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Health Strategies (health + strategy)
Kinds of Health Strategies Selected AbstractsThe Australian experience of deinstitutionalization: interaction of Australian culture with the development and reform of its mental health servicesACTA PSYCHIATRICA SCANDINAVICA, Issue 2006A. Rosen Objective:, To describe the Australian experience of deinstitutionalization of the Australian National Mental Health Strategy in the context of the history of mental health services in Australia, and of Australian culture. Method:, The development of Australian Mental Health Services is described with reference to developments in both psychiatric intervention research and Australian culture. The effects and achievements of national mental health reforms are described and critically examined. Results:, The relationship in Australia between the development of mental health services and the development of Australian society includes the stories of colonization, gold rushes, suppression of indigenous peoples' rights, incarceration of mentally ill people, and incompatible state service systems. Mental health services required reform to provide consistent services and support for full citizenship and rights for such individuals who are still on the margins of society. Recent national developments in service models and service system research have been driven by the Australian National Mental Health Strategy. The translation of national policy into state/territory mental health service systems has led to a ,natural' experiment between states. Differing funding and implementation strategies between states have developed services with particular strengths and limitations. Conclusion:, The effects of competition for limited resources between core mental health service delivery and the shift to a population-based public health approach (to prevention of mental illness and promotion of mental health), leaves our services vulnerable to doing neither particularly well. The recent loss of momentum of these reforms, due to failure of governments to continue to drive and fund them adequately, is causing the erosion of their considerable achievements. [source] African countries propose a regional oral health strategy: The Dakar Report from 1998ORAL DISEASES, Issue 3 2004NG Myburgh It is clear that the African region faces a number of serious oral diseases, either because of their high prevalence or because of the severe tissue damage or death that can occur. Previous approaches to oral health in Africa have failed to recognise the epidemiological priorities of the region or to identify reliable and appropriate strategies to assess them. Efforts have consisted of an unplanned, ad hoc and spasmodic evolution of curative oral health services. This document focuses on the most severe oral problems that people have to live with like noma, oral cancer and the oral consequences of HIV/AIDS infection. It proposes a strategy for assisting member states and partners to identify priorities and interventions at various levels of the health system, particularly at the district level. The strategy aims at strengthening the capacity of countries to improve community oral health by effectively using proven interventions to address specific oral health needs. The strategy identifies five main ,programmatic areas', including (i) the development of national oral health strategies and implementation plans, (ii) integration of oral health in other programmes, (iii) delivery of effective and safe oral health services, (iv) regional approach to education and training for oral health, and (v) development of effective oral health management information systems. Many of the programmatic areas share similar characteristics described as a ,strategic orientation'. These strategic orientations give effect to the concepts of advocacy, equity, quality, partnership, operational research, communication and capacity building. The WHO Regional Committee for Africa (RC) is invited to review the proposed oral health strategy for the African region for the period 1999,2008 and provide an orientation for the improvement of oral health in member states in the region. [source] Maternal, paternal and environmental tobacco smoking and breast feedingPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2002Gabriel M. Leung Summary The effects of environmental tobacco smoke (ETS) on breast-feeding patterns are poorly understood, while those of parental smoking on breast-feeding initiation vs. duration have not been clearly delineated. We conducted a prospective, population-based birth cohort study to examine the independent effects of maternal, paternal and ETS on breast-feeding initiation and duration. A total of 6747 Hong Kong Chinese infants were recruited and followed up in 1997,8. We obtained detailed household smoking history and recorded breast-feeding patterns in three follow-up interviews over 9 months. We found that both maternal and paternal smoking were associated with not initiating breast feeding (odds ratio [OR] for ever maternal smoking = 2.51, 95% confidence interval [CI] = 1.63, 3.86; OR for ever paternal smoking = 1.22, 95% CI = 1.08, 1.39). Exposure to ETS in utero