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Public Health Services (public + health_services)
Selected AbstractsChildhood negative experiences and subclinical psychosis in adolescence: a longitudinal general population studyEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2007Ellen De Loore Abstract Background:, Accumulating evidence suggests that experiences of trauma and victimization during childhood are associated with an increased risk to develop clinical and subclinical psychosis in adulthood. A recent cross-sectional study showed a significant association between trauma and psychotic experiences in adolescents. The current study aimed to extend these findings by investigating the longitudinal effects of negative life experiences on the risk for subclinical psychotic symptoms 2 years later in an adolescent general community sample. Methods:, Data were derived from the standard health screenings of the Youth Health Care Divisions of the Public Health Services, in the South of the Netherlands. A total of 1129 adolescents filled out a self-report questionnaire at age 13/14 years and 2 years later (15/16 years), assessing psychotic experiences, as well as experiences of being bullied, sexual trauma, and negative life events. Results:, Logistic regression analyses revealed that sexual trauma increased the risk for psychotic symptoms 2 years later. Life events contributed to the risk for psychosis over time and psychosis in turn gave rise to new life events. No significant association with bullying was found after controlling for confounders. Conclusion:, The results provide further evidence for an association between childhood environment and psychosis in the crucial developmental period of early adolescence. Early and later psychological stress, if severe, may impact on the risk for psychosis in adolescence through mechanisms of person,environment interaction and correlation. [source] Improving Dental Public Health Services through Advancement of a Workforce AgendaJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2006Robert J. Weyant DMD No abstract is available for this article. [source] The Provision of Public Health Services in the Emergency Department: "Begin with the End in Mind"ACADEMIC EMERGENCY MEDICINE, Issue 2 2008Gary M. Gaddis MD No abstract is available for this article. [source] Childhood leukaemia: experiences of children and attitudes of parents on dental careEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2008Ç.E. ÇUBUKÇU phd Parental perceptions in the importance of dental care and preferences with regard to its provision while profiling the level of dental health knowledge of parents of leukaemic children were elicited. The setting was the Paediatric Dental Care Unit located in Medical Faculty. Data were collected by means of a structured interview, employing a questionnaire. Level of knowledge on both dental facts and preventive dentistry of the participants was insufficient. Major source of dental care was the resident paediatric dentist both in prior to (78.2%) and following (100%) diagnosis. Tooth extraction (17.6%) was the only treatment provided prior to diagnosis. Following diagnosis, 60 (69%) of these children had received operative dental treatment. The source of preventive advice was inconsistent. Parents appeared to place a high level of importance on their children's dental care and the preference for this to be provided within the hospitals in which the child has been treated. There is clearly a need to establish dental care units in hospitals in which treatment of childhood malignancy is provided. The provision for the future should be the continuous education of dentists, physicians and nurses who work in hospitals and public health services. [source] District health systems in a neoliberal world: a review of five key policy areas,INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue S1 2003Malcolm Segall Abstract District health systems, comprising primary health care and first referral hospitals, are key to the delivery of basic health services in developing countries. They should be prioritized in resource allocation and in the building of management and service capacity. The relegation in the World Health Report 2000 of primary health care to a ,second generation' reform,to be superseded by third generation reforms with a market orientation,flows from an analysis that is historically flawed and ideologically biased. Primary health care has struggled against economic crisis and adjustment and a neoliberal ideology often averse to its principles. To ascribe failures of primary health care to a weakness in policy design, when the political economy has starved it of resources, is to blame the victim. Improvement in the working and living conditions of health workers is a precondition for the effective delivery of public health services. A multidimensional programme of health worker rehabilitation should be developed as the foundation for health service recovery. District health systems can and should be financed (at least mainly) from public