are all too often bankrupt and the private sector is expensive, catering mainly for the middle to upper classes of urban areas. An intermediate alternative. Essential Drugs Purchasing Offices (EDPOs), has been proposed to balance social objectives and economic constraints. Some of the experimental strategies have given promising results. However, their implementation raises a number of questions: What is the role of the EDPO? Should it promote public health issues in general or focus purely on drug availability? What is the most appropriate legal status? Public or private? For profit or not? How should the investment capital be structured? In drugs or in funds? With ample provision or a tight budget? How should drug purchases be managed? Where should drugs be purchased? How much? How often? According to which procedures? How should the distribution of drugs be organized? Supplying everyone? Pushing supplies or pulling purchasers in? The answers to these questions, analysis of the reasons for success and failure and the dissemination of the information gathered should identify priorities for action and future research and define a framework for expansion. These are the objectives of the "Concerted Action for the Development of EDPO in Sub-Saharan African Countries" which is supported by the European Union (DG XII).
Full Text Available Abstract Background The Mental Health Country Profile is a tool that was generated by the International Mental Health Policy and Services Project to inform policy makers, professionals and other key stakeholders about important issues which need to be considered in mental health policy development. The Mental Health Country Profile contains four domains, which include the mental health context, resources, provision and outcomes. We have aimed to generate a Mental Health Country Profile for Vietnam, in order to highlight the strengths and weaknesses of the Vietnamese mental health situation, in order to inform future reform efforts and decision-making. Methods This study used snowball sampling to identify informants for generating a Mental Health Country Profile for Vietnam, and the data gathering was done through semi-structured interviews and collection of relevant reports and documents. The material from the interviews and documents was analysed according to qualitative content analysis. Results Marked strengths of the Vietnam mental health system are the aims to move toward community management and detection of mental illness, and the active involvement of several multilateral organizations and NGOs. However, there are a number of shortages still found, including the lack of treatment interventions apart from medications, the high proportion of treatments to be paid out-of-pocket, prominence of large tertiary psychiatric hospitals, and a lack of preventative measures or mental health information to the public. Conclusions At the end of this decade, mental health care in Vietnam is still characterised by unclear policy and poor critical mass especially within the governmental sector. This initial attempt to map the mental health situation of Vietnam suffers from a number of limitations and should be seen as a first step towards a comprehensive profile.
Марія Андріївна Знаменська
Full Text Available Actuality. The role of communications in effective reform of public health in the country is discovered in scientific literature last time. But there are no works that fully present the system of communications in public health; this fact defined actuality of the given research.Methods. The next scientific methods are used in this work: structural and logical analysis, conceptual modeling. The systematic approach became a base of research. Results. There was elaborated conceptual model of the system of communications in public health its node idea is a consistent solution of the priority problem of supply the population of the country in whole and the separate task groups of communicative impact with complex objective information in the system of public health. At constructing of the model there were separated the next groups of problems: structural construction of the system of communication; supply of the system with resources; methods and means of communication; monitoring and assessment of efficiency of communication.Conclusions. The use of this model allows at optimal costs to eliminate the organizational and administrative defects and increase an awareness of the people in organization of public health, in maintenance and improvement of personal health.
Li, Ian W; Awofeso, Niyi
Little information is available on the public health workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in Public Health (MPH) graduates in Australia, using data from the 1999-2009 waves of the Graduate Destination Survey. It was found that public health graduates had a high amount of female representation and very low proportions of indigenous representation. Public health graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of public health graduates working in public health roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for public health professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for public health graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the public health workforce should be a priority. Mapping of public health graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential public health workers with more comprehensive career trajectories. © Royal Society for Public Health 2013.
Rogers, W A
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.
Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén
Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.
Chopra, Mickey; Lawn, Joy E; Sanders, David; Barron, Peter; Abdool Karim, Salim S; Bradshaw, Debbie; Jewkes, Rachel; Abdool Karim, Quarraisha; Flisher, Alan J; Mayosi, Bongani M; Tollman, Stephen M; Churchyard, Gavin J; Coovadia, Hoosen
15 years after liberation from apartheid, South Africans are facing new challenges for which the highest calibre of leadership, vision, and commitment is needed. The effect of the unprecedented HIV/AIDS epidemic has been immense. Substantial increases in mortality and morbidity are threatening to overwhelm the health system and undermine the potential of South Africa to attain the Millennium Development Goals (MDGs). However The Lancet's Series on South Africa has identified several examples of leadership and innovation that point towards a different future scenario. We discuss the type of vision, leadership, and priority actions needed to achieve such a change. We still have time to change the health trajectory of the country, and even meet the MDGs. The South African Government, installed in April, 2009, has the mandate and potential to address the public health emergencies facing the country--will they do so or will another opportunity and many more lives be lost?
McWalter, Kirsty; Gaviglio, Amy
This special issue of the Journal of Genetic Counseling is dedicated to public health genetics and genomics. The seventeen papers featured in this issue span such topics as genetic counselors in public health roles, newborn screening, population screening, ethics, and health beliefs and behaviors. In this introduction to the special issue, we review some history of public health genetics and genomics, present the Centers for Disease Control and Prevention's "10 Essential Public Health Services" with associated genetics specific recommendations and priorities, and briefly overview how each article ties into the world of public health genetics and genomics. We hope this issue encourages genetic counselors to visualize their ever expanding and important roles in public health genetics and genomics, as well as their contributions to improving population health.
Mihir K. R.
Full Text Available Tuberculosis is a major public health problem world o ver and it is India’s worst scourge. In the words of Charles Dickens “it is the disease medicine never cured, wealth warded off, or poverty could boast exemption from.... Which sometimes moves in giant strides & sometimes at tardy sluggish pace, but slow or quick... is never sur e and certain”. India bears 28.4% of the entire world’s burden of Tuberculosis. Every year 2 2 lakh persons contract Tuberculosis, but only half of them seek medical care. One Indian die s of Tuberculosis every 3 minutes! Tuberculosis is not only a medical malady but an ec onomic disaster too it perpetuates poverty and poverty begets Tuberculosis. In view of the enor mity of the problem let us leaf through the pages of history
Springston, Jeffrey K; Weaver Lariscy, Ruth Ann
This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.
Eftekhari, Monir Baradaran; Forouzan, Ameneh Setareh; Mirabzadeh, Arash; Sajadi, Homeira; Dejman, Masoumeh; Rafiee, Hasan; Golmakan, Mohammad Mahdi
Mental health is an essential component for positive adaptation that enables people to cope with adversity to achieve their full potential and humanity. In this study, using a community based approach, the social determinants of mental health in Iranian women were extracted; and in addition, priority setting for interventional programs according to analytical framework of WHO was implemented. This study was a community based participatory research (CBPR) in district 22 of Tehran (Iran). The target group was married females with age range of 18-65 years. In this study, mental health priorities were extracted by qualitative methods according to Essential National Health Research model (ENHR) and the analytical framework of WHO. Data analysis was done based on content analysis by the open code 3.6 software. In the quantitative phase, according to secondary data, 1144 individuals (560 females and 584 males) were selected, of whom 41 percent had impaired mental health based on General Health Questionnaire (GHQ) (P<0.05). According to the qualitative phase, the first mental health priority in socioeconomic level was lack of insurance for unattended families, it was unemployment in differential exposure level and it was lack of knowledge and skills related to dealing with stress in the differential vulnerability level; in differential outcome and consequence levels, the priorities were lack of free counseling centers in the study area and lack of facilities for mental health rehabilitation. Providing training courses to improve the skills to deal with stress is considered one of the most important interventions for mental health promotion in women.
Monir Baradaran Eftekhari
Full Text Available Mental health is an essential component for positive adaptation that enables people to cope with adversity to achieve their full potential and humanity. In this study, using a community based approach, the social determinants of mental health in Iranian women were extracted; and in addition, priority setting for interventional programs according to analytical framework of WHO was implemented.This study was a community based participatory research (CBPR in district 22 of Tehran (Iran. The target group was married females with age range of 18-65 years. In this study, mental health priorities were extracted by qualitative methods according to Essential National Health Research model (ENHR and the analytical framework of WHO. Data analysis was done based on content analysis by the open code 3.6 software.In the quantitative phase, according to secondary data, 1144 individuals (560 females and 584 males were selected, of whom 41 percent had impaired mental health based on General Health Questionnaire (GHQ (P<0.05. According to the qualitative phase, the first mental health priority in socioeconomic level was lack of insurance for unattended families, it was unemployment in differential exposure level and it was lack of knowledge and skills related to dealing with stress in the differential vulnerability level; in differential outcome and consequence levels, the priorities were lack of free counseling centers in the study area and lack of facilities for mental health rehabilitation.Providing training courses to improve the skills to deal with stress is considered one of the most important interventions for mental health promotion in women.
Dorfman, Lori; Krasnow, Ingrid Daffner
Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.
Byskov, Jens; Marchal, Bruno; Maluka, Stephen;
BACKGROUND: Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions...... of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications....
Rubin, Jessica B; Paltiel, A David; Saltzman, W Mark
With the founding of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) in 1999, the National Institutes of Health (NIH) made explicit its dedication to expanding research in biomedical engineering. Ten years later, we sought to examine how closely federal funding for biomedical engineering aligns with U.S. health priorities. Using a publicly accessible database of research projects funded by the NIH in 2008, we identified 641 grants focused on biomedical engineering, 48% of which targeted specific diseases. Overall, we found that these disease-specific NIH-funded biomedical engineering research projects align with national health priorities, as quantified by three commonly utilized measures of disease burden: cause of death, disability-adjusted survival losses, and expenditures. However, we also found some illnesses (e.g., cancer and heart disease) for which the number of research projects funded deviated from our expectations, given their disease burden. Our findings suggest several possibilities for future studies that would serve to further inform the allocation of limited research dollars within the field of biomedical engineering.
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.
McBeath, W H
The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.
Deangelis, Matthew P; Burgel, Barbara J
A 2012 American Association of Occupational Health Nurses, Inc. (AAOHN) web-based membership survey of 5,138 members was designed to identify occupational health and safety issues facing members. A total of 2,123 members responded to the survey (41% response rate). Of the AAOHN members who responded to this survey, 61% reported health risk appraisal (HRA) priorities for 2012. HRA priority areas are identified among various subgroups of the AAOHN responders in this article. The top three HRA priority areas identified were weight management/nutrition/healthy eating, physical activity, and mental health/stress management. These priority areas were consistent across three industry sectors, three occupational health nurse job titles, and the smallest and largest employers. These results suggest that occupational health nurses should consider prioritizing their employee wellness efforts in these areas.
Hirschhorn, Joel S
Legally, governments use their police powers to protect public health, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote public health, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.
Jahnke, Sara A; Haddock, Christopher K; Carlos Poston, Walker S; Jitnarin, Nattinee
Military and Veterans Service Organizations (MVSOs) have a unique opportunity to influence legislation and advocate for the interests of their members. However, little is known about what legislative priorities MVSOs see as important. Understanding the legislative priorities of MVSOs can inform efforts by health scientists to promote policy and laws designed to improve the health of our nation's veterans. Using a mixed methods approach, we conducted a thematic analysis of legislative priorities MVSOs promote with their legislative agendas. Most commonly, MVSOs addressed issues related to disability evaluations and ratings with the Veterans Administration and access to Veterans Administration services. Other common themes identified as priorities include benefits such as retirement, education, housing assistance for veterans, and TRICARE benefits. Findings highlight the broad range of topics MVSOs identify as legislative priorities as well as some health issues that receive relatively limited attention. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
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.
Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San;
In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania....... The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees....
Full Text Available Abstract Background Health system strengthening is critical to ensure the integration and scaling-up of priority health promotion, disease prevention and control programs. Normative guidelines are available to address health system function imbalances while strategic and analytical frameworks address critical functions in complex systems. Tacit knowledge-based health system constructs can help identify actors' perspectives, contributing to improve strengthening strategies. Using maternal health as an example, this paper maps and analyses the health system functions that critical actors charged with formulating and delivering priority health programs consider important for their success. Methods Using concept mapping qualitative and statistical methods, health system functions were mapped for different categories of actors in high maternal mortality states of Mexico and at the federal level. Functions within and across maps were analyzed for degree of classification, importance, feasibility and coding. Results Hospital infrastructure and human resource training are the most prominent functions in the maternal health system, associated to federal efforts to support emergency obstetric care. Health policy is a highly diffuse function while program development, intercultural and community participation and social networks are clearly stated although less focused and with lower perceived importance. The importance of functions is less correlated between federal and state decision makers, between federal decision makers and reproductive health/local health area program officers and between state decision makers and system-wide support officers. Two sets of oppositions can be observed in coding across functions: health sector vs. social context; and given structures vs. manageable processes. Conclusions Concept mapping enabled the identification of critical functions constituting adaptive maternal health systems, including aspects of actor perspectives
González-Block, Miguel A; Rouvier, Mariel; Becerril, Victor; Sesia, Paola
Health system strengthening is critical to ensure the integration and scaling-up of priority health promotion, disease prevention and control programs. Normative guidelines are available to address health system function imbalances while strategic and analytical frameworks address critical functions in complex systems. Tacit knowledge-based health system constructs can help identify actors' perspectives, contributing to improve strengthening strategies. Using maternal health as an example, this paper maps and analyses the health system functions that critical actors charged with formulating and delivering priority health programs consider important for their success. Using concept mapping qualitative and statistical methods, health system functions were mapped for different categories of actors in high maternal mortality states of Mexico and at the federal level. Functions within and across maps were analyzed for degree of classification, importance, feasibility and coding. Hospital infrastructure and human resource training are the most prominent functions in the maternal health system, associated to federal efforts to support emergency obstetric care. Health policy is a highly diffuse function while program development, intercultural and community participation and social networks are clearly stated although less focused and with lower perceived importance. The importance of functions is less correlated between federal and state decision makers, between federal decision makers and reproductive health/local health area program officers and between state decision makers and system-wide support officers. Two sets of oppositions can be observed in coding across functions: health sector vs. social context; and given structures vs. manageable processes. Concept mapping enabled the identification of critical functions constituting adaptive maternal health systems, including aspects of actor perspectives that are seldom included in normative and analytical frameworks
Full Text Available The health matters associated with migration are crucial public health challenges faced by both governments and societies. According to United Nations estimates, 120 million of the approximately 175 million migrants worldwide are migrant workers with their families (1. Legal and illegal workers have a different status and, therefore, varying levels of access to social and health services. The collective health needs and implications of this sizeable population are considerable, and different health determinants and levels of vulnerability could impact on their health (2. The main public health goal is to avoid disparities in health status and access to health services between migrants and the host population (3. The second, closely associated principle, is to ensure migrants’ health rights, as stated during the 4th Conference on Migrant and Ethnic Minority Health in Europe which took place from 21st to 23rd June 2012 in Milan, where Migrants and ethnic minorities were confirmed as a benefit to the society (4.
Kapp, Suzanne; Santamaria, Nick
Chronic wounds are a poorly recognised chronic disease that cause pain and suffering and cost the Australian healthcare system A $2.85 billion dollars per annum. Unlike the highly profiled and relatively well-funded chronic diseases that comprise the Australian National Health Priority Areas, chronic wounds remain a largely hidden and poorly supported problem in the Australian community. This perspective article proposes that one approach to generate action to reduce the burden of chronic wounds is to better articulate the relationship between chronic wounds and the Australian National Health Priority Areas, and to establish a profile of chronic wounds as a chronic disease of national significance in its own right. This approach has the potential to raise awareness of the significance of chronic wounds and garner support from the public, healthcare sector, research funders and policy makers to improve the outcomes for people who are living with or at risk of developing this condition and to potentially reduce expenditure in this area.
Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San
In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania...
Kass-Hout, Taha A; Alhinnawi, Hend
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.
Broeder, Den Lea; Devilee, Jeroen; Oers, Van Hans; Schuit, A.J.; Wagemakers, Annemarie
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
Petersen, Poul E; Baehni, Pierre C
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 local, national and international resources to assure that people can be healthy. Social determinants of health, environmental hazards and unhealthy lifestyles are prioritized in modern public health-care. Disease prevention and health promotion are cornerstones in actions for public health. This volume of Periodontology 2000 is entitled ‘Periodontal health and global public health’; the 12 articles of this volume discuss different aspects of this statement. It covers a range of subjects from public health issues to patient care. This monograph intends to stimulate community action research in the field of periodontology in order to help the development of appropriate public health intervention and relevant surveillance programs. It also expects to stimulate health authorities and professional organizations to initiate and support actions to promote periodontal health in their respective countries.
Italy's recent economic growth and strategic position in the Mediterranean Sea have made it a prime destination for immigrants and asylum seekers in Europe. Despite its well-developed health care system, statistics on foreign citizens' health are worrisome. In 1998 public health services were extended to illegal immigrants, giving them the right to necessary urgent and non-urgent medical assistance, even for a prolonged period. This paper examines a two-year joint intervention project between Centre for the Study and Research of Public Health (Mental Health), Local Health Agency ROMA E (LHA RME) and the non-governmental organization Médecins Sans Frontières (MSF) in Rome.
Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff
Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.
Full Text Available Abstract Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.
Dr. Katrin Kohl, a medical officer at the CDC, discusses the World Health Organizationâs International Health Regulations for assessing and reporting on public health events across the world. Created: 6/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 6/21/2012.
Rudan, Igor; Gibson, Jennifer; Kapiriri, Lydia; Lansang, Mary Ann; Hyder, Adnan A; Lawn, Joy; Darmstadt, Gary L; Cousens, Simon; Bhutta, Zulfiqar A; Brown, Kenneth H; Hess, Sonja Y; Black, Maureen; Gardner, Julie Meeks; Webster, Jayne; Carneiro, Ilona; Chandramohan, Daniel; Kosek, Margaret; Lanata, Claudio F; Tomlinson, Mark; Chopra, Mickey; Ameratunga, Shanthi; Campbell, Harry; El Arifeen, Shams; Black, Robert E
This article reviews theoretical and practical approaches for setting priorities in global child health research investments. It also provides an overview of previous attempts to develop appropriate tools and methodologies to define priorities in health research investments. A brief review of the most important theoretical concepts that should govern priority setting processes is undertaken, showing how different perspectives, such as medical, economical, legal, ethical, social, political, rational, philosophical, stakeholder driven, and others will necessarily conflict each other in determining priorities. We specially address present research agenda in global child health today and how it relates to United Nation's (UN) Millennium Development Goal 4, which is to reduce child mortality by two-thirds between 1990 and 2015. The outcomes of these former approaches are evaluated and their benefits and shortcomings presented. The case for a new methodology for setting priorities in health research investments is presented, as proposed by Child Health and Nutrition Research Initiative, and a need for its implementation in global child health is outlined. A transdisciplinary approach is needed to address all the perspectives from which investments into health research can be seen as priorities. This prioritization requires a process that is transparent, systematic, and that would take into account many perspectives and build on advantages of previous approaches.
Full Text Available Abstract Background Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Methods Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction and secondary (improved population coverage, access to health services, efficiency, and quality using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Results Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Conclusions Targeted priority population health interventions we identified led to improved health
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.
Full Text Available Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority
Kleintjes, Sharon; Lund, Crick; Swartz, Leslie
The paper documents the views of South African mental health care service users on policy directions and service developments that are required to support their recovery. Semi-structured interviews were conducted with forty service users and service user advocates. A framework analysis approach was used to analyse the qualitative data. Service user priorities included addressing stigma, discrimination and disempowerment, and the links between mental health and poverty. They suggested that these challenges be addressed through public awareness campaigns, legislative and policy reform for rights protection, development of a national lobby to advocate for changes, and user empowerment. Users suggested that empowerment can be facilitated through opportunities for improved social relatedness and equitable access to social and economic resources. This study suggests three strategies to bridge the gap between mental health care service users rights and needs on one hand, and unsupportive attitudes, policies and practices on the other. These are: giving priority to service user involvement in policy and service reform, creating empathic alliances to promote user priorities, and building enabling partnerships to effect these priorities.
Full Text Available The problem with traffic congestion is particularly expressed in urban areas where possibilities for physical increment of capacity are limited or impossible. Significant in the approach to solving this problem is the usage of Public Transport (PT and the implementation of various advanced control measures that can improve the quality of overall public transport system. The main objective of this research is to explore the possibilities of implementation of adaptive traffic control on signalized intersections giving priority to public transport vehicles through urban traffic network in the city of Zagreb. The possibilities of implementing public transport priority (PTP technique in the city of Zagreb are analyzed because of specific traffic situations on defined corridors (location of stops, distance between intersections, etc.. With proper usage of PTP techniques (e.g. adequate detector positions, good estimation of PT vehicle arrival time at intersection the total tram travel time can be significantly reduced. The Level of Service at intersection may be approximately retained because cross-street traffic demand was not ignored. According to technological level of traffic control system in the city of Zagreb, global implementation of PTP is not possible. So, for each intersection the PTP algorithm was developed separately, but mutual traffic influence of all intersections on the corridor was considered. The cooperative concept application within urban traffic control is considered as well.
and disease prevention, health economics and leadership, health sociology, ethics, etc.—unified under the comprehensive public health umbrella. This approach will contribute to the prevention of silo thinking and isolated, particularistic action. Conversely, just thinking in and engaging specialists...
Much work in public health ethics is shaped by an 'autonomy first' view, which takes it to be axiomatic that it is difficult to justify state interference in the lives of competent adults unless the behaviours interfered with are compromised in terms of their autonomy, or would wrongfully infringe on the autonomy of others. However, such an approach is difficult to square with much of traditional public heath practice. Recent years have seen running battles between those who assume that an 'autonomy first' approach is basically sound (and so much the worse for public health practice) and those who assume that public health practice is basically sound (and so much the worse for the 'autonomy first' approach). This paper aims to reconcile in a normatively satisfying way what is best about the 'autonomy first' approach with what is best about a standard public health approach. It develops a positive case for state action to promote and protect health as a duty that is owed to each individual. According to this view, the state violates individuals' rights if it fails to take cost-effective and proportionate measures to remove health threats from the environment. It is thus a mistake to approach public health in the way that 'autonomy first' accounts do, as primarily a matter of individual entitlements versus the common good. Too little state intervention in the cause of improving population health can violate individuals' rights, just as too much can.
Full Text Available Abraham Maslow (1908 – 1970 has set up a hierarchy of five levels of basic needs. Of those that are considered to be basic physiological needs hunger, thirst as well as bodily comforts are considered to be the most important. Physiological needs are the strongest needs because if a person were deprived on all needs it is these physiological needs that would take the highest priority. As food is characterized as a basic need, we should have a special view on our daily food and our handling of it. Most people do not act careful with their daily intake of food. In the last decades, the increases of nutrition-associated diseases such as overweight and obesity and on the other hand underweight have been recorded. From a life-span approach, the problem has its offset point in the early age of development, namely in children and adolescents. Malnutrition, overweight and obesity limit children’s personal quality of life in terms of unhappiness with their own body, opposition or even rejection in peer group communication and general difficulties in day-to-day social interaction. A close connection between physical stature and the development of a negative self-concept and a low self-esteem is postulated.
Parales-Quenza, Carlos J
This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to public health based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.
