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Sample records for england public health

  1. Public health in interwar England and Wales: did it fail?

    PubMed

    Gorsky, Martin

    2008-01-01

    British historians initially saw the interwar period as a "golden age" for public health in local government, with unprecedented preventive and curative powers wielded by Medical Officers of Health (MOsH). In the 1980s Lewis and Webster challenged this reading, arguing that MOsH were overstretched, neglectful of their "watchdog" role and incapable of formulating a new philosophy of preventive medicine. The article first details this critique, then reappraises it in the light of recent demographic work. It then provides a case study of public health administration in South-West England. Its conclusion is that some elements of the Lewis/Webster case now deserve to be revised.

  2. Public health in England in 2016-the health of the public and the public health system: a review.

    PubMed

    Middleton, John

    2017-01-01

    This article describes the current state of the health of the public in England and the state of the public health professional service and systems. Data sources are wide ranging including the Global Burden of Disease, the Commonwealth Fund and Public Health England reports. There is a high burden of preventable disease and unacceptable inequalities in England. There is considerable expectation that there are gains to be made in preventing ill health and disability and so relieving demand on healthcare. Despite agreement on the need for prevention, the Government has cut public health budgets by a cumulative 10% to 2020. Public health professionals broadly supportive of remaining in the EU face an uphill battle to retain health, workplace and environmental protections following the 'Leave' vote. There is revitalized interest in air pollution. Extreme weather events are testing response and organizational skills of public health professionals and indicating the need for greater advocacy around climate change, biodiversity and protection of ecological systems. Planetary health and ecological public health are ideas whose time has certainly come.

  3. User requirements and understanding of public health networks in England

    PubMed Central

    Fahey, D; Carson, E; Cramp, D; Muir, G

    2003-01-01

    Background: The movement of public health professionals from health authorities to primary care trusts has increased their isolation and dependence on public health networks for communication. Methods: A cross sectional survey of 60 public health professionals working in England was performed to determine their understanding of the term "public health network" and to explore the functions that they would like these networks to perform. It also assessed their attitudes towards a national network and towards individual, local, and national web sites to support these networks. Results: The most popular functions were the support of CPD/education, the identification of expertise and maximisation of scarce resources, information sharing, and efficient information/knowledge management. The local and national networks and their web sites should provide information on current projects of the network and searches to identify people, expertise, and reports. Conclusion: Public health professionals have a similar but broader understanding of the term "public health network" than that of the government with greater emphasis on sharing of information. The network is more likely to be successful if its priorities are maximising scarce resources, identification of expertise, CPD/education, and knowledge management. PMID:14652257

  4. Public health in interwar England and Wales: did it fail?

    PubMed Central

    Gorsky, Martin

    2008-01-01

    British historians initially saw the interwar period as a «golden age» for public health in local government, with unprecedented preventive and curative powers wielded by Medical Officers of Health (MOsH). In the 1980s Lewis and Webster challenged this reading, arguing that MOsH were overstretched, neglectful of their «watchdog» role and incapable of formulating a new philosophy of preventive medicine. The article first details this critique, then reappraises it in the light of recent demographic work. It then provides a case study of public health administration in South-West England. Its conclusion is that some elements of the Lewis/Webster case now deserve to be revised. PMID:19230339

  5. The return of public health to local government in England: changing the parameters of the public health prioritization debate?

    PubMed

    Marks, L; Hunter, D J; Scalabrini, S; Gray, J; McCafferty, S; Payne, N; Peckham, S; Salway, S; Thokala, P

    2015-09-01

    To explore the influence of values and context in public health priority-setting in local government in England. Qualitative interview study. Decision-makers' views were identified through semi-structured interviews and prioritization tools relevant for public health were reviewed. Interviews (29) were carried out with Health and Wellbeing Board members and other key stakeholders across three local authorities in England, following an introductory workshop. There were four main influences on priorities for public health investment in our case study sites: an organizational context where health was less likely to be associated with health care and where accountability was to a local electorate; a commissioning and priority-setting context (plan, do, study, act) located within broader local authority priority-setting processes; different views of what counts as evidence and, in particular, the role of local knowledge; and debates over what constitutes a public health intervention, triggered by the transfer of a public health budget from the NHS to local authorities in England. The relocation of public health into local authorities exposes questions over prioritizing public health investment, including the balance across lifestyle interventions and broader action on social determinants of health and the extent to which the public health evidence base influences local democratic decision-making. Action on wider social determinants reinforces not only the art and science but also the values and politics of public health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. A wall of information? Exploring the public health component of maternity care in England.

    PubMed

    Sanders, Julia; Hunter, Billie; Warren, Lucie

    2016-03-01

    midwives have traditionally had an important role in providing public health messages to women. The range and diversity of the public health remit within maternity services has expanded rapidly over the past decade and maternity support workers as well as midwives are now engaged in public health work in many areas. Given these changes a review of current practice was indicated. to identify student midwives׳, midwives׳ and midwifery support workers׳ current knowledge of and involvement in the public health agenda in England. descriptive qualitative study using online discussion forums. England, United Kingdom undergraduate student midwives, midwives and maternity support workers employed by the National Health Service in England and University employed Leads for Midwifery Education. key themes identified were: the scope of the midwives׳ public health role, training and support for public health role, barriers and facilitators, specific client groups, specialist referral services. Student midwives, midwives and maternity support workers view engagement with, and delivery of, public health initiatives as an integral component of their roles, but are on occasions frustrated by constraints of time, training and public engagement. the National Health Service in England aims to engage pregnant women and new mothers in a diverse range of population based and individualised, public health initiatives. Currently, there are high levels of involvement in the public health agenda from the maternity workforce across a wide range of activities. However, midwives and maternity support workers are restricted by barriers of time, training and resources. These barriers will need addressing for optimal maternity care engagement in public health to be realised. policy makers, commissioners and National Health Service providers need to provide clear guidance on the expectations of the public health remit of midwives and maternity support workers and ensure that such expectations

  7. The nature, development and contribution of social marketing to public health practice since 2004 in England.

    PubMed

    French, Jeff

    2009-11-01

    Social marketing is a highly systematic approach to health improvement that sets out unambiguous success criteria focused on behaviour change. This paper reviews the key concepts and principles of social marketing and its recent rapid development across government in England in the public health field. This paper outlines the role of the National Social Marketing Centre and concludes with a discussion of the probable future impact of social marketing on public health practice. The paper argues that there is a close ideological match between social marketing and liberal democratic imperatives. Social marketing's focus on outcome, return on investment and its emphasis on developing interventions that can respond to diverse needs, means it is probable that social marketing will increasingly be required by governments as a standard part of public health programmes.

  8. The contribution of nurse consultants in England to the public health leadership agenda.

    PubMed

    Franks, Helen

    2014-12-01

    To examine the contribution of nurse consultants in relation to UK public health outcomes by contrasting the health and public health skills frameworks with a study of the role of nurse consultants. Nurse consultants are the most senior advanced nurse practitioners in the UK. They work clinically, lead, research, develop policy and disseminate knowledge. A synthesis of research and data from the UK professional skills frameworks with data from a mixed-methods study of the role of nurse consultants. Data collected from nurse consultants and stakeholders in England (n = 10) were analysed to identify issues impacting on the skills, competencies and effectiveness of advanced nurses. This was contrasted with the skills and career frameworks for public health and advanced healthcare practice. Nurse consultants use their clinical expertise to lead practice, facilitate change and monitor effectiveness. Within healthcare organisations, they contribute servicewide to the implementation of public health policy, service delivery and policy development, mirroring expected competencies and improved health outcomes. Two barriers were identified. First, that there was little time or will for nurse consultants to undertake research, precluding them from demonstrating their value. Second, that a lack of interprofessional understanding and support of their roles meant that their worth was often not appreciated by decision-makers. Nurse consultants lead and influence public health on many levels and need support to develop needs-led and evidence-based local, national and international public health practice and policy development. This research contributes to the global discussion currently being held about the nomenclature of advanced nurse practitioner roles, their scope and influence. The challenge for nurses to contribute meaningfully to public health structures at an advanced level is a concern for all nations seeking the common goal of addressing public health needs within their

  9. The Public Health Impact score: a new measure of public health effectiveness for general practices in England.

    PubMed

    Ashworth, Mark; Schofield, Peter; Doran, Tim; Cookson, Richard; Sutton, Matthew; Seed, Paul T; Howe, Amanda; Fleetcroft, Robert

    2013-04-01

    Health policy in the UK is increasingly focused on the measurement of outcomes rather than structures and processes of health care. To develop a measure of the effectiveness of primary care in terms of population health outcomes. A cross-sectional study of general practices in England. Twenty clinical quality of care indicators for which there was evidence of mortality reduction were identified from the national Quality and Outcomes Framework (QOF) pay-for-performance scheme. The number of lives saved by 8136 English practices (97.97% of all practices) in 2009/2010 was estimated, based on their performance on these measures, and a public health impact measure, the PHI score, was constructed. Multilevel regression models were used to identify practice and population predictors of PHI scores. The mean estimated PHI score was 258.9 (standard deviation [SD] = 73.3) lives saved per 100 000 registered patients, per annum. This represents 75.7% of the maximum potential PHI score of 340.9 (SD = 91.8). PHI and QOF scores were weakly correlated (Pearson r = 0.28). The most powerful predictors of PHI score were the prevalence of the relevant clinical conditions (β = 0.77) and the proportion of patients aged ≥65 years (β = 0.22). General practices that were less successful at achieving their maximum potential PHI score were those with a lower prevalence of relevant conditions (β = 0.29), larger list sizes (β = -0.16), greater area deprivation (β = -0.15), and a larger proportion of patients aged ≥65 years (β = -0.13). The PHI score is a potential alternative metric of practice performance, measuring the estimated mortality reduction in the registered population. Rewards under the QOF pay-for-performance scheme are not closely aligned to the public health impact of practices.

  10. Changes in recruitment to public health consultant posts and hospital consultant posts in England: potential impact on the sustainability of the Public Health system.

