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Health Priorities (health + priority)

Distribution by Scientific Domains

Medical Sciences	95%

Kinds of Health Priorities

public health priority

Selected Abstracts

Physicians' Preparedness for Bioterrorism and Other Public Health Priorities

ACADEMIC EMERGENCY MEDICINE, Issue 11 2006
G. Caleb Alexander MD
Objectives Potential bioterrorism challenges policy makers to balance competing public health priorities. Earlier surveys showed low physician bioterrorism preparedness but did not assess physicians' general public health preparedness, compare the preparedness of emergency and primary care physicians, or assess temporal trends. Methods This was a national, cross-sectional, random-sample survey conducted in 2003. Results Overall, 744 of 1,200 eligible physicians responded (response rate, 62%). Of these, 58% of emergency physician respondents and 48% of primary care physician respondents reported having learned a lot about responding to bioterror since September 11, 2001 (p < 0.01). However, only 43% of emergency physicians and 21% of primary care physicians agreed they are generally "well prepared to play a role in responding to a bioterror attack" (p < 0.001). Beliefs about balancing public health priorities were similar among emergency and primary care respondents. Seventy-eight percent of respondents believed that local health care systems need to be prepared for bioterrorism, and 92% believed that local health care systems need to be prepared for natural epidemics. By contrast, only 23% and 46% of respondents reported that their local health care systems are well prepared for bioterrorism and natural epidemics, respectively. Meanwhile, 77% agreed that "influenza is a greater threat to public health than bioterrorism," and 21% reported that bioterrorism preparedness efforts are diverting resources from more important public health problems. Conclusions In 2003, most emergency and primary care physicians reported that they and their local health care systems were not yet well prepared to respond to a bioterror attack, and many believed that more resources should go toward preparing for natural epidemics. These findings highlight the importance of expanding bioterrorism preparedness efforts to improve the public health system more broadly. [source]

Public Health Rural Health Priorities in America: Where You Stand Depends on Where You Sit

THE JOURNAL OF RURAL HEALTH, Issue 3 2003
Larry Gamm PhD
Methods: Analysis of responses to a mail survey sent to 999 rural health leaders, with 501 responses. Respondents were asked to rank importance to rural health of focus areas named in Healthy People 2010 Findings: There was substantial agreement on top rural health priorities among state and local rural health leaders across the 50 states. "Access to quality health services" was the top priority among leaders of state-level rural agencies and health associations, local rural public health agencies, rural health clinics and community health centers, and rural hospitals. It was the top priority across all 4 major census regions of the nation as well. The next 4 top-ranking rural priorities,"heart disease and stroke,""diabetes,""mental health and mental disorders," and "oral health",were selected as 1 of the top 5 rural priorities by one third or more of respondents across most groups and regions. At the same time, some observed differences in rural health priorities suggest opportunities for community partnership strategies or for regional multistate policy initiatives by states sharing similar rural health priorities. [source]

Physicians' Preparedness for Bioterrorism and Other Public Health Priorities

Collateral damage from alcohol: implications of ,second-hand effects of drinking' for populations and health priorities

ADDICTION, Issue 8 2010
NORMAN GIESBRECHT
No abstract is available for this article. [source]

Impacts of national surveillance for uncommon conditions in childhood

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 11 2007
Yvonne A Zurynski
Abstract: The Australian Paediatric Surveillance Unit (APSU) facilitates the conduct of national collaborative research that is consistent with national health priorities, has potential to impact on public health, and addresses gaps in knowledge. Since 1993 paediatricians and other child health specialists have contributed monthly data on rare childhood conditions to the APSU. Over 40 conditions, including infectious diseases, injuries, vaccine-preventable diseases and genetic disorders have been studied. Information on epidemiology, frequency, diagnosis, management and short-term outcomes of these conditions is collected and provides evidence to support changes to clinical practice, prevention policy and allocation of health resources. In this review we give examples of the value of information gathered through the APSU surveillance system in the last 14 years. [source]

