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Background: The advantages of patient-held portable health files (PHF) and personal health records (PHR), paper or electronic, are said to include improved health-care provider continuity-of-care and patient empowerment in maintaining health. Top-down approaches are favored by public sector government and health managers. Bottom-up approaches include systems developed directly by health-care providers, consumers and industry, implemented locally on devices carried by patient-consumers or shared via web-based portals. These allow individuals to access, manage and share their health information, and that of others for whom they are authorized, in a private, secure and confidential environment. Few medical record technologies have been evaluated in randomized trials to determine whether there are important clinical benefits of these interventions. The COMMUNICATE trial will assess the acceptability and long-term clinical outcomes of an electronic and paper patient-held PHF. Methods/Design: This is a 48-month, open-label pragmatic, superiority, parallel-group design randomized controlled trial. Subjects (n=792) will be randomized in a 1:1:1 ratio to each of the trial arms: the electronic PHF added to usual care, the paper PHF added to usual care and usual care alone (no PHF). Inclusion criteria include those 60 years or older living independently in the community, but who have two or more chronic medical conditions that require prescription medication and regular care by at least three medical practitioners (general and specialist care). The primary objective is whether use of a PHF compared to usual care reduces a combined endpoint of deaths, overnight hospitalizations and blindly adjudicated serious out-of-hospital events. All primary analyses will be undertaken masked to randomized arm allocation using intention-to-treat principles. Secondary outcomes include quality of life and health literacy improvements. Discussion: Lack of blinding creates potential for bias in trial conduct and ascertainment of clinical outcomes. Mechanisms are provided to reduce bias, including balanced study contact with all participants, a blinded adjudication committee determining which out-of-hospital events are serious and endpoints that are objective (overnight hospitalizations and mortality). The PRECIS tool provides a summary of the trial's design on the Pragmatic-Explanatory Continuum. Trial registration: Registered with Clinicaltrials.gov (identifier: NCT01082978) on 8 March 2010. [ABSTRACT FROM AUTHOR]

The humanitarian crisis precipitated by the ongoing conflict in Sudan poses profound risks to the health and welfare of the country's children. This paper explores essential policy interventions to safeguard child mental health services under these challenging circumstances. Crucial strategies include enhancing healthcare accessibility for children and their caregivers, promoting education, and improving household living conditions. Additionally, it is vital to provide improved access to information about nutritious food and strengthen health systems in areas directly exposed to conflict. Cooperation with international aid organizations is paramount to delivering medical supplies to functioning health facilities. The paper also recommends partnerships with local non-governmental and humanitarian organizations to execute public health programs effectively. These multi-faceted policy measures underscore the importance of a comprehensive response to ensure the health and well-being of children amid the turmoil in Sudan. Through these strategies, we aim to provide a blueprint for policymakers and humanitarian organizations to mitigate the devastating impacts of the conflict on the country's most vulnerable population. [ABSTRACT FROM AUTHOR]

Purpose: There are significant health inequalities experienced by women in prison. They face distinct challenges and have particular and complex needs, specifically with regard to their physical and mental health. The purpose of this paper is to describe the approach taken to develop a set of health and wellbeing standards for the women's prison estate in England, which can be applied elsewhere.Design/methodology/approach: A structured literature review of standard healthcare databases and grey literature was used to inform development of suggested standards. A multidisciplinary expert panel provided consensus on the standards through an online survey and women with a history of contact with the criminal justice system were consulted through consensus groups.Findings: A total of 549 papers were included in the final review. From this, 127 standards were identified for inclusion in the Delphi process. Consensus was achieved on all standards; this, combined with the analysis of qualitative feedback provided by both the survey and the consensus groups, resulted in the development of 6 overarching principles and 122 standards, across ten topic areas.Originality/value: These standards are the most extensive that are known to exist for health and wellbeing of women in prison and the first to be developed in England. The process used ensures the standards have high validity, acceptability and feasibility and can be used to support those developing similar methodologies. There are few papers which document the development of standards to improve health and to the authors knowledge, only one other paper has been published detailing the development of health standards in prison settings specifically. [ABSTRACT FROM AUTHOR]