    PubMed

    Harrell, Ruth; Caley, Michael; Allwood, Dominique; Fowler, Tom

    2011-12-01

    The UK government has proposed major changes to the Public Health system in England. This study aims quantify increasing anecdotal concern that the number of Public Health consultant posts advertised has plummeted since the publication of these plans. The archives of BMJ careers were interrogated for hospital and Public Health consultant posts advertised October 2008 and May 2011. Statistical process control charts were used to compare differences in recruitment over time and the ratio of Public Health:hospital consultant posts. We found a highly significant reduction in the mean number of advertisements for Public Health consultant posts from 27.9 posts per month in the period October 2008-Novermber 2009 to 6.3 posts per month between December 2009 and May 2010 (P< 0.005). The ratio of Public Health:hospital consultant posts fell from 3.3 to 0.9 Public Health consultant posts per 100 hospital consultant posts (P< 0.005). This study confirms the anecdotal concern that there has been a significant reduction in the advertisement, and by extrapolation, recruitment to Public Health consultants posts in England around the time of the publication of the government's reform plans. Public Health consultant posts have been disproportionately affected by this reduction compared to hospital consultant posts.

  11. Public health policy and walking in England-analysis of the 2008 'policy window'.

    PubMed

    Milton, Karen; Grix, Jonathan

    2015-07-05

    Although the government in England has a long-standing interest in walking promotion, this has not been accompanied by a coherent strategic plan or investment to support physical activity behaviour change. However, in 2008 the government announced its intention to invest £7 million into walking promotion. This article utilises Kingdon's Multiple Streams framework as an organising principle through which to interrogate the reasons behind the increased emphasis on walking promotion as part of the public health policy agenda in England. The research adopted a case study design. Data were obtained through document analysis of relevant policies and semi-structured interviews with experts in the walking sector, including both government and non-government representatives. Kingdon's Multiple Streams theory proposes that at certain points in time, 'policy windows' are created through the convergence of a problem, an appropriate solution, and a receptive political environment, and this policy window presents an opportunity for major policy change. The findings of this research suggest that the success of London in securing the 2012 Olympic and Paralympic Games was the primary trigger in the creation of a policy window for walking promotion in recent years. Despite previous interest in walking promotion from the health and transport sectors, it was the recent alignment with the sports agenda that led to increased political commitment. This raises concerns that the research evidence on the health benefits of physical activity and rising levels of inactivity in England, are insufficient to secure government support and investment, and that multi-sector lobbying and joined-up political action may be critical in advancing this agenda.

  12. Professionalization in public health and the measurement of sanitary progress in nineteenth-century England and Wales.

    PubMed

    Mooney, G

    1997-04-01

    During the course of the nineteenth century, the Registrar-General's Office in England and Wales used crude mortality rates as a demographic barometer of the environmental conditions of towns and cities. The local authorities in places with comparatively high rates were exhorted to improve them through more and better public health reforms. This technique of public coercion was often criticized, especially by a selection of Medical Officers of Health, who argued that crude death rates were an inaccurate measure of changing mortality levels and thus the success of preventive medicine. The debate over sanitary progress created no little tension between staff at the General Register Office and the Medical Officers, as well as between the Medical Officers themselves, at a time when public health doctors were seeking to properly establish themselves as a legitimate, professionalized branch within medicine. Despite this, the collection and dissemination of local mortality statistics became an indispensable component for the nineteenth century campaign to improve the nation's health.

  13. Reduced street lighting at night and health: A rapid appraisal of public views in England and Wales

    PubMed Central

    Green, Judith; Perkins, Chloe; Steinbach, Rebecca; Edwards, Phil

    2015-01-01

    Financial and carbon reduction incentives have prompted many local authorities to reduce street lighting at night. Debate on the public health implications has centred on road accidents, fear of crime and putative health gains from reduced exposure to artificial light. However, little is known about public views of the relationship between reduced street lighting and health. We undertook a rapid appraisal in eight areas of England and Wales using ethnographic data, a household survey and documentary sources. Public concern focused on road safety, fear of crime, mobility and seeing the night sky but, for the majority in areas with interventions, reductions went unnoticed. However, more private concerns tapped into deep-seated anxieties about darkness, modernity ‘going backwards’, and local governance. Pathways linking lighting reductions and health are mediated by place, expectations of how localities should be lit, and trust in local authorities to act in the best interests of local communities. PMID:26057894

  14. Development of public health guidance on the prevention of alcohol misuse and cardiovascular disease: the work of the National Institute for Health and Clinical Excellence, England.

    PubMed

    Law, C; Kelly, M P; Kaner, E; Meier, P S; Capewell, S

    2012-03-01

    In 2005, the National Institute for Health and Clinical Excellence in England was asked to extend its work from clinical practice to public health. It has since produced 35 pieces of public health guidance on interventions ranging from the specific (such as the use of pedometers to promote exercise) to major public health issues (such as behaviour change and community engagement). The workshop agreed that research on many public health interventions was lacking, particularly for population-level interventions, which might be more powerful than those targeted at individuals. Epidemiology could make a particular contribution to the evaluation of natural experiments, which have great potential for contributing to this evidence base. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Immigration, Statecraft and Public Health: The 1920 Aliens Order, Medical Examinations and the Limitations of the State in England.

    PubMed

    Taylor, Becky

    2016-08-01

    This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England's major ports-Liverpool and London-and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice.

  16. Building Professionalism Through Management Training: New England Public Health Training Center's Low-Cost, High-Impact Model.

    PubMed

    MacVarish, Kathleen; Kenefick, Hope; Fidler, Anne; Cohen, Bradley; Orellana, Yuri; Todd, Karla

    2017-10-05

    Evolving practices, accreditation, and priorities established in Public Health 3.0 are adding to the long-identified need for management training among public health practitioners. The New England Public Health Training Center is addressing this need with a flexible, open-source, 16-topic training program. The program is designed to build competencies for current and future managers, preparing them for their day-to-day tasks and for the kinds of adaptation suggested by Public Health 3.0 advocates. The training program uses live expert instructors for 10 webinars and 2 in-person trainings. Experts have also created the content for multiple self-paced E-Learnings that trainees undertake in addition to the instructor-led sessions. A webinar platform with breakout rooms and an advanced learning management system allows for online discussion and mentor interaction. The course has now been offered, evaluated, and modified 3 times, and the materials are available for noncommercial use by the public health community. Using the Kirkpatrick training evaluation model, the recent cohort was satisfied (87.5%) with the training, reported identifying actions to apply information learned to their work (85.8%), and experienced statistically significant knowledge gains. Earlier trainees reported work-related behavior change. Management training offers the hope of increasing professionalism; creating better, more effective workplaces and programs; and preparing practitioners for an evolving public health landscape. Early results indicate that NEPHTC's program, Managing Effectively in Today's Public Health Environment, is a useful tool in realizing that hope.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  17. Environmental public health tracking: piloting methods for surveillance of environmentally related diseases in England and Wales.

    PubMed

    Saunders, Patrick; Mohammed, Mohammed A

    2009-04-01

    An effective environmental public health tracking system integrates data and intelligence on environmental hazards, exposures, and health outcomes to focus interventions on reducing the impact of environmental contamination on public health. Most work in this area in the UK has focused on assessing data on hazards that are relatively easy to obtain. However, most hazards will present no actual risk and information on exposure is required to make an effective risk assessment. Obtaining exposure data is technically challenging, expensive, and potentially raises ethical concerns. Consequently, the Health Protection Agency is exploring methods for targeting geographical zones for efficient detailed environmental assessment (including exposure assessment). This paper describes and assesses three methods (indirect standardization, statistical process control (SPC) and kernel density contouring) for the surveillance of potentially environmentally related diseases for this purpose. While the evaluation demonstrates the utility of the three methods, particularly SPC, the comparison was limited due to ethical approval issues.

  18. Reduced street lighting at night and health: A rapid appraisal of public views in England and Wales.

    PubMed

    Green, Judith; Perkins, Chloe; Steinbach, Rebecca; Edwards, Phil

    2015-07-01

    Financial and carbon reduction incentives have prompted many local authorities to reduce street lighting at night. Debate on the public health implications has centred on road accidents, fear of crime and putative health gains from reduced exposure to artificial light. However, little is known about public views of the relationship between reduced street lighting and health. We undertook a rapid appraisal in eight areas of England and Wales using ethnographic data, a household survey and documentary sources. Public concern focused on road safety, fear of crime, mobility and seeing the night sky but, for the majority in areas with interventions, reductions went unnoticed. However, more private concerns tapped into deep-seated anxieties about darkness, modernity 'going backwards', and local governance. Pathways linking lighting reductions and health are mediated by place, expectations of how localities should be lit, and trust in local authorities to act in the best interests of local communities. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Timeliness of electronic reporting and acceptability of public health follow-up of routine nonparatyphoidal and nontyphoidal Salmonella infections, London and South East England, 2010 to 2011.

    PubMed

    Severi, E; Dabrera, G; Boxall, N; Harvey-Vince, L; Booth, L; Balasegaram, S

    2014-01-01

    Nonparatyphoidal and nontyphoidal Salmonella (NTS) infections are major causes of food poisoning in England. Diagnostic laboratories and clinicians have a statutory responsibility to report NTS infection cases to the Health Protection Agency via various means, with electronic reporting encouraged as the universal method. The Health Protection Agency (Public Health England since 1 April 2013) refers cases to environmental health departments for follow-up. Timeliness of reporting and adequacy of NTS infection case follow-up are key factors in the implementation of public health actions. Laboratories, health protection units, and environmental health departments in London and South East (SE) regions of England completed three surveys between December 2010 and April 2011, collecting data about the NTS infection case reporting methods and the time elapsed between symptom onset and public health actions. The median period between symptom onset and public health investigation was 25 days in London and 23 days in SE when electronic reporting was used and 12 days in London and 11 days in SE when other means of reporting were used. The most common follow-up method was a telephone questionnaire in London (53%) and a postal questionnaire in SE (52%). The telephone questionnaire had the highest response rate (98% in London; 96% in SE). Timeliness and efficiency of electronic NTS infection case reports can be improved by decreasing the electronic laboratory report period and using telephone-administered questionnaires to maximize the public health benefit when following up single cases of NTS infection.

  20. Public health nutrition in the civil service (England): approaches to tackling obesity.

    PubMed

    Blackshaw, J R

    2016-08-01

    The seriousness and scale of the physical, psychological, economic and societal consequences relating to poor diets, inactivity and obesity is unprecedented. Consequently, the contextual factors underpinning the work of a nutritionist in the civil service are complex and significant; however, there are real opportunities to make a difference and help improve the health of the nation. The present paper describes the delivery of public health nutrition through two work programmes, namely action to support young people develop healthier lifestyle choices and more recently the investigation and deployment of local insights to develop action to tackle obesity. Combining the application of nutrition expertise along with broader skills and approaches has enabled the translation of research and evidence into programmes of work to better the public's health. It is evident that the appropriate evaluation of such approaches has helped to deliver engaging and practical learning opportunities for young people. Furthermore, efforts to build on local intelligence and seek collaborative development can help inform the evidence base and seek to deliver public health approaches, which resonate with how people live their lives.