Full Text Available Abstract Background In recent years, decision makers in Canada and elsewhere have expressed a desire for more explicit, evidence-based approaches to priority setting. To achieve this aim within health care organizations, knowledge of both the organizational context and stakeholder attitudes towards priority setting are required. The current work adds to a limited yet growing body of international literature describing priority setting practices in health organizations. Methods A qualitative study was conducted using in-depth, face-to-face interviews with 25 key decision makers of the Provincial Health Services Authority (PHSA of British Columbia. Major themes and sub-themes were identified through content analysis. Results Priorities were described by decision makers as being set in an ad hoc manner, with resources generally allocated along historical lines. Participants identified the Strategic Plan and a strong research base as strengths of the organization. The main areas for improvement were a desire to have a more transparent process for priority setting, a need to develop a culture which supports explicit priority setting, and a focus on fairness in decision making. Barriers to an explicit allocation process included the challenge of providing specialized services for disparate patient groups, and a lack of formal training in priority setting amongst decision makers. Conclusion This study identified factors important to understanding organizational context and informed next steps for explicit priority setting for a provincial health authority. While the PHSA is unique in its organizational structure in Canada, lessons about priority setting should be transferable to other contexts.
Full Text Available Abstract Background Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD and cost-effectiveness analysis (CEA, which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for reasonableness' be helpful for improving priority setting in less wealthy countries? Methods In 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach. Results The approach to improving priority setting using 'accountability for reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach. Conclusion Both Tanzanian district and governmental health planners viewed the 'accountability for reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns.
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.
Alexander M. Trbovich
Full Text Available Public health genomics unifies the scientific disciplines of genetics and public health. Public health genomics aims to facilitate the transfer of newly acquired knowledge in genetic and molecular biology into classical medicine, to evaluate the currently available genetic tests, and to educate both the medical community and the general population about advancements in molecular and cell biology of medical interest. Due to various factors, the application of new genetic discoveries in classical medicine and the evaluation of the current genetic clinical tests occur at relatively slow paste. The challenge of public health genomics is to create the most effective modus for coexistence of new molecular and cell biology discoveries and classical medical techniques in applied medicine. The ultimate goal is to accomplish a truly individualized medical therapy.
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Dear public health professionals, Honestly, isn’t it time to ask whether or not we are doing “the right things”in public health? Are our present public health strategies evidence-based? The public health agenda demands a vision that reaches beyond research to the application of public health and the determination of it’s impact. In this scenario what is the role of genomics? In the past twenty years, advances in genome research have revolutionised what is known about the role of inheritance in health and disease.
Nowadays,we know that our DNA determines not only the cause of single-gene disorders, but also determines our predisposition to common diseases.Whereas medicine is currently undergoing extraordinary developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, public health practice has to date concerned itself with environmental determinants of health and disease and has paid scant attention to genetic variations within the population.
The advances brought about by genomics is changing these perceptions.[2,3] Many predict, that this knowledge will enable health promotion messages and disease prevention programmes to be specifically directed at susceptible individuals or at subgroups of the population, based on their genetic profile.[4,5]
The new technologies will allow researchers to examine genetic mutations at the functional genomic unit level, and to better understand the significance of environmental factors such as noxious agents, nutrition and personal behaviour in relation to the causation of diseases such as cardiovascular diseases, psychiatric disorders and infectious diseases.
Tong, Michelle; Sentell, Tetine
Chinese Americans constitute the largest percentage of Asian Americans. In Hawai‘i, Chinese Americans make up approximately 4.7% of the total state population. Accurately assessing health disparities across specific Asian American subgroups is critically important to health research and policy, as there is often substantial variability in risk and outcomes. However, even for Chinese Americans, the largest of the Asian American subgroups, such analyses can present challenges in population-based surveys. This article considers these challenges generally and then specifically in terms of the issue of health literacy and heart disease in Chinese Americans using existing population-based survey data sets in the United States, California, and Hawai‘i.
Full Text Available Background: Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs have not established adequate sustainable funding for health promotion and health infrastructure. Objective: In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design: We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority – road accidents – to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. Results: In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth to address a range of pressing health priorities, including programs that substantially reduced road accidents. Conclusions: Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.
Charoenca, Naowarut; Kungskulniti, Nipapun; Mock, Jeremiah; Hamann, Stephen; Vathesatogkit, Prakit
Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure. In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority - road accidents - to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth) to address a range of pressing health priorities, including programs that substantially reduced road accidents. Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.
Roberts, Marc J; Reich, Michael R
Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.
Kolahdooz, Fariba; Nader, Forouz; Yi, Kyoung J; Sharma, Sangita
Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. Transgenerational trauma from past assimilation policies have affected the health of Indigenous populations. The purpose of this paper is to comprehensively examine the social determinants of health (SDH), in order to identify priorities for health promotion policies and actions. We undertook a series of systematic reviews focusing on four major SDH (i.e. income, education, employment, and housing) among Indigenous peoples in Alberta, following the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Equity. We found that the four SDH disproportionately affect the health of Indigenous peoples. Our systematic review highlighted 1) limited information regarding relationships and interactions among income, personal and social circumstances, and health outcomes; 2) limited knowledge of factors contributing to current housing status and its impacts on health outcomes; and 3) the limited number of studies involving the barriers to, and opportunities for, education. These findings may help to inform efforts to promote health equity and improve health outcomes of Indigenous Canadians. However, there is still a great need for in-depth subgroup studies to understand SDH (e.g. age, Indigenous ethnicity, dwelling area, etc.) and intersectoral collaborations (e.g. community and various government departments) to reduce health disparities faced by Indigenous Canadians.
Full Text Available Background: Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. Transgenerational trauma from past assimilation policies have affected the health of Indigenous populations. Objective: The purpose of this paper is to comprehensively examine the social determinants of health (SDH, in order to identify priorities for health promotion policies and actions. Design: We undertook a series of systematic reviews focusing on four major SDH (i.e. income, education, employment, and housing among Indigenous peoples in Alberta, following the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Equity. Results: We found that the four SDH disproportionately affect the health of Indigenous peoples. Our systematic review highlighted 1 limited information regarding relationships and interactions among income, personal and social circumstances, and health outcomes; 2 limited knowledge of factors contributing to current housing status and its impacts on health outcomes; and 3 the limited number of studies involving the barriers to, and opportunities for, education. Conclusions: These findings may help to inform efforts to promote health equity and improve health outcomes of Indigenous Canadians. However, there is still a great need for in-depth subgroup studies to understand SDH (e.g. age, Indigenous ethnicity, dwelling area, etc. and intersectoral collaborations (e.g. community and various government departments to reduce health disparities faced by Indigenous Canadians.
Kolahdooz, Fariba; Nader, Forouz; Yi, Kyoung J.; Sharma, Sangita
Background Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. Transgenerational trauma from past assimilation policies have affected the health of Indigenous populations. Objective The purpose of this paper is to comprehensively examine the social determinants of health (SDH), in order to identify priorities for health promotion policies and actions. Design We undertook a series of systematic reviews focusing on four major SDH (i.e. income, education, employment, and housing) among Indigenous peoples in Alberta, following the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Equity. Results We found that the four SDH disproportionately affect the health of Indigenous peoples. Our systematic review highlighted 1) limited information regarding relationships and interactions among income, personal and social circumstances, and health outcomes; 2) limited knowledge of factors contributing to current housing status and its impacts on health outcomes; and 3) the limited number of studies involving the barriers to, and opportunities for, education. Conclusions These findings may help to inform efforts to promote health equity and improve health outcomes of Indigenous Canadians. However, there is still a great need for in-depth subgroup studies to understand SDH (e.g. age, Indigenous ethnicity, dwelling area, etc.) and intersectoral collaborations (e.g. community and various government departments) to reduce health disparities faced by Indigenous Canadians. PMID:26187697
... Infectious Diseases has a new Spanish language website! https://t.co… RT @CDCgov: Know when you need ... Together we can fight antibiotic resistance. Be #AntibioticSmart. https://t.… RT @AMJPublicHealth: Whiteness of the #opioidepidemic is ...
El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan
Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary
Van der Voordt, D.J.M.
Purpose Due to the transition of the Dutch health care sector from a governmentally steered domain towards regulated market forces, health care organisations have become fully responsible for their real estate. This paper explores if/how Dutch health care organisations adopt the concept of adding v
Olsen Øystein E
Full Text Available Abstract Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed. Accountability for Reasonableness (AFR is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i relevance to the local setting, decided by agreed criteria; ii publicizing priority-setting decisions and the reasons behind them; iii the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv the provision of leadership to ensure that the first three conditions are met. REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being
The UK's Minister for Health has again raised the debate about the role of health educators, and in particular that of the Health Education Council, in what is termed public policy work. 1 possible definition of public policy work as regards health education is that aspect that seeks to establish certain health promoting principles as part of the conscious factors always to be considered by individuals, by opinion leaders, by manufacturers, by employers and trade unions, by service providers, by local authorities, and by central government in their plans and decisions. The Health Education Council (HEC) has no power to make or impose public policy; the Department of Health and Social Security (DHSS) has that task. The world of health education providers includes the Health Education Officers working for the Health Authorities and with the Education Authorities, an increasing number of important academic workers in the field, the HEC, the Scottish Health Education Group (SHEG), the DHSS, and some of the members of various professions who provide health education to the public as part of their daily work. Most of the HEC's work consists of providing these people with health educational tools. If the HEC begins to do more in the public policy field, it will not be at the cost of providing health educational tools. At the HEC a staff of 4 liaison workers is responsible for keeping field workers informed about future and imminent HEC work programs. They also assess needs and ideas by holding periodic meetings with Health Education Officers and others in various parts of the country. HEC's efforts have contributed substantially to increasing attention to preventive health measures on the part of the DHSS, parliamentary committees, the Royal Colleges, other professional bodies, and the media. In regard to the future, several paths deserve exploration as part of the HEC's education of decision-makers and opinion-formers. These include: local authorities, relevant
Petersen, Poul E; Baehni, Pierre C
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...
Full Text Available Background: Sustainable Development Goals (SDGs aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development.Methods: To contribute to exploring to the academia's role in reaching SDGs, the 1st International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24-25 April 2016, in Tehran, Iran. Results: In line with Goal 3 of SDGs: "ensure healthy lives and promote well-being for all at all ages", the conference discussed various aspects of Universal Health Coverage (UHC, as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs, and explained the special role of academic public health institutes in education, research and service provision in the two above-mentioned areas. Conclusion: To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic public health institutes from low, middle and high-income countries, are essential. Keywords: Sustainable development goals (SDGs, Academia, UHC, NCD
Takian, Amirhossein; Akbari-Sari, Ali
Sustainable Development Goals (SDGs) aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development. To contribute to exploring to the academia's role in reaching SDGs, the 1(st) International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24-25 April 2016, in Tehran, Iran. In line with Goal 3 of SDGs: "ensure healthy lives and promote well-being for all at all ages", the conference discussed various aspects of Universal Health Coverage (UHC), as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs), and explained the special role of academic public health institutes in education, research and service provision in the two above-mentioned areas. To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic public health institutes from low, middle and high-income countries, are essential.
TAKIAN, Amirhossein; AKBARI-SARI, Ali
Background: Sustainable Development Goals (SDGs) aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development. Methods: To contribute to exploring to the academia’s role in reaching SDGs, the 1st International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24–25 April 2016, in Tehran, Iran. Results: In line with Goal 3 of SDGs: “ensure healthy lives and promote well-being for all at all ages”, the conference discussed various aspects of Universal Health Coverage (UHC), as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs), and explained the special role of academic public health institutes in education, research and service provision in the two above-mentioned areas. Conclusion: To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic public health institutes from low, middle and high-income countries, are essential. PMID:28028502
Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie
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.
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Background: Research provides the important evidence base for public health practice. We sought to compare the current support for public health research within European countries.
Methods: Within a collaborative study SPHERE (Strengthening Public Health Research in Europe, we developed an e-mail questionnaire and sent it to 93 representatives of national member associations of the European Public Health Association. We compared the answers with reference to tree macro-areas: Northern, Southern and Eastern Europe.
Results: We gained responses for 22 of the 39 European countries (56% country response rate. Current priorities at national level were: health service and patient safety for Northern Europe; infectious disease, health service and cardiovascular disease for Southern Europe; and food safety and nutrition, environmental and occupational health for Eastern Europe. Respondents gave fewer priorities for international research. In Northern Europe the priorities empathized were health promotion, prevention and education (26.3% together the injuries and alcohol habits (26.3%; health economics, health impact assessment, evaluations of services and programmes in Southern and Eastern Europe respectively 30% and 41.7%.
Conclusions: Support for public-health research differs across Europe, and barriers to undertaking better research included structures and sufficient personnel. National public health associations and public authorities should cooperate in order to find effective answers to common problems.
Simovska, Venka; Nordin, Lone Lindegard; Madsen, Katrine Dahl
of school-based health promotion is underpinned by high level policy documents, declarations and agreements between and within governments. International organizations, such as the World Health Organization, have long called upon governments throughout Europe and globally to incorporate health......-related knowledge, skills and attitudes in their education systems from an early age and to provide a foundation for the promotion of lifelong health and wellbeing (e.g. WHO, 1986; 1991; 1997; 1999; 2014). One question that could be asked in this respect is what happens when these political initiatives...... with the drive to increase the quality and effectiveness of health promotion in schools while remaining loyal to the main principles of the critical, socio-ecological paradigm of the Health Promoting Schools initiative (Green and Tones, 2010). In the following, we first present the conceptual framework, context...
Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre
through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries...... in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?...
Full Text Available BACKGROUND: Starting from 90‘th, the Government of Georgia (GoG made several attempts to transform Georgian health care system into one with improved efficiency, accessibility, and quality services. Mandatory social health insurance which was introduced in the 1990s was abolished and private health insurance has been promoted as its replacement. The main principle of health care reform since 2006 was the transition towards complete marketization of the health care sector: private provision, private purchasing, liberal regulation, and minimum supervision.This paper aims to analyze an impact of ongoing reforms on public health and population health status.MATERIALS AND METHODS: A systematic review of the available literature was conducted through national and international organization reports; key informant interviews were conducted with major stakeholders. RESULTS: The country has attained critical achievements in relation to improved maternal and child health, national responses to HIV, TB and Malaria. Life expectancy has increased from 70.3 years in 1995 to 75.1 years in 2010. Under-5 mortality indicator has improved from 45.3 to 16.4 per 1000 live birth in 2005-2010 meaning a 64% decrease. However, Georgia is still facing a number of critical challenges securing better health for the population. Cardiovascular diseases are by far the largest cause of mortality, respiratory diseases are the leading cause of morbidity and have doubled during last decade. Georgia has one of the highest rates of male smoking in the world (over 50%.CONCLUSION: Governmental efforts in health promotion and disease prevention can have significant impact on health status by preventing chronic diseases and detecting health problems at a treatable stage. Government should consider increasing funding for public health and prevention programmes with the focus on prevention of the main risk factors affecting the population’s health: tobacco and drug use and unsafe
Schlenker, Thomas; Huber, Carol A
In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.
Schäfer, W.; Groenewegen, P.P.; Hansen, J.; Black, N.
Background: All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would be
Choy, Lehua B; Smith, Heidi Hansen; Espiritu, Justine; Higa, Earl; Lee, Thomas; Maddock, Jay
Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166
Glass, Thomas A; Goodman, Steven N; Hernán, Miguel A; Samet, Jonathan M
Causal inference has a central role in public health; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in public health this framework is more suitable, providing an estimate of an action's consequences rather than the less precise notion of a risk factor's causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex public health challenges of our globalized world.
Scott J. N McNabb
Full Text Available Over the past decade, the world has radically changed. New advances in information and communication technologies (ICT connect the world in ways never imagined. Public health informatics (PHI leveraged for public health surveillance (PHS, can enable, enhance, and empower essential PHS functions (i.e., detection, reporting, confirmation, analyses, feedback, response. However, the tail doesn't wag the dog; as such, ICT cannot (should not drive public health surveillance strengthening. Rather, ICT can serve PHS to more effectively empower core functions. In this review, we explore promising ICT trends for prevention, detection, and response, laboratory reporting, push notification, analytics, predictive surveillance, and using new data sources, while recognizing that it is the people, politics, and policies that most challenge progress for implementation of solutions.
O'Hagan, Joshua; Persaud, David
Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.
Shelton, Shoshana R; Connor, Kathryn; Uscher-Pines, Lori; Pillemer, Francesca Matthews; Mullikin, James M; Kellermann, Arthur L
The federal government plays a critical role in achieving national health security by providing strategic guidance and funding research to help prevent, respond to, mitigate, and recover from disasters, epidemics, and acts of terrorism. In this article we describe the first-ever inventory of nonclassified national health security-related research funded by civilian agencies of the federal government. Our analysis revealed that the US government's portfolio of health security research is currently weighted toward bioterrorism and emerging biological threats, laboratory methods, and development of biological countermeasures. Eight of ten other priorities identified in the Department of Health and Human Services' National Health Security Strategy-such as developing and maintaining a national health security workforce or incorporating recovery into planning and response-receive scant attention. We offer recommendations to better align federal spending with health security research priorities, including the creation of an interagency working group charged with minimizing research redundancy and filling persistent gaps in knowledge.
Dryden, Trish; Sumpton, Bryn; Shipwright, Stacey; Kahn, Janet; Reece, Barbara (Findlay)
Background The health care landscape in Canada is changing rapidly as forces, such as an aging population, increasingly complex health issues and treatments, and economic pressure to reduce health care costs, bear down on the system. A cohesive national research agenda for massage therapy (MT) is needed in order to ensure maximum benefit is derived from research on treatment, health care policy, and cost effectiveness. Setting A one-day invitational summit was held in Toronto, Ontario to build strategic alliances among Canadian and international researchers, policy makers, and other stakeholders to help shape a national research agenda for MT. Method Using a modified Delphi method, the summit organizers conducted two pre-summit surveys to ensure that time spent during the summit was relevant and productive. The summit was facilitated using the principles of Appreciative Inquiry which included a “4D” strategic planning approach (defining, discovery, dreaming, designing) and application of a SOAR framework (strengths, opportunities, aspirations, and results). Participants Twenty-six researchers, policymakers, and other stakeholders actively participated in the events. Results Priority topics that massage therapists believe are important to the Canadian public, other health care providers, and policy makers and massage therapists themselves were identified. A framework for a national massage therapy (MT) research agenda, a grand vision of the future for MT research, and a 12-month action plan were developed. Conclusion The summit provided an excellent opportunity for key stakeholders to come together and use their experience and knowledge of MT to develop a much-needed plan for moving the MT research and professionalization agenda forward. PMID:24592299
BACKGROUND: Public spending on health care in many developing countries falls short to provide a comprehensive set of essential health services, which indicates the need to target and prioritize resources. However, governments often attempt to provide free services to the whole population, and often
Full Text Available Setting health research priorities is a complex and value–driven process. The introduction of the Child Health and Nutrition Research Initiative (CHNRI method has made the process of setting research priorities more transparent and inclusive, but much of the process remains in the hands of funders and researchers, as described in the previous two papers in this series. However, the value systems of numerous other important stakeholders, particularly those on the receiving end of health research products, are very rarely addressed in any process of priority setting. Inclusion of a larger and more diverse group of stakeholders in the process would result in a better reflection of the system of values of the broader community, resulting in recommendations that are more legitimate and acceptable.
Full Text Available In 2007 and 2008, the World Health Organization's Department for Child and Adolescent Health and Development commissioned five large research priority setting exercises using the CHNRI (Child Health and Nutrition Research Initiative method. The aim was to define research priorities related to the five major causes of child deaths for the period up to the year 2015. The selected causes were childhood pneumonia, diarrhoea, birth asphyxia, neonatal infections and preterm birth/low birth weight. The criteria used for prioritization in all five exercises were the “standard” CHNRI criteria: answerability, effectiveness, deliverability, potential for mortality burden reduction and the effect on equity. Having completed the exercises, the WHO officers were left with another question: how “fundable” were the identified priorities, i.e. how attractive were they to research funders?
Full Text Available Abstract Background 1 To elicit the opinions of the Public Health alumni of the MPH program; 2 To assess the applicability of the knowledge and skills acquired; 3 To identify the frequency of the public health competencies that the alumni performed. Methods We requested 187 graduates to complete a self-administered questionnaire and conducted in-depth interviews with 8 alumni as well as a focus group discussion with 14 alumni. Results In total 79.1% (148 of the MPH graduates completed and returned the questionnaire. Most alumni (91% agreed that the MPH curriculum corresponded with the working requirements of public health professionals; and nearly all were satisfied with what they have learnt (96%. Most respondents said that the MPH program enabled them to develop relevant professional skills (95% and that they were satisfied with the curriculum (90%. Notably fewer respondents (73% felt that the MPH program structure was balanced and well designed. Most alumni (64.3% were satisfied with Hanoi School of Public Health (HSPH full-time lecturers; but even more (83% were satisfied with visiting lecturers. The most commonly selected of the 34 pre-identified public health competencies were: applying computer skills (66.4%, planning and managing health programs (47.9%, communicating with the community and/or mobilizing the community to participate in health care (43.2%. Overall, the MPH alumni felt that HSPH emphasized research methods at the expense of some management and operational competencies. The most important challenges at work identified by the alumni were insufficient skills in: data analysis, decision making, inter-sectoral cooperation development, English language and training. Conclusion The training program should be reviewed and revised to meet the needs of its graduates who enter diverse situations and positions. English language skills were identified as top priority for further emphasis. The training program should comply with a more
Diem, Günter; Dorner, Thomas Ernst
The future challenges for the Austrian health care system require an increasing number of public health experts of different professions in all fields of public health. In this article the offer of public health education in Austrian universities and universities for applied sciences was searched based on the predominantly online available information on web platforms of the schools. Currently (2013), there are three postgraduate public health university courses and two public health doctoral programs in Austria. Additionally, 34 degree programmes could be identified, in which parts of public health are covered. But also in medical curricula at Austrian medical schools, public health contents have found their place. In Austria, there is already a multifaceted offer for public health education. However, to build an appropriate public health work force, capable to manage the public health challenges in all its dimensions in terms of health in all policies, this offer should still be intensified.
Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.
Esau, Daniel; Ho, Pak To; Blair, Geoffrey K; Duffy, Damian; O'Hara, Nathan N; Kapoor, Videsh; Ajiko, Margaret
Youth living in rural Uganda represent over 20% of the country's population. Despite the size of this demographic, there is a paucity of data on their health priorities. Engaging people in understanding their own health status has been proven to be an effective mechanism for health promotion. The objective of this study was to use Photovoice, a community-based, participatory action research methodology, to understand the current health priorities of youth living in rural Uganda. Thirty-two students between the ages of 13 and 17 were recruited from four schools within the region of Soroti, Uganda. Participants were given a disposable camera and were asked to photograph situations that contributed or detracted from their health status. The cameras were then returned to the investigators and each photo taken by the participant was reviewed with the investigators during a semi-structured interview. Codes were applied to the photographs and organized into overarching themes. Each participant chose one to two photos that were most representative of their health priorities for a secondary analysis. Participants provided 499 photos that met the eligibility criteria. The most common themes presented in the photographs were 'hygiene' (n= 73, 12.4%), 'nutrition' (n= 69, 11.7%), and 'cleanliness' (n= 48, 8%). 'Hygiene' (n= 6, 14.6%) and 'exercise' (n= 6, 14.6%) were the most common priorities articulated in the representative photographs. Photovoice proved to be an effective method to assess and express the health concerns of youth in rural Uganda. Study participants were able to articulate their health concerns and priorities through photographs and reflect on opportunities for health promotion through subsequent interviews. © The Author(s) 2015.