This editorial discusses a collection of papers examining gender across a range of health policy and systems contexts, from access to services, governance, health financing, and human resources for health. The papers interrogate differing health issues and core health systems functions using a gender lens. Together they produce new knowledge on the multiple impacts of gender on health experiences and demonstrate the importance of gender analyses and gender sensitive interventions for promoting well-being and health systems strengthening. The findings from these papers collectively show how gender intersects with other axes of inequity within specific contexts to shape experiences of health and health seeking within households, communities and health systems; illustrate how gender power relations affect access to important resources; and demonstrate that gender norms, poverty and patriarchy interplay to limit women's choices and chances both within household interactions and within the health sector. Health systems researchers have a responsibility to promote the incorporation of gender analyses into their studies in order to inform more strategic, effective and equitable health systems interventions, programmes, and policies. Responding to gender inequitable systems, institutions, and services in this sector requires an 'all hands-on deck' approach. We cannot claim to take a 'people-centred approach' to health systems if the status quo continues. [ABSTRACT FROM AUTHOR]

In this paper, I will argue that a number of well-known health interventions or initiatives could be considered anarchist, or at the very least are consistent with anarchist thinking and principles. In doing this I have two aims: First, anarchism is a misunderstood term—by way of example, I hope to first sketch out what anarchist solutions in health and healthcare could look like; second, I hope to show how anarchist thought could stand as a means to improve the health of many, remedying health inequalities acting as a buffer for the many harms that threaten health and well-being. On this second point, I will argue that there are a number of theoretical and instrumental reasons why greater engagement with anarchism and anarchist thinking is needed, along with how this could contribute to health and in addressing broader injustices that create and perpetuate poor health. [ABSTRACT FROM AUTHOR]

The article reports on a White Paper on care outside of hospitals in England that will be published at the end of 2005 or early in 2006. The potential impact of the document is revealed. The document will be about community health and care services and it will be a combined health and social care paper. The consultation process by which the paper is being developed is deliberative involving regional and national events with the public entitled "Your Health Your Care Your Say."

Presents an editorial on public health. Description of a white paper called "Choosing Health: making healthy choices," that presents the English government's approach to tackling a broad range of public health challenges from smoking, obesity, and drinking to mental and sexual health; Need for several points to be considered in order for this approach to work; How the white paper fails to address the inequalities that purport to be the driving force behind it; Reluctance of the government to take its own medicine.

In public health there is increased focus on evaluating 'complex' interventions for health improvement, examining how their multiple components interact dynamically with the contextual system in which they are delivered. Amid this complexity framing are calls for methodologies that can facilitate contextual understanding as part of the evaluation process, including ethnography. However, while ethnography's attention to 'context' has been recognised as valuable for evaluation, few questions have been raised about the possible tensions of aligning what are quite different expectations for knowledge making in evaluation and in ethnography. This paper introduces a special section illustrating empirical examples of conducting ethnography for and with evaluation of 'complex' health interventions. Central to these experiences, this paper argues, are the concepts of time and temporality through which experience, change and knowledge making are invariably structured. It considers the different expectations for time and temporality in ethnographic and evaluation research, and how the 'long conversation' of ethnography aids interpretation of an intervention's interaction with the pasts, presents and possible futures of people's health experiences. Furthermore, in understanding time not as linear and constant but experienced through a series of encounters, ethnography highlights the spaces in between action and change, vital for understanding the complex dynamics of a health intervention in context. Through temporality, this paper and the related empirical papers present an intricate exploration of the challenges and productive opportunities posed by the use of ethnography for and with evaluation. [ABSTRACT FROM AUTHOR]

The article focuses on the White Paper on community care titled "Caring for People" in relation to the 1990 National Health Service and Community Care Bill pending in the House of Lords. Criticisms levelled against the White Paper, particularly the issue of grant aid, are misplaced. The White Paper's outstanding value is that it outlines a clear structure and a set of general principles which should grant local authorities greater autonomy, authority and responsibility in healthcare administration.