  1. Getting England to be more physically active: are the Public Health Responsibility Deal's physical activity pledges the answer?

    PubMed

    Knai, C; Petticrew, M; Scott, C; Durand, M A; Eastmure, E; James, L; Mehrotra, A; Mays, N

    2015-09-18

    The Public Health Responsibility Deal (RD) in England is a public-private partnership involving voluntary pledges between government, industry, and other organisations to improve public health by addressing alcohol, food, health at work, and physical activity. This paper analyses the RD physical activity (PA) pledges in terms of the evidence of their potential effectiveness, and the likelihood that they have motivated actions among organisations that would not otherwise have taken place. We systematically reviewed evidence of the effectiveness of interventions proposed in four PA pledges of the RD, namely, those on physical activity in the community; physical activity guidelines; active travel; and physical activity in the workplace. We then analysed publically available data on RD signatory organisations' plans and progress towards achieving the physical activity pledges, and assessed the extent to which activities among organisations could be attributed to the RD. Where combined with environmental approaches, interventions such as mass media campaigns to communicate the benefits of physical activity, active travel in children and adults, and workplace-related interventions could in principle be effective, if fully implemented. However, most activities proposed by each PA pledge involved providing information or enabling choice, which has limited effectiveness. Moreover, it was difficult to establish the extent of implementation of pledges within organisations, given that progress reports were mostly unavailable, and, where provided, it was difficult to ascertain their relevance to the RD pledges. Finally, 15 % of interventions listed in organisations' delivery plans were judged to be the result of participation in the RD, meaning that most actions taken by organisations were likely already under way, regardless of the RD. Irrespective of the nature of a public health policy to encourage physical activity, targets need to be evidence-based, well

  2. Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection

    PubMed Central

    Cosford, Paul A; O'Mahony, Mary; Angell, Emma; Bickler, Graham; Crawshaw, Shirley; Glencross, Janet; Horsley, Stephen S; McCloskey, Brian; Puleston, Richard; Seare, Nichola; Tobin, Martin D

    2006-01-01

    Background Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England. Methods We sent a postal questionnaire to all health protection professionals in England from the following groups: (a) Directors of Public Health in Primary Care Trusts; (b) Directors of Health Protection Units within the Health Protection Agency; (c) Directors of Public Health in Strategic Health Authorities and; (d) Regional Directors of the Health Protection Agency Results The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a)-(d). Concordance in views of which organisation should, and which does deliver was high (≥90%) for 6 of 18 health protection functions, but much lower (≤80%) for 6 other functions, including managing the implications of a case of meningitis out of hours, of landfill environmental contamination, vaccination in response to mumps outbreaks, nursing home infection control, monitoring sexually transmitted infections and immunisation training for primary care staff. The proportion of respondents reporting that they felt confident most or all of the time in the safe delivery of a health protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038). Conclusion Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there are important areas

  3. Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection.

    PubMed

    Cosford, Paul A; O'Mahony, Mary; Angell, Emma; Bickler, Graham; Crawshaw, Shirley; Glencross, Janet; Horsley, Stephen S; McCloskey, Brian; Puleston, Richard; Seare, Nichola; Tobin, Martin D

    2006-12-07

    Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England. We sent a postal questionnaire to all health protection professionals in England from the following groups: (a) Directors of Public Health in Primary Care Trusts; (b) Directors of Health Protection Units within the Health Protection Agency; (c) Directors of Public Health in Strategic Health Authorities and; (d) Regional Directors of the Health Protection Agency The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a)-(d). Concordance in views of which organisation should, and which does deliver was high (> or =90%) for 6 of 18 health protection functions, but much lower (< or =80%) for 6 other functions, including managing the implications of a case of meningitis out of hours, of landfill environmental contamination, vaccination in response to mumps outbreaks, nursing home infection control, monitoring sexually transmitted infections and immunisation training for primary care staff. The proportion of respondents reporting that they felt confident most or all of the time in the safe delivery of a health protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038). Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there are important areas of health protection where

  4. Meals described as healthy or unhealthy match public health education in England.

    PubMed

    Laguna-Camacho, Antonio; Booth, David A

    2015-04-01

    Dietary guidelines for the general public aim to lower the incidence of nutrition-related diseases by influencing habitual food choices. Yet little is known about how well the guidelines are matched by the actual practices that people regard as healthy or unhealthy. In the present study, British residents were asked in a cognitive interview to write a description of an occasion when either they ate in an unhealthy way or the eating was healthy. The reported foods and drinks, as well as sort of occasion, location, people present and time of day, were categorised by verbal and semantic similarities. The number of mentions of terms in each category was then contrasted between groups in exact probability tests. Perceived unhealthy and healthy eating occasions differed reliably in the sorts of foods and the contexts reported. There was also full agreement with the national guidelines on eating plenty of fruit and vegetables, eating small amounts of foods and drinks high in fat and/or sugar, drinking plenty of water, and cutting down on alcohol. There was a tendency to regard choices of bread, rice, potatoes, pasta and other starchy foods as healthy. Reported healthy and unhealthy eating did not differ in incidences of meat, fish, eggs, beans and other non-dairy sources of protein or of dairy foods and milk. These results indicate that operationally clear recommendations by health professionals are well understood in this culture but members of the public do not make clear distinctions in the case of foods that can be included in moderate amounts in a healthy diet. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Can legislation prevent debauchery? Mother gin and public health in 18th-century England.

    PubMed Central

    Warner, J; Her, M; Gmel, G; Rehm, J

    2001-01-01

    The "gin epidemic" of 1720 to 1751 in England was the first time that government intervened in a systematic fashion to regulate and control sales of alcohol. The epidemic therefore provides an opportunity to gauge the effects of multiple legislative interventions over time. Toward that end, we employed time series analysis in conjunction with qualitative methodologies to test the interplay of multiple independent variables, including real wages and taxes, on the consumption of distilled spirits from 1700 through 1771. The results showed that each of the 3 major gin acts was successful in the short term only, consistent with the state's limited resources for enforcement at the local level, and that in each instance consumption actually increased shortly thereafter. This was true even of the Gin Act of 1751, which, contrary to the assumptions of contemporaries and many historians, succeeded by accident rather than by design. The results also suggest that the epidemic followed the inverse U-shaped trajectory of more recent drug scares and that consumption declined only after the more deleterious effects of distilled spirits had been experienced by large numbers of people. PMID:11236401

  6. 77 FR 35359 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting...), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England...

  7. Mental health service provision in England.

    PubMed

    Johnson, S; Zinkler, M; Priebe, S

    2001-01-01

    To describe mental health service provision for adults of working age in England. Services in an inner London area are described so as to illustrate current patterns of service organization in England. National trends are then discussed. Despite relatively low public expenditure, substantial progress has been made in deinstitutionalization and development of comprehensive community-based services. Persisting difficulties include high staff turnover, a minority of patients. who do not engage with community services, user and carer dissatisfaction with emergency services, and social exclusion because of stigma. Recent government policy advocates resolving some of these problems using new service models such as assertive outreach and crisis teams. Closure of the large asylums has largely been accomplished. England is now entering a new phase in community service development, with a range of innovative developments aimed at resolving problems still encountered after the initial phases of integrated community service development.

  8. 77 FR 5774 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA980 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  9. 75 FR 78976 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... National Oceanic and Atmospheric Administration RIN 0648-XA092 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  10. 75 FR 49466 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... National Oceanic and Atmospheric Administration RIN 0648-XY17 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee will meet to consider actions affecting New England...

  11. 78 FR 18963 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... National Oceanic and Atmospheric Administration RIN 0648-XC594 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Recreational Advisory Panel will meet to consider actions affecting New England...

  12. 75 FR 31425 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XW76 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee will meet to consider actions affecting New England...

  13. 76 FR 52640 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... National Oceanic and Atmospheric Administration RIN 0648-XA653 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  14. Health economic evaluation in England.

    PubMed

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness.

  15. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... National Oceanic and Atmospheric Administration RIN: 0648-XA462 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  16. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... National Oceanic and Atmospheric Administration RIN 0658-XA461 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  17. 77 FR 71786 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XC375 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  18. 78 FR 4391 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC454 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  19. 77 FR 70737 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ...; ] DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC366 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England...

  20. 77 FR 27716 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's...

  1. 77 FR 27717 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's...

  2. 78 FR 44929 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

    ... National Oceanic and Atmospheric Administration RIN 0648-XC778 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. ] SUMMARY: The New England Fishery...

  3. 78 FR 65616 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... National Oceanic and Atmospheric Administration RIN 0648-XC940 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  4. 78 FR 54868 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XC854 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  5. 78 FR 65617 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... National Oceanic and Atmospheric Administration RIN 0648-XC952 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  6. 78 FR 51712 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XC819 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  7. An evaluation of the Public Health Responsibility Deal: Informants' experiences and views of the development, implementation and achievements of a pledge-based, public-private partnership to improve population health in England.

    PubMed

    Durand, Mary Alison; Petticrew, Mark; Goulding, Lucy; Eastmure, Elizabeth; Knai, Cecile; Mays, Nicholas

    2015-11-01

    The Coalition Government's Public Health Responsibility Deal (RD) was launched in England in 2011 as a public-private partnership designed to improve public health in the areas of food, alcohol, health at work and physical activity. As part of a larger evaluation, we explored informants' experiences and views about the RD's development, implementation and achievements. We conducted 44 semi-structured interviews with 50 interviewees, purposively sampled from: RD partners (businesses, public sector and non-governmental organisations); individuals with formal roles in implementing the RD; and non-partners and former partners. Data were analysed thematically: NVivo (10) software was employed to manage the data. Key motivations underpinning participation were corporate social responsibility and reputational enhancement. Being a partner often involved making pledges related to work already underway or planned before joining the RD, suggesting limited 'added value' from the RD, although some pledge achievements (e.g., food reformulation) were described. Benefits included access to government, while drawbacks included resource implications and the risk of an 'uneven playing field' between partners and non-partners. To ensure that voluntary agreements like the RD produce gains to public health that would not otherwise have occurred, government needs to: increase participation and compliance through incentives and sanctions, including those affecting organisational reputation; create greater visibility of voluntary agreements; and increase scrutiny and monitoring of partners' pledge activities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Real or Illusory? Case Studies on the Public Perception of Environmental Health Risks in the North West of England

    PubMed Central

    Stewart, Alex G; Luria, Paolo; Reid, John; Lyons, Mary; Jarvis, Richard

    2010-01-01

    Applied research in a public health setting seeks to provide professionals with insights and knowledge into complex environmental issues to guide actions that reduce inequalities and improve health. We describe ten environmental case studies that explore the public perception of health risk. We employed logical analysis of components of each case study and comparative information to generate new evidence. The findings highlight how concerns about environmental issues measurably affect people’s wellbeing and led to the development of new understanding about the benefits of taking an earlier and more inclusive approach to risk communication that can now be tested further. PMID:20617024

  9. The Eastern Region Public Health Observatory.

    PubMed

    Wright, Kerri

    2014-06-03

    The Eastern Region Public Health Observatory (ERPHO) became part of Public Health England on April 1 2013. Its website provides population health data, analysis and interpretation to support healthcare professionals in commissioning, prioritising and improving health outcomes.