La Torre, Giuseppe; Mannocci, Alice; McCarthy, Mark; Ricciardi, Walter; Bes-Rastrollo, Maira
Research provides the important evidence base for public health practice. We sought to compare the current support for public health research within European countries. Within a collaborative study SPHERE (Strengthening Public Health Research in Europe), we developed an e-mail questionnaire and sent it to 93 representatives of national member associations of the European Public Health Association. We compared the answers with reference to tree macro-areas: Northern, Southern and Eastern Europe. We gained responses for 22 of 39 European countries (56% country response rate). Current priorities at national level were: health service and patient safety for Northern Europe; infectious disease, health service and cardiovascular disease for Southern Europe; and food safety and nutrition, environmental and occupational health for Eastern Europe. Respondents gave fewer priorities for international research. In the North Europe the priorities empathized were health promotion, prevention and education (26.3%) together the injuries and alcohol habits (26.3%). Support for public-health research differs across Europe, and barriers to undertaking better research include structures and sufficient personnel. National public health associations and public authorities should cooperate in order to find effective answers to common problems. Copyright 2010. Published by Elsevier Espana.
Full Text Available In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013–2025.
Olsen, J A
The paper aims to show how three theories of distributive justice; utilitarianism, egalitarianism and maximum, can provide a clearer understanding of the normative basis of different priority setting regimes in the health service. The paper starts with a brief presentation of the theories, followed by their prescriptions for distribution, as illustrated with their respective preferred points on a utility possibility frontier. After this general discussion, attention is shifted from utils to health. The paper discusses how the recent Norwegian guidelines for priority setting can be understood in the light of the theories.
Douw, Karla; Vondeling, Hindrik; Oortwijn, Wija
impact on health policy; such as the educational needs and organisational changes associated with the new technology. The proposed changes are regarded as an intermediate step in the process of producing a fully adapted instrument that can serve as a formal support for priority setting of new health technologies......In the context of the establishment of a Danish Horizon Scanning System (HSS) the views of health care stakeholders and health economists were solicitated by means of postal survey on the need for adaptation of a priority setting instrument for health technology assessment (HTA). The aim...... differing views between the two groups. The results show that the instrument should apply a health care perspective, and that technologies should be prioritised on the basis of the criteria: marginal benefits, marginal costs, budget impact, impact on access to care, and additional criteria with an...
Hitch, Danielle; Lhuede, Kate
The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. This study provides an updated indication of research priorities for mental health occupational therapy in Australia. © 2015 Occupational Therapy Australia.
Rocks, Sophie A; Schubert, Iljana; Soane, Emma; Black, Edgar; Muckle, Rachel; Petts, Judith; Prpich, George; Pollard, Simon J
Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy-level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others.
McCutcheon, Patricia; And Others
This teaching guide is designed to be used with secondary school students and the unit Air Pollution and Your Health. Material for the teacher includes the following: (1) an introduction to the unit; (2) a discussion of the sections of the unit; (3) instructional objectives; (4) suggestions for use of filmstrips, worksheets, reference materials,…
Twine, Rhian; Kahn, Kathleen; Scholtz, Alexandra Scholtz; Norris, Shane A
Background: When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo (‘hope’) aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process.Objective: This study aimed to determine adolescent health priorities ac...
Full Text Available Research in public health is a range that includes from fundamental research to research in clinical practice, including novel advances, evaluation of results and their spreading. Actually, public health research is considered multidisciplinary incorporating numerous factors in its development. Establishing as a mainstay the scientific method, deepens in basic research, clinical epidemiological research and health services. The premise of quality and relevance is reflected in international scientific research, and in the daily work and good biomedical practices that should be included in the research as a common task. Therefore, the research must take a proactive stance of inquiry, integrating a concern planned and ongoing development of knowledge. This requires improve international coordination, seeking a balance between basic and applied research as well as science and technology. Thus research cannot be considered without innovation, weighing up the people and society needs. Acting on knowledge of scientific production processes requires greater procedures thoroughness and the effective expression of the results. It is noted as essential to establish explicit principles in review and evaluation of the adjustments of actions, always within the standards of scientific conduct and fairness of the research process. In the biomedical scientific lines it have to be consider general assessments that occur related to the impact and quality of health research, mostly leading efforts to areas that require further attention. However, other subject areas that may be deficient or with lower incidence in the population should not be overlook. Health research as a source of new applications and development provides knowledge, improving well-being. However, it is understandable without considering the needs and social demands. Therefore, in public health research and to improve the health of the population, we must refine and optimize the prevention and
Grube, Mark E; Kaufman, Kenneth; Clarin, Dan; O'Riordan, Jason
Consumers who are accustomed to on-demand, virtual services are looking for more convenient ways to access health care. Giving patients the opportunity to connect with physicians remotely can promote higher patient satisfaction and engagement. Telehealth options may have a high start-up cost, but that cost is likely well-justified by the potential to enhance quality, outcomes, and customer attraction and satisfaction/retention over the long-term.
Leventhal, Alex; Karsenty, Eric; Sadetzki, Siegal
The increased use of mobile cellular phone by the public is associated with a wave of contradictory reports about the possible health effects, due to the exposure of the users to electromagnetic non-ionizing radiation. This article reviews the state of the art of the present knowledge concerning the biological and medical effects of exposure to cellular phones, with an emphasis on its possible carcinogenic effect. Health conditions, which have been ascribed to the use of mobile phones mainly include some types of cancer and changes of brain activity. However, the balance of evidence from available studies has not yet supported these claims. Following the recommendation of special international expert committees, the IARC (International Association for Research on Cancer) is conducting a multi-center study to determine the possible effect of cellular phone use on brain and salivary gland tumors. Israel is one of the participants of this study. The only established health effect associated with the use of such technology is an increased risk for road accidents, unrelated to the amount of radiation emitted by phone. The challenge posed by this new technology to health authorities all over the world has lead to the definition of a new principle, the so-called "prudent avoidance", used as guidelines for the definition of an adequate public health policy. The public policy in Israel has used the prudent avoidance principles, while awaiting the results of the multi-national epidemiological studies.
Smith, Stephanie L; Shiffman, Jeremy
This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years.
Zulu, Joseph M.; Michelo, Charles; Msoni, Carol;
level in Kapiri-Mposhi District in Zambia. METHODS: Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district...... devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing...
This paper summarises the status of public health in Quebec at the dawn of the 21st century. After introducing the current definition, the author lays out five basic functions of public health in Quebec: knowledge and surveillance of populations health and wellbeing, health protection; prevention of disease, trauma and social problems that influence health; health and wellbeing promotion; and service organization and evaluation. The organization of public health services is then described at the local level (CLSC), regional level (Public health units) and national level (Ministry, Public health directorate and National Institute of Public Health). Finally, the trends and priorities elaborated over the last ten years, as well as the National Public Health Program to be implemented over the next ten years are described.
Goodman, Richard A; Moulton, A; Matthews, G; Shaw, F; Kocher, P; Mensah, G; Zaza, S; Besser, R
Public health law is an emerging field in U.S. public health practice. The 20th century proved the indispensability of law to public health, as demonstrated by the contribution of law to each of the century's 10 great public health achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential tool in public health practice. Public health laws are any laws that have important consequences for the health of defined populations. They derive from federal and state constitutions; statutes, and other legislative enactments; agency rules and regulations; judicial rulings and case law; and policies of public bodies. Government agencies that apply public health laws include agencies officially designated as "public health agencies," as well as health-care, environmental protection, education, and law enforcement agencies, among others.
Jat, Tej Ram; Deo, Prakash Ramchandra; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel
Politics plays a critical role in agenda setting in health affairs; therefore, understanding the priorities of the political agenda in health is very important. The political priority for safe motherhood has been investigated at the national level in different countries. The objective of this study was to explore why and how maternal health became a political priority at sub-national level in the state of Madhya Pradesh in India. This study followed a qualitative design. Data were collected by carrying out interviews and review of documents. Semi-structured interviews were carried out with twenty respondents from four stakeholder groups: government officials, development partners, civil society and academics. Data analysis was performed using thematic analysis. The analysis was guided by Kingdon's multiple streams model. The emergence of maternal health as a political priority in Madhya Pradesh was the result of convergence in the developments in different streams: the development of problem definition, policy generation and political change. The factors which influenced this process were: emerging evidence of the high magnitude of maternal mortality, civil society's positioning of maternal mortality as a human rights violation, increasing media coverage, supportive policy environment and launch of the National Rural Health Mission (NRHM), the availability of effective policy solutions, India's aspiration of global leadership, international influence, maternal mortality becoming a hot debate topic and political transition at the national and state levels. Most of these factors first became important at national level which then cascaded to the state level. Currently, there is a supportive policy environment in the state for maternal health backed by greater political will and increased resources. However, malnutrition and population stabilization are the competing priorities which may push maternal health off the agenda. The influence of the events and factors
Gustavsson, Erik; Sandman, Lars
In this paper we explore the relation between health-care needs and patients' desires within shared decision-making (SDM) in a context of priority setting in health care. We begin by outlining some general characteristics of the concept of health-care need as well as the notions of SDM and desire. Secondly we will discuss how to distinguish between needs and desires for health care. Thirdly we present three cases which all aim to bring out and discuss a number of queries which seem to arise due to the double focus on a patient's need and what that patient desires. These queries regard the following themes: the objectivity and moral force of needs, the prediction about what kind of patients which will appear on a micro level, implications for ranking in priority setting, difficulties regarding assessing and comparing benefits, and implications for evidence-based medicine.
Bawo, Luke; Hunter, Jennifer C.; Massaquoi, Moses; Matanock, Almea; Dahn, Bernice; Ayscue, Patrick; Nyenswah, Tolbert; Forrester, Joseph D.; Hensley, Lisa E.; Monroe, Benjamin; Schoepp, Randal J.; Chen, Tai-Ho; Schaecher, Kurt E.; George, Thomas; Rouse, Edward; Schafer, Ilana J.; Pillai, Satish K.; De Cock, Kevin M.
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. We outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country’s health care system, such as infections among health care workers. During this time, priorities included strengthening EVD surveillance; establishing safe settings for EVD patient care (and considering alternative isolation and care models when Ebola Treatment Units were overwhelmed); improving infection control practices; establishing an incident management system; and working with Liberian airport authorities to implement EVD screening of departing passengers. PMID:25811176
Lockey, JE; Redlich, CA; Streicher, R; Pfahles-Hutchens, A; Hakkinen, PJ; Ellison, GL; Harber, P; Utell, M; Holland, J; Comai, A; White, Marc
Objective Outline the knowledge gaps and research priorities identified by a broad-base of stakeholders involved in the planning and participation of an international conference and research agenda workshop on isocyanates and human health held in Potomac, Maryland in April 2013. Methods A multi-modal iterative approach was employed for data collection including pre-conference surveys, review of a 2001 consensus conference on isocyanates, oral and poster presentations, focused break-out sessions, panel discussions and post-conference research agenda workshop. Results Participants included representatives of consumer and worker health, health professionals, regulatory agencies, academic and industry scientists, labor, and trade associations. Conclusions Recommendations were summarized regarding knowledge gaps and research priorities in the following areas: worker and consumer exposures; toxicology, animal models, and biomarkers; human cancer risk; environmental exposure and monitoring; and respiratory epidemiology and disease, and occupational health surveillance. PMID:25563538
Arwady, M Allison; Bawo, Luke; Hunter, Jennifer C; Massaquoi, Moses; Matanock, Almea; Dahn, Bernice; Ayscue, Patrick; Nyenswah, Tolbert; Forrester, Joseph D; Hensley, Lisa E; Monroe, Benjamin; Schoepp, Randal J; Chen, Tai-Ho; Schaecher, Kurt E; George, Thomas; Rouse, Edward; Schafer, Ilana J; Pillai, Satish K; De Cock, Kevin M
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. We outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country's health care system, such as infections among health care workers. During this time, priorities included strengthening EVD surveillance; establishing safe settings for EVD patient care (and considering alternative isolation and care models when Ebola Treatment Units were overwhelmed); improving infection control practices; establishing an incident management system; and working with Liberian airport authorities to implement EVD screening of departing passengers.
Curtis, Valerie A.; Garbrah-Aidoo, Nana; Scott, Beth
Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646
Full Text Available Background: When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo (‘hope’ aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process. Objective: This study aimed to determine adolescent health priorities according to key stakeholders, to align stakeholder and researcher priorities, and to form a stakeholder forum, which would be active throughout the intervention. Design: Thirty-two stakeholders were purposefully identified as community members interested in the health of adolescents. An adapted Delphi incorporating face-to-face discussions, as well as participatory visualisation, was used in a series of three workshops. Consensus was determined through non-parametric analysis. Results: Stakeholders and researchers agreed that peer pressure and lack of information, or having information but not acting on it, were the root causes of adolescent health problems. Pregnancy, HIV, school dropout, alcohol and drug abuse, not accessing health services, and unhealthy lifestyle (leading to obesity were identified as priority adolescent health issues. A diagram was developed showing how these eight priorities relate to one another, which was useful in the development of the intervention. A stakeholder forum was founded, comprising 12 of the stakeholders involved in the stakeholder involvement process. Conclusions: The process brought researchers and stakeholders to consensus on the most important health issues facing adolescents, and a stakeholder forum was developed within which to address the issues. Stakeholder involvement as part of a research engagement strategy can be of mutual benefit to the researchers and the community in which the research is taking place.
Arwady, M. Allison; Bawo, Luke; Hunter, Jennifer C.; Massaquoi, Moses; Matanock, Almea; Dahn, Bernice; Ayscue, Patrick; Nyenswah, Tolbert; Forrester, Joseph D; Hensley, Lisa E.; Monroe, Benjamin; Schoepp, Randal J.; Chen, Tai-Ho; Schaecher, Kurt E.; George, Thomas
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. We outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and th...
Full Text Available Abstract Background Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers. Methods We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported. Results Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity. Conclusion This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers.
Saleh Abubakir M
Full Text Available Abstract Background The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. Methods A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. Results The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%, the availability of sufficient medical equipment and investigation tools (68.7%, and the quality of offered services (65.3%. Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively. The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%, enhancing the role of family medicine (77.2%, adopting health
Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana
The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make
Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...
Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana
The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make
Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana
The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make
Gallagher, J.E.; Alajbeg, I.; Buchler, S.; Carrassi, A.; Hovius, M.; Jacobs, A.; Jenner, M.; Kinnunen, T.; Ulbricht, S.; Zoitopoulos, L.
Beck, Christina S; Benitez, Jose Luis; Edwards, Autumn; Olson, Amanda; Pai, Aarthi; Torres, Maria Beatriz
Based on an analysis of articles in health communication journals and in regional, national, and international communication journals, this study identifies publication trends and research priorities for health communication articles in the 1990s and the year 2000. Based on a content analysis of article abstracts, researchers determined the extent to which health communication articles appeared in various journals as well as the emphasis on specific topics in health communication research, methodological approaches, and theoretical frameworks. The article concludes with reflections on the implications of this study for future work in the area of health communication.
Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M
A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.
Public health focuses on health of the population and it is concerned with threats to health based on population health analysis. Anthropology covers most aspects that concern human beings. Both sciences converge on community and this fact represents a foundation for the partnership between public health and anthropology. Biological/medical anthropology is one of the highly developed fields of anthropology and the most important for public health.
The legend about Parmentier is quite reductive when it limits his activity to the promotion of potato. This military pharmacist intended mainly to make science serve human being, whatever could be his various activities. Actor of the foundation of food chemistry, reorganizer of military pharmacy, he has always been highly concerned with hygiene and public health. He then studied the quality of water, particularly in the case of river Seine, or the purity of air, especially in hospitals. The affair of Dunkerque exhumations or that of cesspools, or the utilisation of human excrements in agriculture were parts of the occurrences for which he had the opportunity to find a scientific approach allowing to solve the difficult questions that were asked to him, for the best benefit of public health. The exhaustive study he published in "Bulletin de pharmacie" for the conservation of meat shows that he did not ignore anything about freezing of food in order to preserve it. It is necessary not to forget the important role he played, as soon as he were informed of Jenner's discovery, for the diffusion of vaccination in France. It is simply astounding to observe how modern were the questions he solved and how intense was his spirit of dedication to the public good, when exerting his functions in "Comité de Salubrité de la Seine" or "Conseil de Santé des Armées", as well as outside these prestigious institutions. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Silverman, Ross D
Although interest in the field of public health law has dramatically increased over the past two decades, there remain significant challenges in communicating and sharing public health law-related knowledge. Access to quality information, which may assist in a public health department's efforts to protect the public's health, welfare, and safety, varies widely from jurisdiction to jurisdiction, and interjurisdictional communication remains at best a patchwork quilt with many holes. What follows is an analysis of several approaches the Public Health Law Association or other public health law-related organizations might undertake to serve as a conduit for the identification, gathering, and dissemination of extant public health law information, as well as the development of new public health law-related content, with a particular focus on the use of electronic means for such efforts.
... this? Submit Button Past Emails CDC Features Insufficient Sleep Is a Public Health Problem Language: English Español ( ... insufficient sleep is an important public health concern. Sleep-Related Unhealthy Behaviors The Behavioral Risk Factor Surveillance ...
Hansen, Morten Balle
The question posed is whether and how public senior managers’ perceptions of what is important in performing their roles have changed from the beginning of the 1990s to the end of the 2000s. The theoretical approach to the analysis is based on a macro-phenomenological institutional perspective...... models of good leadership. Municipal senior managers orient themselves more towards leadership priorities that are recommended in the international literature on leadership. They have generally become more oriented towards production, development of relations, innovation and attention to the external...... environment. During the same period the classic administrator role has been given a lower priority...
Morrice, Emily; Colagiuri, Ruth
Given the current insatiable demand for coal to build and fuel the world's burgeoning cities the debate about mining-related social, environmental and health injustices remains eminently salient. Furthermore, the core issues appear universally consistent. This paper combines the theoretical base for defining these injustices with reports in the international health literature about the impact of coal mining on local communities. It explores and analyses mechanisms of coal mining related injustice, conflicting priorities and power asymmetries between political and industry interests versus inhabitants of mining communities, and asks what would be required for considerations of health to take precedence over wealth.
Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon
School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…
Morse, Stephen S
Zoonotic infections are important sources of human disease; most known emerging infections are zoonotic (e.g., HIV, Ebola virus, severe acute respiratory syndrome, Nipah virus, and enteropathogenic Escherichia coli) and originated as natural infections of other species that acquired opportunities to come in contact with humans. There are also serious infectious diseases classically considered zoonotic, such as influenza, rabies, bubonic plague, brucellosis, and leptospirosis. More recently, it has been recognized that wildlife constitutes a particularly important source of novel zoonoses. With all this microbial movement, surveillance is considered the first line of public health defense. The zoonotic origin of many human and livestock infections argues strongly for the synergistic value of a One Health approach, which provides the capability to identify pathogens crossing into new species and could provide earlier warning of potential epidemics. This article discusses public health surveillance and major recent surveillance initiatives and reviews progress toward implementing a One Health surveillance framework. Networks discussed include global intergovernmental organizations and recent combined efforts of these organizations; Web-based nongovernmental systems (e.g., ProMED, the Program for Monitoring Emerging Diseases); and networks of bilateral or multilateral government programs (e.g., the CDC's Global Disease Detection [GDD] platform; the U.S. Department of Defense's Global Emerging Infections Surveillance and Response System [GEIS]; regional and subregional networks; and the U.S. Agency for International Development's Emerging Pandemic Threats [EPT] program and its surveillance component, PREDICT). Syndromic surveillance also has potential to complement existing systems. New technologies are enabling revolutionary capabilities for global surveillance, but in addition to serious technical needs, both sustainability and data-sharing mechanisms remain
Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.
Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.
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...... 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...
... 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......
D'Andreamatteo, Carla; Davison, Karen M; Vanderkooy, Pat
In 2014, a national initiative aimed at defining a research agenda for nutrition and mental health among diverse stakeholders was completed and included insights from more than 300 registered dietitians. This study explores the data from dietitians based on their years of practice, mental health experiences, and community of practice in relationship to identified mental health and nutrition research priorities. Analysis of numerical data (n = 299) and content analysis of open-ended responses (n = 269) revealed that respondents desired research for specific mental health conditions (MHCs), emotional eating, food addiction, populations with special needs, and people encountering major life transitions (e.g., recovery from abuse, refugees). Findings from the quantitative and textual data suggested that dietitians want research aimed at addressing the concerns of those in the community, fostering consumer nutrition knowledge and skill acquisition, and developing services that will impact quality of life. Subgroup analysis indicated that dietitians: (i) in early years of practice want information about specific MHCs; (ii) living in smaller towns and rural areas want data about the cost benefits of dietetics practice in mental health; and (iii) who also had additional stakeholder roles (e.g., service provider) selected priorities that address gaps in mental health services. This study highlights opportunities to tailor nutrition and mental health research that advance dietetics practice.
Full Text Available Abstract Background Controlling obesity has become one of the highest priorities for public health practitioners in developed countries. In the absence of safe, effective and widely accessible high-risk approaches (e.g. drugs and surgery attention has focussed on community-based approaches and social marketing campaigns as the most appropriate form of intervention. However there is limited evidence in support of substantial effectiveness of such interventions. Discussion To date there is little evidence that community-based interventions and social marketing campaigns specifically targeting obesity provide substantial or lasting benefit. Concerns have been raised about potential negative effects created by a focus of these interventions on body shape and size, and of the associated media targeting of obesity. Summary A more appropriate strategy would be to enact high-level policy and legislative changes to alter the obesogenic environments in which we live by providing incentives for healthy eating and increased levels of physical activity. Research is also needed to improve treatments available for individuals already obese.
Walls, Helen L; Peeters, Anna; Proietto, Joseph; McNeil, John J
Controlling obesity has become one of the highest priorities for public health practitioners in developed countries. In the absence of safe, effective and widely accessible high-risk approaches (e.g. drugs and surgery) attention has focussed on community-based approaches and social marketing campaigns as the most appropriate form of intervention. However there is limited evidence in support of substantial effectiveness of such interventions. To date there is little evidence that community-based interventions and social marketing campaigns specifically targeting obesity provide substantial or lasting benefit. Concerns have been raised about potential negative effects created by a focus of these interventions on body shape and size, and of the associated media targeting of obesity. A more appropriate strategy would be to enact high-level policy and legislative changes to alter the obesogenic environments in which we live by providing incentives for healthy eating and increased levels of physical activity. Research is also needed to improve treatments available for individuals already obese.