and post partum were also related to not starting breast feeding (ORETS in utero = 1.10, 95% CI = 0.99,1.24; ORETS post partum = 1.21, 95% CI = 1.08, 1.36). These effects, however, did not persist for breast-feeding duration of , 4 months. Cox proportional hazards modelling confirmed the lack of association between any form of smoking and breast-feeding duration. Our findings suggest that smoking of any kind, during or after pregnancy, is a strong risk indicator for not initiating breast feeding. Smoking as a risk indicator for underlying socio-economic, demographic and psychosocial factors is probably responsible for most of the observed adverse effects, although we cannot rule out direct contributions from pathophysiological mechanisms. Public health strategies directed at these underlying factors should be vigorously pursued to reduce the adverse effects of tobacco on breast feeding and infant health in general. [source] New criteria of normal serum lipid levels in Japanese children: The nationwide studyPEDIATRICS INTERNATIONAL, Issue 6 2002Tomoo Okada Abstract Aim: To make new criteria of serum lipid levels in current Japanese children using the large nationwide data provided from Japan Association of Health Service for the analysis. Methods: The subjects were schoolchildren who received screening and care programs for lifestyle related diseases since 1993,1999. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglyceride (TG) levels were measured, and low-density lipoprotein cholesterol (LDLC) levels were calculated. Serum lipid levels were analyzed by age and sex. For each serum lipid, we extracted age- and sex-specific group which the mean value was not statistically different from that in 1999 by Student's t -test analysis. Results: The level below the 75th percentile was defined to be acceptable, from the 75th to 95th to be borderline and over the 95th to be high in TC/LDLC. The level below the fifth percentile in HDLC was defined to be low and the level over the 95th percentile in TG to be high. Therefore, TC level was categorized as follows: acceptable < 190 mg/dL; borderline 190,219 mg/dL; and high > 220 mg/dL. The LDLC level was also categorized into: acceptable < 110 mg/dL; borderline 110,139 mg/dL; and high > 140 mg/dL. The cut-off value in TG was determined to be 140 mg/dL and in HDLC was 40 mg/dL. Conclusions: This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately. [source] A survey of folate knowledge and consumer behaviours in Western Australia prior to the introduction of mandatory food fortificationAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2009Caron Molster Abstract Objectives: Prior to the introduction of mandatory folic acid fortification in September 2009, this study collected baseline data on folate awareness, knowledge of pregnancy-relevant public health messages and consumer behaviours in Western Australia. Methods: One thousand residents aged 18 years or older participated in a cross sectional telephone survey in September 2006. Respondents were recruited randomly from the electronic residential telephone directory. Results: Most respondents reported knowing little or nothing about folate (86%). Women of childbearing age were more likely than other adults to know the association between folate intake and birth defects (82% v 56%) but 41% did not know that folate should be consumed periconceptionally to reduce the risk of spina bifida. Overall, half the respondents did not take supplements and two-thirds did not know if the food products they ate were fortified with folic acid. Associations were detected between knowledge, consumer behaviours and socio-economic indicators such as age, income, highest level of education, area of residence and parental status. Implications: A mix of public health strategies that includes mandatory fortification and the promotion of supplement use should improve the timely and sufficient intake of folate across all socio-economic strata of the Australian population. Strategies that support the introduction of mandatory fortification, such as awareness and education campaigns should be built on a solid understanding of the drivers and barriers to knowledge acquisition and desired consumer behaviours. [source] Periodontal disease and systemic health: current statusAUSTRALIAN DENTAL JOURNAL, Issue 2009MP Cullinan Abstract The relationship between poor oral health and systemic diseases has been increasingly recognized over the past two decades. Indeed, the clichés "You cannot have good general health without good oral health", "The mouth is part of the body" and "Floss or die", are gaining an increasing momentum. A large number of epidemiological studies have now linked poor oral health with cardiovascular diseases, poor glycaemic control in diabetics, low birthweight preterm babies and a variety of other conditions. The majority have shown an association, although not always strong. As a result, a number of meta-analyses have been conducted and have confirmed the associations and at the same time cautioned that further studies are required, particularly with regard to the effect of periodontal treatment in reducing risk. A number of biologically plausible mechanisms have been