  10. 76 FR 32143 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting...), Commerce. ACTION: Public meeting. SUMMARY: The New England Fishery Management Council (Council) will hold a... the New England Fishery Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950; telephone...

  11. 76 FR 30306 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ... New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS...: The New England Fishery Management Council (Council) is scheduling a public meeting of its Scientific and Statistical Committee on June 14-15, 2011 to consider actions affecting New England fisheries in...

  12. 75 FR 2111 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... National Oceanic and Atmospheric Administration RIN 0648-XT75 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Monkfish Fishery Management Plan Amendment 5; Public Hearings; Request for Comments. SUMMARY: The New England Fishery Management Council (Council) will hold six...

  13. Exporting Poor Health: The Irish in England

    PubMed Central

    Delaney, Liam; Fernihough, Alan; Smith, James P

    2013-01-01

    The Irish-born population in England typically were in worse health than both the native population and the Irish population in Ireland, a reversal of the commonly observed healthy migrant effect (HIE). Recent birth-cohorts living in England and born in Ireland, however, are healthier than the English population. The substantial Irish migrant health penalty arises principally for cohorts born between 1920 and 1960. This paper attempts to understand the processes that generated these changing migrant health patterns for Irish migrants to England. Our results suggest a strong role for economic selection in driving the dynamics of health differences between the Irish-born migrants and White English populations. PMID:24014181

  14. Immigration, Statecraft and Public Health: The 1920 Aliens Order, Medical Examinations and the Limitations of the State in England

    PubMed Central

    Taylor, Becky

    2016-01-01

    This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England’s major ports—Liverpool and London—and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice. PMID:27482146

  15. UK Renal Registry 17th Annual Report: Chapter 12 Epidemiology of Reported Infections amongst Patients Receiving Dialysis for Established Renal Failure in England in 2012 to 2013: a Joint Report from Public Health England and the UK Renal Registry.

    PubMed

    Pitcher, David; Rao, Anirudh; Caskey, Fergus; Davies, John; Crowley, Lisa; Fluck, Richard; Farrington, Ken

    2015-01-01

    Infection remains one of the leading causes of mortality in established renal failure patients receiving renal replacement therapy (RRT). Data were submitted to Public Health England (PHE) by NHS acute Trusts via Health Care Associated Infection Data Capture System (HCAI-DCS) including whether the patients were receiving dialysis. Individual renal units then confirmed the record either directly via the database or after being contacted. Data were collected for the period 1st May 2012 to the 30th April 2013. There were 31 episodes of MRSA bacteraemia, an overall rate of 0.13 per 100 dialysis patient years, representing a further year-on-year fall in MRSA rate. There were a higher number of MSSA episodes, 372 in total,with an overall rate of 1.59 per 100 dialysis patient years. The number of episodes of E. coli and C. difficile were 308 (1.32 per 100 dialysis patient years) and 123 (0.55 per 100 dialysis patient years) respectively. The presence of a central venous catheter was associated with an elevated risk of MRSA and MSSA bacteraemia. We present data relating to infections in renal dialysis patients reported to PHE in one year. The rate of MRSA bacteraemia episodes in England continues to fall. There is a higher rate of MSSA infections.We also report the results of the second year of E. coli and C. difficile data collection. Future cycles will give further ideas of the trend in incidences of these infections. Further work to refine the definitions and data collection is necessary to ensure consistency of reporting across centres.

  16. 77 FR 20613 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-05

    ... National Oceanic and Atmospheric Administration RIN 0648-XB129 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of cancellation of a public meeting. SUMMARY: The New England... FURTHER INFORMATION CONTACT: Paul J. Howard, Executive Director, New England Fishery Management Council...

  17. 77 FR 64490 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC305 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  18. 77 FR 16211 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-20

    ... National Oceanic and Atmospheric Administration RIN 0648-XB091 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  19. 77 FR 15721 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... National Oceanic and Atmospheric Administration RIN0648-XB090 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  20. 76 FR 28214 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-16

    ... National Oceanic and Atmospheric Administration RIN 0648-XA437 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... actions affecting New ] England fisheries in the exclusive economic zone (EEZ). Recommendations from this...

  1. 77 FR 64491 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC306 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  2. 77 FR 15720 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... National Oceanic and Atmospheric Administration RIN 0648-XB092 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... April, 2012 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  3. 76 FR 57718 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... National Oceanic and Atmospheric Administration RIN 0648-XA706 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Groundfish Committee will meet to consider actions affecting New England fisheries in...

  4. 76 FR 48806 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... National Oceanic and Atmospheric Administration RIN 0648-XA621 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

  5. 77 FR 75612 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XC407 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

  6. 78 FR 14982 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XC546 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  7. 77 FR 19228 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... National Oceanic and Atmospheric Administration RIN 0648-XB137 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Groundfish Committee will meet to consider actions affecting New England fisheries in...

  8. 77 FR 19231 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... National Oceanic and Atmospheric Administration RIN 0648-XB129 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

  9. 78 FR 13326 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... National Oceanic and Atmospheric Administration RIN 0648-XC520 New England Fishery Management Council... Administration (NOAA), Commerce ACTION: Notice; public meeting. ] SUMMARY: The New England Fishery Management... New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will be...

  10. 77 FR 75614 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XC411 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

  11. 75 FR 36360 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

    ... National Oceanic and Atmospheric Administration RIN 0648-XX09 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Groundfish/Scallop Advisory Panel will meet to consider actions affecting New England...

  12. 76 FR 48807 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... National Oceanic and Atmospheric Administration RIN 0648-XA623 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this...

  13. 75 FR 74008 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... National Oceanic and Atmospheric Administration RIN 0648-XA065 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on...

  14. 75 FR 43928 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-27

    ... National Oceanic and Atmospheric Administration RIN 0648-XX80 New England Fishery Management Council... Administration (NOAA), Commerce ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., 2010 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  15. 78 FR 71565 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... National Oceanic and Atmospheric Administration RIN 0648-XD006 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The New England Fishery Management Council (Council) will hold a 3-day meeting to consider actions affecting New England fisheries in the...

  16. 78 FR 48420 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XC795 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., 2013 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  17. 78 FR 14981 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XC547 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will be...

  18. 78 FR 64480 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... National Oceanic and Atmospheric Administration RIN 0648-XC939 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this...

  19. 78 FR 62587 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC923 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...: Thomas A. Nies, Executive Director, New England Fishery Management Council; telephone: (978) 465-0492...

  20. 77 FR 58983 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-25

    ... National Oceanic and Atmospheric Administration RIN 0648-XC250 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management... October 2012, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  1. 76 FR 543 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... National Oceanic and Atmospheric Administration RIN 0648-XA127 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management... actions affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will...

  2. 78 FR 48419 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XC796 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  3. 78 FR 48860 - New England Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... National Oceanic and Atmospheric Administration RIN 0648-XC802 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meetings. SUMMARY: The New England Fishery Management...: Thomas A. Nies, Executive Director, ] New England Fishery Management Council; telephone: (978) 465-0492...

  4. 78 FR 53730 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... National Oceanic and Atmospheric Administration RIN 0648-XC842 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meetings. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meetings will be held on...

  5. 77 FR 52314 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... National Oceanic and Atmospheric Administration RIN 0648-XC199 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will...

  6. 77 FR 75615 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XC410 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

  7. 75 FR 20567 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... National Oceanic and Atmospheric Administration RIN 0648-XV95 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Herring Committee will meet to consider actions affecting New England fisheries in the...

  8. 77 FR 779 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA919 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

  9. 76 FR 53415 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... National Oceanic and Atmospheric Administration RIN 0648-XA664 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... September 14-15, 2011, to consider actions affecting New England fisheries in the exclusive economic zone...

  10. 76 FR 53417 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... National Oceanic and Atmospheric Administration RIN 0648-XA665 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... Panel, on September 14-15, 2011, to consider actions affecting New England fisheries in the exclusive...

  11. 76 FR 26706 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-09

    ... National Oceanic and Atmospheric Administration RIN 0648-XA418 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management Council's (Council) Groundfish Committee will meet to consider actions affecting New England fisheries in...

  12. 75 FR 25208 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... National Oceanic and Atmospheric Administration RIN: 0648-XW16 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of cancellation of a public meeting. SUMMARY: The New England... FURTHER INFORMATION CONTACT: Paul J. Howard, Executive Director, New England Fishery Management Council...

  13. 75 FR 11135 - New England Fishery Management Council; Public Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XU97 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of public meetings. SUMMARY: The New England Fishery Management... on March 24, 2010 and March 25, 2010 to consider actions affecting New England fisheries in the...

  14. 75 FR 31424 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XW78 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., 2010 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  15. 76 FR 16619 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-24

    ... National Oeanic and Atmospheric Administration RIN 0648-XA318 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...-13, 2011 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  16. 75 FR 28566 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... National Oceanic and Atmospheric Administration RIN 0648-XW57 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management Council's (Council) Groundfish/Scallop Advisory Panel will meet to consider actions affecting New England...

  17. 77 FR 14004 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XB064 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on...

  18. 77 FR 47373 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XC151 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of public meeting. SUMMARY: The New England Fishery Management... actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this...

  19. 76 FR 7548 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-10

    ... National Oceanic and Atmospheric Administration RIN 0648-XA205 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...) 734-9700. Council address: New England Fishery Management Council, 50 Water Street, Mill 2...