Purpose Comment on the contribution that housing can make to delivering better health and wellbeing outcomes. More specifically, the purpose of this paper is threefold: summarise recent evidence that makes the case for housing in helping to address health and social care issues; comment on the challenges and opportunities of partnership working; and describe examples of interesting and innovative local joint provision.Design/methodology/approach Draws on the author's briefing papers on housing, health and social care for housing quality network, which is a national housing consultancy organisation as well as the author's role as Chairperson of East Midlands Housing Care and Support, which is a regional housing association.Findings Collaboration between housing, health and social care is making slow progress at the national level in England. This is despite an ever-increasing evidence base highlighting that good housing can help to address issues, such as delayed discharges. Nevertheless, there are an increasing number of interesting examples of successful local initiatives on housing, health and adult social care. The way forward is to facilitate joint working at a local level.Originality/value Focusses on the success of examples of local joint working between housing, health and social care to achieve better outcomes for vulnerable people. [ABSTRACT FROM AUTHOR]

Discusses the World Health Organization Euro Office "Nursing in Action" six-year program which will be launched in 1992. Description of the first phase of the program which focused on multinational study on people's needs for nursing care; List of titles of the eight working documents in the Health for All Nursing series.

This paper compares two indices of horizontal inequity in the delivery of health care, the index proposed by Wagstaff, van Doorslaer, and Paci (1991), and another index derived in this paper. As well as discussing the computational aspects of these two indices, the paper also addresses the issue of statistical inference, comparing two estimators for the standard error of each index. The paper contains an empirical illustration of both sets of methods using data from the 1992 Dutch Health Interview Survey. [ABSTRACT FROM AUTHOR]

Background: The present research aims to identify the application of social media for marketing or communication purposes in healthcare. We studied the opinion of healthcare professionals, organizations and health consumers, trying to identify the current status, trends and beliefs. The research reveals that healthcare organizations have to move forward and engage with their customers. The health consumers are more mature than the health providers. The descriptive characteristics of the sample's responses collected during the survey are presented.Objective: The current research tries to identify the application of social media for marketing or communication purposes in healthcare in Greece. The scope of the paper is to investigate the status in Greece and compare it with other countries.Methods: We studied the opinion of healthcare professionals, organizations and health consumers, trying to identify the current status, trends and beliefs. We formed adequate questionnaires which were distributed to the different target groups, while for statistical analysis we performed tests (in order to investigate the dependence between certain respondents' categories) as well as one-way ANOVA analysis for inference purposes. In this context, the results can depict the (average) behavior, as well as the homogeneity of the corresponding general population.Results: The research conducted took into account the individualities of the Greek environment and revealed that both physicians and healthcare organizations have to move forward in order to engage with their customers. There is also a clear need to measure the effectiveness of any such media marketing effort. Most adopters are not yet-taking maximum advantage of the technology. Social networks are prevalent and several paradigms support their adoption for marketing purposes in the sensitive healthcare domain. Even though the expectations are ambitious, there is a lot of work to do in Greece in order to achieve the desired outcome. An important finding is that patients' attitudes are, in general, differentiated from those of healthcare professionals. Even though the results of the present paper can be generalized, according to the statistical analysis performed, further research would be warranted to cover all possible participants in the healthcare chain. It is clear that both physicians and healthcare organizations have to adopt social media marketing in their daily practice in order to meet the needs of their customers. The present paper advances the current state of knowledge, as there is not any prior study on this field in Greece. [ABSTRACT FROM AUTHOR]

The article presents comments to the article entitled "Measuring the Health of the U.S. Population," by David M. Cutler and Elizabeth Richardson. According to Theodore E. Keeler, the paper opens up a new way of looking at health in economic terms, both over time and across populations. He also thinks the use of the National Health Interview Survey Data to determine the effects of chronic illness on well-being is clever. According to Douglas Staiger, the authors are very clear about what is being measured. He also emphasizes the importance of the specifics of the health capital calculation.

Abstract This response to Edgar Dahls paper in this issue of Health Care Analysis clarifies my argument concerning sex selection and shows that our disagreement is less than he believes it is. [ABSTRACT FROM AUTHOR]

Ayurveda is India’s traditional system of medicine. around 80% population, especially using this system of medicine for their health care management. There are many issues and concerns over the usage of Ayurveda, They are simplified and try to deal in this paper. The methodology used to complete this review was through empirical research. This is a cross-sectional study where the use of Ayurveda utilized in this current period is examined. The sources are mostly from a doctor of Ayurvedic medicine and credible online sources. [ABSTRACT FROM AUTHOR]