put forward to explain the association and there is accumulating evidence in support of them, although at this stage, insufficient to establish causality. Nevertheless, the relationship between poor oral health and systemic diseases has become a significant issue, such that adult oral health can no longer be ignored in overall health strategies. This review provides an update on current understanding of the contribution of poor oral health to systemic diseases, the possible mechanisms involved and the relevance of this for general dental practitioners. [source] LEARNING ISSUES FOR NURSES IN RENAL SATELLITE CENTRESAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2000Sally Wellard ABSTRACT: The introduction of ,satellite' dialysis centres has increased local access to renal services for patients living in rural and remote areas across Australia and is, therefore, consistent with rural health policies. Rural health strategies also aim to maintain and improve the skills of health professionals through regular review of the scope of their practice and evaluation of the education required. Yet, the results of the present national study of nurses working in satellite dialysis centres indicate that, for many, the context of practice influences their ability to access ongoing professional education to support and extend their nursing practice. The present study showed that there was a range of educational backgrounds among nurses working in rural ,satellite' centres with reportedly limited access to specific dialysis-related professional development. In the present paper we report on factors that influence the ability of nurses working in satellite dialysis centres to access ongoing professional education. [source] The evolution of human fatness and susceptibility to obesity: an ethological approachBIOLOGICAL REVIEWS, Issue 2 2006Jonathan C. K. Wells ABSTRACT Human susceptibility to obesity is an unusual phenomenon amongst animals. An evolutionary analysis, identifying factors favouring the capacity for fat deposition, may aid in the development of preventive public health strategies. This article considers the proximate causes, ontogeny, fitness value and evolutionary history of human fat deposition. Proximate causes include diet composition, physical activity level, feeding behaviour, endocrine and genetic factors, psychological traits, and exposure to broader environmental factors. Fat deposition peaks during late gestation and early infancy, and again during adolescence in females. As in other species, human fat stores not only buffer malnutrition, but also regulate reproduction and immune function, and are subject to sexual selection. Nevertheless, our characteristic ontogenetic pattern of fat deposition, along with relatively high fatness in adulthood, contrasts with the phenotype of other mammals occupying the tropical savannah environment in which hominids evolved. The increased value of energy stores in our species can be attributed to factors increasing either uncertainty in energy availability, or vulnerability to that uncertainty. Early hominid evolution was characterised by adaptation to a more seasonal environment, when selection would have favoured general thriftiness. The evolution of the large expensive brain in the genus Homo then favoured increased energy stores in the reproducing female, and in the offspring in early life. More recently, the introduction of agriculture has had three significant effects: exposure to regular famine; adaptation to a variety of local niches favouring population-specific adaptations; and the development of social hierarchies which predispose to differential exposure to environmental pressures. Thus, humans have persistently encountered greater energy stress than that experienced by their closest living relatives during recent evolution. The capacity to accumulate fat has therefore been a major adaptive feature of our species, but is now increasingly maladaptive in the modern environment where fluctuations in energy supply have been minimised, and productivity is dependent on mechanisation rather than physical effort. Alterations to the obesogenic environment are predicted to play a key role in reducing the prevalence of obesity. [source] Childhood deaths due to electrocution in Adana, TurkeyACTA PAEDIATRICA, Issue 3 2007R Akçan Abstract Aim: This retrospective study was conducted to determine the general features of childhood deaths due to electrocution, and draw the attention of community to these preventable deaths. Methods: The autopsy records of the Morgue of the Adana Branch of the Turkish Forensic Medicine Council were used. Thirty-seven cases of childhood (under 18) electrocution during the period 1999,2004 were analyzed. Results: Electrocution deaths comprised 0.8% of all the medico-legal autopsy cases (4515) during these 6 years. Thirty-one (83.8%) of the victims were male and only six (16.2%) were female. They were between 18 months and 18 years of age, and the mean age was 11.35, and all deaths were recorded as accidental. Conclusion: Medical units, and paramedical and educational centres should play important roles in formulating public health strategies to tackle preventable deaths such as