A Model for Mapping Linkages Between Health and Education Agencies to Improve School Health

JOURNAL OF SCHOOL HEALTH, Issue 2 2000
Lawrence St. Leger
ABSTRACT: Efforts to develop effective and sustainable school health programs evolved in sophistication the past 20 years through research and practical experience. This paper reviews these developments, arguing they were significantly driven by public health priorities, and have not adequately accounted for educational perspectives and priorities. To better understand the differences in perspective, a model is presented which illustrates linkages between different school-based inputs and strategies, and long-term health and educational outcomes. The model describes similarities and differences between the two perspectives. A significant coincidence exists in factors that determine educational attainment and improved health outcomes for students. A more holistic and integrated approach to school health is emerging, and at these interfaces our implementation and research efforts for the 21st century should be concentrated. [source]

Hepatitis A and B vaccination and public health

JOURNAL OF VIRAL HEPATITIS, Issue 2007
F. Blaine Hollinger
Summary., 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. [source]

Public Health Rural Health Priorities in America: Where You Stand Depends on Where You Sit

Evaluating performance of and organisational capacity to deliver brief interventions in Aboriginal and Torres Strait Islander medical services

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010
Katie Panaretto
Abstract Objective: This study assessed brief intervention (BI) activity and organisation capacity for smoking, nutrition, alcohol and physical activity (SNAP framework) and key clinical prevention activities in four Aboriginal and Torres Strait Islander medical services in Queensland. Methods: A mixed methods design was used including: staff surveys of knowledge and attitudes (n=39), focus groups to discuss perceived barriers and enablers and chart audits (n=150) to quantify existing BI activity. Results: Of 50 clinical staff, 46 participated in the staff survey and focus groups across the four sites. BI was perceived to be important. There was significant variation in completion of records for SNAP risk factors, key clinical and BI activities across the sites. At least one SNAP factor status was recorded in 130/150 (86.7%) patient charts audited and there was a significant trend of increased recording of SNAP factors with increasing number of patient visits. Of those identified at risk 78% received at least one BI. Where risk was identified 65/96 (67.7%) patients required multiple BIs. BI for tobacco use was consistently high across all sites. Only one site recorded regular care planning and Adult Health Checks. Impacting factors included leadership, high staff turnover, multiple medical records and staff health status. Conclusions: Inflexible staff training, competing health priorities and high levels of staff turnover were identified as key barriers to the delivery of BI in clinical settings. The data suggests a good base of existing BI activity for smoking and key clinical activities which may improve with further support. [source]

HEALTH AND THE 1999 REGIONAL AUSTRALIA SUMMIT

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2000
John S. Humphreys
The Regional Australia Summit brought together 282 invited delegates from all parts of Australia. The aim of the Summit was to develop partnerships between the government, business and community sectors to deliver a better future for regional, rural and remote areas facing significant change. Health was one of 12 themes discussed at the Summit. Five key health priorities were identified; the need to change the dominant metropolitan mind-set, improve access to health-care services, improve service provision and workforce training, ensure equitable resource allocation, and adopt a population health approach. The ultimate success of the Regional Australia Summit will be gauged over time by the extent to which the health, wellbeing and prosperity of rural, remote and regional Australians has been improved, and existing problems and issues addressed. Nonetheless, the Summit is a significant event because it addresses issues at the highest level of government, emphasises coordination and the adoption of an intersectoral approach, and recognises the need to empower local communities and build partnerships between the government, corporate and community sectors. [source]

From the Emergency Department to Vital Statistics: Cause of Death Uncertain

ACADEMIC EMERGENCY MEDICINE, Issue 8 2008
Carla C. Keirns MD
Abstract Vital statistics are widely used to evaluate trends in health and illness, inform policy, and allocate resources among health priorities. Literature comparing autopsies to clinical death certification has shown that the clinical "cause of death" certification is inaccurate or incomplete in many cases. Short of increasing autopsies, however, these studies have proposed few improvements. Using the case of death certification in the emergency department (ED), the authors analyzed the current approach to death certification. The authors propose the following to improve the quality of data: 1) acceptance of the declaration "manner of death, natural; cause of death, uncertain"; 2) training for physicians in the selection of appropriate underlying causes of death and "chains of causation"; and 3) participation of physicians with ongoing relationships to the patient in the certification process. [source]

