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Selected AbstractsReflections on and alternatives to WHO's fairness of financial contribution indexHEALTH ECONOMICS, Issue 2 2002*Article first published online: 28 FEB 200, Adam Wagstaff Abstract In its 2000 World Health Report (WHR), the World Health Organization argues that a key dimension of a health system's performance is the fairness of its financing system. This paper provides a critical assessment of the index of fairness of financial contribution (FFC) proposed in the WHR. It shows that the index cannot discriminate between health financing systems that are regressive and those that are progressive, and cannot discriminate between horizontal inequity on the one hand, and progressivity and regressivity on the other. The paper compares the WHO index to an alternative and more illuminating approach developed in the income redistribution literature in the early 1990s and used in the late 1990s to study the fairness of various OECD countries' health financing systems. It ends with an illustrative empirical comparison of the two approaches using data on out-of-pocket payments for health services in Vietnam for two years , 1993 and 1998. This analysis is of some interest in its own right, given the large share of health spending from out-of-pocket payments in Vietnam, and the changes in fees and drug prices over the 1990s. Copyright © 2002 John Wiley & Sons, Ltd. [source] Resources Used by General Practitioners for Advising Travelers from New ZealandJOURNAL OF TRAVEL MEDICINE, Issue 2 2000Peter A. Leggat Background: The risks of the destination and any specific requirements for travel health advice may be obtained from a variety of resources. This study was designed to investigate the usefulness of various resources available in New Zealand for providing travel health advice and the extent to which GPs used these resources in providing travel health advice. Methods: Four hundred GPs (400/2830) were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Two reminders were sent. Results: Three hundred and thirty-two (332/400, 83%) GPs responded. The usefulness of various resources was reported, including Health Advice for Overseas Travellers (277/289, 96%), New Ethicals (256/278, 92%), New Zealand Public Health Report (79/164, 48%), International Travel and Health (41/144, 28%), computerized databases (6/122, 5%), journals (14/130, 11%), and other resources (44/139, 32%). Health Advice for Overseas Travellers was regarded as significantly more useful than International Travel and Health (x2= 4,68, df = 1, p < .05). Only 23% (70/309) of respondents indicated that they always used these resources in their practice of travel medicine. Fifty percent (154/309) of respondents indicated that they usually used these resources, while 27% (83/309) of respondents indicated that they used these resources sometimes. Only 1% (2/309) of GPs did not use resources at all for their practice of travel medicine. Conclusion: The most useful resource was Health Advice for Overseas Travellers, which outlines the New Zealand recommendations for medical practitioners providing travel health advice. It may be useful for GPs to gain access to and training in association with a greater range of specialist resources to use in conjunction with the provision of travel health advice. These might include international guidelines, journals, and access to computerized databases and the internet. With the recent introduction of a widely accessible computerized database in New Zealand, follow-up studies could be instituted to determine if GPs' use of computerized databases becomes more widespread and whether access to and use of these computerized databases influences the provision of travel health advice by GPs. Further studies are needed to examine the appropriateness of the advice provided by the various resources used by GPs in New Zealand. [source] Burden of disease related to Parkinson's disease in Spain in the year 2000MOVEMENT DISORDERS, Issue 11 2005Esther Cubo MD Abstract We measured the burden caused by Parkinson's disease (PD) in Spain during the year 2000 and compared it against PD burden worldwide and in the European A subregion. Burden of disease (BoD) is an important factor in health policy. Disability-adjusted life years (DALY) as a measure of BoD is the result of adding years of life lost (YLL) and years lived with disability (YLD). The burden of PD (BPD) has not been studied in Spain. YLL were obtained from the Spanish death certificates and YLD from the estimated number of incident PD cases and the average PD duration. PD disability was calculated, using the Disability Weights for Diseases in the Netherlands. Prior PD DALY data for Europe and the world were obtained from the 2001 World Health Organization World Health Report. A discount rate of 3% and age-weighting modulation factor with K = 1 were used. In Spain, PD generated 67,582 DALY, comprising 6,351 (9.4%) YLL and 61,231 (90.6%) YLD. Most PD DALY (57.5%) occurred in the population 60 to 74 years of age. When PD DALY estimates were adjusted using the world population in 2000, Spain registered a PD DALY rate of 84 per 100,000 population, higher