Journal of Public Health Research (PAGEPress Publications)
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Medically assisted procreation and fast-moving developments in science and law: ethical and legal issues in heterologous procreation in Italy
Get PDFIn Italy, a law on Medically Assisted Procreation was passed in 2004. In 2014 the Constitutional Court declared section 4 para. 3 of this Law to be unconstitutional in the part where it prohibits couples from accessing heterologous medically assisted procreation techniques if a condition which causes complete, irreversible sterility or infertility has been diagnosed. The fast-moving developments in science and law, and the deep implications that the application of new techniques − which involve in the context of procreation a third person − can have in terms of protection of health and not only, makes it appropriate to keep under review this area, taking into account the pronouncements of the European Court of Human Rights and regulations in European countries
Public health and health promotion capacity at national and regional level: a review of conceptual frameworks
Get PDFThe concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising them into a new framework. The framework proposed in this paper can act as a theoretical guide for academic researchers and institutions to set up their own public health capacity assessment
Polychlorinated biphenyls in residential soils and their health risk and hazard in an industrial city in India
Get PDFBackground. Polychlorinated biphenyls (PCBs) have never been produced in India, but were used in industrial applications. PCBs have been detected in environmental samples since 1966, and their sources in soils come from depositions of industrial applications, incinerators and biomass combustions. PCBs adsorb to soil particles and persist for long time due to their properties. Their close proximity may also lead to human exposure through ingestion, inhalation, dermal contact, and may exert neurotoxic, mutagenic and carcinogenic health effects. Design and Methods. Residential soil from Korba, India, was extracted using pressurized liquid extraction procedure, cleaned on modified silica and quantified for PCBs. Soil ingestion was considered as the main exposure pathways of life-long intake of PCBs. Human health risk in terms of life time average daily dose, incremental lifetime cancer risk (ILCR) and non-cancer hazard quotient (HQ) were estimated using established guidelines. Results. The estimated average ILCR from non dioxin like PCBs for human adults and children was 3.1×10−8 and 1.1×10−7, respectively. ILCR from dioxin like PCBs for human adults and children was 3.1×10−6 and 1.1×10−5, respectively. The HQ for PCBs was 6.3×10−4 and 2.2×10−3, respectively for human adults and children. Study observed that ILCR from non dioxin like PCBs was lower than acceptable guideline range of 10−6-10−4, and ILCR from dioxin like PCBs was within the limit. HQ was lower than safe limit of 1. Conclusions. Study concluded that human population residing in Korba had low health risk due to PCBs in residential soils
National responses to HIV/AIDS and non-communicable diseases in developing countries: analysis of strategic parallels and differences
Get PDFHIV/AIDS and non-communicable diseases (NCDs) epidemics may have many important similarities in their aetiology, pathogenesis and management. Evidence about the similarities and differences between the national responses HIV/AIDS and NCDs is essential for an integrated response. The objective of this study was to examine the parallels and differences between national responses to HIV/AIDS and NCDs in selected developing countries. This study applied a strategic level comparative case study approach as its study design. The main construct was national response to HIV/AIDS and NCDs. The 4 overarching themes were policy response, institutional mechanism, programmatic response and strategic information. Four countries were purposively selected as cases. Data were collected and triangulated from a multiple sources. The focus of analysis included identifying items for comparison, characteristics to be compared, degrees of similarity, and strategic importance of similarities. Analysis of data was qualitative content analysis with within-case, between-case, and across-case comparisons. While the nature of the disease and the contents of national HIV/AIDS and NCD policies are different, the policy processes involved are largely similar. Functional characteristics of programmatic response to HIV/AIDS and NCDs are similar. But the internal constituents are different. Though both HIV and NCDs require both a multi-sectorial response and a national coordination mechanism, the model and the complexity of the coordination are different. Strategic information frameworks for HIV/AIDS and NCDs use similar models. However, the indicators, targets and priorities are different. In conclusion, the national responses between HIV/AIDS and NCDs are largely similar in approaches and functions but different in content
Implementation of a socio-ecological system navigation approach to human development in Sub-Saharan African communities
Get PDFThis paper presents a framework for the development of socio-eco- logical systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of all stakeholders should be reconciled in a pragmatic approach to social-ecological system management