McNabb Scott JN
Full Text Available Abstract At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources. Three movements now set the stage for transformation of surveillance: 1 adoption by Member States of the World Health Organization (WHO of the revised International Health Regulations (IHR; 2 maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3 consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers. To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners. We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it’s needed, where it’s needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities
McNabb, Scott J N
At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources.Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers.To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners.We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it's needed, where it's needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship
... 42 Public Health 1 2010-10-01 2010-10-01 false Priorities for grants. 56.107 Section 56.107 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR MIGRANT HEALTH... propose to serve catchment areas in which 6,000 or more migratory agricultural workers and members...
doctors, nurses, lawyers, and architects can enjoy the benefits of the 2005/36/EC Directive amended by 2013/55/EU Directive on the recognition of professional qualifications, public health professionals are left out from these influential (elite professions. Firstly, we use the profession traits theory as a framework in arguing whether public health can be a legitimate profession in itself; secondly, we explain who public health professionals are and what usually is required for shaping the public health profession; and thirdly, we attempt to sketch the road to the authorisation or licensing of public health professionals. Finally, we propose some recommendations.
Sallis, James F.; McKenzie, Thomas L.
Analyzes contributions physical education makes to child and adult health. Topics discussed are current levels of U.S. children's physical activity; status of elementary physical education programs; health-related physical activity interventions; public health analysis of elementary physical education; and public health role and goal for physical…
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…
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.
U.S. Department of Health & Human Services — A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified...
"This text has a large emphasis on mixed methods, examples relating to health research, new exercises pertaining to health research, and an introduction on qualitative and mixed methods in public health...
Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas
The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.
Leipert, B D
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.
Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M
In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.
Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public
... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...
Mobinizadeh, Mohammadreza; Raeissi, Pouran; Nasiripour, Amir Ashkan; Olyaeemanesh, Alireza; Tabibi, Seyed Jamaleddin
Background: In the recent years, using health technologies to diagnose and treat diseases has had a considerable and accelerated growth. The proper use of these technologies may considerably help in the diagnosis and treatment of different diseases. On the other hand, unlimited and unrestricted entry of these technologies may result in induced demand by service providers. The aim of this study was to determine the appropriate criteria used in health technologies priority-setting models in the world. Methods: Using MESH and free text, we sought and retrieved the relevant articles from the most appropriate medical databases (the Cochrane Library, PubMed and Scopus) through three separate search strategies up to March 2015. The inclusion criteria were as follows: 1) Studies with specific criteria; 2) Articles written in English; 3) Those articles conducted in compliance with priority setting of health technologies. Data were analyzed qualitatively using a thematic synthesis technique. Results: After screening the retrieved papers via PRISMA framework, from the 7,012 papers, 40 studies were included in the final phase. Criteria for selecting health technologies (in pre assessment and in the assessment phase) were categorized into six main themes: 1) Health outcomes; 2) Disease and target population; 3) Technology alternatives; 4) Economic aspects; 5) Evidence; 6) and other factors. "Health effects/benefits" had the maximum frequency in health outcomes (8 studies); "disease severity" had the maximum frequency in disease and target population (12 studies); "the number of alternatives" had the maximum frequency in alternatives (2 studies); "cost-effectiveness" had the maximum frequency in economic aspects (15 studies); "quality of evidence" had the maximum frequency in evidence (4 studies); and "issues concerning the health system" had the maximum frequency in other factors (10 studies). Conclusion: The results revealed an increase in the number of studies on health
Linell, Anita; Richardson, Matt X; Wamala, Sarah
In 2003, the Swedish Parliament adopted a cross-sectorial national public health policy based on the social determinants of health, with an overarching aim--to create societal conditions that will ensure good health, on equal terms, for the entire population--and eleven objective domains. At that time the policy was globally unique, and serves as guidance for public health practice at the national, regional and local levels. The development of the public health policy and the determinants of health are presented regularly in various reports by the Swedish National Institute of Public Health. This supplement is a condensed version of the 174-page Public Health Policy Report 2010, the second produced since the national policy was adopted in 2003. In order to provide a holistic approach to analysing implemented measures and providing new recommendations within the eleven objective domains of the Swedish national public health policy, we have divided these in three strategic areas. These are: Good Living Conditions, Health-Promoting Living Environments and Living Habits, and Alcohol, Illicit Drugs, Doping, Tobacco and Gambling, each described in the respective introductions for Chapters 3-5. The production of the report was supported by a common analytical model that clarified the societal prerequisites for health in the eleven objective domains. These are factors that can be influenced by political actions in order to create a change. Economic analyses have also been developed to provide a priority basis for political decisions. Analyses of the development of public health determinants were based on data from the National Public Health Survey and data delivered from about 15 various national agencies. Measures that have been implemented between 2004 and 2009 are analysed in details, as the basis for new recommendations for future measures. The introduction describes Swedish public health policy in the new millennium and how it has developed, the role of the Swedish
CDCâs Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC. Created: 8/29/2011 by Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR). Date Released: 8/30/2011.
Winder, A.E.; Stanitis, M.A.
Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.
Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Levin, Scott; Shortliffe, Edward; Colwell, Rita
Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning. Public health agencies' current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost-effectiveness. As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost-effectiveness analyses widely recommended and used for public health planning. Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Our work employed a multicriteria systems analysis approach--specifically, multiattribute utility theory--to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach. (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. The teaching of strategic planning in public
Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R
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.
Lorant, Vincent; Grard, Adeline; Nicaise, Pablo
Belgium has recently reformed its mental health care delivery system with the goals to strengthen the community-based supply of care, care integration, and the social rehabilitation of users and to reduce the resort to hospitals. We assessed whether these different reform goals were endorsed by stakeholders. One-hundred and twenty-two stakeholders ranked, online, eighteen goals of the reform according to their priorities. Stakeholders supported the goals of social rehabilitation of users and community care but were reluctant to reduce the resort to hospitals. Stakeholders were averse to changes in treatment processes, particularly in relation to the reduction of the resort to hospitals and mechanisms for more care integration. Goals heterogeneity and discrepancies between stakeholders' perspectives and policy priorities are likely to produce an uneven implementation of the reform process and, hence, reduce its capacity to achieve the social rehabilitation of users.
David A. Sleet
Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering . Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts .
Annas, George J; Mariner, Wendy K
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.
Hollinger, F Blaine; Bell, B; Levy-Bruhl, D; Shouval, D; Wiersma, S; Van Damme, P
The introduction and implementation of hepatitis B vaccination programmes in areas of high endemicity has been very stressful. However, this initial accomplishment has led to the reassessment of priorities in some countries which could undermine these early successes. Work still remains to be done to support and implement interventions that will bring us closer to the WHO goal and to the control of hepatitis B in the community at large. Hepatitis A vaccine strategy for immunizing toddlers is shifting to those countries with intermediate endemicity where increasing morbidity in adults is being observed. Accumulating evidence indicates that such programmes can result in impressive reductions in the incidence of hepatitis A by herd immunity. Monitoring of these populations to determine durability of protection will be important to avoid shifting the infection to the older age population, when symptoms are more likely to occur. National policies need to consider hepatitis A vaccination in the context of other public health priorities.
JPRS: ^472 21 March 1961 PUBLIC HEALTH AND MIDWIFERY IN INDONESIA 3y M. Joedono DISTRIBUTION STATEMENT A Approved for Public Release...established to service the translation and research needs of the various government departments. ,-^’ JPRS: J^72 CSO: 1335-S/d PUBLIC HEALTH AND MIDWIFERY
Benzian, Habib; Hobdell, Martin; Holmgren, Christopher; Yee, Robert; Monse, Bella; Barnard, Johannes T; van Palenstein Helderman, Wim
Global Oral Health suffers from a lack of political attention, particularly in low- and middle-income countries. This paper analyses the reasons for this political neglect through the lens of four areas of political power: the power of the ideas, the power of the issue, the power of the actors, and the power of the political context (using a modified Political Power Framework by Shiffman and Smith. Lancet370  1370). The analysis reveals that political priority for global oral health is low, resulting from a set of complex issues deeply rooted in the current global oral health sector, its stakeholders and their remit, the lack of coherence and coalescence; as well as the lack of agreement on the problem, its portrayal and possible solutions. The shortcomings and weaknesses demonstrated in the analysis range from rather basic matters, such as defining the issue in an agreed way, to complex and multi-levelled issues concerning appropriate data collection and agreement on adequate solutions. The political priority of Global Oral Health can only be improved by addressing the underlying reasons that resulted in the wide disconnection between the international health discourse and the small sector of Global Oral Health. We hope that this analysis may serve as a starting point for a long overdue, broad and candid international analysis of political, social, cultural, communication, financial and other factors related to better prioritisation of oral health. Without such an analysis and the resulting concerted action the inequities in Global Oral Health will grow and increasingly impact on health systems, development and, most importantly, human lives.
Ivanov, Luba L; Oden, Tami L
Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations.
Full Text Available As a new service model, home health care can provide effective health care by adopting door-to-door service. The reasonable arrangements for nurses and their routes not only can reduce medical expenses, but also can enhance patient satisfaction. This research focuses on the home health care scheduling optimization problem with known demands and service capabilities. Aimed at minimizing the total cost, an integer programming model was built in this study, which took both the priorities of patients and constraints of time windows into consideration. The genetic algorithm with local search was used to solve the proposed model. Finally, a case study of Shanghai, China, was conducted for the empirical analysis. The comparison results verify the effectiveness of the proposed model and methodology, which can provide the decision support for medical administrators of home health care.
Kirk, Megan; Tomm-Bonde, Laura; Schreiber, Rita
More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to public health in its emphasis on the economic, legal, political and cultural factors that influence health. With public health renewal underway across Canada, and despite overwhelming support in the public health community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear. In this paper, we present the historical understanding of health promotion in Canada, namely highlighting the contributions from the Lalonde Report, Alma Ata Declaration, the Ottawa Charter for Health Promotion and the more recent population health movement. We discuss public health renewal, using the province of British Columbia in Canada as an example. We identify the potential threats to health promotion in public health renewal as it unfolds.
Maaitah, Rowaida Al; AbuAlRub, Raeda Fawzi
ABSTRACT Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation. PMID:28146176
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
Stein, Richard; Davis, Devra Lee
Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…
Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock
Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.
Inés M. Barrio Cantalejo
Full Text Available Introducción: Los libros de texto escolares son una herramienta didáctica para aprender hábitos saludables. El objetivo de este estudio es conocer cómo se recogen en los libros las prioridades de salud infantil y adolescente definidas por las autoridades sanitarias. Métodos: Estudio descriptivo en 3 fases: a identificación de las prioridades según las autoridades sanitarias; b identificación de los mensajes sobre salud de los textos usados en los colegios de un distrito municipal, y c observación de cómo se adecuan estos mensajes a las prioridades. Resultados: La Organización Mundial de la Salud, la Unión Europea, el Ministerio de Sanidad y Consumo, y la Sociedad Española de Salud Pública y Administración Sanitaria definen 24 prioridades. Se recogieron 100 libros de texto y 663 mensajes sobre salud. Las prioridades tratadas con más frecuencia son la alimentación, el ejercicio físico y el impacto de la contaminación medioambiental. Las menos tratadas son el acoso escolar, el maltrato infantil, la pobreza, la autolesión y la obesidad, esta última especialmente en educación infantil y primaria. Conclusiones: Los mensajes sobre salud de los libros no se ajustan suficientemente a las prioridades definidas por las autoridades.Background: Textbooks are an educational tool for learning health habits. The aim of this study was to determine how these textbooks present the health priorities defined by health organizations to children and teenagers. Method: We performed a descriptive study in 3 steps: a the priorities defined by health organizations were identified; b the messages on health in the textbooks used in the schools of a municipality were identified, and c the extent to which these messages fitted the priorities established was analyzed. Results: The World Health Organization, the European Union, the Spanish Ministry of Health and Consumption, and the Spanish Society of Public Health and Healthcare Administration define 24
El Lawindi, Mona I; Galal, Yasmine S; Khairy, Walaa A
Assessing the research output within the universities could provide an effective means for tracking the Millennium Development Goals (MDGs) progress. This analytical database study was designed to assess the trend of research theses conducted by the Public Health Department (PHD), Faculty of Medicine, Cairo University during the period 1990 to 2014 as related to the: MDGS, Faculty and department research priority plans and to identify the discrepancies between researchers' priorities versus national and international research priorities. A manual search of the theses was done at the Postgraduate Library using a specially designed checklist to chart adherence of each thesis to: MDGs, Faculty and department research plans (RPs). The theses' profile showed that the highest research output was for addressing the MDGS followed by the PHD and Faculty RPs. Compliance to MDGs 5 and 6 was obvious, whereas; MDGs 2, 3, and 7 were not represented at all after year 2000. No significant difference was found between PH theses addressing the Faculty RPs and those which were not before and after 2010. A significantly lower percent of PH theses was fulfilling the PHD research priorities compared to those which were not after 2010. This study showed a definite decline in research output tackling the MDGS and PHD research priorities, with a non-significant increase in the production of theses addressing the Faculty RPs. The present study is a practical model for policy makers within the universities to develop and implement a reliable monitoring and evaluation system for assessment of research output.
Winett, L B
Once viewed primarily as a criminal justice problem, violence and its prevention are now often claimed by public health professionals as being within their purview. The author reviewed 282 articles published in public health and medical journals from 1985 through 1995 that discussed violence as a public health problem. She found that while authors tended to identify social and structural causes for violence, they suggested interventions that targeted individuals' attitudes or behaviors and improved public health practice. Her study illuminates the tension between public health professionals' vision of the social precursors of violence and their attempts to apply a traditional set of remedies. In targeting individuals to rid the nation of violence, the public health community is deemphasizing societal causes.
Duran, Júlia; Villalbí, Joan R; Guix, Joan
Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.
Albitskiy, V S; Ustinova, N V; Antonova, Ye V
The article considers trends and priority directions of research studies of the field of public health and health care of children population. The interpretative content analysis was applied to study dissertations in the field of public health and health care in 1991-2012. The sampling included 4194 units of information. The first stage of study established that problems of children population are considered in 14.8% dissertations defended on the mentioned specialty. The next stage the categories of content-analysis were examined. They were divided on the following axes: axis I "Main problem of study", axis II "Localization of study", axis III "Examined age groups", axis IV "Distribution of studies on gender of examined contingent", axis V "Examined contingent", axis VI "Additional medical specialty". It is established that in dissertations on public health and health care of children population on axis I prevails organizational subject matter (27.2%). The health condition of various contingents of children population (16.8%), preventive aspects of pediatrics (12.2%), examination of particular conditions/diseases/classes of diseases (10.8%) are fixed as priority directions. In the most dissertations the regional character of studies is presented (98.2%). The prevailing age group in studies is the adolescent group (19.9%). The inter-disciplinary relationships of dissertations on problems of public health and health care of children population are revealed with such specialties as "Pediatrics" (16.2%), "Obstetrics and gynecology" (3.8%) and "Hygiene" (3.4%). With consideration for recognition of health promotion and optimization of health care of children population as priority directions of public health policy amount of research studies in this field is to be admitted as inadequate. With purpose of optimization of scientific knowledge and development of system of medical social care to children population it is needed to promote research studies of problems of
Inhorn, Stanley L.; Astles, J. Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M.; Wilcke, Burton W.; White, Vanessa A.
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 go...
... Statement in the Federal Register published on April 11, 2000 (65 FR 19477-78) or you may visit http... stakeholders including individual citizens, members of the private sector, the academic community, non... priorities include: Safety--Fostering a safety culture in our daily work and encouraging our...
Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V
This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.
Kimberly, John; Cronk, Imran
The world of health care is changing dramatically, as reflected in the number, magnitude, and scope of innovative new approaches-to how illness is treated and how better health is promoted-that are being implemented around the globe. The changes triggered by these initiatives affect both how care is organized, managed, and paid for and the kinds of approaches that are being developed to keep people healthy. Underlying these changes is a more fundamental paradigm shift, a shift in the priority given to "value" in the formulation of policy and management practice. This brief essay highlights five trends that are central in this shift: increasing emphasis on health promotion, movement toward value-based payment, advances in digital/mobile technology, exploitation of big data, and changes in support for biomedical research. Each of these has its own value controversies, and the individual impact of each is impossible to predict. Collectively, however, their impact is likely to be significant.
Alexandrova-Yankulovska, S; Bozhinov, P; Bojinova, S
Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and public health have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy.
Full Text Available The microbial agents that cause infectious diseases are highly prevalent in health care facilities. Adequate water supply, sanitation and hygiene are the key elements for the provision of basic health services. The consequences of poor sanitary and hygienic conditions and inadequate water supply are numerous in health care facilities. The importance of improving water supply, sanitation and hygiene in health care facilities has been recognized as an international priority and set in the 2030 Agenda for Sustainable Development, particularly through goal 3.8 and 6. The establishment and maintenance of safe water supply and adequate sanitary and hygienic conditions has multiple benefits for health care facilities. It is necessary to introduce and implement risk assessment and risk management approach as effective way of continuously ensuring and maintaining the safety of drinking water quality in health care facilities as recommended by the World Health Organization, in order to reduce the risks associated with inadequate water supply and protect health of patients and staff. Realization of activities on the improvement requires a multidisciplinary approach and good inter-sectoral cooperation at all levels local, national and global.
Collier, M T; Lambropoulos, A S; Williams-Glasser, G; Baron, S T; Birkmeyer, J
The Institute of Medicine's The Future of Public Health calls for a strengthening of linkages between public health and mental health, with a view to integrating the functions at the service delivery level. This paper details the history of the mental health/public health interface in Baltimore, Maryland. In 1977, mental health and addiction services were merged into the Department of Health. More recently, in 1988 adult mental health services were split off into a quasi-public corporation. Children's mental health, however, was retained as a distinct service within the Department of Health in order to enhance coordination with other health services for children. Replication of such coordinated-care models is certainly feasible.
Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L
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.
Ogilvie, David; Craig, Peter; Griffin, Simon; Macintyre, Sally; Wareham, Nicholas J
The paradigm of translational medicine that underpins frameworks such as the Cooksey report on the funding of health research does not adequately reflect the complex reality of the public health environment...
and cardiovascular diseases. There exists enormous potential to promote health and prevent diseases through targeting unhealthy life style, and it is crucial to develop a qualified public health nutrition workforce to reduce the NCD burden. Professionals with broad capacity within the field of public health...... nutrition are necessary to identify and respond to the current health challenges. However, public health nutrition has not been recognized as a profession in all countries. Public health nutrition (PHN) is an evolving profession within nutrition science that focuses on solving nutritional problems affecting...... population groups rather than those of individuals. Central elements of the profession are to assess the impact of various aspects of the food systems on the nutritional status, health and health inequalities of population groups, and to develop, recommend and implement evidence-based measures to improve...
Baugh, Christine M; Shapiro, Zachary E
Concussion from sport is increasingly recognized as a public health priority. In response, all states and the District of Columbia have enacted youth concussion legislation. This paper first examines key developments in concussion-related policy and legislation and then uses the findings from recent scientific studies to highlight the need to incorporate evolving scientific evidence into concussion legislation in order to better protect youth and adolescent athletes. Next, the paper discusses the framework of empirical health law research and why it should be applied in the case of concussion legislation. Finally, this paper argues that empirical health law research should be considered in any decision about whether legislation can help improve the health and safety of young players, a particularly vulnerable population whose unique needs have not yet been adequately addressed.
Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.
This paper explores the consequences of the oft ignored fact that public health insurance must actually be supplied by the state. Depending how the state is modeled, different health insurance outcomes are expected. The benevolent model of the state does not account for many actual features of public health insurance systems. One alternative is to use a standard public choice model, where state action is determined by interaction between self-interested actors. Another alternative--related to a strand in public choice theory--is to model the state as Leviathan. Interestingly, some proponents of public health insurance use an implicit Leviathan model, but not consistently. The Leviathan model of the state explains many features of public health insurance: its uncontrolled growth, its tendency toward monopoly, its capacity to buy trust and loyalty from the common people, its surveillance ability, its controlling nature, and even the persistence of its inefficiencies and waiting lines.
Vladimir Aleksandrovich Ilyin
Full Text Available December 3, 2015, the President of Russia Vladimir Putin delivered his annual Address to the Federal Assembly. Having analyzed the Address, experts pointed out the President’s worries and concerns about the efficiency of execution of development priorities he had set out. Vladimir Putin repeatedly urged the Government to implement effective measures on specific issues in the shortest time possible. However, it has not been done so far; therefore, we think that the President’s concern is reasonable. Recent research carried out by ISEDT RAS reveals certain alarming trends in the social health of the regional society
Khazei, Afshin; Jarvis-Selinger, Sandra; Ho, Kendall; Lee, Anna
We surveyed eight Canadian physicians who had each provided medical care for six months on the remote and under-served island of Tanna in Vanuatu. The most frequently encountered medical problems on Tanna were infectious diseases (tuberculosis, hepatitis, abscesses, malaria, pneumonia, typhoid fever, meningitis and skin infections). When physicians were asked about the top three health-care priorities, they ranked tuberculosis control, clean water and improved health-care delivery/communication between hospital and outposts as most important. The key issues were: (1) basic public health needs and infrastructure development are higher in priority than telehealth; (2) telehealth consultants must have knowledge pertinent to local conditions and resources available to the population; (3) electronic equipment suited to tropical environments is needed; (4) projects must be developed locally rather than internationally. Understanding how telehealth can provide support to health professionals under challenging conditions may assist with the health priorities in developing countries and potentially provide access to resources both locally and internationally.
Rabarison, Kristina M; Bish, Connie L; Massoudi, Mehran S; Giles, Wayne H
Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking "how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?" is important when making decisions about resource allocation and scaling of interventions.
Kristina M. Rabarison
Full Text Available Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking how do investments in public health strategies influence or offset the need for downstream spending on medical care and /or social services? is important when making decisions about resource allocation and scaling of interventions.
Frumkin, Howard; Hess, Jeremy; Luber, George; Malilay, Josephine; McGeehin, Michael
There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations.
Full Text Available One of the main objectives of all larger cities is to ensure effective transportation of people. There are two ways; how this objective can be reached – building of new infrastructure and effective using of the existing one. Because of the narrow streets and density of existing buildings within the city, in most cases it is not possible to extend current infrastructure. Hence, the second way is the only possible solution for such cities. Well-functioning management system improves the flow of traffic, reduces road accidents, and improves the comfort during transportation. Public transport is able to satisfy the transport requirements of a much larger number of passengers and acts more favourably than private transport in urban areas. Therefore building a public transport system of high quality, which also means public transport priority on the signal controlled junctions, is the key part of reaching the objective of ensuring effective transportation of people. In 2011, there were reconstructed roads around the Aupark Shopping Centre in Žilina. The paper is focused on traffic situation of the street Veľká Okružná; which was also rebuilt during the reconstruction. Based on microscopic modelling and road accidents data this paper compares two variants: (1 current traffic situation of this street and (2 the traffic situation, when the public transport priority was implemented during the reconstruction.
Erwin, Paul Campbell; Brownson, Ross C
The requisite capacities and capabilities of the public health practitioner of the future are being driven by multiple forces of change, including public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, globalized travel, and the repercussions of the Affordable Care Act. We describe five critical capacities and capabilities that public health practitioners can build on to successfully prepare for and respond to these forces of change: systems thinking and systems methods, communication capacities, an entrepreneurial orientation, transformational ethics, and policy analysis and response. Equipping the public health practitioner with the requisite capabilities and capacities will require new content and methods for those in public health academia, as well as a recommitment to lifelong learning on the part of the practitioner, within an increasingly uncertain and polarized political environment.
Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R
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.
Özkan, Şeyda; Vitali, Andrea; Lacetera, Nicola; Amon, Barbara; Bannink, André; Bartley, Dave J; Blanco-Penedo, Isabel; de Haas, Yvette; Dufrasne, Isabelle; Elliott, John; Eory, Vera; Fox, Naomi J; Garnsworthy, Phil C; Gengler, Nicolas; Hammami, Hedi; Kyriazakis, Ilias; Leclère, David; Lessire, Françoise; Macleod, Michael; Robinson, Timothy P; Ruete, Alejandro; Sandars, Daniel L; Shrestha, Shailesh; Stott, Alistair W; Twardy, Stanislaw; Vanrobays, Marie-Laure; Ahmadi, Bouda Vosough; Weindl, Isabelle; Wheelhouse, Nick; Williams, Adrian G; Williams, Hefin W; Wilson, Anthony J; Østergaard, Søren; Kipling, Richard P
Climate change has the potential to impair livestock health, with consequences for animal welfare, productivity, greenhouse gas emissions, and human livelihoods and health. Modelling has an important role in assessing the impacts of climate change on livestock systems and the efficacy of potential adaptation strategies, to support decision making for more efficient, resilient and sustainable production. However, a coherent set of challenges and research priorities for modelling livestock health and pathogens under climate change has not previously been available. To identify such challenges and priorities, researchers from across Europe were engaged in a horizon-scanning study, involving workshop and questionnaire based exercises and focussed literature reviews. Eighteen key challenges were identified and grouped into six categories based on subject-specific and capacity building requirements. Across a number of challenges, the need for inventories relating model types to different applications (e.g. the pathogen species, region, scale of focus and purpose to which they can be applied) was identified, in order to identify gaps in capability in relation to the impacts of climate change on animal health. The need for collaboration and learning across disciplines was highlighted in several challenges, e.g. to better understand and model complex ecological interactions between pathogens, vectors, wildlife hosts and livestock in the context of climate change. Collaboration between socio-economic and biophysical disciplines was seen as important for better engagement with stakeholders and for improved modelling of the costs and benefits of poor livestock health. The need for more comprehensive validation of empirical relationships, for harmonising terminology and measurements, and for building capacity for under-researched nations, systems and health problems indicated the importance of joined up approaches across nations. The challenges and priorities identified can
Falzon, Dennis; Timimi, Hazim; Kurosinski, Pascal; Migliori, Giovanni Battista; Van Gemert, Wayne; Denkinger, Claudia; Isaacs, Chris; Story, Alistair; Garfein, Richard S; do Valle Bastos, Luis Gustavo; Yassin, Mohammed A; Rusovich, Valiantsin; Skrahina, Alena; Van Hoi, Le; Broger, Tobias; Abubakar, Ibrahim; Hayward, Andrew; Thomas, Bruce V; Temesgen, Zelalem; Quraishi, Subhi; von Delft, Dalene; Jaramillo, Ernesto; Weyer, Karin; Raviglione, Mario C
In 2014, the World Health Organization (WHO) developed the End TB Strategy in response to a World Health Assembly Resolution requesting Member States to end the worldwide epidemic of tuberculosis (TB) by 2035. For the strategy's objectives to be realised, the next 20 years will need novel solutions to address the challenges posed by TB to health professionals, and to affected people and communities. Information and communication technology presents opportunities for innovative approaches to support TB efforts in patient care, surveillance, programme management and electronic learning. The effective application of digital health products at a large scale and their continued development need the engagement of TB patients and their caregivers, innovators, funders, policy-makers, advocacy groups, and affected communities.In April 2015, WHO established its Global Task Force on Digital Health for TB to advocate and support the development of digital health innovations in global efforts to improve TB care and prevention. We outline the group's approach to stewarding this process in alignment with the three pillars of the End TB Strategy. The supplementary material of this article includes target product profiles, as developed by early 2016, defining nine priority digital health concepts and products that are strategically positioned to enhance TB action at the country level. The content of this work is ©the authors or their employers. Design and branding are ©ERS 2016.
Timimi, Hazim; Kurosinski, Pascal; Migliori, Giovanni Battista; Van Gemert, Wayne; Denkinger, Claudia; Isaacs, Chris; Story, Alistair; Garfein, Richard S.; do Valle Bastos, Luis Gustavo; Yassin, Mohammed A.; Rusovich, Valiantsin; Skrahina, Alena; Van Hoi, Le; Broger, Tobias; Abubakar, Ibrahim; Hayward, Andrew; Thomas, Bruce V.; Temesgen, Zelalem; Quraishi, Subhi; von Delft, Dalene; Jaramillo, Ernesto; Weyer, Karin; Raviglione, Mario C.
In 2014, the World Health Organization (WHO) developed the End TB Strategy in response to a World Health Assembly Resolution requesting Member States to end the worldwide epidemic of tuberculosis (TB) by 2035. For the strategy's objectives to be realised, the next 20 years will need novel solutions to address the challenges posed by TB to health professionals, and to affected people and communities. Information and communication technology presents opportunities for innovative approaches to support TB efforts in patient care, surveillance, programme management and electronic learning. The effective application of digital health products at a large scale and their continued development need the engagement of TB patients and their caregivers, innovators, funders, policy-makers, advocacy groups, and affected communities. In April 2015, WHO established its Global Task Force on Digital Health for TB to advocate and support the development of digital health innovations in global efforts to improve TB care and prevention. We outline the group's approach to stewarding this process in alignment with the three pillars of the End TB Strategy. The supplementary material of this article includes target product profiles, as developed by early 2016, defining nine priority digital health concepts and products that are strategically positioned to enhance TB action at the country level. PMID:27230443
Savel, Thomas G; Foldy, Seth
Public health surveillance has benefitted from, and has often pioneered, informatics analyses and solutions. However, the field of informatics also serves other facets of public health including emergency response, environmental health, nursing, and administration. Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning. It is an interdisciplinary profession that applies mathematics, engineering, information science, and related social sciences (e.g., decision analysis) to important public health problems and processes. Public health informatics is a subdomain of the larger field known as biomedical or health informatics. Health informatics is not synonymous with the term health information technology (IT). Although the concept of health IT encompasses the use of technology in the field of health care, one can think of health informatics as defining the science, the how and why, behind health IT. For example, health IT professionals should be able to resolve infrastructure problems with a network connection, whereas trained public health informaticians should be able to support public health decisions by facilitating the availability of timely, relevant, and high-quality information. In other words, they should always be able to provide advice on methods for achieving a public health goal faster, better, or at a lower cost by leveraging computer science, information science, or technology.
Brown, Alison M C; Pirotta, Marie
Prioritisation of clients requesting physiotherapy in Victorian community health services has occurred in the absence of a uniform evidence-based prioritisation process. The effect of the varying prioritisation procedures on client outcomes is unknown. This two-part study sought to answer two questions: what are the current prioritisation practices? And what is the evidence for prioritisation? Staff of Victorian community health services offering physiotherapy (n=67) were sent a structured questionnaire regarding their prioritisation practices. The questionnaire data revealed a wide range of poorly defined criteria and methods of assessment for prioritisation. The evidence for prioritisation and the use of specific prioritisation criteria were examined via a literature search. The literature suggested the use of acute severe pain, interference with activities of daily living and falls as indicators of need for priority service. The lack of uniformity found in determining priority of access reflects the complexity of determining need and the lack of research and validated tools to assist decision making. Further research into prioritisation criteria is required to determine their validity and if their use in a prioritisation tool would actually improve outcomes for clients.
Conceição, Cláudia; Leandro, Alexandra; McCarthy, Mark
Within SPHERE (Strengthening Public Health Research in Europe), a collaborative study funded by the European Commission, we have assessed the support for public health research at ministry level in European countries. We surveyed the health and science ministries in 25 EU countries and 3 EEA countries, using a broad definition of public-health research at population level. We made over 600 phone calls and emails to identify respondents and to gain answers. We gained formal replies from 42 out of 56 ministries (73% response) in 25 countries. There were 22 completed questionnaires (from 25 ministries), 6 short answers and 11 contacts declaring that their ministries were not responsible for public health research, while in 14 ministries (both ministries in three countries) no suitable ministry contact could be found. In most European countries, ministries of health, or their devolved agencies, were regarded as the leading organizations. Most ministries were able to specify thematic areas for public-health research (from three to thirty), and others ministries referred to policy documents, health plans or public-health plans to define research priorities. Ministries and their agencies led on decisions for financial support of public-health research, with less involvement of other external organisations compared with the process of identifying priorities. However, the actual funds available for public health were not easily identifiable. Most ministries relied on general academic means for dissemination of results of public-health research, while ministries get information on the use of public-health research usually through informal means. Ministries made suggestions for strengthening public-health research through initiatives of their own countries and of the European Union: as well as more resources, improving coordination was most frequently suggested. There is no common approach to support for public-health research across Europe, and significant gaps in
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.
Akintola, S O
The preservation of the public's health is one of the most important goals of government. The enactment and enforcement of law is the primary means by which government can encourage as well as compel conditions for healthier and safer lifestyles. The Law creates and assigns functions for public health authorities. In this regard, law is a fundamental element of effective public health policy and practice. It has played a crucial role in many of public health's greatest achievements. In spite of its contribution to effective Public Health practice, the potential for the application of law to chronic disease prevention and control is yet to be fully recognized. The development and implementation of legal frameworks could broaden the range of effective public health strategies and provide valuable tools for the public health workforce. In order to expand the range of effective public health interventions, the government should use the law as a tool to achieve the goal of preventing chronic diseases and ameliorate the growing epidemic of obesity, heart disease, stroke, cancer and other chronic diseases and their risk factors.
This podcast discusses bullying as a public health problem, and provides information and resources for public health practitioners. Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC). Date Released: 1/19/2012.
McKenzie, Thomas L.; Kahan, David
Physical inactivity is a serious public health problem that is associated with numerous preventable diseases. Public health concerns, particularly those related to the increased prevalence of overweight, obesity, and diabetes, call for schools to become proactive in the promotion of healthy, physically active lifestyles. This article begins by…
Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy
Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing
Byskov, Jens; Marchal, Bruno; Maluka, Stephen; Zulu, Joseph M; Bukachi, Salome A; Hurtig, Anna-Karin; Blystad, Astrid; Kamuzora, Peter; Michelo, Charles; Nyandieka, Lillian N; Ndawi, Benedict; Bloch, Paul; Olsen, Oystein E
Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. District stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to be responding to an actual demand. This
Background Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). Methods This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. Results The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. Conclusions District stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to
Honekamp, Ivonne; Possenriede, Daniel
This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing.
Full Text Available Background: Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results: Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making.Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.
Lovelace, Kay A; Bibeau, Daniel L; Donnell, Brigid M; Johnson, Hans H; Glascoff, Mary A; Tyler, Emily
Collaboration among public health organizations is essential to ensuring the health of the public. Much of the day-to-day work of public health educators is done in groups or teams or in consultation with others. This study examined the extent of health educators' work in teams as a proxy for collaboration. Health educators participated in an average of four teams per individual; three of these were interorganizational teams. Moreover, 40% of the respondents participated in five or more teams. Health educators supervised by other health educators were more likely to work in interorganizational teams than were those supervised by other professionals. Certified Health Education Specialists were more likely to participate in intraorganizational teams. Curricula in academic programs should reflect the extensive teamwork in which health educators are involved. Employers need to provide health educators with grounding in organizational priorities and support to carry out their collaborative work.
Goldberg, Daniel S
Application of fundamental cause theory to Powers and Faden's model of social justice highlights the ethical superiority of upstream public health interventions. In this article, I assess the ramifications of fundamental cause theory specifically in context of public health priority setting. Ethically optimal public health policy simultaneously maximizes overall population health and compresses health inequalities. The fundamental cause theory is an important framework in helping to identify which categories of public health interventions are most likely to advance these twin goals.
Hill, H W
Public health is the science and art of conscious physical adjustment between man and his surroundings in the universe. The modern conception of man as a product of and a part of nature brings the subject of man's individual physical adjustments with his immediate surroundings into its proper place as the fundamental study-the basis of every form of education. Hence, public health is not only eligible for a position as an independent faculty in any university but is as definitely entitled to such a place as any of those now recognized. It is futile to consider the ordinary 45 hour course in public health, furnished as an incident in the ordinary 4000 to 5000 hour medical course, as more than a smattering, offered to medical students alone, of the 900 to 4500 hour courses in public health offered to professional public health students.
...In accordance with the requirements of section 333A(b)(1) of the Public Health Service (PHS) Act, as amended by the Health Care Safety Net Amendments of 2002, 42 U.S.C. 254f-1(b)(1), the Secretary of HHS shall establish the criteria which she will use to make determinations under section 333A(a)(1)(A) of the health professional shortage areas (HPSAs) with the greatest shortages. This notice......
Full Text Available To establish strategic priorities for the Public Health Agency of Sweden we prioritized pathogens according to their public health relevance in Sweden in order to guide resource allocation. We then compared the outcome to ongoing surveillance. We used a modified prioritization method developed at the Robert Koch Institute in Germany. In a Delphi process experts scored pathogens according to ten variables. We ranked the pathogens according to the total score and divided them into four priority groups. We then compared the priority groups to self-reported time spent on surveillance by epidemiologists and ongoing programmes for surveillance through mandatory and/or voluntary notifications and for surveillance of typing results. 106 pathogens were scored. The result of the prioritization process was similar to the outcome of the prioritization in Germany. Common pathogens such as calicivirus and Influenza virus as well as blood-borne pathogens such as human immunodeficiency virus, hepatitis B and C virus, gastro-intestinal infections such as Campylobacter and Salmonella and vector-borne pathogens such as Borrelia were all in the highest priority group. 63% of time spent by epidemiologists on surveillance was spent on pathogens in the highest priority group and all pathogens in the highest priority group, except for Borrelia and varicella-zoster virus, were under surveillance through notifications. Ten pathogens in the highest priority group (Borrelia, calicivirus, Campylobacter, Echinococcus multilocularis, hepatitis C virus, HIV, respiratory syncytial virus, SARS- and MERS coronavirus, tick-borne encephalitis virus and varicella-zoster virus did not have any surveillance of typing results. We will evaluate the possibilities of surveillance for the pathogens in the highest priority group where we currently do not have any ongoing surveillance and evaluate the need of surveillance for the pathogens from the low priority group where there is ongoing
Friel, Sharon; Hattersley, Libby; Townsend, Ruth
Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.
Martynenko, A V
The article is dedicated to development of directions and specific functions of the health system bodies/institutions public relations (PR) activities. Priorities are set forth depending on the form of property thereof. A complex use of approaches toward carrying out of PR activities permits optimizing work both within the system itself and relations with the society as a whole.
Pereira, Chrystian; McNamara, Anusha; Sorge, Lindsay; Arya, Vibhuti
To describe the creation of a health avatar, with the goals of providing patients with complete health information from various sources, establishing an interactive and customizable platform, empowering users to determine how the health information best fits or speaks to their personal needs, and providing perspective by comparing the health status of the individual with that of the individual's community. The Internet is rapidly becoming integrated into Americans' daily lives. According to the 2007 Health Information National Trends Study, 69% of U.S. adults had access to the Internet and 23% reported using a social networking site. The impact of social media has further grown, and an estimated 50% of adults in America have a profile on social media. The potential for using cyber communities to improve health messaging is great. Several health care organizations have implemented the use of social media in a variety of ways to varying degrees of success. We propose a platform that automatically gathers information and reflects the health status of an individual back to the user. An avatar, which is a representation of a user, could be created and assigned characteristics that allow users to appreciate their health status. The health avatar platform also would allow users to compare their personal status with that of their community. The overall goal is to engage and then motivate users to improve their overall health status. Medicine must acknowledge the evolving relationships that the next generation of patients will have with technology. The health avatar is a platform that incorporates a connection with the health system through electronic medical records and connects individuals to the greater community.
Myers, Julie; Frieden, Thomas R; Bherwani, Kamal M; Henning, Kelly J
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.
In this podcast, Erin Edgerton, CDC, and Eric Holman, President of SmartReply, discuss why mobile technologies are an important communications tool for disseminating health messages. Created: 9/5/2008 by National Center for Health Marketing (NCHM), Division of eHealth Marketing (DeHM). Date Released: 1/12/2009.
Ivanov, L Louise; Paganpegara, Galina
The collapse of the Soviet Union in 1990 brought many changes to Russia, including changes in nursing education. However, the changes did not include content in public health nursing. Most health care in Russia is provided at the tertiary level in hospitals. Health promotion and health education are new concepts in Russia and are not well understood. When health education does occur, it is at the individual level, taught by physicians, and in response to new diagnoses. Health promotion at the primary level and with aggregates is not often practiced. Russia currently is in a demographic crisis where health indicators continue to decline. Russian nurses trained in public health principles, such as health promotion, health education, and providing primary and secondary prevention services at the population and aggregate level, can positively affect the current demographic crisis.
Dawson, Angus J
In this paper I outline and explore some problems in the way that the Nuffield Council of Bioethics' report Public Health: Ethical Issues (2007) presents its 'Intervention Ladder'. They see the metaphor of a ladder both as capturing key normative priorities and as making a real and important contribution to ethical policymaking in public health. In this paper I argue that the intervention ladder is not a useful model for thinking about policy decisions, that it is likely to produce poor decisions and that it is incompatible with the report's stated approach to relevant public health policy values.
Fiorillo, Andrea; Luciano, Mario; Del Vecchio, Valeria; Sampogna, Gaia; Obradors-Tarragó, Carla; Maj, Mario
Within the ROAMER project, funded by the European Commission, a survey was conducted with national associations/organizations of psychiatrists, other mental health professionals, users and/or carers, and psychiatric trainees in the 27 countries of the European Union, aiming to explore their views about priorities for mental health research in Europe. One hundred and eight associations/organizations returned the questionnaire. The five most frequently selected research priorities were early detection and management of mental disorders, quality of mental health services, prevention of mental disorders, rehabilitation and social inclusion, and new medications for mental disorders. All these areas, except the last one, were among the top ten research priorities according to all categories of stakeholders, along with stigma and discrimination. These results seem to support the recent argument that some rebalancing in favor of psychosocial and health service studies may be needed in psychiatric research. PMID:23737426
Croner, Charles M
Internet access and use of georeferenced public health information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in public health decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled public health GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Public health will become a responsive and integral part of the National Spatial Data Infrastructure.
Edward W Maibach
Full Text Available While climate change is inherently a global problem, its public health impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The public health infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local public health departments view and are responding to climate change as a public health issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their
Maibach, Edward W; Chadwick, Amy; McBride, Dennis; Chuk, Michelle; Ebi, Kristie L; Balbus, John
While climate change is inherently a global problem, its public health impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The public health infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local public health departments view and are responding to climate change as a public health issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their words and actions
Full Text Available The prevention measures and possible priority measures in treating the patients suffering from diabetes ketoacidosis at the Health Center are defined. A retrospective analysis of the patients suffering from diabetes in the Health Center of Bela Palanka for the period from January, 1,1995 to December, 31,1991 is used. The series numbers 461 patients while the newly-detected ones is 134. The registered number of the patients with ketoacidosis is 17. The priority measures in treating the patients suffering from ketoacidosis in the health centers have a multi - functional character.
Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted.
Public health personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the "peripheral nerves" of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City Public Health Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that public health staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by "treating patients as relatives" was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and public health staff knowledge.
Conner, Mark; Abraham, Charles; Prestwich, Andrew; Hutter, Russell; Hallam, Jennifer; Sykes-Muskett, Bianca; Morris, Benjamin; Hurling, Robert
Goal intentions are the key proximal determinant of behavior in a number of key models applied to predicting health behavior. However, relatively little previous research has examined how characteristics of goals moderate the intention-health-behavior relations. The present research examined the effects of goal priority and goal conflict as moderators of the intention-health-behavior relationship. The main outcome measures were self-reported performance of physical activity (Studies 1, 2, and 3) and other health behaviors (Study 4), and objectively measured physical activity (Study 3). Studies 1 and 4 used prospective correlational designs to predict later behavior from earlier cognitions. Studies 2 and 3 were experimental studies manipulating goal priority and goal conflict. Studies 1 and 2 used between-subjects designs while Studies 3 and 4 used within-subjects designs. Goal priority significantly moderated the intention-health-behavior relationship for physical activity (Study 1) and a range of protective and risk health behaviors (Study 4). Manipulations of goal priority significantly increased the intention-physical-activity relationship when self-reported (Study 2) and objectively measured (Study 3). In contrast, inconsistent effects were observed for goal conflict as an intention-behavior moderator. When goal priority is high, then intentions are strong predictors of health behaviors. Further studies testing manipulations of goal conflict and in particular goal priority in combination with goal intentions are required to confirm their value as a means to change health behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Salvador-Carulla, Luis; Cloninger, C Robert; Thornicroft, Amalia; Mezzich, Juan E
Declarations are relevant tools to frame new areas in health care, to raise awareness and to facilitate knowledge-to-action. The International College on Person Centered Medicine (ICPCM) is seeking to extend the impact of the ICPCM Conference Series by producing a declaration on every main topic. The aim of this paper is to describe the development of the 2013 Geneva Declaration on Person-centered Health Research and to provide additional information on the research priority areas identified during this iterative process. There is a need for more PCM research and for the incorporation of the PCM approach into general health research. Main areas of research focus include: Conceptual, terminological, and ontological issues; research to enhance the empirical evidence of PCM main components such as PCM informed clinical communication; PCM-based diagnostic models; person-centered care and interventions; and people-centered care, research on training and curriculum development. Dissemination and implementation of PCM knowledge-base is integral to Person-centered Health Research and shall engage currently available scientific and translational dissemination tools such journals, events and eHealth.
Brandon L Grimm
Full Text Available IntroductionIn 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821 conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments and urban Indian clinic public health workforce across three professional levels. The objectives of the needs assessment were to, determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health training interests, needs and preferences and, determine the barriers and motivators to participating in public health training.MethodsThe assessment was developed using the Council on Linkages Between Academia and Public Health Practice, Core Competencies for Public Health Professionals survey (Council of Linkages, 2010. The final assessment was created and piloted by numerous individuals representing practice and academia. ResultsRespondents identified cultural competency and communication skills as the two most important public health competency domains. Although the public health professionals perceived that they were least proficient in the area of policy development and program planning, participants identified the greatest needs for training in financial planning & management skills and analytical/assessment skills. In general, respondents preferred instructor-led interactive training sessions offered as onsite multi-day workshops or computer-based courses. Respondents identified obesity, health disparities, physical activity, chronic diseases and diabetes as the top five public health topical areas. ConclusionThese priorities align with State and National public health plans. The findings of the needs assessment were used to tailor educational opportunities to build the capacity of Nebraska’s public health system. Additionally, the results were used to develop workforce development plans for numerous local health departments throughout Nebraska.
among the largest groups of registered users, followed by librarians, dieticians, medical officers of health, and nutritionists. The majority of users (67% access the website from direct traffic (e.g., have the health-evidence.ca webpage bookmarked, or type it directly into their browser. Conclusions Consistent use of health-evidence.ca and particularly the searching for reviews that correspond with current public health priorities illustrates that health-evidence.ca may be playing an important role in achieving evidence-informed public health decision making.
registered users, followed by librarians, dieticians, medical officers of health, and nutritionists. The majority of users (67%) access the website from direct traffic (e.g., have the health-evidence.ca webpage bookmarked, or type it directly into their browser). Conclusions Consistent use of health-evidence.ca and particularly the searching for reviews that correspond with current public health priorities illustrates that health-evidence.ca may be playing an important role in achieving evidence-informed public health decision making. PMID:20718970
Hansen, Henning Sten; Kristensen, Peter Nordskov
involved in the decision-making process. The current paper demonstrates how web-based interactive tools can support the participation of the citizens. The use of 3D geo-visualisation / VR makes it easier to represent spatial information in a way that is more similar to how people observe and perceive them...... of the respondents had tried the 3D visualisation (flight simulator) of the various alternatives. One characteristic of interactive participatory planning is feedback and learning, and therefore the County decided to develop a priority game to support the learning process. However, according to the survey...