The asthma,obesity link in childhood: open questions, complex evidence, a few answers only

CLINICAL & EXPERIMENTAL ALLERGY, Issue 4 2007
P. M. Matricardi
Summary Obesity and asthma are public health priorities in developed countries. Genes which may contribute to the control of both conditions include those encoding for the ,2 -adrenergic receptor, tumour necrosis factor-, (TNF-,) and the insulin-like growth factor 1 (IGF-1). Prospective studies consistently supported a link between obesity and reported wheezing or asthma diagnosis in children. However, there are still no clear explanations for such a link. On one hand, overweight asthmatic children may perceive their asthma as worse. On the other hand, atopic sensitization and bronchial hyper-reactivity do not explain the observed associations. After puberty, the association between asthma and obesity tends to be stronger in girls than in boys. It is conceivable that severe obesity in adolescent females may aggravate asthma through mechanisms different from those linking prepubertal obesity to unremitting asthma in males. Future studies should therefore address multiple age- and gender-specific hypotheses about the mechanisms that link obesity to asthma throughout childhood. [source]

PALLIATIVE CARE, PUBLIC HEALTH AND JUSTICE: SETTING PRIORITIES IN RESOURCE POOR COUNTRIES

DEVELOPING WORLD BIOETHICS, Issue 3 2009
CRAIG BLINDERMAN
ABSTRACT Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries. [source]

Assessing motivation to quit smoking in people with mental illness: a review

ADDICTION, Issue 5 2009
Ranita Siru
ABSTRACT Background People with mental health (MH) disorders smoke at higher rates, are more nicotine-dependent and suffer greater morbidity and mortality from smoking-related illnesses than the general population. Helping these people to quit smoking is a public health priority; however, many MH professionals assume that those with mental illness are not motivated to quit. Objectives To use predetermined criteria to identify, review critically and evaluate empirically all English language, peer-reviewed data on motivation to quit smoking in MH populations. Methods A systematic search was conducted and key data on subject characteristics, measures of motivation and other variables abstracted. ,2 analyses were used to compare motivation between MH and general populations, between in-patients and out-patients and between people with depression and people with psychotic disorders. Results Evidence suggests that people with MH disorders are as motivated to quit smoking as the general population, although those with psychotic disorders may be less motivated than individuals with depression. Although readiness to cease smoking was assessed in 14 studies, only two evaluated motivation to quit smoking in in-patient populations. Conclusions People with MH disorders are motivated to quit smoking, although more research is needed looking at in-patient populations. The commonly held false belief that people with MH disorders are not motivated to cease smoking means that opportunities to encourage smoking cessation among this disenfranchised group are being missed. [source]

Cost-effectiveness analysis of two strategies for mass screening for colorectal cancer in France

HEALTH ECONOMICS, Issue 3 2004
Célia Berchi
Abstract The implementation of colorectal cancer mass screening is a high public health priority in France, as in most other industrialised countries. Despite evidences that screening using guaiac fecal occult blood test may reduce colorectal cancer mortality, no European country has organised widespread mass screening with this test. The low sensitivity of this test constitutes its main limitation. Immunological tests, which provide higher sensitivity than the guaiac test, may constitute a satisfactory alternative. This study was carried out to compare the costs and the effectiveness of 20 years of biennial colorectal cancer (CRC) screening with an automated reading immunological test (Magstream) with those obtained with a guaiac stool test (Haemoccult). The model used to estimate the costs and effectiveness of successive biennial CRC screening campaigns was a transitional probabilistic model. The parameters used in this model concerning costs and CRC epidemiological data were calculated from results obtained in the screening program run in Calvados or from published results of foreign studies because of the lack of French studies. The use of Magstream for 20 years of biennial screening costs 59 euros more than Haemoccult per target individual, and should lead to a mean increase in individual life expectancy of 0.0198 years (i.e. about one week), which corresponds to an incremental cost-effectiveness ratio of 2980 euros per years of life saved. Our results suggest that using an immunological test could increase the effectiveness of CRC screening at a reasonable cost for society. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Faecal screening of colorectal cancer