  20. 76 FR 26253 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA417 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management...-2000; fax: (774) 634-2001. Council address: New England Fishery Management Council, 50 Water Street...

  1. Processes of local alcohol policy-making in England: Does the theory of policy transfer provide useful insights into public health decision-making?

    PubMed

    Gavens, Lucy; Holmes, John; Buykx, Penny; de Vocht, Frank; Egan, Matt; Grace, Daniel; Lock, Karen; Mooney, John D; Brennan, Alan

    2017-06-13

    Recent years have seen a rise in new and innovative policies to reduce alcohol consumption and related harm in England, which can be implemented by local, as opposed to national, policy-makers. The aim of this paper is to explore the processes that underpin the adoption of these alcohol policies within local authorities. In particular, it aims to assess whether the concept of policy transfer (i.e. a process through which knowledge about policies in one place is used in the development of policies in another time or place) provides a useful model for understanding local alcohol policy-making. Qualitative data generated through in-depth interviews and focus groups from five case study sites across England were used to explore stakeholder experiences of alcohol policy transfer between local authorities. The purposive sample of policy actors included representatives from the police, trading standards, public health, licensing, and commissioning. Thematic analysis was used inductively to identify key features in the data. Themes from the policy transfer literature identified in the data were: policy copying, emulating, hybridization, and inspiration. Participants described a multitude of ways in which learning was shared between places, ranging from formal academic evaluation to opportunistic conversations in informal settings. Participants also described facilitators and constraints to policy transfer, such as the historical policy context and the local cultural, economic, and bureaucratic context, which influenced whether or not a policy that was perceived to work in one place might be transferred successfully to another context. Theories of policy transfer provide a promising framework for characterising processes of local alcohol policy-making in England, extending beyond debates regarding evidence-informed policy to account for a much wider range of considerations. Applying a policy transfer lens enables us to move beyond simple (but still important) questions of

  2. Towards developing new partnerships in public services: users as consumers, citizens and/or co-producers in health and social care in England and Sweden.

    PubMed

    Fotaki, Marianna

    2011-01-01

    The causes and effects of marketization of public services have been analysed extensively in the literature, but there is relatively little research on how those policies impact on the development of new forms of governance, and the role of users in these new arrangements. This study reviews examples of competition, freedom of choice and personalized care in health and social services in England and Sweden, in order to examine the type of relationships emerging between the user/consumer vis-à-vis market driven providers and various agencies of the state under the marketized welfare. The article focuses on the possible roles users might assume in new hybrid arrangements between markets, collaborations and steering. A user typology: namely, that of a consumer, citizen, co-producer and responsibilized agent in various governance arrangements, is then suggested. The article concludes by arguing that pro-market policies instead of meeting the alleged needs of post-modern users for individualized public services are likely to promote a new type of highly volatile and fragile partnerships, and create a new subordinated user who has no choice but to ‘choose’ services they have little control over.

  3. Forest health monitoring in New England: 1990 annual report

    Treesearch

    Robert T. Brooks; David R. Dickson; William B. Burkman; Imants Millers; Margaret Miller-Weeks; Ellen Cooter; Luther Smith; Luther Smith

    1992-01-01

    The USDA Forest Service, in cooperation with the U.S. Environmental Protection Agency and the New England State Forestry Agencies initiated field sampling for the Forest Health Monitoring program in 1990. Two hundred and sixty-three permanent sample plots were established. Measurements were taken to characterize the physical conditions of the plots. This publication...

  4. Evaluating the Use of Multilocus Variable Number Tandem Repeat Analysis of Shiga Toxin-Producing Escherichia coli O157 as a Routine Public Health Tool in England

    PubMed Central

    Byrne, Lisa; Elson, Richard; Dallman, Timothy J.; Perry, Neil; Ashton, Philip; Wain, John; Adak, Goutam K.; Grant, Kathie A.; Jenkins, Claire

    2014-01-01

    Multilocus variable number tandem repeat analysis (MLVA) provides microbiological support for investigations of clusters of cases of infection with Shiga toxin-producing E. coli (STEC) O157. All confirmed STEC O157 isolated in England and submitted to the Gastrointestinal Bacteria Reference Unit (GBRU) during a six month period were typed using MLVA, with the aim of assessing the impact of this approach on epidemiological investigations. Of 539 cases investigated, 341 (76%) had unique (>2 single locus variants) MLVA profiles, 12% of profiles occurred more than once due to known household transmission and 12% of profiles occurred as part of 41 clusters, 21 of which were previously identified through routine public health investigation of cases. The remaining 20 clusters were not previously detected and STEC enhanced surveillance data for associated cases were retrospectively reviewed for epidemiological links including shared exposures, geography and/or time. Additional evidence of a link between cases was found in twelve clusters. Compared to phage typing, the number of sporadic cases was reduced from 69% to 41% and the diversity index for MLVA was 0.996 versus 0.782 for phage typing. Using MLVA generates more data on the spatial and temporal dispersion of cases, better defining the epidemiology of STEC infection than phage typing. The increased detection of clusters through MLVA typing highlights the challenges to health protection practices, providing a forerunner to the advent of whole genome sequencing as a diagnostic tool. PMID:24465775

  5. Prospective evaluation of a complex public health intervention: lessons from an initial and follow-up cross-sectional survey of the tuberculosis strain typing service in England.

    PubMed

    Mears, Jessica; Abubakar, Ibrahim; Crisp, Debbie; Maguire, Helen; Innes, John A; Lilley, Mike; Lord, Joanne; Cohen, Ted; Borgdorff, Martien W; Vynnycky, Emilia; McHugh, Timothy D; Sonnenberg, Pam

    2014-10-02

    The national tuberculosis strain typing service (TB-STS) was introduced in England in 2010. The TB-STS involves MIRU-VNTR typing of isolates from all TB patients for the prospective identification, reporting and investigation of TB strain typing clusters. As part of a mixed-method evaluation, we report on a repeated cross-sectional survey to illustrate the challenges surrounding the evaluation of a complex national public health intervention. An online initial and follow-up questionnaire survey assessed the knowledge, attitudes and practices of public health staff, physicians and nurses working in TB control in November 2010 and March 2012. It included questions on the implementation, experience and uptake of the TB-STS. Participants that responded to both surveys were included in the analysis. 248 participants responded to the initial survey and 137 of these responded to the follow-up survey (56% retention). Knowledge: A significant increase in knowledge was observed, including a rise in the proportion of respondents who had received training (28.6% to 67.9%, p = 0.003), and the self-rated knowledge of how to use strain typing had improved ('no knowledge' decreased from 43.2% to 27.4%). Attitudes: The majority of respondents found strain typing useful; the proportion that reported strain typing to be useful was similar across the two surveys (95.7% to 94.7%, p = 0.67). Practices: There were significant increases between the initial and follow-up surveys in the number of respondents who reported using strain typing (57.0% to 80.5%, p < 0.001) and the proportion of time health protection staff spent on investigating TB (2.74% to 7.08%, p = 0.04). Evaluation of a complex public health intervention is challenging. In this example, the immediate national roll-out of the TB-STS meant that a controlled survey design was not possible. This study informs the future development of the TB-STS by identifying the need for training to reach wider professional groups, and argues

  6. Public health implications of campylobacter outbreaks in England and Wales, 1995-9: epidemiological and microbiological investigations.

    PubMed Central

    Frost, J. A.; Gillespie, I. A.; O'Brien, S. J.

    2002-01-01

    Although campylobacter has been the most commonly recognized bacterial cause of gastrointestinal infection in England and Wales since 1981, there are few reported campylobacter outbreaks. Of the 2374 general outbreaks of infectious intestinal disease reported to CDSC between 1995 and 1999, for which an aetiological agent was identified, campylobacter accounted for only 50 (2%). Foodborne transmission was identified in 35 outbreaks and the majority took place in commercial catering establishments; waterborne transmission was responsible for a further four outbreaks. Isolates of Campylobacter jejuni were referred for typing from 25 outbreaks. In 13 outbreaks all isolates were the same subtype, as defined by serotype and phage type, while in the remainder more than one campylobacter subtype was involved. PMID:12002527

  7. 76 FR 17381 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in April, 2011, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  8. 75 FR 66072 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-27

    ... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in November, 2010, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  9. 76 FR 7823 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in February 2011, to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  10. 76 FR 17626 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-30

    ... National Oceanic and Atmospheric Administration RIN 0648-XA336 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management...

  11. On Affordability: Public Higher Education in New England

    ERIC Educational Resources Information Center

    Syverud, Gretchen

    2015-01-01

    As the lowest-priced higher education institutions serving the greatest share of students in New England, public institutions are a crucial access point for the region's students who may not have other opportunities to enroll in college. Maintaining the cost of attending a public institution in New England is imperative for students, families,…

  12. On Affordability: Public Higher Education in New England

    ERIC Educational Resources Information Center

    Syverud, Gretchen

    2015-01-01

    As the lowest-priced higher education institutions serving the greatest share of students in New England, public institutions are a crucial access point for the region's students who may not have other opportunities to enroll in college. Maintaining the cost of attending a public institution in New England is imperative for students, families,…

  13. United Kingdom (England): Health system review.

    PubMed

    Boyle, Seán

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

  14. UK Renal Registry 18th Annual Report: Chapter 12 Epidemiology of Reported Infections amongst Patients Receiving Dialysis for Established Renal Failure in England 2013 to 2014: a Joint Report from Public Health England and the UK Renal Registry.

    PubMed

    Evans, Rebecca; Caskey, Fergus; Fluck, Richard; Crowley, Lisa; Davies, John; Nsonwu, Olisaeloka; Farrington, Ken

    2016-01-01

    From 1st May 2013 to 30th April 2014 there were 35 episodes of Methicillin resistant Staphylococcus aureus (MRSA) bacteraemia in established renal failure patients on dialysis. This is now fairly stable year-on-year equating to a rate of 0.15 episodes per 100 dialysis patient years, following an initial decline in rates from 4.0 episodes per 100 dialysis patient years in 2005 when reporting began. Methicillin sensitive Staphylococcus aureus (MSSA) bacteraemia rates were slightly higher this year at 2.23 per 100 dialysis patient years (compared with 1.59 episodes per 100 dialysis patient years last year) with 526 episodes of blood stream infection reported. In 2005, the first year this was reported, there were 1,114 MSSA bacteraemias in 54 centres. There were 247 Clostridium difficile infection episodes with a rate of 1.05 per 100 dialysis patient years, slightly higher than last year at 0.55 episodes per 100 dialysis patient years. Escherichia coli infections occurred at a rate of 1.49 per 100 dialysis patient years, very similar to the rate reported last year (1.32 episodes per 100 dialysis patient years). This report has utilised a new methodology to identify cases, linking all established renal failure cases known to the UK Renal Registry (UKRR) with all infections reported to Public Health England and avoids the need for the local microbiology team to flag the patient as a renal patient. This may have increased the reliability of diagnosis at the UKRR level. In each infection for which access data were collected, the presence of a central venous catheter appeared to correlate with increased risk.

