Journal of Public Health Research (PAGEPress Publications)
Not a member yet
556 research outputs found
Sort by
What makes health demand-side financing schemes work in low- and middle-income countries? A realist review
Get PDFThis realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluation designs. Based on methodological rigor and content relevance, only 24 studies published up to April 2013 were selected for the final review. A conceptual framework consisting of various program theories on potential context-mechanism-outcome (C-M-O) configuration of DSF initiative was designed, tested and adapted during the review. Synthesized results were presented as a C-M-O configuration for each of the consumer-side effect. DSF was effective to improve health seeking behaviour considerably and health status to some extent. The causal pathway of DSF’s functioning and effectiveness was not linear. Key demand-side contextual factors which affected DSF’s consumer-side effects were background characteristics of the beneficiaries including their socio-cultural beliefs, motivations, and level of health awareness. At the supply-side, service availability status and provider incentives were contextual determinants. The mechanisms which enabled the interaction of contextual influence were consumer and provider accountability and consumer trust on providers. In order to enhance DSF programs’ effectiveness, their design and implementation should carefully consider the potential contextual elements that may influence the causal pathways
Awareness, treatment, and control of hypertension among adult population in the Federation of Bosnia and Herzegovina over the past decade
Get PDFBackground. Many studies throughout the world show that hypertension is not effectively treated and controlled, which continued to pose an important challenge in health systems in the world. Design and methods. Population surveys were carried out in 2002 and 2012 in the Federation of Bosnia and Herzegovina (FBIH) on representative sample at the age of 25-64. The surveys used systematic stratified sample. Questionnaires and anthropometric measure protocols were adapted from internationally recommended surveys. Results. In the past ten years there has been a slight increase in hypertension prevalence in researched population (41% vs. 42%). Percentage of hypertensive male and female respondents who are not aware of their hypertension actually dropped in the past decade from 54.3% to 51.4%. In 2002 total number of hypertensive respondents aware of their hypertension included 8.1% of male respondents and 10.3% female respondents whose condition was not treated and this rate effectively dropped during the 10-year period. Number of hypertensive, treated, and uncontrolled respondents dropped as reported in the 2012 survey; consequently percentage of hypertensive, treated, and controlled respondents in the 2012 survey increased, in particular in female population.Conclusions. Investments in primary health care, improved availability, and improved quality of health care in the FBIH in the past 10 years can explain increased rate of hypertension detection and treatment; however, efforts should be continued to introduce hypertension screening programs and hypertension control programs
Epidemiology and geographical distribution of enteric protozoan infections in Sydney, Australia
Get PDFBackground. Enteric protozoa are associated with diarrhoeal illnesses in humans; however there are no recent studies on their epidemiology and geographical distribution in Australia. This study describes the epidemiology of enteric protozoa in the state of New South Wales and incorporates spatial analysis to describe their distribution. Design and methods. Laboratory and clinical records from four public hospitals in Sydney for 910 patients, who tested positive for enteric protozoa over the period January 2007-December 2010, were identified, examined and analysed. We selected 580 cases which had residence post code data available, enabling us to examine the geographic distribution of patients, and reviewed the clinical data of 252 patients to examine possible links between protozoa, demographic and clinical features. Results. Frequently detected protozoa were Blastocystis spp. (57%), Giardia intestinalis (27%) and Dientamoeba fragilis (12%). The age distribution showed that the prevalence of protozoa decreased with age up to 24 years but increasing with age from 25 years onwards. The geographic provenance of the patients indicates that the majority of cases of Blastocystis (53.1%) are clustered in and around the Sydney City Business District, while pockets of giardiasis were identified in regional/rural areas. The distribution of cases suggests higher risk of protozoan infection may exist for some communities. Conclusions. These findings provide useful information for policy makers to design and tailor interventions to target high risk communities. Follow-up investigation into the risk factors for giardiasis in regional/rural area is needed
An ecological study of food desert prevalence and 4th grade academic achievement in New York State school districts
Get PDFBackground. This ecological study examines the relationship between food desert prevalence and academic achievement at the school district level. Design and methods. Sample included 232 suburban and urban school districts in New York State. Multiple open-source databases were merged to obtain: 4th grade science, English and math scores, school district demographic composition (NYS Report Card), regional socioeconomic indicators (American Community Survey), school district quality (US Common Core of Data), and food desert data (USDA Food Desert Atlas). Multiple regression models assessed the percentage of variation in achievement scores explained by food desert variables, after controlling for additional predictors.Results. The proportion of individuals living in food deserts significantly explained 4th grade achievement scores, after accounting for additional predictors. School districts with higher proportions of individuals living in food desert regions demonstrated lower 4th grade achievement across science, English and math. Conclusions. Food deserts appear to be related to academic achievement at the school district level among urban and suburban regions. Further research is needed to better understand how food access is associated with academic achievement at the individual level
Care for the person, protection of health and respect for the will of the patient in Italy: support administration as a tool to jointly promote health and respect for autonomy in incompetent patients