funds. Although in certain situations user fees have improved the quality and increased the utilization of primary care services, direct charges deter health care use by the poor and can result in further impoverishment. Direct user fees should be replaced progressively by increased public finance and, where possible, by prepayment schemes based on principles of social health insurance with public subsidization. Priority setting should be driven mainly by the objective to achieve equity in health and wellbeing outcomes. Cost effectiveness should enter into the selection of treatments for people (productive efficiency), but not into the selection of people for treatment (allocative efficiency). Decentralization is likely to be advantageous in most health systems, although the exact form(s) should be selected with care and implementation should be phased in after adequate preparation. The public health service should usually play the lead provider role in district health systems, but non-government providers can be contracted if needed. There is little or no evidence to support proactive privatization, marketization or provider competition. Democratization of political and popular involvement in health enhances the benefits of decentralization and community participation. Integrated district health systems are the means by which specific health programmes can best be delivered in the context of overall health care needs. International assistance should address communicable disease control priorities in ways that strengthen local health systems and do not undermine them. The Global Fund to Fight AIDS, Tuberculosis and Malaria should not repeat the mistakes of the mass compaigns of past decades. In particular, it should not set programme targets that are driven by an international agenda and which are achievable only at the cost of an adverse impact on sustainable health systems. Above all the targets must not retard the development of the district health systems so badly needed by the rural poor. Copyright © 2003 John Wiley & Sons, Ltd. [source] Vasectomy within the public health services in Campinas, São Paulo, BrazilINTERNATIONAL NURSING REVIEW, Issue 2 2010N.M. Marchi rn MARCHI N.M., DE ALVARENGA A.T., OSIS M.J.D., DE AGUIAR GODOY H.M., SIMÕES E SILVA DOMENI M.F. & BAHAMONDES L. (2010) Vasectomy within the public health services in Campinas, São Paulo, Brazil. International Nursing Review57, 254,259 Objective:, To describe some of the characteristics of men who underwent a vasectomy in the public health network of Campinas, São Paulo, Brazil. Methods:, A descriptive study including 202 men randomly selected from a list of all the men vasectomized between 1998 and 2004 in the public health network. Results:, Most of the men were 30 years of age or older when vasectomized, had completed elementary school and had two or more children of both sexes. Most of the men came from the lowest income segment of the population: 47.6% in 1998,1999 and 61.3% in 2003,2004. Although the men knew various contraceptive methods, 51.2% reported that their partners were using combined oral contraceptives at the time of surgery. Most men initially sought information on vasectomy at health-care clinics where care was provided by a multidisciplinary team; most received counselling, however, 47.9% of the men waited more than 4 months for the vasectomy. Conclusions:, The profile of the vasectomized men in this study appears to indicate that the low-income population from Campinas, São Paulo, Brazil has access to vasectomy; however, the waiting time for vasectomy reveals that difficulties exist in obtaining this contraceptive method in the public health service. [source] Catastrophic payments for health care among households in urban Tamil Nadu, IndiaJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 2 2009Salem Deenadayalan Vaishnavi Abstract Urban residents in India face important health problems due to unhygienic conditions, excessive crowding and lack of proper sanitation. The private sector has started occupying the centre stage of the health system and households are burdened with increasing levels of health expenditure. This paper aims to study out-of-pocket expenditure (OOPE) and the extent of catastrophic payments for health care among households in a highly urbanised state, Tamil Nadu. The study used data on morbidity and health care for the year 2004 collected by the National Sample Survey Organization, India. Care was sought for 84 per cent of illness episodes in urban areas, and the majority used private sector providers (67 per cent for inpatients and 78 per cent for outpatients). Mean OOPE for inpatients and outpatients was higher for households with higher income. The average cost burden per visit was higher among those who sought care from private providers for inpatient services (29 per cent of household consumption expenditure) and outpatient services (20% of household consumption expenditure) compared with the burden associated with public health service use (3,4 per cent of consumption expenditure). About 60 