What does self rated mental health represent
Get PDFBackground. Unlike the widely used self rated health, the self rated mental health was found unsuitable as a proxy for mental illness. This paper analyses the relationships between the self ratings of physical health, mental health and overall health, and their association of with the objective indicators for physical and mental health. Design and methods. The study is a secondary analysis of data from a nationwide representative sample of the non-institutionalized adult residents of Israel in 2003 that was collected via computer-assisted personal interview methods [n=4859].Results. The self rated physical health and the self rated mental health were strongly related to each other yet the self rated mental health was not related to chronic physical conditions and the self rated physical health was not related to mental disorders. In a multiple logistic regression analysis, those with positive self rated mental health had 93 times the odds of reporting positive overall health whereas those with positive self rated physical health had 40 times the odds of reporting positive overall health. Conclusions. The self rating of mental health presents a qualitatively different dimension from mental illness. The self rated mental health is two times more important than the self rated physical health in predicting the self rated overall healt
Association between cancer literacy and cancer-related behaviour: evidence from Ticino, Switzerland
Get PDFBackground. This paper details the role of different dimensions of health literacy in the relationship between health literacy and cancer-related health behaviours. In particular, Cancer Literacy is studied as an exemplar of a dimension of health literacy beyond basic reading and writing skills. The link between functional health literacy, Cancer Literacy and cancer-related health behaviours is investigated in a sample of Ticino (Switzerland) residents (n=639). Design and methods. Detailed data is collected about respondents’ functional health literacy, Cancer Literacy, cancer information seeking behaviour, engagement in cancer preventive behaviours, participation to cancer screenings, and intention to adhere to current screening recommendations. Results. Results confirm the added value of Cancer Literacy – compared to functional health literacy – in explaining people’s cancer information seeking behaviour, their participation to several cancer screenings and their screening intention, underscoring the need to take into account dimensions of health literacy beyond basic functional skills. Conclusions. From a public health perspective, findings provide further evidence on the importance of adapting informational and educational communication intervention designed to improve cancer prevention and screening to different audiences
Impact of patients’ judgment skills on asthma self-management: a pilot study
Get PDFBackground. The majority of current health literacy tools assess functional skills including reading, writing, and numeracy. Although these tools have been able to underline the impact of such skills on individuals’ health behaviour, there is a need for comprehensive measures to examine more advanced skills. The individual’s ability to use health-related information considering his/her own health context, and judging positive and negative consequences of their decisions has been conceptualized as judgment skills. The present study used a newly developed judgment skills tool to explore asthma self-management practices. Design and methods. Eighty asthma patients were recruited from medical offices during the year 2013. The questionnaire was self-administered and contained health literacy questions, the judgment skill tool, the Asthma Control Test, and several self-management questions.Results. Sixty-nine percent of participants had adequate health literacy, while 24% and 5% had marginal and inadequate levels, respectively. The high-judgment group referred more to their doctor when experiencing asthma problems t(76)=−2.18, P<0.032; complied more with the use of their control medicine t(77)=−3.24, P<0.002 and went more regularly to the doctor t(78)=−1.80, P<0.038 (one-tailed) than the low-judgment group.Conclusions. The judgment skills tool can help identify asthma patients’ health information use and reveal how this use may affect some self-management practices
Paediatric rehabilitation treatment standards: a method for quality assurance in Germany
Get PDFOver the last few years, the German Pension Insurance has implemented a new method of quality assurance for inpatient rehabilitation of children and adolescents diagnosed with bronchial asthma, obesity, or atopic dermatitis: the so-called rehabilitation treatment standards (RTS). They aim at promoting a comprehensive and evidence-based care in rehabilitation. Furthermore, they are intended to make the therapeutic processes in medical rehabilitation as well as potential deficits more transparent. The development of RTS was composed of five phases during which current scientific evidence, expert knowledge, and patient expectations were included. Their core element is the specification of evidence-based treatment modules that describe a good rehabilitation standard for children diagnosed with bronchial asthma, obesity, or atopic dermatitis. Opportunities and limitations of the RTS as a tool for quality assurance are discussed