Get PDFIn Italy, advance health care directives are a subject of considerable debate in both legal theory and practice. This debate focuses in partic- ular not only on the appropriateness of approving ad hoc statutory reg- ulations but also on the extent to which similar advance indications of a person’s wishes are applicable under the existing legal system, albeit in the absence of a law regulating them. The authors of this paper con- sider, in particular, guidelines relating to the possible use of the mech- anism of support administration (amministrazione di sostegno) (Law No. 6/2004) as a procedure to be used for the legal recognition of advance health care directives, particularly in the light of the legal pro- vision for the possible designation in advance of a support administra- tor by a beneficiary in anticipation of an eventual situation of incapac- ity. This underlines how the concept of health does not only exist in the abstract, but must be measured in relation to the particular patient in the particular situation and how beneficence and respect for auton- omy are both essential elements in the choices aimed at promoting the health and the wellbeing of its citizens
T-cell receptor and K-deleting recombination excision circles in newborn screening of T- and B-cell defects: review of the literature and future challenges
Get PDFSince its introduction as a public health programme in the United States in the early 1960s, newborn blood screening (NBS) has evolved from the detection of phenylalanine levels on filter paper to the application of DNA-based technologies to identify T-cell lymphopenia in infants with severe combined immunodeficiency. This latter use of NBS has required the development of an assay for T-cell lymphopenia based on the quantification of T-cell receptor excision circles (TRECs) that could be performed on dried blood spots routinely collected from newborn infants. The TREC-based NBS was developed six years ago, and there have already been 7 successful pilot studies since then. Similarly, efforts are now being made to establish a screen for B-cell defects, in particular agammaglobulinaemia, taking advantage of the introduction of the method for the quantification of K-deleting recombination excision circles (KRECs). A further achievement of NBS could be the simultaneous recognition of T- and B-cell defects using the combined quantification of TRECs and KRECs from Guthrie card blood spots. This approach may help the early identification of infants with T- and B-cell deficiencies so that they can then be referred to specialised paediatric centres, where a precise diagnosis of severe combined immunodeficiency and agammaglobulinaemia can be performed, and where then they can immediately receive specific therapy. Simultaneous TREC and KREC quantification should also allow classification of patients into subgroups and help identify children with less serious primary immunodeficiencies. This would help avoid the opportunistic infections and frequent hospitalisations that result from a late or lack of diagnosis
The European Union Directive on the application of patients’ rights in cross-border healthcare
Get PDFEvolution of public participation in the assessment and management of environmental health risks: a brief history of developments in the United States
Get PDFIn the United States, the risk assessment − risk management paradigm that underpins federal decisions about environmental health risks was first established in 1983. In the beginning, the importance of public participation was not explicitly recognized within the paradigm. Over time, however, it has become evident that not only must risk-based decisions be founded on the best available scientific knowledge and understanding, but also that they must take account of the knowledge, values, and preferences of interested and affected parties, including community members, business people, and environmental advocates. This article examines the gradually expanding role of public participation in risk-based decision making in the United States, and traces its evolution from a peripheral issue labeled as an external pressure to an integral element of the 21st century risk assessment − risk management paradigm. Today, and into the foreseeable future, public participation and stakeholder involvement are intrinsic features of the emerging American regulatory landscape, which emphasizes collaborative approaches for achieving cooperative and cost-effective solutions to complicated and often controversial environmental health problems
Learning environments’ activity potential for preschoolers (LEAPP): study rationale and design
Get PDFBackground. The purpose of this paper is to provide an overview of the study protocol for the Learning Environments’ Activity Potential for Preschoolers (LEAPP) study, the goal of which is to describe the activity levels of preschoolers attending various early learning venues and explore which attributes of these facilities (e.g. curriculum, policies, equipment, etc.) support activity participation.Design and Methods. This cross-sectional study aimed to recruit approximately 30 early learning environments requesting participation from preschoolers aged 2.5-5 years. Data collection included: Actical accelerometers (MiniMitter, Oregon, USA) to measure the activity levels of children for five consecutive days (15-second epoch length) while in care; the Environment and Policy Assessment and Observation tool to explore the early learning environment’s impact on activity; anthropometric data; the Child Temperament Questionnaire to assess the influence of preschoolers’ temperament on physical activity; and demographic information from parents/guardians and early learning staff. ANOVA and linear regression analyses will be conducted to assess variances in activity levels among preschoolers attending different early learning types and to explore the impact of early learning environments on their activity levels. Independent sample t-tests will be used to examine differences in activity levels based on sex and weight status.Expected impact of the study for public health. This research will provide the first Canadian data to address environmental influences on preschoolers’ activity levels in differing early learning environments. Additionally, this work will highlight the extent to which activity levels vary among preschoolers enrolled in full-day kindergarten, centre-, and home-based childcare
Understanding safety in healthcare: the system evolution, erosion and enhancement model
Get PDFThe paper summarises previous theories of accident causation, human error, foresight, resilience and system migration. Five lessons from these theories are used as the foundation for a new model which describes how patient safety emerges in complex systems like healthcare: the System Evolution Erosion and Enhancement model. It is concluded that to improve patient safety, healthcare organisations need to understand how system evolution both enhances and erodes patient safety