per cent of households which used private health services faced catastrophic payments at the 10 per cent threshold level. To avoid catastrophic expenditure, greater use of the public sector which is providing services at an affordable cost is needed. Improving access to public health services, better gate-keeping systems, stronger controls on drug prices and increasing the quality of services are required to reduce the incidence of catastrophic expenditure both on inpatients and outpatients. Greater use of risk pooling mechanisms would encourage the poor to seek health care and also to protect households from all socio-economic groups from catastrophic expenditure. Copyright © 2009 John Wiley & Sons, Ltd. [source] Factors influencing parental decision to consult for children with upper respiratory tract infectionJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2008Chirk-Jenn Ng Aim: This study aimed to determine which factors could influence (i) parents' decision to seek medical consultatin and (ii) their preference for either public or private medical service in children with upper respiratory tract infection. Methods: This cross-sectional study was conducted at the Gombak district, which is an urban area in Malaysia. We randomly selected parents of kindergarten children aged 4,5 years to participate in this questionnaire survey. The main outcome measures were predictors of early medical consultation and type of service utilisation (public versus private). Results: We achieved a response rate of 84.5% (n = 1033/1223). 64.1% sought early medical consultation and 70.9% preferred to consult a private doctor. Early consultation was predicated by the parent gender being male (OR 1.50; 95% CI 1.09, 2.05), non-Chinese (OR 1.75%; 95% CI 1.10, 2.79), and those who preferred child specialists (OR 2.02; 95% CI 1.27, 3.23). Lower income group (OR 4.28; 95% CI 2.30, 7.95) and not having a regular doctor (OR 4.99%; 95% CI 3.19, 7.80) were predictors of using the public health services. Conclusions: Parent's gender, ethnicity and income influenced their decision to seek early medical consultation for their children's respiratory illness while income and having a regular doctor could predict their choice of healthcare services. [source] Will Subsidising Private Health Insurance Help the Public Health System?THE ECONOMIC RECORD, Issue 242 2002Rhema Vaithianathan This paper challenges the argument that expanding private health insurance coverage in Australia will reduce the demand for public hospitals. We construct a simple model to illustrate that although a premium subsidy might expand insurance coverage, it may not reduce the demand for public health services. The reason is that, under certain conditions, government subsidies only increase insurance coverage among self,insured consumers; that is, consumers who are uninsured but purchase private health care if they fall ill. We argue that subsidising private health care rather than insurance is a more effective way of reducing the demand for public health services. [source] General health in Timor-Leste: self-assessed health in a large household surveyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2009Jaya Earnest Abstract Objective: Timor-Leste is one of the world's newest nations and became a democracy in 2002. Ranked 150 out of 177 in the 2007 UNDP Human Development Index, the country has the worst health indicators in the Asia-Pacific region. The objective of this study was to collect and analyse data on subjectively assessed general health, health service use, migration and mobility patterns. Methods: The data collection involved recording self-reported status of general health using a structured questionnaire. The survey was administered to 1,213 Timorese households in six districts using a multi-stage random cluster sampling procedure. Basic descriptive statistical analyses were performed on all variables with SPSS version 13. Results: More than a quarter (27%) of respondents reported a health problem at the time of the survey. Only approximately half of respondents assessed their health to be good (53%) or average (38%). Barriers reported in the uptake of healthcare services were no felt needed; difficulty in accessing services and unavailability of service. Conclusions: Results reveal that Timor-Leste needs a more decentralised provision of healthcare through primary healthcare centres or integrated health services. Trained traditional healers, who are familiar with the difficult terrain and understand cultural contexts and barriers, can be used to improve uptake of public health services. An adult literacy and community health education program is needed to further improve the extremely poor health indicators in the country. Implications: Key lessons that emerged were the importance of understanding cultural mechanisms in areas of protracted conflict and the need for integrated health services in communities. [source] Facilitating effective health promotion practice in a public health unit: lessons from the fieldAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2007Jessica