  15. 76 FR 61345 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XA745 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950. FOR FURTHER INFORMATION CONTACT: Paul...

  16. 76 FR 22080 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... access general category management program for the Northern Gulf of Maine (NGOM) area. The action may... National Oceanic and Atmospheric Administration RIN 0648-XA377 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  17. 75 FR 55540 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ... adjustments to make the overall FMP more effective including adjustments to the general category management... National Oceanic and Atmospheric Administration RIN 0648-XY90 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management...

  18. 76 FR 52639 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... state waters is accounted for in both the limited access general category management program for the... National Oceanic and Atmospheric Administration RIN 0648-XA651 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  19. 76 FR 55647 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... National Oceanic and Atmospheric Administration RIN 0648-XA689 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management... 8 a.m. on Tuesday, Wednesday and Thursday. ADDRESSES: The meeting will be held at the Coco Key...

  20. 78 FR 78823 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ...The New England Fishery Management Council (Council) is scheduling a joint public meeting of its Skate Oversight Committee and Skate Advisory Panel on January 15, 2014 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will be brought to the full Council for formal consideration and action, if...

  1. 75 FR 63147 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... National Oceanic and Atmospheric Administration RIN 0648-XZ63 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management... held at the Providence Biltmore Hotel, 11 Dorrance Street, Providence, RI 02903; telephone: (401)...

  2. 77 FR 14351 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-09

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... will be held at the Providence Biltmore Hotel, 11 Dorrance Street, Providence, RI 02903; telephone... Director, New England Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION:...

  3. 78 FR 11820 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... requirements for lobster trawls, stability issues, and unintentional conflicts with mobile gear. The committee...

  4. EPA Awards $270K for Environmental and Health Projects in New England Communities

    EPA Pesticide Factsheets

    EPA has awarded 12 grants across New England under its 2016 Healthy Communities Grant Program, totaling approximately $270,566, to fund community projects addressing environmental and public health issues.

  5. 77 FR 8809 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-15

    ...; Public Hearings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public hearings. SUMMARY: The New England Fishery Management Council (Council) will hold eight public hearings to solicit comment on Draft Amendment 5 to the Atlantic...

  6. Eliciting the Level of Health Inequality Aversion in England.

    PubMed

    Robson, Matthew; Asaria, Miqdad; Cookson, Richard; Tsuchiya, Aki; Ali, Shehzad

    2017-10-01

    Health inequality aversion parameters can be used to represent alternative value judgements about policy concern for reducing health inequality versus improving total health. In this study, we use data from an online survey of the general public in England (n = 244) to elicit health inequality aversion parameters for both Atkinson and Kolm social welfare functions. We find median inequality aversion parameters of 10.95 for Atkinson and 0.15 for Kolm. These values suggest substantial concern for health inequality among the English general public which, at current levels of quality adjusted life expectancy, implies weighting health gains to the poorest fifth of people in society six to seven times as highly as health gains to the richest fifth. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Through the glass ceiling - and back again: the experiences of two of the first non-medical directors of public health in England.

    PubMed

    Evans, David; Adams, Lee

    2007-06-01

    In 2001, the English Department of Health announced a radical re-organisation of the NHS under the banner of 'shifting the balance of power'. As part of this re-organisation health authorities were abolished and the main NHS public health responsibilities devolved to the new primary care trusts (PCTs) from April 2002. Following several years of campaigning by the Multidisciplinary Public Health Forum (MPHF), in November 2001 the Acting Minister for Public Health, Lord Hunt, announced that PCT director of public health (DPH) posts would be open to 'suitably qualified' candidates from any discipline. From April 2002 a number of new DsPH from backgrounds other than medicine were appointed. This paper reports on the experiences of two such DsPH who shared a commitment to multidisciplinary public health, but who did not wholly share the objectives of the MPHF. We place the opening of PCT DPH posts in the context of tensions within NHS public health between a focus on health services versus the wider determinants of health, and the development of multidisciplinary public health. The paper reflects on both the degree of change this opening represented and the limitations and tensions such appointments exposed.

  8. Developing Evidence for Public Health Policy and Practice: The Implementation of a Knowledge Translation Approach in a Staged, Multi-Methods Study in England, 2007-09

    ERIC Educational Resources Information Center

    South, Jane; Cattan, Mima

    2014-01-01

    Effective knowledge translation processes are critical for the development of evidence-based public health policy and practice. This paper reports on the design and implementation of an innovative approach to knowledge translation within a mixed methods study on lay involvement in public health programme delivery. The study design drew on…

  9. Local Government Health Services in Interwar England:

    PubMed Central

    Gorsky, Martin

    2011-01-01

    Summary This article provides a critical discussion of recent work on local government health care and health services in interwar England. A literature review examines case study approaches and comparative quantitative surveys, highlighting conventional and revisionist interpretations. Noting the differing selection criteria evident in some works, it argues that studies based upon a limited number of personal health services provide an insufficient basis for assessing local health activity and policy. There follows a regional study demonstrating various discrepancies between health financing data in local sources and those in nationally collated returns. These in turn give rise to various problems of assessment and interpretation in works relying on the latter, particularly with respect to services for schoolchildren and long-stay patients. The case study points to the importance of integrating poor law medical services in evaluations, and of learning more about the role of government subsidy in supporting expanding services. PMID:22080797

  10. Could you starve to death in England in 1839? The Chadwick-Farr controversy and the loss of the "social" in public health.

    PubMed Central

    Hamlin, C

    1995-01-01

    The public health field has long been pulled in two directions, either toward a narrower biomedical mission to control infectious disease or toward a broader mission to address the social and economic factors that adversely affect health and wellbeing. This paper explores as an instance of this tension an 1839 controversy between the statistician William Farr and the pioneering sanitary reformer Edwin Chadwick on the role of starvation as a cause of death. Farr thought hunger contribution significantly to many deaths; Chadwick wanted Farr to concentrate on the diseases from which people actually died. The paper then considers what the "constitutional" disease theories, which underlay Farr's concerns, implied for public health using medical testimony on child labor in industrial revolution factories as an illustration. An exploration of this constitutional medicine may help provide a "useable past" for modern public health workers interested in broadening the scope of public health. Images p857-a p857-b p859-a PMID:7762726

  11. Using a public health approach to improve end-of-life care: results and discussion of a health needs assessment undertaken in a large city in northern England.

    PubMed

    Ingold, Kathryn; Hicks, Fiona

    2015-06-01

    A detailed health needs assessment (HNA) for end-of-life care (EoLC) services was led by public health in Leeds to inform a commissioning strategy. To answer the question: are we delivering the best possible EoLC services within the resources available? Mixed methods were used with three approaches: epidemiological, corporate and comparative. More people from deprived communities die in hospital. 18% of people who die each year are on a palliative care register, reflecting a lack of recognition and planning for EoLC given that 75% of people who die need EoLC. Over 100 staff, patients and carers were interviewed and over 200 staff returned questionnaires. Staff highlighted concerns about capacity of services; pressure on out-of-hospital care; problems at physical and electronic interfaces between services; suboptimal hospital discharge; need for earlier recognition of the EoL stage for patients. Patients and carers stressed the importance of communication, coordination and continuity of care; full involvement in care planning; honesty and support for the bereaved; an advocate for patients and families; accessible information; improved urgent care; integrated team working; pain relief, dignity and respect. Issues from comparator sites included the need for sustainable leadership for change, lack of interoperability between IT systems; building advance care planning into working culture; gaps in psychological services, bereavement and pastoral support; integration within all clinical areas; lack of district nurses; few investment opportunities; getting home care support right; concerns about 111; incentives for general practitioners to deliver EoLC; variability in service and the Liverpool Care Pathway controversy. Ethical approval was not sought as the HNA was undertaken as a service evaluation. Local policy is that ethical approval is not required for service evaluation.

  12. The New England forest: baseline for New England forest health monitoring

    Treesearch

    Robert T. Brooks; Thomas S Frieswyk; Douglas M. Griffith; Ellen Cooter; Luther Smith; Luther Smith

    1992-01-01

    The USDA Forest Service along with various cooperators has initiated Forest Health Monitoring (FHM) in New England to assess the condition and stressors of the region's forests, to analyze changes in these data over time, and to identify any relationships between forest condition and stressors. A major component of FHM in New England is 263 permanent plots located...

  13. Public Perceptions of Reliability in Examination Results in England

    ERIC Educational Resources Information Center

    He, Qingping; Boyle, Andrew; Opposs, Dennis

    2011-01-01

    Building on findings from existing qualitative research into public perceptions of reliability in examination results in England, a questionnaire was developed and administered to samples of teachers, students and employers to study their awareness of and opinions about various aspects of reliability quantitatively. Main findings from the study…

  14. 75 FR 80798 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-23

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... a.m. ADDRESSES: The meeting will be held at the Clarion Hotel, 1230 Congress Street, Portland, ME..., Executive Director, New England Fishery Management Council; telephone: (978) 465-0492....

  15. 76 FR 77492 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... will be held at the Hotel Providence, 139 Mathewson Street, Providence, RI 02903: telephone: (401) 861... England Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The advisors...

  16. 78 FR 13868 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... Hotel, 18 Washington Square W, Salem, MA 01970; telephone: (978) 744-4080 or (800) 729-7829; or email.... SUPPLEMENTARY INFORMATION: Wednesday, March 20, 2013 and Thursday, March 21, 2013 The New England...

  17. [Publicly funded programs of psychotherapy in Australia and England].