Our paper analyses the technical efficiency and the change in the efficiency of the healthcare systems in 23 European Union (EU) countries between 2008 and 2016 based on the data published by OECD. We apply Dynamic Network Data Envelopment Analysis (DNDEA) to assess the efficiency of the medical care system and public health system, together with overall healthcare system efficiency. The findings suggest that the efficiency of public health systems in 2016 were higher than the efficiency of medical care systems in the same year only in Denmark. In the case of France, Hungary, Ireland, Lithuania, Poland, Portugal, Spain and the United Kingdom, the medical systems were more efficient. The model marked Austria, Czech Republic, Estonia, Finland, Germany, Greece, Italy, Latvia, Luxembourg, Netherlands, Slovak Republic, Slovenia and Sweden as efficient in terms of the medical care system as well as the public health system in 2016. [ABSTRACT FROM AUTHOR]

Addressing inequalities in health has featured strongly in UK health care policy over recent years, and efforts to consider inequalities at 'ground level' are increasingly evident. This includes enhancing primary care and other community-based services and emphasising consultation at community levels. The Healthy Living Approach to community development in Pembrokeshire, West Wales, was initiated and evaluated as part of the Welsh Assembly Government's Sustainable Health Action Research Programme (SHARP). As part of that programme an action research project was organised to respond to a context of funding and service delivery coloured by rural isolation, social exclusion and poor health. The project was adopted in three marginal communities and was evaluated using multiple methods to understand the effects of the initiative and how well it was seen to have worked. This paper reports on one aspect of that evaluation: focus groups with Project Steering Group members that examined the impact of the intervention from the perspective of those involved in the study's implementation. The paper highlights the perceived impact on community members and study organisers, the process of liaison between community and statutory body advisers and the appropriateness of the methodology. There was overwhelming support for the project and agreement that action research was the only feasible working methodology. The results offer insider views on the potential for 'healthy living' community interventions to enable communities to engage with locally defined health issues, but sets a note of caution about being able to achieve real and sustainable change. [ABSTRACT FROM AUTHOR]

The main purpose of this short paper is to provide reflections on the potential to operationalise the Theory of Social Quality within public health and also on its utility for both public health policy and practice. In addition, we outline the inter-relationships between the theory of social quality and other areas of social theory and social policy. We do not attempt to provide a wide ranging or in-depth critique of social quality as it applies across the board in public health. Rather, we wish to provide an outline of a public health programme (or set of integrated interventions) which is currently running in a location in the UK (called Fit for the Future), and show how the different domains inherent within social quality may be operationalised. The paper is organised around two central themes. Firstly, we outline the theory of social quality as it applies to public health policy and practice. This section provides the context for the rest of the paper, since it renders our understanding and interpretation of social quality both explicit and transparent. We also outline our understanding of how particular domains of the theory of social quality relate to areas of social theory and social policy. Secondly, we provide the background, rationale and setting for Fit for the Future (FFTF), in addition to providing details of the actual programme itself. Within this section, we also provide reflections on the inter-connectivity between the four domains within the theory of social quality and the over-arching philosophies and themes within FFTF. [ABSTRACT FROM AUTHOR]

Purpose - The pupose of this paper is to present an overview of the main conceptual and methodological issues that underlie our current understanding of benchmarking initiatives in the field of health. Design/methodology/approach - The paper is based on a pragmatic review of the literature and policy reports. It outlines some of the major conceptual problems associated with the use of benchmarking indicators and discusses how health policy research and practice is evolving to address the challenges raised, drawing examples from national and international benchmarking initiatives. Findings - Benchmarking has become an intrinsic part of most developed health care systems, yet the impact of benchmarking initiatives on improvements in system performance and their integration within existing policy processes still need to be elucidated. Several methodological challenges remain in the field of benchmarking, many of them related to the selection and quality of indicators used to make comparisons both within and between health care systems. Further research and applications are needed to ensure that benchmarking in health fulfils its objective, namely to further our understanding of where to focus policy efforts in order to improve the performance of health care systems. Originality/value - This paper poses the timely question of whether benchmarking initiatives are in fact guiding health policy towards the improvement of health care system performance. It draws from the policy literature and existing frameworks to offer an outline for the future evaluation of benchmarking initiatives by policy-makers. [ABSTRACT FROM AUTHOR]