Berentson-Shaw Objectives: Health promotion is a core function of public health services and improving the effectiveness of health promotion services is an essential part of public health service development. This report describes the rationale, the process and the outcomes of a realignment designed to improve the effectiveness of health promotion activities in a public health unit (PHU) in New Zealand. Methods: A practice environment analysis revealed several factors that were hindering the effectiveness of the health promotion unit's (HPU) activities. Two primary change mechanisms were implemented. The first was an outcomes-focused model of planning and service delivery (to support evidenced-based practice), the second was the reorganisation of the HPU from a topicsbased structure to an integrated one based on a multi-risk factor paradigm of population health. Results: During the realignment barriers were encountered on multiple levels. At the individual level, unfavourable attitudes to changes occurred because of a lack of information and knowledge about the benefits of evidence and research. At higher levels, barriers included resourcing concerns, a lack of organisational commitment and understanding, and tensions between the political need for expedient change and research and development need for timely consideration of the impact of different models of practice. Conclusions and Implications: This realignment took place within the context of a changing public health environment, which is significantly altering the delivery of public health and health promotion. Realignments designed to facilitate more effective health promotion and public health practice will continue, but need to do so in the light of others' experience and debate. [source] The Australian Health Care Agreement 1998,2003: Implications and strategic directions for occupational therapistsAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2000Susan Brandis Funding for public health services in Australia is provided to the States and Territories from the Commonwealth. Contractual obligations for how these monies are allocated are detailed in the Australian Health Care Agreement 1998,2003, which has replaced the Medicare Agreement 1993,1998. Key issues identified in the new Agreement, which will impact on occupational therapy services, include arrangements for mental health services, palliative care initiatives, casemix, health system reform, and private health insurance. Particular implications stem from the proposed reforms to the health system. These include the quality agenda, outcome-based funding and evidence-based practice. Other themes identified include future opportunities for occupational therapists working in health services and the imperative to form collaborative partnerships with consumers and other health care providers. The Australian Health Care Agreement is analysed and suggestions given for strategic directions for occupational therapists to consider. [source] CULTURAL CIRCUMCISION IN EU PUBLIC HOSPITALS , AN ETHICAL DISCUSSIONBIOETHICS, Issue 8 2009MARGHERITA BRUSA ABSTRACT The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system. We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation. From the unique structure of patient-medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian argument that finds hospital-based circumcision safer than non-medicalized alternatives. The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation. [source] Coverage of recommended vaccines in children at 7,8 years of age in Flanders, BelgiumACTA PAEDIATRICA, Issue 8 2009Heidi Theeten Abstract Aim:, Evaluation of the coverage of primary diphtheria-tetanus-pertussis (DTP), poliomyelitis, hepatitis B (HBV) and measles-mumps-rubella (MMR) vaccine doses recommended before the age of 18 months in 7-year-old school children in Flanders, Belgium. Meningococcal serogroup C and DT-polio vaccines offered respectively as catch-up and booster vaccinations were also evaluated. Methods:, Parents of 792 children born in Flanders in 1997 and selected by cluster sampling were interviewed at home in 2005. Vaccination data since infancy were collected retrospectively from vaccination documents and school health records. Results:, Coverage rates were 88.0% for the first dose of MMR, and 72.0%, 84.2% and 91.4% for the recommended HBV, DTP and poliomyelitis primary vaccine doses, respectively. These rates included catch-up of missed infant MMR (4.9%) and HBV (6.4%) vaccinations. In addition, 88.3% of the target group received the DT-polio booster dose recommended at 6 years of age and 83.1% a meningococcal C vaccine dose. Preventive public health services as well as private physicians were involved to a varying extent. A lower socioeconomic status of the family was associated with a higher risk of nonvaccination. Conclusion:, Vaccinators in Flanders reach children relatively well during infancy and at school age, but catch-up of missed infant vaccine doses, especially MMR, should be optimized. [source] | |||||||||||||