    PubMed

    Vasiliadis, Helen-Maria; Dezetter, Anne

    2015-01-01

    Quebec's HealthCommissioner on the performance of the health system clearly highlighted gaps in the collaboration between primary care physicians and mental health specialists, decreased accessibility and inequity in access to effective mental health services such as psychotherapy.Objectives The aim of this article was to describe the implementation of two publicly funded programs of psychotherapy in Australia and England with similar gatekeeper systems to the one in Quebec.Findings Following the Access to Allied Psychological Services (ATAPS) program introduced in Australia in 2003, one of the most important initiatives from the Council of Australian Governments' National Action Plan on Mental Health 2006-2011 was the Better Access Initiative which commenced in 2006. The plan included AUD1.2 billion in funding for integrating and improving the mental health care system. The purpose of Better Access was to improve the treatment and management of mental illnesses and increasing community access to mental health professionals and providing more affordable mental health care. GPs were encouraged to work more closely with mental health professionals. Under this program, these professionals are able to provide mental health services on a fee-for-service basis subsidized through Medicare. Access to psychological therapies is provided through private providers, rather than through fund holding arrangements. As of 2009 in Australia, 2 million people (1 in 11) had received over 11.2 million subsidized mental health services. A recent study showed clinical improvements in patients with depression associated with Better Access, concluding that the program is meeting previously unmet mental health needs.In the case of England, the IAPT - Improving Access to psychological Therapies-program enabled primary care trusts (PCTs) to implement evidence-based psychological therapies as recommended by National Institute for Health and Clinical Excellence for people suffering from

  18. Institutionalising of public health.

    PubMed

    Karkee, R

    2014-01-01

    Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.

  19. UK Renal Registry 16th annual report: chapter 15 epidemiology of reported infections amongst patients receiving dialysis for established renal Failure in England from May 2011 to April 2012: a joint report from Public Health England and the UK renal registry.

    PubMed

    Crowley, Lisa; Pitcher, David; Wilson, Jennie; Guy, Rebecca; Fluck, Richard

    2013-01-01

    Infection remains one of the leading causes of mortality in established renal failure patients receiving renal replacement therapy (RRT). Since 2007, centres providing RRT in England have been asked to provide additional data on patients with methicillin resistant Staphylococcus aureus (MRSA) bacteraemia. Since 2011, the option to provide data on methicillin sensitive Stapylococcus aureus (MSSA) and Escherichia coli bacteraemia, as well as Clostridium difficile infection has also been available. Data were submitted to Public Health England by laboratories via HCAI-DCS including whether the patients were receiving dialysis. Individual renal centres then confirmed the record either directly via the database or after being contacted. Data were collected for the period of the 1st May 2011 to the 30th April 2012. There were 49 episodes of MRSA bacteraemia, an overall rate of 0.22 per 100 dialysis patients per year, representing a further year on year fall in MRSA rate. There were a higher number of MSSA episodes, 322 in total, with an overall rate of 1.15 per 100 dialysis patients per year. The number of episodes and overall rate of E. coli and C. difficile were 284 and 0.92 per 100 prevalent dialysis patients per year and 172 and 0.61 per 100 prevalent dialysis patients per year respectively. In each infection type the presence of a central venous catheter appeared to correlate with an elevated risk. Data are presented from one year of infections reported to PHE. The rate of MRSA bacteraemia episodes in England continues to fall. There was a higher rate of MSSA infections amongst renal dialysis patients. Findings from the first year of E. coli and C. difficile data collection are also reported. Future cycles will give us a further idea of the trend in incidences of these infections. © 2014 S. Karger AG, Basel.

  20. International Study of Health Care Organization and Financing of renal services in England and Wales.

    PubMed

    Nicholson, Tricia; Roderick, Paul

    2007-12-01

    In England and Wales, the quantity and quality of renal services have improved significantly in the last decade. While acceptance rates for renal replacement therapy appear low by international standards, they are now commensurate with many other northern European countries. The major growth in renal services has been in hemodialysis, especially at satellite units. Health care is predominantly publicly funded through a tax-based National Health Service, and such funding has increased in the last 10 years. Improvements in health outcomes in England and Wales are expected to continue due to the recent implementation of standards, initiatives, and monitoring mechanisms for renal transplantation, vascular access, and patient transport.

  1. Public Health

    EPA Science Inventory

    Earth observations can be used to address human health concerns in many ways: projecting occurrence of disease or disease outbreaks; rapid detection and tracking of events; construction of risk maps; targeting interventions; and enhancing knowledge of human health-environment int...

  2. Public Health

    EPA Science Inventory

    Earth observations can be used to address human health concerns in many ways: projecting occurrence of disease or disease outbreaks; rapid detection and tracking of events; construction of risk maps; targeting interventions; and enhancing knowledge of human health-environment int...

  3. Engaging local public health system partnerships to educate the future public health workforce.

    PubMed

    Caron, Rosemary M; Hiller, Marc D; Wyman, William J

    2013-04-01

    The Institute of Medicine concluded that keeping the public healthy required a well-educated public health workforce, thus leading to its recommendation that "all undergraduates should have access to education in public health" [2]. In response to this call, the authors examined the current practice, feasibility, and value in strengthening (or building) a functional collaborative model between academic institutions and practitioners from local health departments to educate tomorrow's public health workforce. Local and regional health departments in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of collaborations with academic partners; (3) assess how they jointly promote public health workforce development; and (4) analyze which essential public health services their partnership addresses. Despite the lack of financial resources often cited for the absence of academic-local health department collaborations, some New England states reported that their academic institution and local public health department partnerships were valued and productive. The authors discuss how effective academic-community collaborations have the potential to facilitate a broad-based appreciation of public health among students via a wide array of public health curricula and applied experiential learning opportunities in public health settings. The authors propose a model for how to combine basic public health lessons with practical experience and leadership offered by local health departments, in order to foster a real understanding of public health, its importance, practice, and relevance in today's society from a public health workforce perspective.

  4. 78 FR 79402 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ...The New England Fishery Management Council's (Council) Joint VMS/Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone...

  5. 76 FR 7823 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... National Oceanic and Atmospheric Administration RIN 0648-XA208 New England Fishery Management Council... (NEFSC), in cooperation with the New England Fishery Management Council (Council) will convene a webinar..., Executive Director, New England Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY...

  6. 76 FR 70420 - New England Fishery Management Council (NEFMC); Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-14

    ... Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in November, 2011, to consider actions affecting New England fisheries in the exclusive economic zone...

  7. Using Modern Test Theory to Maintain Standards in Public Qualifications in England

    ERIC Educational Resources Information Center

    Wheadon, Christopher

    2013-01-01

    This paper describes how item response theory (IRT) methods of test-equating could be applied to the maintenance of public examination standards in England. IRT methods of test-equating have been sparingly applied to the main public examinations in England, namely the General Certificate of Secondary Education (GCSE), the equivalent of a school…

  8. Using Modern Test Theory to Maintain Standards in Public Qualifications in England

    ERIC Educational Resources Information Center

    Wheadon, Christopher

    2013-01-01

    This paper describes how item response theory (IRT) methods of test-equating could be applied to the maintenance of public examination standards in England. IRT methods of test-equating have been sparingly applied to the main public examinations in England, namely the General Certificate of Secondary Education (GCSE), the equivalent of a school…

  9. Public health governance: views of key stakeholders.

    PubMed

    Marks, L; Cave, S; Hunter, D J

    2010-01-01

    To identify views of key stakeholders on public health governance. Focus groups and interviews. Key national and regional stakeholders in England were invited to participate in focus groups. Three focus groups and four additional interviews were transcribed and a thematic analysis was carried out. Focus groups and interviewees identified points of transition in public health governance including changes in the notion of stewardship, governance across a local public health system and a shift from organizational governance to 'governance of place'. Different governance arrangements and approaches to governance can influence health outcomes through their impact on commissioning strategies, public health practice and performance management regimes. Failure to address these issues will hamper the development of a stewardship role in local organizations and across a local public health system. Copyright 2009 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. American Public Health Association

    MedlinePlus

    ... is Public Health? Creating Healthy Communities Topics & Issues Climate Change Environmental Health Gun Violence Health Equity Health Reform ... 2017 EST Show More Oct 19 Climate Webinar Climate Changes Children's Health: Protecting Our Future Date: Oct 19 ...

  11. Public health system partnerships: role for local boards of health in preparing the future public health workforce.

    PubMed

    Caron, Rosemary M; Hiller, Marc D; Wyman, William J

    2014-02-01

    The Institute of Medicine's report, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, recommended that public health education be accessible to undergraduate students. Promoting access to public health education will ideally contribute to a well-educated public health workforce, thus assuring the fulfillment of the public health mission. In response to this call to action, the authors examined the current practice, feasibility, and value in developing a functional partnership between academic institutions and local boards of health in preparing future public health professionals. Local boards of health in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of their collaborations with academic partners; and (3) assess how they jointly advance public health workforce development. Despite the main barriers of a lack of time, staff, and funding that are often cited for the absence of collaborations between institutions, one New England state, in particular, reported that their academic institution and local board of health partnerships were important and effective. The authors discuss how academic-practice collaborations hold the potential to combine basic public health principles with leadership and governance experience offered by local boards of health. Such partnerships are underutilized and have the potential to integrate core public health concepts while facilitating applied experiential learning opportunities in a professional public health setting, thus contributing to the development of the future public health workforce.

  12. 76 FR 10561 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-25

    ... Consortium and the Southern New England Research Collaborative Initiative. Information about project topic... review all funded cooperative research projects in the Northeast over the last several years, including...

  13. Training Public Health Advisors.

    PubMed

    Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L

    2015-01-01

    Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

  14. 78 FR 24730 - New England Fishery Management Council (NEFMC); Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... National Oceanic and Atmospheric Administration RIN 0648-XC641 New England Fishery Management Council... Management Council (Council) is scheduling a public meeting of its Scientific and Statistical Committee (SSC...) 339-2200; fax: (508) 339- 1040. Council address: New England Fishery Management Council, 50...

  15. 77 FR 42699 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... Director, New England Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The... modifications to the current days-at-sea (DAS) management system, including alternatives to enable DAS leasing... National Oceanic and Atmospheric Administration RIN 0648-XC116 New England Fishery Management...

  16. Health status of Gypsies and Travellers in England.

    PubMed

    Parry, Glenys; Van Cleemput, Patrice; Peters, Jean; Walters, Stephen; Thomas, Kate; Cooper, Cindy

    2007-03-01

    To provide the first valid and reliable estimate of the health status of Gypsies and Travellers in England by using standardised instruments to compare their health with that of a UK resident non-Traveller sample, drawn from different socioeconomic and ethnic groups, matched for age and sex. Epidemiological survey, by structured interview, of quota sample and concurrent age-sex-matched comparators. The homes or alternative community settings of the participants at five study locations in England. Gypsies and Travellers of UK or Irish origin (n = 293) and an age-sex-matched comparison sample (n = 260); non-Gypsies or Travellers from rural communities, deprived inner-city White residents and ethnic minority populations. Gypsies and Travellers reported poorer health status for the last year, were significantly more likely to have a long-term illness, health problem or disability, which limits daily activities or work, had more problems with mobility, self-care, usual activities, pain or discomfort and anxiety or depression as assessed using the EuroQol-5D health utility measure, and a higher overall prevalence of reported chest pain, respiratory problems, arthritis, miscarriage and premature death of offspring. No inequality was reported in diabetes, stroke and cancer. Significant health inequalities exist between the Gypsy and Traveller population in England and their non-Gypsy counterparts, even when compared with other socially deprived or excluded groups, and with other ethnic minorities.