The policy imperative to increase public participation in health and social care research, planning and service delivery raises significant questions about optimum approaches, methods and the extent to which this policy can influence change in practice. This paper highlights the key policy literature on user involvement and participatory research methods to establish the context for a partnership research project exploring perceptions of risk in relation to falls from the perspectives of older people, carers, and health and social care professionals. The paper reports the methods used in developing user involvement in the research at a number of levels, including project management, and a consumer panel working alongside the research team and influencing the dissemination in local falls prevention strategies. The authors draw out the issues related to the context and method of involvement, and discuss the impact on research quality and local service development in health and social care. [ABSTRACT FROM AUTHOR]

This position paper arises as a result of the 2000 OPHA position paper "Improving the Access to and Quality of Public Health Services for Lesbian and Gay Men" submitted by the Public Health Alliance for LGBTIQ Equity workgroup. In that paper, the authors note that they are unable to adequately represent the issues of bisexual people and in order to respect the differences between gay men, lesbians and bisexuals they include a resolution that the OPHA support the development of a community based research project and position paper specifically focussing on issues of accessibility and health services needs for bisexuals. Existing research and literature on bisexuality and health has focussed primarily on two topics: HIV/AIDS and mental health, therapy or counselling. Those wishing to find information on other aspects of bisexual health and wellness must sort through the sea of research and writing on gay, lesbian and bisexual health to try to find any bits and pieces that specifically address bisexuals. Even in research where bisexuals are included they are usually not adequately represented and not looked at separately. Although sharing some common concerns with both gay/lesbian and heterosexual persons, bisexuals also have specific experiences and needs regarding health and wellness that need to be researched and addressed. This paper outlines a wide range of these specific experiences and needs based on the results of a community consultation that was undertaken with bisexual communities and individuals in Ontario, in conjunction with the relevant literature. This is a community based participatory action research (PAR) project, which means it is designed for education and action, to work with and empower the people and communities involved in the project. The goal is to improve the access to and quality of public health services for bisexuals by gathering information from bisexuals themselves about their health and wellness needs and experiences, existing gaps in health care services, as well as the barriers they face with regard to meeting these needs and obtaining appropriate services and support. Between January-March 2003, 5 focus groups (4 in Toronto and 1 in Ottawa) and 43 individual semi-structured interviews were conducted for a total of 62 participants from across Ontario. People identifying as bisexual as well as those who have sex with both men and women but don't necessarily identify as bisexual were invited to participate in this project. The first section of the community consultation results addresses the social context of bisexual lives including unique issues facing bisexuals, relationships, social support, LGBT and bisexual community involvement, and specific issues for older bisexuals, youth, bisexuals of diverse cultures and trans people. The second section focuses on health and wellness issues such as disclosure to health care providers, experiences using services (including LBGT services), barriers to care and suggestions for change. The paper concludes with recommendations for action in the areas of additional research, service and program development designed to include bisexuals, public education, and education for providers on the diversity, complexity and wholeness of bisexual people as well as resources and referrals pertaining to bisexuality. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although measures of sensitivity to inequality are important in judging the welfare effects of health-care programmes, it is far from straightforward how to elicit them and apply them in health-care decision-making. This paper provides an overview of the literature on the measurement of inequality aversion, examines some of the features specific of the health domain that depart from the income domain, and discusses its implementation in health-system priority-setting decisions. We find evidence that individuals exhibit a preference for more equitable health distribution, but inequality aversion estimates from the literature are unclear. Unlike the income-inequality literature, standard approaches in the health economics do not follow a 'veil-of-ignorance' approach and elicit mostly bivariate (income-related health) inequality aversion estimates. We suggest some ideas to reduce the disconnect between the income inequality and health economics literature. [ABSTRACT FROM AUTHOR]

The objective of this work is to argue that the decentralization of health services for the uninsured population in Mexico has not yielded the expected results. By analyzing the evolution of some indicators constructed from INEGI and Ministry of Health databases, we conclude that the current government's effort to recentralize health services to the uninsured population in Insabi is justified. However, the contradiction between the declared objectives and the financial effort made is evident, which makes a fiscal reform unavoidable. In the last part, we show the feasibility of this reform in the current economic context and outline its main characteristics, which will be specified in a future paper. [ABSTRACT FROM AUTHOR]