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2008
A. Loganayagam
Summary Aims:, Screening and prevention of colorectal cancer (CRC) is a public health priority. Recent progress in understanding the biology of CRC has lead to possible new approaches to screening. In particular, assay of faecal molecular markers represents a promising non-invasive approach to screening, with improved safety, accuracy and patient compliance. Methods:, MEDLINE/PubMed searches were used to identify key articles relating to faecal-based screening with secondary review of cited publications. Results:, Faecal markers of CRC can be broadly divided into DNA based and non-DNA based. Conclusions:, Faecal occult blood testing for CRC screening has been advocated for decades for its non-invasiveness and low cost. It has exhibited a 15,33% decrease in mortality, despite drawbacks with sensitivity and compliance. Other non-DNA markers have the adequate sensitivity for inflammatory lesions but do not have the required specificity for screening average-risk populations. Faecal DNA testing has the potential to enhance the performance characteristics of stool testing. Because of molecular heterogeneity of cancer, no single DNA marker has yielded adequate sensitivity. Analysis of several combinations of markers in studies have produced high detection rates of both CRC and advanced adenomas in selected patient groups. However, the currently available markers, both non-DNA and DNA, have not yet been validated in large-scale studies screening average -risk population nor have they so far shown the necessary sensitivity and specificity required for large-scale screening programmes. Another major drawback with the DNA-based markers is the cost-effectiveness. Issues regarding implementation and compliance remain unanswered. These critical problems have to be rectified before these techniques can be recommended for large-scale CRC screening. [source]

Environmental Nursing Diagnoses: A Proposal for Further Development of Taxonomy II

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2003
Pauline M. Green PhD
PURPOSE. To propose further development of environmental diagnoses and to offer recommendations for expanding Taxonomy II to include more diagnostic labels that encompass the environmental domain. SOURCES. Literature in the disciplines of nursing, biology, toxicology, public health, sociology, and anthropology. DATA SYNTHESIS. Nurses need language to describe the human responses of individuals, families, communities, and global society to environmental health threats. CONCLUSIONS. New environmental diagnoses will lead to refinement of language that describes the contribution of nursing to an emerging international and community health priority. PRACTICE IMPLICATIONS. Environmental diagnostic labels will allow nurses to name responses and plan interventions that respond to instances or risks of exposure to threats from the physical and sociocultural environment. Search terms: Environmental contamination, environmental health threats, exposure, nursing diagnoses [source]

Fluoridation and Social Equity

JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2002
Brian A. Burt BDS
Abstract The overall reduction in caries prevalence and severity in the United States over recent decades is largely due to widespread exposure to fluoride, most notably from the fluoridation of drinking waters. Despite this overall reduction, however, caries distribution today remains skewed, with the poor and deprived carrying a disproportionate share of the disease burden. Dental caries, like many other diseases, is directly related to low socioeconomic status (SES). In some communities, however, caries experience has now diminished to the point where the need for continuing water fluoridation is being questioned. This paper argues that water fluoridation is still needed because it is the most effective and practical method of reducing the SES-based disparities in the burden of dental caries. There is no practical alternative to water fluoridation for reducing these disparities in the United States. For example, a school dental service, like those in many other high-income countries, would require the allocation of substantial public resources, and as such is not likely to occur soon. But studies in the United States, Britain, Australia, and New Zealand have demonstrated that fluoridation not only reduces the overall prevalence and severity of caries, but also reduces the disparities between SES groups. Water fluoridation has been named as one of the 10 major public health achievements of the 20th century by the Centers for Disease Control and Prevention, and promoting it is a Healthy People objective for the year 2010. Within the social context of the United States, water fluoridation is probably the most significant step we can take toward reducing the disparities in dental caries. It therefore should remain as a public health priority. [source]