than both the world and European A subregion rates (24 and 35 per 100,000 population, respectively). PD burden in Spain in 2000 was high, with disability being the major contributing factor. Although BPD in Spain was greater than both world and European A subregion BPD, these differences should nevertheless be interpreted with caution. © 2005 Movement Disorder Society [source] Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approachCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2004Poul Erik Petersen Abstract , Despite great improvements in the oral health of populations across the world, problems still persist particularly among poor and disadvantaged groups in both developed and developing countries. According to the World Oral Health Report 2003, dental caries remains a major public health problem in most industrialized countries, affecting 60,90% of schoolchildren and the vast majority of adults. Although it appears that dental caries is less common and less severe in developing countries of Africa, it is anticipated that the incidence of caries will increase in several countries of that continent, due to changing living conditions and dietary habits, and inadequate exposure to fluorides. Research on the oral health effects of fluoride started around 100 years ago; the focus has been on the link between water and fluorides and dental caries and fluorosis, topical fluoride applications, fluoride toothpastes, and salt and milk fluoridation. Most recently, efforts have been made to summarize the extensive database through systematic reviews. Such reviews concluded that water fluoridation and use of fluoride toothpastes and mouthrinses significantly reduce the prevalence of dental caries. WHO recommends for public health that every effort must be made to develop affordable fluoridated toothpastes for use in developing countries. Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages in public health; alternatively, fluoridation of salt and milk fluoridation schemes may be considered for prevention of dental caries. [source] A national survey of support and counselling after maternal death,ANAESTHESIA, Issue 11 2009S. McCready Summary The 2000,2002 Confidential Enquiry into Maternal and Child Health report highlighted several cases of maternal death where the staff who had been involved, were not offered support. The report recommended that ,Trusts must make provision for the prompt offer of support and/or counselling for all staff who have cared for a woman who has died.' We conducted a postal survey to firstly establish whether Trusts had implemented this, and also to ascertain the experience of consultant obstetric anaesthetists. Of 706 respondents (response rate 64%), 60% involved in a maternal death or other traumatic event received no offer of support, 65% were unaware of potential sources of support and only 5% received details of further help available. Furthermore, 69% were unaware of policies within their own Trusts for the provision of support services. We suggest that a formal structure should exist within all units that offers confidential support services and/or debriefing facilities to all staff involved in a maternal death or other traumatic event. [source] Ambulatory monitoring and physical health report in Vietnam veterans with and without chronic posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 4 2003Jean C. Beckham Abstract This study investigated the associations among PTSD, ambulatory cardiovascular monitoring, and physical health self-reports in 117 male Vietnam combat veterans (61 with PTSD and 56 without PTSD). PTSD was associated with health symptoms and number of current health conditions beyond the influence of several covariates. PTSD was associated with greater systolic blood pressure variability, and an elevated percentage of heart rate and systolic blood pressure readings above baseline. Higher mean heart rate and an elevated percentage of heart rate above baseline were associated with physical health symptoms. None of the ambulatory monitoring variables mediated the association between PTSD and physical health outcomes. Findings suggest that the interrelationships among ambulatory autonomic responses, PTSD, and physical health deserve more research attention. [source] On the brink of change?INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2001Implications of the review of undergraduate education in New Zealand for mental health nursing ABSTRACT: A New Zealand Nursing Council review of undergraduate education provides an ideal opportunity to make much needed changes to the system of preparation for mental health nurses. This article critiques comprehensive nursing education through an examination of its history in New Zealand, recent mental health reports and a projected estimate of workforce needs. Historical analysis reveals a process of marginalization and invisibilization of psychiatric/mental health nursing within comprehensive programmes with a consequent reduction of skills and a weakening of the profession. The author concludes that psychiatric/mental health nursing is a distinct scope of practice which requires specialty undergraduate preparation. [source] |