Background To date the healthcare experiences of gender diverse Australians have received little attention. Previous international research indicates a range of both negative and positive healthcare experiences amongst this diverse population, with negative experiences being those most frequently reported. Method An online survey was designed to examine the healthcare experiences of gender diverse Australians. The survey included Likert scales asking participants to rate their mental and physical health, and their experiences with psychiatrists, general practitioners and surgeons (in terms of perceived comfort, discrimination and information provision). Open-ended questions provided the opportunity for participants to further elaborate on their experiences. Data were collected between June 2012 and July 2013. Quantitative data analysis was conducted utilising SPSS 17.0, including ANCOVAs and correlations to examine the relationships between variables. Qualitative data were coded by the authors in terms of negative or positive responses and the validity of ratings were assessed utilising Cohen's kappa. Results 110 people assigned male at birth (MAAB) and 78 people assigned female at birth (FAAB) completed two separate surveys. All identified as gender diverse as defined in this paper. 70% of participants had accessed a psychiatrist. Participants MAAB rated their experiences with psychiatrists more highly than participants FAAB. 80% of participants had accessed a general practitioner. Comfort with, and respect from, general practitioners were both positively correlated with mental health, whilst discrimination was negatively correlated with mental health. 42.5% of participants had undertaken sex-affirming surgery. Those who had such surgery reported higher levels of physical and mental health than those who had not undertaken surgery. Participants MAAB reported more positive experiences of surgery than did participants FAAB. Conclusions Findings highlight the need for increased education of medical practitioners in regards to engaging with gender diverse clients. [ABSTRACT FROM AUTHOR]

Copyright of Research Papers of the Wroclaw University of Economics / Prace Naukowe Uniwersytetu Ekonomicznego we Wroclawiu is the property of Uniwersytet Ekonomiczny we Wroclawiu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article explores the historical relationship between health and location in the United States, with a focus on urban areas. It discusses four books that delve into the impact of health care practices and policies on various communities throughout American history. The books emphasize the importance of considering cultural traditions and addressing disparities in health care delivery. The article also examines specific case studies, such as maternal and child health care programs in New York City and the development of culturally sensitive clinics in Miami. Overall, the article underscores the need for a nuanced approach to health care that takes into account the diverse perspectives and needs of different communities. [Extracted from the article]

The ideal future state of health for the world's populations requires a cohesive model that considers the synergistic roles of communities, public health and healthcare. This future state reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing. This is the definition of Integrative Medicine. We are far from this idealistic future. Healthcare costs continue to escalate while life expectancy declines. We train our future healthcare professionals in our current disease-based model that prioritizes siloed pharmaceutical and interventional approaches over whole person prevention focused care. As healthcare professionals, we disregard our capacity to influence the leading risk factors for disease-related death and disability which include health behaviors, social, economic and environmental drivers. Burnout is high and rising. Rapid shifts are expected in the coming years as the current system's cost becomes untenable. We need a sustainable future for healthcare. That means we must figure out how to re-center on the patient, on a full spectrum of prevention and treatment, and how to influence public and community health. The future model must focus on health behaviors at its foundation, use systems thinking, be environmentally sustainable, and approach health from a population lens. The future will require an ability to consider complex systems approaches to health and wellbeing that include a focus on both the patient and the healthcare team. Research strategies must not only consider effectiveness but also reach, implementation and institutionalization in a multi-dimensional capacity that looks at whole person health as an outcome while looking at individuals in the context of where they live and work. The Integrative Medicine community has an opportunity to help lead the way to a sustainable and health focused future. [ABSTRACT FROM AUTHOR]

The Chongqing Bureau of Public Health, established shortly after the Nationalists relocated to the wartime capital, faced frequent air raids, rampant inflation, and acute personnel shortages. Still it accomplished an astonishing amount of work, demonstrating its commitment to public health as a barometer of modernity, national stability, and political fitness. The Bureau also treated male and female bodies differently, institutionalizing gender roles through its public health administration. This paper illustrates differences between medical care for men and women, arguing that Chongqing health officials' myopic focus on maternal issues when discussing women's healthcare, their failure to address highly skewed gender ratios in the patient reports and vaccination statistics that their office received on a monthly basis, and the relatively late opening of the city's most substantial maternal health facilities, all point to malecentric priorities within the administration. Military health took priority not only because of the war, but because soldiers' health conditions and facilities were so appallingly dismal. Thus, wartime health conditions reveal the continued haunting of modem Chinas great specter, the "Sick Man of East Asia," and two types of disease in the wartime capital: the Nationalist state, politically diseased, failed to protect its civilians and soldiers from common diseases. [ABSTRACT FROM AUTHOR]