Parker, Cindy L.; Caine, Virginia A.; McKee, Mary; Shirley, Lillian M.; Links, Jonathan M.
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
Full Text Available Abstract Background The National Health Policy 2000 - 2009 and Health sector strategic plans I & II emphasized that Primary Health Care (PHC would be the main strategy for national development and would be operationalized through provision of the minimum health care package. Commitment was to spend an increasing proportion of the health budget for the provision of the basic minimum package of health services which was interpreted to mean increasing spending at health centre level. This analysis was undertaken to gain a better understanding of changes in the way recurrent funding is allocated in the health sector in Uganda and to what extent it has been in line with agreed policy priorities. Methods Government recurrent wage and non-wage expenditures - based on annual releases by the Uganda Ministry of Finance, Planning and Economic Development were compiled for the period 1997/1998 to financial year 2007/2008. Additional data was obtained from a series of Ministry of Health annual health sector reports as well as other reports. Data was verified by key government officials in Ministry of Finance, Planning and Economic Development and Ministry of Health. Analysis of expenditures was done at sector level, by the different levels in the health care system and the different levels of care. Results There was a pronounced increase in the amount of funds released for recurrent expenditure over the review period fueled mainly by increases in the wage component. PHC services showed the greatest increase, increasing more than 70 times in ten years. At hospital level, expenditures remained fairly constant for the last 10 years with a slight reduction in the wage component. Conclusion The policy aspiration of increasing spending on PHC was attained but key aspects that would facilitate its realization were not addressed. At any given level of funding for the health sector, there is need to work out an optimal balance in investment in the different inputs to
Hahn, Robert A.; Truman, Benedict I.
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. PMID:25995305
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.
Mollura, Daniel J; Carrino, John A; Matuszak, Diane L; Mnatsakanyan, Zaruhi R; Eng, John; Cutchis, Protagoras; Babin, Steven M; Sniegoski, Carol; Lombardo, Joseph S
Radiology and public health have an emerging opportunity to collaborate, in which radiology's vast supply of imaging data can be integrated into public health information systems for epidemiologic assessments and responses to population health problems. Fueling the linkage of radiology and public health include (i) the transition from analog film to digital formats, enabling flexible use of radiologic data; (ii) radiology's role in imaging across nearly all medical and surgical subspecialties, which establishes a foundation for a consolidated and uniform database of images and reports for public health use; and (iii) the use of radiologic data to characterize disease patterns in a population occupying a geographic area at one time and to characterize disease progression over time via follow-up examinations. The backbone for this integration is through informatics projects such as Systematized Nomenclature of Medicine Clinical Terms and RadLex constructing terminology libraries and ontologies, as well as algorithms integrating data from the electronic health record and Digital Imaging and Communications in Medicine Structured Reporting. Radiology's role in public health is being tested in disease surveillance systems for outbreak detection and bioterrorism, such as the Electronic Surveillance System for the Early Notification of Community-based Epidemics. Challenges for radiologic public health informatics include refining the systems and user interfaces, adhering to privacy regulations, and strengthening collaborative relations among stakeholders, including radiologists and public health officials. Linking radiology with public health, radiologic public health informatics is a promising avenue through which radiology can contribute to public health decision making and health policy.
Elfeddali, I.; van der Feltz-Cornelis, C.M.; van Os, J.; Knappe, S.; Vieta, E.; Wittchen, H.-U.; Obradors-Tarragó, C.
Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to the importance of
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In this special issue the four articles focus on population health in terms of primary care and preventive medicine. This critical area of health often receives less attention than health care issues (more so in the popular press but also in academic analyses.Upon reviewing these very interesting and illuminating articles it was striking that despite significant cultural, economic, geographic and historical differences there are many commonalities which exist throughout the Americas.
In this podcast, Erin Edgerton, CDC, and Craig Lefebvre, George Washington University discuss social media, blogs, and mobile technologies and how they can be used for public health. Created: 5/15/2009 by National Center for Health Marketing (NCHM), Division of eHealth Marketing (DeHM). Date Released: 6/30/2009.
Community health educators are well versed in the behavior sciences, including intervention theories. However, most public health professionals are not familiar with the policy theories related to political advocacy. Because health educators are engaging in policy advocacy more frequently, and as a result of the profession including policy…
Community health educators are well versed in the behavior sciences, including intervention theories. However, most public health professionals are not familiar with the policy theories related to political advocacy. Because health educators are engaging in policy advocacy more frequently, and as a result of the profession including policy…
Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.
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......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...... 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...
Full Text Available Maternal, child, and newborn health is a priority area in Canada and around the world. The work of public health nurses (PHNs is often invisible and misunderstood. The purpose of this qualitative research project was to explore how universal and targeted home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs (n = 16 and mothers (n = 16 in Nova Scotia, Canada. Feminist poststructuralism and discourse analysis were used to analyze interviews. Concepts of relations of power enabled an understanding of how health outcomes had been socially and institutionally constructed through binary relations. PHNs and mothers spoke about the importance of “softer” health outcomes, including maternal self-confidence and empowerment that had been constructed as less important than health outcomes that were seen to be more tangible and physical. Findings from this research could be used to guide practice and planning of postpartum home visiting programs.
Aston, Megan; Etowa, Josephine; Price, Sheri; Vukic, Adele; Hart, Christine; MacLeod, Emily; Randel, Patricia
Maternal, child, and newborn health is a priority area in Canada and around the world. The work of public health nurses (PHNs) is often invisible and misunderstood. The purpose of this qualitative research project was to explore how universal and targeted home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs (n = 16) and mothers (n = 16) in Nova Scotia, Canada. Feminist poststructuralism and discourse analysis were used to analyze interviews. Concepts of relations of power enabled an understanding of how health outcomes had been socially and institutionally constructed through binary relations. PHNs and mothers spoke about the importance of "softer" health outcomes, including maternal self-confidence and empowerment that had been constructed as less important than health outcomes that were seen to be more tangible and physical. Findings from this research could be used to guide practice and planning of postpartum home visiting programs.
Full Text Available Maternal, child, and newborn health is a priority area in Canada and around the world. The work of public health nurses (PHNs is often invisible and misunderstood. The purpose of this qualitative research project was to explore how universal and targeted home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs ( n = 16 and mothers ( n = 16 in Nova Scotia, Canada. Feminist poststructuralism and discourse analysis were used to analyze interviews. Concepts of relations of power enabled an understanding of how health outcomes had been socially and institutionally constructed through binary relations. PHNs and mothers spoke about the importance of “softer” health outcomes, including maternal self-confidence and empowerment that had been constructed as less important than health outcomes that were seen to be more tangible and physical. Findings from this research could be used to guide practice and planning of postpartum home visiting programs.
The book brings together experts working in public health and multi-disciplinary areas to present recent issues in statistical methodological development and their applications. This timely book will impact model development and data analyses of public health research across a wide spectrum of analysis. Data and software used in the studies are available for the reader to replicate the models and outcomes. The fifteen chapters range in focus from techniques for dealing with missing data with Bayesian estimation, health surveillance and population definition and implications in applied latent class analysis, to multiple comparison and meta-analysis in public health data. Researchers in biomedical and public health research will find this book to be a useful reference, and it can be used in graduate level classes.
Ploug, Thomas; Holm, Søren; Gjerris, Mickey
Background Multi-resistant bacteria pose an increasing and significant public health risk. As awareness of the severity of the problem grows, it is likely that it will become the target for a range of public health interventions. Some of these can intentionally or unintentionally lead...... to stigmatization of groups of citizens. Discussion The article describes the phenomenon of stigmatization within the health care area by discussing the concept in relation to AIDS and psychiatric diagnosis. It unfolds the ethical aspects of using stigmatization as a public health instrument to affect unwanted...... behaviours e.g. smoking. Moreover it discusses stigmatization as an unintended albeit expected side effect of public health instruments potentially used to counter the challenge of multi-resistant bacteria with particular reference to the Danish case of the growing problems with Methicillin...
Frenk, J.; Coutre, le J.; Bladeren, van P.J.; Blum, S.
The relationship between health and the economy is complex and hardly a matter of unidirectional cause and consequence. With health increasingly being understood as a stimulus for the economy, nutrition directly assumes the status of an economic identifier. This paper discusses the growing complexit
Frenk, J.; Coutre, le J.; Bladeren, van P.J.; Blum, S.
The relationship between health and the economy is complex and hardly a matter of unidirectional cause and consequence. With health increasingly being understood as a stimulus for the economy, nutrition directly assumes the status of an economic identifier. This paper discusses the growing
To earn legitimacy and more likely acceptance of important public decisions we suggest a comprehensive set of 'gold standard' state-society attributes for improving governance. Multi-stakeholder platforms (MSPs can help deliberation to become routine, enabling complex water issues to be more rigorously examined. The combination of increased public trust, earned by the state, and high-quality MSPs to assist more informed negotiations, we see as being key to the gaining of public acceptance.
Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra
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.
Kang, Minah; Reich, Michael R
Priority-setting involves diverse parties with intense and often conflicting interests and values. Still, the political aspects of priority-setting are largely unexplored in the literature on health policy. In this paper, we examine how policy makers in Korea changed their strategies as the policy context for priority setting changed from only expanding benefits to a double burden of benefit expansion plus cost containment. This analysis shows that priority-setting is a profoundly political process. The policy context shapes how policy makers choose their political strategies. In particular, we find that policy makers sway between "credit claiming" and "blame avoidance" strategies. Korean policy makers resorted to three types of political strategies when confronted with a double burden of benefit expansion and cost containment: delegating responsibility to other institutions (agency strategies), replacing judgment-based decisions with automatic rules (policy strategies), and focusing on the presentation of how decisions are made (presentational strategies). The paper suggests implications for future studies on priority-setting in the Korean health care system and in other countries that face similar challenges, and concludes that Korean policy makers need to put more effort into developing transparent and systematic priority-setting processes, especially in times of double burden of benefit expansion and cost containment. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Gwinn, Marta; MacCannell, Duncan R; Khabbaz, Rima F
Advances in laboratory and information technologies are transforming public health microbiology. High-throughput genome sequencing and bioinformatics are enhancing our ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced Molecular Detection (AMD) initiative has allowed the Centers for Disease Control and Prevention (CDC) to provide leadership and coordination in integrating new technologies into routine practice throughout the U.S. public health laboratory system. Collaboration and partnerships are the key to navigating this transition and to leveraging the next generation of methods and tools most effectively for public health.
Bjerregaard, Peter; Curtis, Tine
research. Two health surveys have been carried out in Greenland by the National Institute of Public Health, and a follow-up is being planned together with the Directorate of Health. The results have been widely used by politicians, administrators, and health care professionals.......In 1992, the Greenland Home Rule Government took over the responsibility for health care. There has since been a growing cooperation between the Directorate of Health and researchers in Denmark and Greenland, for instance by the Directorate supporting workshops and funding a chair in health...
LaPorte, R E
Applications of networking to health care have focused on the potential of networking to transmit data and to reduce the cost of health care. In the early 198Os networks began forming among academic institutions; one of them was Bitnet. During the 1980s Internet evolved, which joined diverse networks, including those of governments and industry. The first step is to connect public health organizations such as ministries of health, the World Health Organization, the Pan-American Health Organization, and the United Nations. Computer-based telecommunication will vastly increase effective transmission of information. Networking public health workers in local health departments, academia, governments, industry, and private agencies, will bring great benefits. One is global disease telemonitoring: with new epidemiological techniques such as capture-recapture, accurate estimates of incidences of important communicable and non-communicable diseases can now be obtained. Currently all countries in the Americas except Haiti are connected through Internet. No systematic integration of telecommunication and public health systems across countries has occurred yet. On-line vital statistics could be usable almost instantaneously to facilitate monitoring and forecasting of population growth and the health needs of mothers and children. Linking global disease telemonitoring (morbidity data for non-communicable diseases) with environmental data systems would considerably improve understanding of the environmental determinants of disease. Internet is already linked to the National Library of Medicine through Bitnis. Computer based distance education is rapidly improving through E-mail searches. Reading materials, video, pictures, and sound could be transmitted across huge distances for low costs. Hundreds of schools are already networked together. On-line electronic journals and books have the potential for instantaneous dissemination of free information through gopher servers. Global
Full Text Available Background: Quality of care is central to current efforts under National Rural Health Mission (NRHM in India to sustain gains in utilization of institutional maternal and newborn care. For effective planning around institutionalizing quality improvement systems, it is important to critically evaluate India's maternal health policy and services in historical perspective. Objectives: The narrative review was conducted (i to trace the evolution of concern with quality in maternal health in the context of health system development in India from independence (1947 to the present; and (ii identify quality-related issues and areas for further action to improve maternal and infant survival outcomes. Materials and Methods: Peer reviewed scientific publications were identified through systematic searches of scientific databases, grey literature and policy documents. Altogether 174 documents were reviewed. Prospectively designed forms extracted data on (i health system and quality development; (ii service performance; (iii health and safe delivery outcomes. Results: In the first four decades after independence, concerns with infrastructure expansion and vertical disease eradication programmes neglected quality of maternal healthcare in India. With growing concern for quality, strategies addressing this were incorporated in NRHM launched in 2005, including public health standards and quality assurance system in reproductive and child health services. Conclusion: Focus on quality in maternal health in India has increased in recent years, especially under NRHM, and this has helped accelerate progress in maternal and neonatal outcomes. Further action areas include the need to increase funding, match rising demand with quality services and enhance functioning of quality assurance system.
Byskov, Jens; Marchal, Bruno; Maluka, Stephen
researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. RESULTS: The values underlying the AFR approach were in all three districts well...... to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. CONCLUSIONS: District stakeholders were able to take greater charge of closing the gap between nationally set planning on one hand and the local realities and demands of the served...... communities on the other within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to be responding to an actual demand. This provides arguments for the continued application and further assessment...
Full Text Available While it is important to support the development of methods for public participation, we argue that this should not be at the expense of a broader consideration of the role of public participation. We suggest that a rights based approach provides a framework for developing more meaningful approaches that move beyond public participation as synonymous with consultation to value the contribution of lay knowledge to the governance of health systems and health research.
Hudmon, Karen Suchanek; Addleton, Robert L.; Vitale, Frank M.; Christiansen, Bruce A.; Mejicano, George C.
This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the…
Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.
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...
Roslind Preethi George
Full Text Available The use of Qualitative Research (QR methods are now getting common in various aspects of health and healthcare research and they can be used to interpret, explore, or obtain a deeper understanding of certain aspects of human beliefs, attitudes, or behavior through personal experiences and perspectives. The potential scope of QR in the field of dental public health is immense, but unfortunately, it has remained underutilized. However, there are a number of studies which have used this type of research to probe into some unanswered questions in the field of public health dentistry ranging from workforce issues to attitudes of patients. In recent health research, evidence gathered through QR methods provide understanding to the social, cultural, and economic factors affecting the health status and healthcare of an individual and the population as a whole. This study will provide an overview of what QR is and discuss its contributions to dental public health research.
Celeste, Roger Keller; Warmling, Cristine Maria
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.
Pollock, Alex; St George, Bridget; Fenton, Mark; Firkins, Lester
Research resources should address the issues that are most important to people affected by a particular healthcare problem. Systematic identification of stroke survivor, caregiver, and health professional priorities would ensure that scarce research resources are directed to areas that matter most to people affected by stroke. We aimed to identify the top 10 research priorities relating to life after stroke, as agreed by stroke survivors, caregivers, and health professionals. Key stages involved establishing a priority setting partnership; gathering treatment uncertainties from stroke survivors, caregivers, and health professionals relating to life after stroke (using surveys administered by e-mail, post, and at face-to-face meetings); checking submitted treatment uncertainties to ensure that they were clear, unanswered questions about the effects of a treatment/intervention; interim prioritization to identify the highest priority questions (objectively identified from ranking of personal priorities by original survey respondents); and a final consensus meeting to reach agreement on the top 10 research priorities. We gathered 548 research questions that were refined into 226 unique unanswered treatment uncertainties. Ninety-seven respondents completed the interim prioritization process, objectively identifying 24 shared priority treatment uncertainties. A representative group of 28 stroke survivors, caregivers, and health professionals attended a final meeting, reaching consensus on the top 10 research priorities relating to life after stroke. Six of the agreed top 10 research priorities related to specific stroke-related impairments, including cognition, aphasia, vision, upper limb, mobility, and fatigue. Three related to more social aspects of 'living with stroke' including coming to terms with long-term consequences, confidence, and helping stroke survivors and their families 'cope' with speech problems. One related to the secondary consequences of stroke and
Full Text Available Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders – not only the technical capacity to “do” research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values; academics need to understand and respond to decision-makers’ needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England’s National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to
Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice
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.
Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice
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
Full Text Available Global Public Health is increasingly being seen as a speciality field within the university education of Public Health. However, the exact meaning of Global Public Health is still unclear resulting in varied curricula and teaching units among universities. The contextual differences between high and low and middle income countries, and the process of globalisation need to be taken into account while developing any global public health course.Global Public Health and Public Health are not separable and Global Public Health often appears as an extension of Public Health in the era of globalisation and interdependence. Though Global Public Health is readily understood as health of global population, it is mainly practised as health problems and their solutions set within low and middle income countries. Additional specialist competencies relevant to the context of low and middle income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalisation and its impact on health; disease burden; culture, society and politics; and management are important.
Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano
In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific
62 Confirmed Positive 39 92 42 Residences Abated 40 92 43 Rabies and Zoonosis Control 2 Animal Bite Investigation3 1,280 … … Pets...Shops Inspected 9 9 100 Notes: 1 LHER: Local Health Evaluation Report 2 Zoonosis : Diseases transmitted from animals to humans 3 Number of...5,984 5,984 Childhood Lead Poisoning Risk assessments 2 466 932 Residences abated 8 40 320 Rabies and Zoonosis Control 2 Animal
Allotey, Pascale A; Diniz, Simone; Dejong, Jocelyn; Delvaux, Thérèse; Gruskin, Sofia; Fonn, Sharon
This paper addresses the challenges faced in mainstreaming the teaching of sexual and reproductive health and rights into public health education. For this paper, we define sexual and reproductive health and rights education as including not only its biomedical aspects but also an understanding of its history, values and politics, grounded in gender politics and social justice, addressing sexuality, and placed within a broader context of health systems and global health. Using a case study approach with an opportunistically selected sample of schools of public health within our regional contexts, we examine the status of sexual and reproductive health and rights education and some of the drivers and obstacles to the development and delivery of sexual and reproductive health and rights curricula. Despite diverse national and institutional contexts, there are many commonalities. Teaching of sexual and reproductive health and rights is not fully integrated into core curricula. Existing initiatives rely on personal faculty interest or short-term courses, neither of which are truly sustainable or replicable. We call for a multidisciplinary and more comprehensive integration of sexual and reproductive health and rights in public health education. The education of tomorrow's public health leaders is critical, and a strategy is needed to ensure that they understand and are prepared to engage with the range of sexual and reproductive health and rights issues within their historical and political contexts. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
... sheets Fact files Questions & answers Features Multimedia Contacts Electromagnetic fields and public health: mobile phones Fact sheet N° ... an estimated 6.9 billion subscriptions globally. The electromagnetic fields produced by mobile phones are classified by the ...
Solomons, Noel W
An inquiry into options for Masters-level training and into attitudes and perceptions among a convenience sample of nutrition students and professionals from 11 countries suggests that the term, "Public Health Nutrition", as such, is poorly represented and poorly understood in the Latin American region. At least six countries (Brazil, Chile, Cuba, Mexico, Peru, Puerto Rico) at seven sites have Masters programs to provide training for nutrition in a public health context or public health with an emphasis in nutrition. Exploring alliances from the Americas with the formal PHN discipline emerging in Europe should enrich the mutual perspective on curriculum design. However, the form and context of postgraduate training in Latin America must consider first and foremost its own job-markets, diverse public health needs, and resource allocations in building or transforming training programs.
Tirado-Otálvaro, Andrés Felipe
This article addresses illegal drug use within the current debate in traditional public health and in proposals from Latin America, while emphasizing the need to approach the issue from an alternative public health perspective centered on individual users, groups, and social movements as protagonists. This counterhegemonic approach thus aims to orient the discussion on the need for inclusive and democratic public policies. Illegal drug use has been addressed from various perspectives: clinical medicine, viewing it as a problem that generates mental disorders and infectious diseases, both through risky sexual practices and/or use of injecting paraphernalia; from a legal perspective, as a problem related to delinquency; and according to traditional public health, as a problem that generates school dropout and work absenteeism and increases the demand on health services, in addition to increasing violence and death. However, not all forms of drug consumption involve problematic use, nor do they all trigger disorders related to substance use.
Vermont Center for Geographic Information — What is Environmental Public Health Tracking?Tracking is an ongoing national effort to better understand how environmental hazards can contribute to certain...
Antibiotic resistance is a global threat and has reached ... and World Health Organization (WHO) have taken ... and 5) Education of the public. .... to decrease transmission of microbes and ... interventions are designed for behavioral change.
EPA and the Centers for Disease Control and Prevention (CDC) issued a joint statement on the public health impacts of bed bugs, which are blood-sucking ectoparasites (external parasites). EPA also has a pesticide registration notice on this topic.
... Navigation Bar Home Current Issue Past Issues Celebrating Leadership in Public Health and Medicine Friends of the ... a Distinguished Medical Science Award for his global leadership in cancer research and the development of combination ...
Bjegovic-Mikanovic, Vesna; Otok, Robert
The public health profession in Europe has a leadership role for ensuring European’s health in the twenty-first century and therefore must assume responsibility for advancing education for research and practice. Three fundamental questions are explored: (1) What are the main public health problems facing public health professionals; (2) What are their existing competencies after training; and (3) What competencies do European employers expect? The European Schools of Public Health assessed their best success to be in the field of health promotion, followed by disease prevention including identification of priority health problems, and elimination of health hazards in the community. Conversely, they see the least success in dealing with preparedness and planning for public health emergencies. From an employer’s perspective, significant gaps between current and desired levels of performance at the job exist for all Essential Public Health Operations of World Health Organization. Based on prior research and recent European surveys of Schools and Departments of Public Health, the following recommendations are made, which emphasize the leadership role of the European public health community: (1) the preparation of public health professionals requires an interface between public health functions, competencies, and performance; (2) competence-based education is important and allows debates on the scope of the required education; (3) governments have to realize that the present lack of infrastructure and capacity is detrimental to the people’s health; (4) as public health challenges are increasingly global, educational institutions have to look beyond the national boundaries and participate in European and global networks for education, research, and practice. PMID:28261578
The next EU research and innovation framework programme 'Horizon 2020' will address a number of important societal challenges including health, demographic changes and well-being. To prepare the work in these areas, the Health Directorate of the European Commission's Research & Innovation...... the following four questions: What should the thematic priorities for EU funded public health research under Horizon 2020 be? How to best structure European Public Health Research in the future? How to develop stronger links and synergies between EU funded research and national research activities, EU policy...... agendas and national policy agendas? How to improve the uptake of evidence generated from public health research in the development of public health policy? This report summarises the recommendations from Subgroup 2....