electrocution. [source] Highlights of Papers in Clinical Investigations Section: Vascular Risk and Cognitive Impairment in an Older, British, African-Caribbean PopulationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2001R Steward In this study, 278 adults age 55 to 75 who were born in a Caribbean nation were interviewed and examined for cardiovascular risk factors and their association with cognitive impairment. Marked differences were found between groups with low and normal/high levels of education in the strength of associations between measures of vascular risk and cognitive impairment. However, physical activity was negatively associated with cognitive impairment. Physical exercise may be an important public health strategy in reducing the burden of cognitive impairment. [source] African countries propose a regional oral health strategy: The Dakar Report from 1998ORAL DISEASES, Issue 3 2004NG Myburgh It is clear that the African region faces a number of serious oral diseases, either because of their high prevalence or because of the severe tissue damage or death that can occur. Previous approaches to oral health in Africa have failed to recognise the epidemiological priorities of the region or to identify reliable and appropriate strategies to assess them. Efforts have consisted of an unplanned, ad hoc and spasmodic evolution of curative oral health services. This document focuses on the most severe oral problems that people have to live with like noma, oral cancer and the oral consequences of HIV/AIDS infection. It proposes a strategy for assisting member states and partners to identify priorities and interventions at various levels of the health system, particularly at the district level. The strategy aims at strengthening the capacity of countries to improve community oral health by effectively using proven interventions to address specific oral health needs. The strategy identifies five main ,programmatic areas', including (i) the development of national oral health strategies and implementation plans, (ii) integration of oral health in other programmes, (iii) delivery of effective and safe oral health services, (iv) regional approach to education and training for oral health, and (v) development of effective oral health management information systems. Many of the programmatic areas share similar characteristics described as a ,strategic orientation'. These strategic orientations give effect to the concepts of advocacy, equity, quality, partnership, operational research, communication and capacity building. The WHO Regional Committee for Africa (RC) is invited to review the proposed oral health strategy for the African region for the period 1999,2008 and provide an orientation for the improvement of oral health in member states in the region. [source] Progress in cancer screening practices in the United States,CANCER, Issue 6 2003Results from the 2000 National Health Interview Survey Abstract BACKGROUND Understanding differences in cancer screening among population groups in 2000 and successes or failures in reducing disparities over time among groups is important for planning a public health strategy to reduce or eliminate health disparities, a major goal of Healthy People 2010 national cancer screening objectives. In 2000, the new cancer control module added to the National Health Interview Survey (NHIS) collected more detailed information on cancer screening compared with previous surveys. METHODS Data from the 2000 NHIS and earlier surveys were analyzed to discern patterns and trends in cancer screening practices, including Pap tests, mammography, prostate specific antigen (PSA) screening, and colorectal screening. The data are reported for population subgroups that were defined by a number of demographic and socioeconomic characteristics. RESULTS Women who were least likely to have had a mammogram within the last 2 years were those with no usual source of health care (61%), women with no health insurance (67%), and women who immigrated to the United States within the last 10 years (61%). Results for Pap tests within the last 3 years were similar. Among both men and women, those least likely to have had a fecal occult blood test or endoscopy within the recommended screening interval had no usual source of care (14% for men and 18% for women), no health insurance (20% for men and 18% for women), or were recent immigrants (20% for men and 18% for women). An analysis of changes in test use since the 1987 survey indicates that the disparities are widening among groups with no usual source of care. CONCLUSIONS No striking improvements have been observed for the groups with greatest need. Although screening use for most groups has increased since 1987, major disparities remain. Some groups, notably individuals with no usual source of care and the uninsured are falling further behind; and, according to the 2000 data, recent immigrants also experience a significant gap in screening utilization. More attention is needed to overcome screening barriers for these groups if the population benefits of cancer screening are to be achieved. Cancer 2003;97:1528,40. Published 2003 by the American Cancer Society. DOI 10.1002/cncr.11208 [source] | ||||||||||