This paper charts analytic and conceptual debates on the burden of hypertension among Africans and the interlocking role of diet and genetic factors. The discussions in this paper are about (indigenous) rather than (white) Africans. In trying to show understanding in the issues raised within this paper, the debate highlights the increasing burden of hypertension in Africans. The paper also mentions the role of adverse factors over the life course on hypertension, which is described in public health literature as a widespread burden. It also mentions that there appears to be an increasing prevalence of high blood pressure among Africans explained by widespread nutrition transitions to lipid-rich diets and a decrease in physical activity; as a result, hypertension has become a ubiquitous cause of morbidity and contributor to mortality among Africans. While these issues are acknowledged, the authors argue that it is not enough to think that persuading and encouraging poorer households to purchase ‘cheap’ and less fatty foods will address nutritional problems. It is one thing making food available and it is another putting the food basket on the table. Both conditions require negotiations of complex political, social, economic, cultural and environmental hurdles. What is needed is reorienting existing health care systems to meet these challenges while empowering and saturating African populations and households with systematic but intense health information, education and communication. [ABSTRACT FROM PUBLISHER]

Cross-national ranking and rating of public services does not always provide the conditions for effective cross-national learning, because such learning requires causal understanding of the mechanisms underlying ranking scores. That causal understanding means grappling with the production functions involved in public services, and it is particularly difficult for organizations or policy domains where processes are more readily measurable than outcomes relative to goals. Health is to a large extent a policy domain of that type, which makes effective ranking and comparison difficult and also presents a particular challenge for cross-national learning. Numerous attempts have been made to compare the efficiency of different health care systems, and though there is a certain logic about such approaches to ranking and rating, this paper argues that much can be learnt for health policy using life expectancy as the basis for ranking and comparison. [ABSTRACT FROM AUTHOR]

Objective. To summarize findings from a systematic exploration of existing literature and views regarding interdisciplinarity, to discuss themes and components of such work, and to propose a theoretically based definition of interdisciplinary research. Data Sources/Study Setting. Two major data sources were used: interviews with researchers from various disciplines, and a systematic review of the education, business, and health care literature from January 1980 through January 2005. Study Design. Systematic review of literature, one-on-one interviews, field test (survey). Data Collection/Extraction Methods. We reviewed 14 definitions of interdisciplinarity, the characteristics of 42 interdisciplinary research publications from multiple fields of study, and 14 researcher interviews to arrive at a preliminary definition of interdisciplinary research. That definition was then field tested by 12 individuals with interdisciplinary research experience, and their responses incorporated into the definition of interdisciplinary research proposed in this paper. Principal Findings. Three key definitional characteristics were identified: the qualitative mode of research (and its theoretical underpinnings), existence of a continuum of synthesis among disciplines, and the desired outcome of the interdisciplinary research. Conclusion. Existing literature from several fields did not provide a definition for interdisciplinary research of sufficient specificity to facilitate activities such as identification of the competencies, structure, and resources needed for health care and health policy research. This analysis led to the proposed definition, which is designed to aid decision makers in funding agencies/program committees and researchers to identify and take full advantage the interdisciplinary approach, and to serve as a basis for competency-based formalized training to provide researchers with interdisciplinary skills. [ABSTRACT FROM AUTHOR]

Many initiatives have been taken in European countries that are designed to reduce inequalities in health. However, the effects of only a very few of these initiatives have been assessed. The main aim of a Dutch research and development programme was to systematically investigate and evaluate interventions aimed at reducing inequalities in health. In this paper, we report on this investigation, and draw lessons from the methodology used to evaluate such interventions. Approach: The programme included 12 evaluation studies, focusing on the wider determinants of inequalities in health (n = 2), behavioural determinants (n = 4), working conditions (n = 3) and health care (n = 3). Results: An experimental design was applied in two evaluation studies. The studies provided evidence of a positive effect. A quasi-experimental design appeared to be the only attainable option in seven studies. Five of these provided sufficient evidence for a positive effect, but two interventions appeared not to be successful. In three studies, no experimental or quasi-experimental design could be applied. Conclusions: The programme showed that it is possible to apply experimental or quasi-experimental studies to complex public health interventions. The Programme Committee steering the programme considered that the evidence generated by the experimental and quasi-experimental studies justified the implementation of the interventions on a wider scale, accompanied by further evaluation studies. Further development of the methodology of public health interventions is necessary. These include non-experimental designs such as international comparisons and time trend studies, especially in order to be able to evaluate broader policy measures. [ABSTRACT FROM AUTHOR]