Tesler, Laura E; Malone, Ruth E
To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders.
Tesler, Laura E.
To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators’ pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders. PMID:18923118
Salinas, Hugo; Erazo, Marcia; Reyes, Alvaro; Carmona, Sergio; Veloz, Patricio; Bocaz, Francisca; Silva, Paulina; Carvajal, Rodrigo
Chile has a National Health Services System, formed by 29 Health Services. An efficient resource distribution among this services is crucial for an efficient health care delivery. To obtain indices from the Chilean Public Health Services, that could improve allocation of resources. Information from the Chilean Public Health Services, corresponding to activities during 2001 budgetary period, was collected. This is the latest complete and official information for the totality of Health Services in the country. Seventeen variables generated or monitored by the Instituto Nacional de Estadísticas (INE), the Ministerio de Salud (MINSAL), the Ministerio de Hacienda, the Ministerio de Planificación y Cooperación (MIDEPLAN) and the Fondo Nacional de Salud (FONASA) were studied. The Main Components Analysis (ACP) was used, obtained from the R correlation matrix. The first two main components were selected, with an accumulated percentage of explained variability of 63.05%. The first component is related to the population assigned to each Health Service. This corresponds to the number of people needed to treat in the hospitals of these Services and their answer to this demand, justified by the expenses in which each Health Service incurs. There is an inverse relation of the first component with health indicators, measured by burden of disease and death. The second main component would represent the social and economic characteristics of the population, poor and very poor populations and public health insurance beneficiaries, to take care of in each Health Service. Health indicators in each Health Service are not considered a priority for resource distribution among Health Services in the country. The transference is done considering the indices contained in the two main components defined.
Kemp, Karen; Sephton, Mark
Oral mesalazine represents a crucial front-line agent for the treatment of active ulcerative colitis (UC) and the maintenance of remission. Clinical aspects of mesalazine therapy are guided by robust evidence-based guidelines, although there is a relative paucity of guidance examining the specific administrative and professional issues faced by inflammatory bowel disease (IBD) nurses. As IBD nurses frequently influence treatment decisions in UC, this article was written to provide a practical review of the key evidence and issues affecting mesalazine treatment. Therefore, it may act as an additional resource for IBD nurses, to enhance prescribing decisions. Using the UK's Quality, Innovation, Productivity and Prevention (QIPP) agenda as a framework, it considers clinical and health service priorities affecting treatment decisions. The quality of care perspective naturally focuses on efficacy; recent interest in specific aspects of efficacy, such as the speed of symptom resolution allows targeting of mesalazine treatment to individual needs. Furthermore, innovative adherence programmes build on the latest evidence to develop robust, integrated patient support approaches. In terms of productivity, nurse-led activities and more sophisticated management strategies may offer the best routes towards reducing the costs of care. Key opportunities for preventing ill health include improving adherence to maintenance therapy and achieving mucosal healing. The principles and approaches highlighted by the QIPP agenda emphasise that prescribing decisions for mesalazine in UC must take account of the full spectrum of clinical and health service needs, and cannot focus on any one element in isolation.
In 2005, Senegal had an estimated maternal mortality ratio of 980 deaths per 100,000 live births, well above the global average of 400. The concentration of health workers has been shown to be associated with improved health outcomes, including maternal mortality. To explore this relationship, this paper uses geographic information systems (GIS) to examine the regional distribution of human resources for health and related maternal health indicators in Senegal. Results show that a regional imbalance in the distribution of health personnel and health indicators exists in Senegal. This disparity may contribute to the disproportionate burden of disease experienced in the eastern part of the country. Based on a spatial analysis, a priority index is used to identify regions to target for the recruitment and training of midwives. GIS is an appropriate and practical tool for governments and other agencies to use in identifying regional disparities and for priority setting.
Kattia Rojas Loría
Full Text Available OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia.
Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández
OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia. PMID:25210820
Public health institutions, as ancient as civilizations itself, are intrinsically connected with soils. The massive body of the empirical knowledge about this connection has been accumulated. Recently unraveling the underlying mechanisms of this link has begun, and many of them appear to have the microbiological origin. The impressive progress in understanding the nexus between soil and health has been achieved by experimentation with preserved soil microbial systems functioning along with the metagenomic characterization. The objective of this work is to present an overview of some recent onsets. In the food safety arena, survival of human pathogens in soils has been related to the degree of soil eutrophication and/or related structure of soil microbial communities. Soil microbial systems affect the affinity of plants to internalizing pathogenic organisms. Pharmaceutical arsenals benefit from using field soil environment for developing antibiotics. Enzyme production by soil bacteria is used as the signal source for drug activation. Sanitary functions of sols are dependent on soil microbial system workings. The healthy living can be enhanced by the human immune system training received from direct contact with soils. The hygiene hypothesis considers the microbial input due to exposure to soil as the essential ecosystem service. The invisible links between soil and public health result in large-scale consequences. Examples of concurrent degradation of soil and public health are worth scrutinizing. Public health records can provide valuable sources of 'soil-public health' interactions. It may be worthwhile to examine current assessments of soil health from the public health standpoint. Soil management can be an efficient instrument of public health control.
Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D
According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.
Blouin Genest, Gabriel
Health issues now evolve in a global context. Real-time global surveillance, global disease mapping and global risk management characterize what have been termed 'global public health'. It has generated many programmes and policies, notably through the work of the World Health Organization. This globalized form of public health raises, however, some important issues left unchallenged, including its effectiveness, objectivity and legitimacy. The general objective of this article is to underline the impacts of WHO disease surveillance on the practice and theorization of global public health. By using the surveillance structure established by the World Health Organization and reinforced by the 2005 International Health Regulations as a case study, we argue that the policing of 'circulating risks' emerged as a dramatic paradox for global public health policy. This situation severely affects the rationale of health interventions as well as the lives of millions around the world, while travestying the meaning of health, disease and risks. To do so, we use health surveillance data collected by the WHO Disease Outbreak News System in order to map the impacts of global health surveillance on health policy rationale and theory.
Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.
Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853
Petersen, Poul Erik
prevention and health promotion into action programmes, this is particularly the case with developing countries that have not yet benefited from advances in oral health science to the fullest extent possible. The WHO Oral Health programme gives priority to research helping correct the so called 10/90 gap...
The Constitution of the World Health Organization (1946) states that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position." The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas public health law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national public health laws and international obligations relating to public health in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea's Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national public health laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African.
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…
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…
Judith W. Leavitt
Full Text Available Review of: Launching Global Health: The Caribbean Odyssey of the Rockefeller Foundation. Steven Palmer. Ann Arbor: University of Michigan Press, 2010. xi + 301 pp. (Cloth US$ 70.00 Partner to the Poor: A Paul Farmer Reader. Paul Farmer, edited by Haun Saussy. Berkeley: University of California Press, 2010. xii + 660 pp. (Paper US$ 27.50
Passchier-Vermeer, W.; Passchier, W.F.
Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and
Hansen, Kristian Schultz; Chapman, Glyn
estimates of the burden of disease, the present paper developed packages of health interventions using the estimated cost-effectiveness ratios. These packages could avert a quarter of the burden of disease at total costs corresponding to one tenth of the public health budget in the financial year 1997...... if more research resources were available. Conclusions: The present study showed that it was feasible to conduct cost-effectiveness analyses for a large number of health interventions in a developing country like Zimbabwe using a consistent methodology.......Background: This study aimed at providing information for priority setting in the health care sector of Zimbabwe as well as assessing the efficiency of resource use. A general approach proposed by the World Bank involving the estimation of the burden of disease measured in Disability-Adjusted Life...
Hansen, Kristian Schultz; Chapman, Glyn
estimates of the burden of disease, the present paper developed packages of health interventions using the estimated cost-effectiveness ratios. These packages could avert a quarter of the burden of disease at total costs corresponding to one tenth of the public health budget in the financial year 1997...... if more research resources were available. CONCLUSION: The present study showed that it was feasible to conduct cost-effectiveness analyses for a large number of health interventions in a developing country like Zimbabwe using a consistent methodology.......BACKGROUND: This study aimed at providing information for priority setting in the health care sector of Zimbabwe as well as assessing the efficiency of resource use. A general approach proposed by the World Bank involving the estimation of the burden of disease measured in Disability-Adjusted Life...
Griffith, Jennifer M; Kay Carpender, S; Crouch, Jill Artzberger; Quiram, Barbara J
The Texas A&M Health Science Center School of Rural Public Health, a member of the Training and Education Collaborative System Preparedness and Emergency Response Learning Center (TECS-PERLC), has long-standing partnerships with 2 Health Service Regions (Regions) in Texas. TECS-PERLC was contracted by these Regions to address 2 challenges identified in meeting requirements outlined by the Risk-Based Funding Project. First, within Metropolitan Statistical Areas, there is not a formal authoritative structure. Second, preexisting tools and processes did not adequately satisfy requirements to assess public health, medical, and mental health needs and link mitigation strategies to the Public Health Preparedness Capabilities, which provide guidance to prepare for, respond to, and recover from public health incidents. TECS-PERLC, with its partners, developed a framework to interpret and apply results from the Texas Public Health Risk Assessment Tool (TxPHRAT). The 3-phase community engagement-based TxPHRAT Mitigation Planning Process (Mitigation Planning Process) and associated tools facilitated the development of mitigation plans. Tools included (1) profiles interpreting TxPHRAT results and identifying, ranking, and prioritizing hazards and capability gaps; (2) a catalog of intervention strategies and activities linked to hazards and capabilities; and (3) a template to plan, evaluate, and report mitigation planning efforts. The Mitigation Planning Process provided a framework for Regions to successfully address all funding requirements. TECS-PERLC developed more than 60 profiles, cataloged and linked 195 intervention strategies, and developed a template resulting in 20 submitted mitigation plans. A public health-focused, community engagement-based mitigation planning process was developed by TECS-PERLC and successfully implemented by the Regions. The outcomes met all requirements and reinforce the effectiveness of academic practice partnerships and importance of
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 institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...... is able to cope with the tensions associated with diverse values and competing institutional logics. This definition calls for an understanding of the tensions between values associated with quality, efficiency and integrity, and a dialectical perspective when attempting to assess the integration as well...
Makundi, E A; Manongi, R; Mushi, A K
. It is the provision of ownership of the derived health priorities to partners including the community that enhances research utilization of the end results. In addition to disease-based methods, the Nominal Group Technique is being proposed as an important research tool for involving the non-experts in priority....... The patients/caregivers, women's group representatives, youth leaders, religious leaders and community leaders/elders constituted the principal subjects. Emphasis was on providing qualitative data, which are of vital consideration in multi-disciplinary oriented studies, and not on quantitative information from...... larger samples. We found a high level of agreement across groups, that malaria remains the leading health problem in Moshi rural district in Tanzania both in the highland and lowland areas. Our findings also indicate that 'non-medical' issues including lack of water, hunger and poverty heralded priority...
Straton, Nadiya; Hansen, Kjeld; Mukkamala, Raghava Rao
In recent years, social media has offered new opportunities for interaction and distribution of public health information within and across organisations. In this paper, we analysed data from Facebook walls of 153 public organisations using unsupervised machine learning techniques to understand...... the characteristics of user engagement and post performance. Our analysis indicates an increasing trend of user engagement on public health posts during recent years. Based on the clustering results, our analysis shows that Photo and Link type posts are most favourable for high and medium user engagement respectively....
Full Text Available This paper presents the algorithm Courteous Priority Access to the shared commercial radio with offloading (CPAwO, for public safety network (PSN over LTE heterogeneous networks (HetNets. We propose a solution for prioritization of PSN users with access to the commercial radio network resources. Our model offers additional radio resources to the PSN. Furthermore, it ensures a certain priority for commercial users by assigning quantities of additional radio resources through the courteous scheme. This allows delaying preemption and blocking bearers when the radio resources are limited. The other part of CPAwO model is to apply the principle of offloading in order to reduce the impact of the macrocell congestion. This technique is to switch the new bearers arriving at the LTE macrocells to small cells, in order to decrease the number of the blocked and interrupted bearers in the network. The results of the simulation showed that the allocation of radio resources via the courteous mechanism with offloading of new bearers to small cells reduces the rate of blocking bearers and delays the preemption of active bearers present in the LTE HetNets. It also reduces the cost of the end-to-end communications, thanks to the reallocation of free frequencies.
Yoshida, Sachiyo; Rudan, Igor; Cousens, Simon
Crowdsourcing has become an increasingly important tool to address many problems - from government elections in democracies, stock market prices, to modern online tools such as TripAdvisor or Internet Movie Database (IMDB). The CHNRI method (the acronym for the Child Health and Nutrition Research Initiative) for setting health research priorities has crowdsourcing as the major component, which it uses to generate, assess and prioritize between many competing health research ideas. We conducted a series of analyses using data from a group of 91 scorers to explore the quantitative properties of their collective opinion. We were interested in the stability of their collective opinion as the sample size increases from 15 to 90. From a pool of 91 scorers who took part in a previous CHNRI exercise, we used sampling with replacement to generate multiple random samples of different size. First, for each sample generated, we identified the top 20 ranked research ideas, among 205 that were proposed and scored, and calculated the concordance with the ranking generated by the 91 original scorers. Second, we used rank correlation coefficients to compare the ranks assigned to all 205 proposed research ideas when samples of different size are used. We also analysed the original pool of 91 scorers to to look for evidence of scoring variations based on scorers' characteristics. The sample sizes investigated ranged from 15 to 90. The concordance for the top 20 scored research ideas increased with sample sizes up to about 55 experts. At this point, the median level of concordance stabilized at 15/20 top ranked questions (75%), with the interquartile range also generally stable (14-16). There was little further increase in overlap when the sample size increased from 55 to 90. When analysing the ranking of all 205 ideas, the rank correlation coefficient increased as the sample size increased, with a median correlation of 0.95 reached at the sample size of 45 experts (median of the rank
In this thesis different public health aspects of physical activity in the Netherlands were addressed, taking into account its broad scope. Research was carried out on physical activity methodology, determinants of physical activity and the relationship between physical activity and different health
In this thesis different public health aspects of physical activity in the Netherlands were addressed, taking into account its broad scope. Research was carried out on physical activity methodology, determinants of physical activity and the relationship between physical activity and different health
Robertson, Peter J.
Career guidance may have the potential to promote public health by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive…
Minhas Gunjeet S
Full Text Available Abstract Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.
Becerra-Posada, Francisco; de Snyder, Nelly Salgado; Cuervo, Luis Gabriel; Montorzi, Gabriela
Understand and analyze procedures used to create national integrated research agendas from 2007 to 2011 in Argentina, Guatemala, Mexico, Panama, and Paraguay. Descriptive, cross-sectional study using an online survey of agenda preparation processes; specifically, development, integration, implementation, and use and dissemination of the agenda. The 45 respondents reported following specific methodologies for agenda construction and had a good opinion of organizational aspects with regard to prior information provided and balance among disciplines and stakeholders. Some 60% considered the coordinators impartial, although 25% mentioned biases favoring some subject; 42% received technical support from consultants, reading matter, and methodological guidelines; 40% engaged in subject-matter priority-setting; and 55% confirmed dissemination and communication of the agenda. However, only 22% reported inclusion of agenda topics in national calls for research proposals. In the countries studied, development of the health research agenda was characterized by prior planning and appropriate organization to achieve - consensus-based outcomes. Nevertheless, the agendas were not used in national calls for research proposals, reflecting lack of coordination in national health research systems and lack of connection between funders and researchers. It is recommended that stakeholders strengthen integration and advocacy efforts to modify processes and structures of agenda-based calls for research proposals.
Ramirez, Cherie L; Gajdos, Zofia K Z; Kreatsoulas, Catherine; Afeiche, Myriam C; Asgarzadeh, Morteza; Nelson, Candace C; Kanjee, Usheer; Caban-Martinez, Alberto J
Graduate students and postdoctoral fellows-including those at the Harvard School of Public Health (HSPH)-have somewhat limited opportunities outside of traditional coursework to learn holistically about public health. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the Public Health 101 Nanocourse was developed to provide an overview of five core areas of public health (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of public health.
Geronimus, Arline T; James, Sherman A; Destin, Mesmin; Graham, Louis A; Hatzenbuehler, Mark; Murphy, Mary; Pearson, Jay A; Omari, Amel; Thompson, James Phillip
The extent to which socially-assigned and culturally mediated social identity affects health depends on contingencies of social identity that vary across and within populations in day-to-day life. These contingencies are structurally rooted and health damaging inasmuch as they activate physiological stress responses. They also have adverse effects on cognition and emotion, undermining self-confidence and diminishing academic performance. This impact reduces opportunities for social mobility, while ensuring those who "beat the odds" pay a physical price for their positive efforts. Recent applications of social identity theory toward closing racial, ethnic, and gender academic achievement gaps through changing features of educational settings, rather than individual students, have proved fruitful. We sought to integrate this evidence with growing social epidemiological evidence that structurally-rooted biopsychosocial processes have population health effects. We explicate an emergent framework, Jedi Public Health (JPH). JPH focuses on changing features of settings in everyday life, rather than individuals, to promote population health equity, a high priority, yet, elusive national public health objective. We call for an expansion and, in some ways, a re-orienting of efforts to eliminate population health inequity. Policies and interventions to remove and replace discrediting cues in everyday settings hold promise for disrupting the repeated physiological stress process activation that fuels population health inequities with potentially wide application.
Pagano, Giovanni; Aliberti, Francesco; Guida, Marco; Oral, Rahime; Siciliano, Antonietta; Trifuoggi, Marco; Tommasi, Franca
A number of applications have been developed using rare earth elements (REE), implying several human exposures and raising unsolved questions as to REE-associated health effects. A MedLine survey was retrieved from early reports (1980s) up to June 2015, focused on human and animal exposures to REE. Literature from animal models was selected focusing on REE-associated health effects. Some REE occupational exposures, in jobs such as glass polishers, photoengravers and movie projectionists showed a few case reports on health effects affecting the respiratory system. No case-control or cohort studies of occupational REE exposures were retrieved. Environmental exposures have been biomonitored in populations residing in REE mining areas, showing REE accumulation. The case for a iatrogenic REE exposure was raised by the use of gadolinium-based contrast agents for nuclear magnetic resonance. Animal toxicity studies have shown REE toxicity, affecting a number of endpoints in liver, lungs and blood. On the other hand, the use of REE as feed additives in livestock is referred as a safe and promising device in zootechnical activities, possibly suggesting a hormetic effect both known for REE and for other xenobiotics. Thus, investigations on long-term exposures and observations are warranted. The state of art provides a limited definition of the health effects in occupationally or environmentally REE-exposed human populations. Research priorities should be addressed to case-control or cohort studies of REE-exposed humans and to life-long animal experiments. Copyright © 2015 Elsevier Inc. All rights reserved.
Quattrochi, Dale A.; Rickman, Douglas; Mohammad, Al-Hamdan; Crosson, William; Estes, Maurice, Jr.; Limaye, Ashutosh; Qualters, Judith
HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance public health surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate public health linkages. Proving the feasibility of the approach is the main objective
Christine A. Bevc
Full Text Available Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162, to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.
Peck, Megan; Scullard, Mickey; Hedberg, Craig; Moilanen, Emily; Radi, Deborah; Riley, William; Bowen, Paige Anderson; Petersen-Kroeber, Cheryl; Stenberg, Louise; Olson, Debra K
Between May 2010 and September 2011, the University of Minnesota School of Public Health partnered with the Minnesota Department of Health (MDH) to assess the effect of exercises on team performance during public health emergency response. Participants were divided into 3 research teams exposed to various levels of intervention. Groups consisted of a control group that was given standard MDH training exercises, a didactic group exposed to team dynamics and communication training, and a treatment group that received the didactic training in addition to a post-exercise facilitated debriefing. To assess differences in team performance, teams engaged in 15 functional exercises. Differences in team performance across the 3 groups were identified, although there was no trend in team performance over time for any of the groups. Groups demonstrated fluctuation in team performance during the study period. Attitudinal surveys demonstrated an increase in workplace satisfaction and confidence in training among all groups throughout the study period. Findings from this research support that a critical link exists between training type and team performance during public health emergency response. This research supports that intentional teamwork training for emergency response workers is essential for effective public health emergency response. (Disaster Med Public Health Preparedness. 2017;11:7-10).
Johnson, Ane Turner; Hirt, Joan B.
As colleges and universities have adopted a corporate model in recent decades, debate over the public versus private good associated with higher education has surged. The deliberations have typically been entrenched in Western notions about academia's contributions to development and scholars have framed academic capitalism dichotomously; a force…
Fielding, David; Freytag, Andreas; Münch, Angela
The paper argues that the type of the political regime does not only drive public spending on health, but that dependent on the type of regime inequality in health status within its population is fostered by applying selective strategies. An empirical analysis is conducted for 132 low- and middle...... income states for the years 1995-2010. A simple political economic framework is implemented in order to analyse the rational of policy makers in implementing effective health care provision....
D238 Write training reports 1.41 3 D234 Score tests .65 16 0014 3. Occupational Health E252 Maintain Environmental Protection Agency (EPA) reference...hazard reports 2.22 9 E252 Maintain Environmental Protection Agency (EPA) reference files 1.59 6 0024 3j. Industrial Case files B B 131 Update shop...0048 3bb. Indoor Air Quality B E252 Maintain Environmental Protection Agency (EPA) reference files 1.59 6 0050 4a. Food Inspection Program B E242
The primary goal of many park and recreation agencies is to provide resources and programs that improve quality of life for the community. Increasing physical activity is one aspect of this agenda. Promoting physical activity is a public health goal; however, increasing population-level physical activity will require access to places for physical activity (e.g. parks). Practitioners and policy makers need more information to document the roles that parks and recreation facilities play to promote physical activity and contribute to public health. A working group of approximately 20 professionals experienced in data collection came together to discuss the needs for better surveillance and measurement instruments in the fields of parks, recreation, and public health. The working group made two major recommendations: (1) the need for collaborative research and data sharing, and (2) the need for surveillance measures to demonstrate the amount of health-related physical activity acquired in the park setting.