Asthma in Latin America: a public heath challenge and research opportunity

ALLERGY, Issue 1 2009
P. J. Cooper
,Asthma has emerged as an important public health problem in many Latin American countries over the past decade. In Brazil and Costa Rica, the prevalence of asthma and associated morbidity is as great or greater as reported in traditional high prevalence countries such as the US, but remains neglected as a public health priority. Asthma in Latin America is associated particularly with underprivileged populations living in cities but remains relatively rare in many rural populations. The causes of asthma in Latin America are likely to be associated with urbanization, migration, and the adoption of a modern ,Westernized' lifestyle and environmental changes that follow these processes that include changes in diet, physical activity, hygiene, and exposures to allergens, irritants, and outdoor and indoor pollutants. Because of the enormous social, genetic, and environmental contrasts within and between Latin American countries, and the large differences in prevalence associated with these differences, the investigation of asthma in Latin America provides important research opportunities to identify the social and biological mechanisms that underlie asthma development. Asthma in Latin America poses enormous challenges for health policy makers, health services, and researchers to respond to and alleviate the growing burden of asthma disability, particularly among marginalized urban populations. [source]

Revisiting the Emergency Medicine Services for Children Research Agenda: Priorities for Multicenter Research in Pediatric Emergency Care

ACADEMIC EMERGENCY MEDICINE, Issue 4 2008
Steven Zane Miller MD
Abstract Objectives:, To describe the creation of an Emergency Medical Services for Children (EMSC) research agenda specific to multicenter research. Given the need for multicenter research in EMSC and the unique opportunity afforded by the creation of the Pediatric Emergency Care Applied Research Network (PECARN), the authors revisited existing EMSC research agendas to develop a PECARN-specific research agenda. They sought to prioritize PECARN research efforts, to guide investigators planning to conduct research in PECARN, and to describe the creation of a prioritized EMSC research agenda specific for multicenter research. Methods:, The authors used the Nominal Group Process and Hanlon Process of Prioritization (HPP), which are recognized research prioritization methods incorporating both quantitative and qualitative data collection in group settings. The formula used to generate the final priority list heavily weighted practicality of conduct in a multicenter research network. By using size, seriousness, and practicality measures of each health priority, PECARN was able to identify factors that could be scored individually and were weighted relative to each other. Results:, The prioritization processes resulted in a ranked list of 16 multicenter EMSC research topics. Top among these priorities were 1) respiratory illnesses/asthma, 2) prediction rules for high-stakes/low-likelihood diseases, 3) medication error reduction, 4) injury prevention, and 5) urgency and acuity scaling. Conclusions:, The PECARN prioritization process identified high-priority EMSC research topics specific to multicenter research. PECARN has the capacity to answer long-standing, important clinical controversies in EMSC, largely due to its ability to conduct randomized controlled trials and observational studies on a large scale. [source]

OZ OT EBP 21C: Australian occupational therapy, evidence-based practice and the 21st century

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2001
Anne Cusick
Occupational therapy in Australia is entering the 21st century as a dynamic and growing profession. The adoption of evidence-based practice is an important feature to ensure the profession's continued success. There are also other issues evident in Australian occupational therapy today that need to be considered to ensure the profession's continued growth. These are: the terminology that is and could be used in occupational therapy; the possibility of ,collateral damage' to occupational therapy concepts and processes if deterministic elements of evidence-based practice predominate; and the importance of making explicit our national position on occupational therapy core concepts and processes. Regarding the latter, the author proposes that this position is best described as ,finding unity in diversity'. This position reflects the national heritage, character and social/health priorities facing Australian occupational therapy. The implications of these issues are explored. [source]