The article presents a paper on primary healthcare in Hongkong. The objective of the paper is to demonstrate how primary healthcare is implemented in the country by showing the importance of primary healthcare, the usual obstacles that students encounter when learning about primary healthcare, and the necessity of adopting a primary healthcare approach. It is the paper's assessment that Hongkong gives greater weight to curative rather than the preventive aspect of healthcare. Thus, the paper advocates a more proactive and preventive healthcare approach. The paper credits the leadership elected in 2005 for adopting a democratic and citizen-based approach to the implementation of healthcare policy.

This paper proposes a new framework for describing well-being and hardship among low-income families. We describe previously unmeasured costs of being poor as latent, those costs that are hidden and not counted in other poverty measures, and sequential, those costs that are consequential and have subsequent cost implications. Using data from in-depth interviews with cash assistance recipients and working poor heads of household, we explore latent and sequential costs of poverty related to health. Families experience a wide variety of latent and sequential costs associated with their dental, vision, and general health needs. [ABSTRACT FROM AUTHOR]

The paper shows how policies aimed at confronting HIV/AIDS in sub-Saharan Africa have shifted over the past 10 years. Initially, the focus was on prevention. Anti-retroviral treatments (ARVs), which could prolong the lives of people living with HIV and AIDS, were considered too expensive for the African poor. In 2000, following global campaigns to lower the prices of ARVs, and concern about the political instability caused by AIDS in Africa, policies started focusing on access to treatment. Cost-effectiveness arguments played a key role in the formulation and implementation of the prevention policies, while human rights and equity considerations drive the current treatment programmes. Though different in policy content, the prevention and treatment policies have in common that they pay little attention to the socio-cultural realities in sub-Saharan Africa that ultimately determine their success. Based on illustrative case material from Uganda, the paper calls for more research on and understanding of the successes and failures of prevention and treatment programmes. Such understanding can help adapt global policies to local realities. [ABSTRACT FROM AUTHOR]

This paper compares health systems in the US and the UK in relation to levels and types of finance and provision. The main part of the paper focuses on comparisons between the British National Health Service (NHS) and Kaiser Permanente in California. Although major differences in financing and provision make cross-national comparisons between the US and the UK difficult, recent work comparing service utilization between the NHS and Kaiser Permanente has highlighted opportunities for learning between the two systems. The paper describes the results of this work, and the way in which the NHS has sought to apply and adapt some of the managed care techniques used in Kaiser Permanente. It concludes by identifying the cultural and other obstacles that have to be addressed in translating practices from one system to another. [ABSTRACT FROM AUTHOR]

The article presents information about various studies related to health care. "Messy Details" reports that technical work in health-care presents tensions between the universal cognitive works. "Technical Work in Healthcare" covers a wide range of topics, use different methods of investigation, pursue different lines of inquiry and yield different sorts of insights. The papers show some of the many ways that human factors researchers can study technical work in healthcare.

The World Health Organization have stressed the importance of nurses and midwives as a “force for health” in society's efforts to tackle the public health challenges of our time. The public health challenges are both diverse and complex. Principally, they emanate from a social model of health that takes cognizance of our behavior, our environment, and the historical, political, and cultural structures that facilitate health or militate against it. This paper provides a critical overview of public health nursing in Ireland, toward situating both our contribution to public health and some of the challenges that lie ahead of us. Specifically, it looks at nonquantifiable practice, where, through the presentation of stories, the wealth of public health nursing work is demonstrated in the ordinary voices of public health nurses. The potential risk of ignoring and minimizing the contribution of public health nursing in future developments in primary care in Ireland is discussed. Finally, it is proposed that public health nurses need to get political. [ABSTRACT FROM AUTHOR]

The Commission on Macroeconomics and Health recommended a significant expansion in funding for health interventions in poor countries. However, there are a range of constraints to expanding access to health services: as well as an absolute lack of resources, access to health interventions is hindered by problems of demand, weak service delivery systems, policies at the health and cross-sectoral levels, and constraints related to governance, corruption and geography. This special issue is devoted to analysis of the nature and intensity of these constraints, and how they can best be overcome. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]