Full Text Available Abstract Background Public health includes policy, practice and research but to sufficiently connect academic research, practice and public health policy appears to be difficult. Collaboration between policy, practice and research is imperative to obtaining more solid evidence in public health. However, the three domains do not easily work together because they emanate from three more or less independent 'niches'. Work cycles of each niche have the same successive steps: problem recognition, approach formulation, implementation, and evaluation, but are differently worked out. So far, the research has focused on agenda-setting which belongs to the first step, as expressed by Kingdon, and on the use of academic knowledge in policy makers' decision-making processes which belongs to the fourth step, as elaborated by Weiss. In addition, there are more steps in the policy-making process where exchange is needed. Method A qualitative descriptive research was conducted by literature search. We analyzed the four steps of the policy, practice and research work cycles. Next, we interpreted the main conflicting aspects as disconnections for each step. Results There are some conspicuous differences that strengthen the niche character of each domain and hamper integration and collaboration. Disconnections ranged from formulating priorities in problem statements to power roles, appraisal of evidence, work attitudes, work pace, transparency of goals, evaluation and continuation strategies and public accountability. Creating awareness of these disconnections may result in more compatibility between researchers, policy makers and practitioners. Conclusion We provide an analysis that can be used by public health services-related researchers, practitioners and policy makers to be aware of the risk for disconnections. A synthesis of the social, practical and scientific relevance of public health problems should be the starting point for a dialogue that seeks to
Peragallo Urrutia, Rachel; Merisier, Delson; Small, Maria; Urrutia, Eugene; Tinfo, Nicole; Walmer, David K
This 2009 qualitative study investigated Haitian women's most pressing health needs, barriers to meeting those needs and proposed solutions, and how they thought the community and outside organizations should be involved in addressing their needs. The impetus for the study was to get community input into the development of a Family Health Centre in Leogane, Haiti. Individual interviews and focus group discussions were conducted with 52 adult women in six communities surrounding Leogane. The most pressing health needs named by the women were accessible, available and affordable health care, potable water, enough food to eat, improved economy, employment, sanitation and education, including health education. Institutional corruption, lack of infrastructure and social organization, the cost of health care, distance from services and lack of transport as barriers to care were also important themes. The involvement of foreign organizations and local community groups, including grassroots women's groups who would work in the best interests of other women, were identified as the most effective solutions. Organizations seeking to improve women's health care in Haiti should develop services and interventions that prioritize community partnership and leadership, foster partnerships with government, and focus on public health needs.
Mackey, Tim K; Strathdee, Steffanie A
Peace and stability in Eastern Europe is now at a crossroads with the rapidly deteriorating foreign policy crisis continuing to unfold in the Ukraine. However, largely overlooked in the context of other foreign policy and diplomatic priorities are the serious public health consequences for the region following the annexation of Crimea and the subsequent decision to ban opioid substitution therapy in the disputed territory. On 1 May 2014, the Republic of Crimea officially announced it would end access to opioid substitution therapy, an essential harm reduction tool recognized by international organizations and virtually all other European countries. The policy development marks a critical reversal in the region's fight against its growing HIV epidemic and also threatens years of public health gains aimed at providing evidence-based and integrated treatment approaches to combat drug dependence and HIV. Beyond these risks, the Ukrainian conflict could also negatively impact control of other infectious diseases that are converging with HIV and injection drug use, such as multidrug-resistant tuberculosis and hepatitis C virus. The continuing conflict is also likely to have a significant negative impact on Ukraine's fragile public health system leading to even worse population health outcomes than currently experienced by the country. In response to this crisis, the application of global health diplomacy principles represents a possible route of advocacy to ensure that HIV prevention, humane treatment of substance using populations, and improving public health outcomes in the region are pursued among concerned international stakeholders. In order to be effective, global health diplomacy efforts must be coordinated and advocated in all forms of diplomatic engagement, including at the core, multistakeholder and informal levels and through existing channels such as the different human rights bodies of the United Nations as well as amongst other actors. Hence, the Ukraine
Soils sustain life. They affect human health via quantity, quality, and safety of available food and water, and via direct exposure of individuals to soils. Throughout the history of civilization, soil-health relationships have inspired spiritual movements, philosophical systems, cultural exchanges, and interdisciplinary interactions, and provided medicinal substances of paramount impact. Given the climate, resource, and population pressures, understanding and managing the soil-health interactions becomes a modern imperative. We are witnessing a paradigm shift from recognizing and yet disregarding the 'soil-health' nexus complexity to parameterizing this complexity and identifying reliable controls. This becomes possible with the advent of modern research tools as a source of 'big data' on multivariate nonlinear soil systems and the multiplicity of health metrics. The phenomenon of suppression of human pathogens in soils and plants presents a recent example of these developments. Evidence is growing about the dependence of pathogen suppression on the soil microbial community structure which, in turn, is affected by the soil-plant system management. Soil eutrophication appears to create favorable conditions for pathogen survival. Another example of promising information-rich research considers links and feedbacks between the soil microbial community structure and structure of soil physical pore space. The two structures are intertwined and involved in the intricate self-organization that controls soil services to public health. This, in particular, affects functioning of soils as a powerful water filter and the capacity of this filter with respect to emerging contaminants in both 'green' and 'blue' waters. To evaluate effects of soil services to public health, upscaling procedures are needed for relating the fine-scale mechanistic knowledge to available coarse-scale information on soil properties and management. More needs to be learned about health effects of soils
Full Text Available This article displays the characteristic of a complex of measures on differentiation of powers and obligations between various levels of authority in sphere of public health services, on maintenance of equation of volumes of rendering of medical aid to citizens with volumes of its financing. The special attention is given to an estimation of medical insurance using to improve quality of the medical aid and to preserve the health of the population. In this article the primary goals of a state policy in this sphere are represented.
Chatters, L M; Levin, J S; Ellison, C G
This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.
Full Text Available Background: If access to equitable health care is to be achieved for all, policy documents must mention and address in some detail different needs of groups vulnerable to not accessing such health care. If these needs are not addressed in the policy documents, there is little chance that they will be addressed at the stage of implementation.Objectives: This paper reports on an analysis of 11 African Union (AU policy documents to ascertain the frequency and the extent of mention of 13 core concepts in relation to 12 vulnerable groups, with a specific focus on people with disabilities.Method: The paper applied the EquiFrame analytical framework to the 11 AU policy documents. The 11 documents were analysed in terms of how many times a core concept was mentioned and the extent of information on how the core concept should be addressed at the implementation level. Each core concept mention was further analysed in terms of the vulnerable group in referred to.Results: The analysis of regional AU policies highlighted the broad nature of the reference made to vulnerable groups, with a lack of detailed specifications of different needs of different groups. This is confirmed in the highest vulnerable group mention being for ‘universal’. The reading of the documents suggests that vulnerable groups are homogeneous in their needs, which is not the case. There is a lack of recognition of different needs of different vulnerable groups in accessing health care.Conclusion: The need for more information and knowledge on the needs of all vulnerable groups is evident. The current lack of mention and of any detail on how to address needs of vulnerable groups will significantly impair the access to equitable health care for all.
Tisminetzky, Mayra; Bayliss, Elizabeth A; Magaziner, Jay S; Allore, Heather G; Anzuoni, Kathryn; Boyd, Cynthia M; Gill, Thomas M; Go, Alan S; Greenspan, Susan L; Hanson, Leah R; Hornbrook, Mark C; Kitzman, Dalane W; Larson, Eric B; Naylor, Mary D; Shirley, Benjamin E; Tai-Seale, Ming; Teri, Linda; Tinetti, Mary E; Whitson, Heather E; Gurwitz, Jerry H
To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions (MCCs). Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs. Survey conducted through the Health Care Systems Research Network (HCSRN) and Claude D. Pepper Older Americans Independence Centers (OAICs) Advancing Geriatrics Infrastructure and Network Growth Initiative, a joint endeavor of the HCSRN and OAICs. Individuals affiliated with the HCSRN or OAICs and national MCC experts, including individuals affiliated with funding agencies having MCC-related grant portfolios. A "top box" methodology was used, counting the number of respondents selecting the top response on a 5-point Likert scale and dividing by the total number of responses to calculate a top box percentage for each of 37 topics. The highest-ranked research topics relevant to the health and healthcare of older adults with MCCs were health-related quality of life in older adults with MCCs; development of assessment tools (to assess, e.g., symptom burden, quality of life, function); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association between clusters of chronic conditions and clinical, financial, and social outcomes; role of caregivers; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making. Study findings serve to inform the development of a comprehensive research agenda to address the challenges relating to the care of this "high-need, high-cost" population and the healthcare delivery systems responsible for serving it. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Meagher, Karen M
As bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critiques of dominant contemporary bioethics can be met by a virtue ethics approach. I present a virtue ethics response to criticisms that concern (1) increased rigor in bioethics discourse; (2) the ability of normative theory to accommodate context; and (3) explicit attention to the nature of ethical conflict. I conclude that a virtue ethics approach is a viable avenue for further inquiry, one that leads us away from developing ethics of public health in a vacuum and has the potential for overcoming certain pitfalls of contemporary bioethics discourse. © 2011 Blackwell Publishing Ltd.
Olusanya Bolajoko O
Full Text Available Abstract Background An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Methods Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test. Results Valid responses were received from 152 (65.8% of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality. Conclusions Current global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the
McCormick, Marie C; Litt, Jonathan S; Smith, Vincent C; Zupancic, John A F
The high rate of premature births in the United States remains a public health concern. These infants experience substantial morbidity and mortality in the newborn period, which translate into significant medical costs. In early childhood, survivors are characterized by a variety of health problems, including motor delay and/or cerebral palsy, lower IQs, behavior problems, and respiratory illness, especially asthma. Many experience difficulty with school work, lower health-related quality of life, and family stress. Emerging information in adolescence and young adulthood paints a more optimistic picture, with persistence of many problems but with better adaptation and more positive expectations by the young adults. Few opportunities for prevention have been identified; therefore, public health approaches to prematurity include assurance of delivery in a facility capable of managing neonatal complications, quality improvement to minimize interinstitutional variations, early developmental support for such infants, and attention to related family health issues.
Suresh Rathi MBBS, M.Sc Epidemiology, Assistant Professor, Department Of Community Medicine, S. B. K. S. Medical Institute and Research Centre, Piparia, Vadodara - 391760, Gujarat, Email -email@example.com
Full Text Available is a fast changing field. In fact, the whole concept of diagnosing and treating a patient is modifying rapidly. Benchmarks of the medical progress are continually changing: infectious/communicable diseases ravaged mankind for centuries but the dramatic decline in infectious/communicable diseases, during mid 19th century due to improvements in sanitation, nutrition and general living conditions among affluent countries has changed the picture. But due to re-emergence of certain infectious/communicable diseases the World Health Report 1996 declared that infectious/communicable diseases have not only become the world's leading cause of premature death, but they also threaten to cripple social and economic development in developing countries1. And here we are living in the twenty-first century still bewildered and confused by infectious/communicable diseases despite the availability of vaccination, latest diagnostic facilities, chemotherapy and above all well-trained medical professionals. What makes the scenario particularly tragic is that most infectious/communicable diseases are easily treatable; the failure is operational one. .........
The objective of this article is to: (1) evaluate the rationality and opportunity of this debate; (2) try to establish links with legal drugs; (3) evaluate the available data on the effect of legalization of a drug; and (4) propose an alternative drug police based on clear objectives to be reached; (5) describe how Sweden is dealing with the theme of drugs restriction as a social care. Methodologically the text constitutes in a summary of readings and elaborations of the author, placed to incite a discussion. It is concluded that four aspects need to be taken into consideration when a drug police of a country is analyzed, they are: (1) external factors influence the police: international agreements, health and social assistance police, individual rights, authority and autonomy of physicians and other professionals; (2) the objective established influence formal polices and its implementation; (3) the symbolic influence that excels the implementation. Influent people make declarations that strongly reach the legitimacy and adhesion to actions; (4) formal polices and their implementation receive direct influence to socially perceived damages by the drugs use, which could be independent of the real level of its use in a determined society.
Fox, Marie; Thomson, Michael
Law has played an important, but largely constitutive, role in the development of the public health enterprise. Thus, law has been central to setting up the institutions and offices of public health. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women's interests which we see as crucial to a fully realised vision of social justice. We argue that, aside from particular interventions in the field of reproduction, public health practice tends to marginalise women-a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalisation of women's interests, this article argues that Amartya Sen's capabilities approach has much to contribute to the framing of public health law and policy. Sen's approach provides an evaluative and normative framework which recognises the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice.
Ling, J C; Franklin, B A; Lindsteadt, J F; Gearon, S A
This review of the public health role of social marketing begins by tracing the history of social marketing and noting that social marketing adopts the traditional marketing framework of product, price, place, and promotion and embraces several methods of commercial marketing as well as consumer research. However, no universally acknowledged definition exists. A review of the literature is divided into three time periods representing early theoretical development, the evaluation of experiences, and increasing acceptance. Concerns about social marketing are discussed in terms of ethics, disempowerment, and the commercialization of health information. Examples of social marketing are then provided from developing countries and are analyzed in groupings defined as tangible products, sustained health practices, and service utilization. Practitioners' views and concerns are also reviewed. The strengths of social marketing include knowledge of the audience, systematic use of qualitative methods, use of incentives, closer monitoring, strategic use of the mass media, realistic expectations, aspiring to high standards, and recognition of price. Weaknesses of social marketing include its time, money, and human requirements; the fact that marketing elements are missing (public health lacks the flexibility to adjust products and services to clients' interests and preferences); and the potential serious impact on the future of Public Service Announcements, which may die out because social marketers pay for air time. After placing social marketing in context with other practices designed to achieve social change, the review ends with the prediction that the public health role of social marketing is likely to increase. The World Health Organization's recent call for health promotion and the UN Children's Fund's social mobilization actions are provided as examples of this increased role. It is noted, however, that social marketing alone cannot solve public health problems.
Tarlov, A R
Four conceptual frameworks provide bases for constructing comprehensive public policy strategies for improving population health within wealthy (OECD) nations. (1) Determinants of population health. There are five broad categories: genes and biology, medical care, health behaviors, the ecology of all living things, and social/societal characteristics. (2) Complex systems: Linear effects models and multiple independent effects models fail to yield results that explain satisfactorily the dynamics of population health production. A different method (complex systems modeling) is needed to select the most effective interventions to improve population health. (3) An intervention framework for population health improvement. A two-by-five grid seems useful. Most intervention strategies are either ameliorative or fundamentally corrective. The other dimension of the grid captures five general categories of interventions: child development, community development, adult self-actualization, socioeconomic well-being, and modulated hierarchical structuring. (4) Public policy development process: the process has two phases. The initial phase, in which public consensus builds and an authorizing environment evolves, progresses from values and culture to identification of the problem, knowledge development from research and experience, the unfolding of public awareness, and the setting of a national agenda. The later phase, taking policy action, begins with political engagement and progresses to interest group activation, public policy deliberation and adoption, and ultimately regulation and revision. These frameworks will be applied to help understand the 39 recommendations of the Independent Inquiry into Inequalities in Health, the Sir Donald Acheson Report from the United Kingdom, which is the most ambitious attempt to date to develop a comprehensive plan to improve population health.
O'Hara, Lily; Taylor, Jane; Barnes, Margaret
The field of health promotion has arguably shifted over the past thirty years from being socially proactive to biomedically defensive. In many countries this has been accompanied by a gradual decline, or in some cases the almost complete removal of health promotion designated positions within Government health departments. The language or discourse used to describe the practice and discipline of health promotion is reflective of such changes. In this study, critical discourse analysis was used to determine the representation of health promotion as a practice and a discipline within 10 Australian Government weight-related public health initiatives. The analysis revealed the invisibilization of critical health promotion in favour of an agenda described as 'preventive health'. This was achieved primarily through the textual practices of overlexicalization and lexical suppression. Excluding document titles, there were 437 uses of the terms health promotion, illness prevention, disease prevention, preventive health, preventative health in the documents analysed. The term 'health promotion' was used sparingly (16% of total terms), and in many instances was coupled with the term 'illness prevention'. Conversely, the terms 'preventive health' and 'preventative health' were used extensively, and primarily used alone. The progressive invisibilization of critical health promotion has implications for the perceptions and practice of those identifying as health promotion professionals and for people with whom we work to address the social and structural determinants of health and wellbeing. Language matters, and the language and intent of critical health promotion will struggle to survive if its speakers are professionally unidentifiable or invisible.
Full Text Available Introduction: The state of Chhattisgarh today faces several challenges in improving the health status of its people. The on-going problems of maternal and child mortality, communicable diseases, and HIV/AIDS pandemic still need greater interventions/support from the already overburdened health systems. In addition, the public health challenges include the escalating burden of chronic noncommunicable diseases. Keeping all these things in mind a study was carried out to have an overview of the public health scenario of Chhattisgarh. Aim: This paper aims to review the different public health indicators of Chhattisgarh. Materials and Methods: This study comprised of reviewing different health indicators of Chhattisgarh adopting three different methods during the period March-April 2013. The methods were: (i extensive online search, (ii reviewing the related literatures from different journals and other authentic printed materials, and (iii information collected from public health experts through e-mail, telephone, or direct interaction. Results: Out of 2.55 crore populations in the state (as per Census 2011, 78% lives in rural areas and 37% of the population is tribal. The sex ratio is 968 and the literacy rate is 65.5% in population above 7 years of age. There is a shortage of trained health care providers in Chhattisgarh. The crude birth rate is 23.5 per 1000 (population Annual Health Survey [AHS] 2011-2012. The infant mortality rate is 48 per 1000 live births (SRS 2012. Malnutrition, anemia, sickle cell hemoglobinopathy, Beta thalassemia trait, and G6 PD enzyme deficiency are very high among the tribes of Chhattisgarh. Malaria has been a major health problem. Chhattisgarh is one of the states with annual parasite index >5 (MRC report. The other states are Rajasthan, Gujarat, Karnataka, Goa, Southern Madhya Pradesh, Jharkhand, Odisha, and Northeastern states. Conclusion: From a public health point of view, most of the health indicators are below
Aurengo, A. [Hopital Pitie-Salpetriere, Dept. Nucleaire Medecine, 75 - Paris (France)
Because of its public health, ecological and industrial consequences, the Chernobyl accident has become a myth which serves as the focus of many fears, justified or not. no one can question the seriousness of the event, but after fifteen years there is still no agreement about the effect it has had or will have on public health. For example, the total number of deaths attributed to Chernobyl varies from less than a hundred to several millions and congenital malformations from negligible to cataclysmic. Effects on public health may be calculated from data on contamination, from the dose received and from the risk, all three of which are likely to be very roughly known; or they may be evaluated on the spot, either by epidemiological studies or by examining medical registers. This report makes an inventory of the different risks and takes stock on them. (N.C.)
Corrado De Vito
Full Text Available Vaccines represent some of the most important tools available for the prevention of diseases. In addition to protecting the vaccinated individual from developing a potentially serious disease, they help protect the community by reducing the spread of infectious agents. Therefore, there are not only benefits for the single individual, but also advantages for the entire community and the society. This very simple consideration makes unique the public health evaluation of vaccines, with substantial differences with other public health interventions and a need to adopt different criteria to develop recommendations for use. The public health evaluation of vaccines is challenged by several factors. Vaccine randomized trials often lack adequate sample size, fail to provide critical study details, exclude important populations, and rely on proxies for important outcomes.
Vernick, Jon S
In District of Columbia v. Heller, the U.S. Supreme Court ruled that the Second Amendment protects an individual's right to own handguns in the home for protection, invalidating a Washington, D.C. law banning most handgun possession. The Heller decision, however, provided lower courts with little guidance regarding how to judge the constitutionality of gun laws other than handgun bans. Nevertheless, lower courts have upheld the vast majority of federal, state, and local gun laws challenged since Heller. One area in which some lower courts have disagreed has been the constitutionality of laws regulating the ability to carry firearms in public. This issue may be the next to be addressed by the Supreme Court under its evolving Second Amendment jurisprudence. Courts should carefully consider the negative public health and safety implications of gun carrying in public as they weigh the constitutionality of these laws.
R. Baltussen (R.); Jansen, M.P. (Maarten P.); T.S. Mikkelsen; N. Tromp; J.A.C. Hontelez (Jan A.C.); Bijlmakers, L. (Leon); G.-J. van der Wilt (Gert-Jan)
textabstractPriority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs) in their strive for universal health coverage (UHC). However, present initiatives on priority setting are mainly geared towards the development of m
Shaw, Kathy; Harpin, Scott; Steinke, Geraldine; Stember, Marilyn; Krajicek, Marilyn
Strong professional priorities, evolving Affordable Care Act requirements, and a significantly limited public health nursing workforce prompted the University of Colorado College of Nursing to collaborate with the School of Public Health to implement one of the first Doctor of Nursing Practice/Master of Public Health dual degree programs in the nation. Federal grant funding supported the development, implementation, and evaluation of this unique post-baccalaureate dual degree program, for which there were no roadmaps, models, or best practices to follow. Several key issues emerged that serve as lessons learned in creating a new, novel higher education pathway for Advanced Public Health Nursing. This paper highlights two of those: (1) marketing, admission, and matriculation across two programs, and (2) enhancing curricula through distance coursework and interprofessional education. When collaboration with a school of public health is possible, the Doctor of Nursing Practice/Master of Public Health dual degree is an efficient way to prepare public health nurses' with the highest level of public health knowledge, practice, and leadership expertise. © 2016 Wiley Periodicals, Inc.
Drehobl, Patricia; Stover, Beth H; Koo, Denise
The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public's health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements-goals and strategies-to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other's work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC's commitment to working with partners on the highest priorities for strengthening the workforce to improve the public's health. Published by Elsevier Inc.
Wallington, Sherrie Flynt; Blake, Kelly; Taylor-Clark, Kalahn; Viswanath, K
The influence of news media on audience cognitions, attitudes, and behaviors in the realm of politics, race relations, science, and health has been extensively documented.Agenda setting and framing studies show that news media influence how people develop schema and place priorities on issues, with media stories serving as a major source of issue frames. Although news media are an important intermediary in the translation of scientific knowledge to different publics, little has been documented about the production of health news and factors that may predict media agenda setting and framing in health journalism. We used data from a 2005 national survey of U.S. health reporters and editors to examine predictors of source, resource, story angle, and frame usage among reporters and editors by variables such as organizational structure, individual characteristics of respondents (such as education and years working as a journalist),and perceptions of occupational autonomy. Multivariable logistic regression models revealed several differences among U.S. health reports and editors in the likelihood of using a variety of news sources, resources, priorities, and angles in reporting. Media agenda setting and framing theories suggest that practitioners familiar with media processes can work with journalists to frame messages, thereby increasing the probability of accurate and effective reporting. Results from this study may help to inform interactions between public health and medical practitioners and the press [corrected].
Comerford, C.; Wolff, M.
Centralized policies and programs are critical to forwarding sustainable practices and improving health. Yet without communication tools and the participation of local residents and policy makers, cities are limited in how much they can achieve. The objective of this presentation is to highlight solutions developed by the San Francisco Department Public Health that intelligently use data-driven planning and on-line communication to engage communities in climate change action and build sustainable and healthy neighborhoods. Climate change is expected to more seriously affect the health and well-being of communities that are least able to prepare for, cope with, and recover from the impacts. By 2100, Extreme heat days in San Francisco are projected to increase by up to 40 days per year and sea levels are expected to rise up to 46 inches by 2100. These climate impacts will have cascading impacts on public health. To address these challenges, the Climate and Health Program is successfully addressing the public health impacts of climate change