  17. Health status of Gypsies and Travellers in England

    PubMed Central

    Parry, Glenys; Van Cleemput, Patrice; Peters, Jean; Walters, Stephen; Thomas, Kate; Cooper, Cindy

    2007-01-01

    Objective To provide the first valid and reliable estimate of the health status of Gypsies and Travellers in England by using standardised instruments to compare their health with that of a UK resident non‐Traveller sample, drawn from different socioeconomic and ethnic groups, matched for age and sex. Design Epidemiological survey, by structured interview, of quota sample and concurrent age–sex‐matched comparators. Setting The homes or alternative community settings of the participants at five study locations in England. Participants Gypsies and Travellers of UK or Irish origin (n = 293) and an age–sex‐matched comparison sample (n = 260); non‐Gypsies or Travellers from rural communities, deprived inner‐city White residents and ethnic minority populations. Results Gypsies and Travellers reported poorer health status for the last year, were significantly more likely to have a long‐term illness, health problem or disability, which limits daily activities or work, had more problems with mobility, self‐care, usual activities, pain or discomfort and anxiety or depression as assessed using the EuroQol‐5D health utility measure, and a higher overall prevalence of reported chest pain, respiratory problems, arthritis, miscarriage and premature death of offspring. No inequality was reported in diabetes, stroke and cancer. Conclusions Significant health inequalities exist between the Gypsy and Traveller population in England and their non‐Gypsy counterparts, even when compared with other socially deprived or excluded groups, and with other ethnic minorities. PMID:17325395

  18. Variations in prison mental health services in England and Wales.

    PubMed

    Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean

    2013-01-01

    In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Modernizing public health law.

    PubMed

    Griffith, Richard; Tengnah, Cassam

    2011-07-01

    The rapid spread of a mutant strain of Escherichia coli throughout Europe highlights the need for modern and flexible public health laws to identify, control and treat infections and contamination that give significant concern for the health of the population. In this article, Richard Griffith and Cassam Tengnah outline the amendments to the Public Health (Control of Disease) Act 1984 that adopt an all-hazards approach to threats to public health.

  20. 78 FR 37796 - New England Fishery Management Council (NEFMC); Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-24

    ... National Oceanic and Atmospheric Administration RIN 0648-XC718 New England Fishery Management Council (NEFMC); Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... Deputy Director, Office of Sustainable Fisheries, National Marine Fisheries Service. BILLING CODE...

  1. 78 FR 29116 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... Council's (Council) Vessel Monitoring System (VMS)/Enforcement will meet jointly with the Advisory Panel to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The...

  2. 76 FR 64901 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-19

    ..., in which the New England and Mid-Atlantic Councils are considering the inclusion of catch shares... meeting is physically accessible to people with disabilities. Requests for sign language interpretation...

  3. 77 FR 34024 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will.... Northeast University; (5) Ecological Role of Adult and Juvenile Anadromous Forage fish in Downeast Maine...

  4. 75 FR 80796 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-23

    ... Water Street, Mill 2, Newburyport, MA 01950. FOR FURTHER INFORMATION CONTACT: Paul J. Howard, Executive Director, New England Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The... apply to those hotspots (sampling, monitoring, avoidance, protection). 3. They will...

  5. 75 FR 47780 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... Council's (Council) Herring Advisory Panel (AP) will meet to consider actions affecting New England...: 1. Review and provide AP recommendations regarding catch monitoring alternatives under development in Amendment 5 to the Atlantic Herring Fishery Management Plan (FMP); AP discussion may...

  6. 77 FR 86 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-03

    ... Panel (AP) in January 2012 to consider actions affecting New England fisheries in the exclusive economic..., Committee and PDT members. It is highly recommended that AP and other participants bring...

  7. 77 FR 42278 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA... meeting will be held at the Sheraton Harborside Hotel, 250 Market Street, Portsmouth, NH 03801; telephone... Director, New England Fishery Management Council; telephone: (978) 465-0492. ] SUPPLEMENTARY...

  8. 77 FR 29315 - New England Fishery Management Council; Public Meeting;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... FURTHER INFORMATION CONTACT: Paul J. Howard, Executive Director, New England Fishery Management Council... FR 26515). The DATES caption has been corrected. The agenda and the rest of the text have not...

  9. Public health workforce enumeration.

    PubMed

    Gebbie, Kristine M; Raziano, Amanda; Elliott, Sterling

    2009-05-01

    Comprehensive data on the public health workforce are fundamental to workforce development throughout the public health system. Such information is also a critical data element in public health systems research, a growing area of study that can inform the practice of public health at all levels. However, methodologic and institutional issues challenge the development of comparable indicators for the federal, state, and local public health workforce. A 2006-2007 Association of State and Territorial Health Officials workforce enumeration pilot project demonstrated the issues involved in collecting workforce data. This project illustrated key elements of an institutionalized national system of workforce enumeration, which would be needed for a robust, recurring count that provides a national picture of the public health workforce.

  10. Transportation and public health.

    PubMed

    Litman, Todd

    2013-01-01

    This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

  11. Prisons and health reforms in England and Wales.

    PubMed

    Hayton, Paul; Boyington, John

    2006-10-01

    Prison health in England and Wales has seen rapid reform and modernization. Previously it was characterized by over-medicalization, difficulties in staff recruitment, and a lack of professional development for staff. The Department of Health assumed responsibility from Her Majesty's Prison Service for health policymaking in 2000, and full budgetary and health care administration control were transferred by April 2006. As a result of this reorganization, funding has improved and services now relate more to assessed health need. There is early but limited evidence that some standards of care and patient outcomes have improved. The reforms address a human rights issue: that prisoners have a right to expect their health needs to be met by services that are broadly equivalent to services available to the community at large. We consider learning points for other countries which may be contemplating prison health reform, particularly those with a universal health care system.

  12. Prisons and Health Reforms in England and Wales

    PubMed Central

    Hayton, Paul; Boyington, John

    2006-01-01

    Prison health in England and Wales has seen rapid reform and modernization. Previously it was characterized by over-medicalization, difficulties in staff recruitment, and a lack of professional development for staff. The Department of Health assumed responsibility from Her Majesty’s Prison Service for health policymaking in 2000, and full budgetary and health care administration control were transferred by April 2006. As a result of this reorganization, funding has improved and services now relate more to assessed health need. There is early but limited evidence that some standards of care and patient outcomes have improved. The reforms address a human rights issue: that prisoners have a right to expect their health needs to be met by services that are broadly equivalent to services available to the community at large. We consider learning points for other countries which may be contemplating prison health reform, particularly those with a universal health care system. PMID:17008562

  13. Public Health Law Reform

    PubMed Central

    Gostin, Lawrence O.

    2001-01-01

    Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agencies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system. PMID:11527757

  14. Public health law reform.

    PubMed

    Gostin, L O

    2001-09-01

    Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agen cies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system.

  15. ENVIRONMENTAL PUBLIC HEALTH INDICATORS

    EPA Science Inventory

    Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

  16. ENVIRONMENTAL PUBLIC HEALTH INDICATORS

    EPA Science Inventory

    Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

  17. Integrated mental health services in England: a policy paradox

    PubMed Central

    England, Elizabeth; Lester, Helen

    2005-01-01

    Abstract Purpose The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Data sources Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. Conclusion We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. Discussion We conclude with suggestions for strategies that may facilitate more integrated working. PMID:16773165

  18. Integrated mental health services in England: a policy paradox.

    PubMed

    England, Elizabeth; Lester, Helen

    2005-01-01

    The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. We conclude with suggestions for strategies that may facilitate more integrated working.

  19. What Ails Public Health?

    ERIC Educational Resources Information Center

    Alcabes, Philip

    2007-01-01

    Public health, once the gem of American social programs, has turned to dross. During the 20th century, the public-health sector wiped smallpox and polio off the U.S. map; virtually eliminated rickets, rubella, and goiter; stopped epidemic typhoid and yellow fever; and brought tuberculosis--once the leading cause of death in U.S. cities--under…

  20. What Ails Public Health?

    ERIC Educational Resources Information Center

    Alcabes, Philip

    2007-01-01

    Public health, once the gem of American social programs, has turned to dross. During the 20th century, the public-health sector wiped smallpox and polio off the U.S. map; virtually eliminated rickets, rubella, and goiter; stopped epidemic typhoid and yellow fever; and brought tuberculosis--once the leading cause of death in U.S. cities--under…

  1. Development of integrated care in England and the Netherlands: managing across public-private boundaries.

    PubMed

    Mur-Veeman, Ingrid; Hardy, Brian; Steenbergen, Marijke; Wistow, Gerald

    2003-09-01

    This paper addresses the impact of the public-private mix in the Dutch and English health and social care systems on the development and delivery of integrated care. Integrated care is conceived of as an organisational process of coordination which seeks to achieve seamless and continuous care, tailored to the patients' needs and based on a holistic view of the patient. We describe both systems' structures and characteristics from a historical perspective, which means that developments and processes within the systems are put in the spotlight. We demonstrate that the dividing- or fault-lines, such as the financial split between short-term and long-term care in the Netherlands and the divisions between health and social care as well as between the public, private and voluntary sectors in England have hindered integrated care development and delivery in both countries. Contradictory interests, differences in professional and organisational cultures, power relations, and mistrust between and within these sectors have had a clear impact on integrated care development and delivery within networks of public authorities and public and/or private providers. We explain these phenomena in terms of network theory as a basis for drawing lessons for policy makers and those developing integrated care networks.

  2. How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives.

    PubMed

    Saramunee, Kritsanee; Krska, Janet; Mackridge, Adam; Richards, Jacqueline; Suttajit, Siritree; Phillips-Howard, Penelope

    2014-01-01

    Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. 75 FR 76703 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-09

    ... Plan (FMP). The purpose of Amendment 6 is to consider one or more catch share management approaches for... National Oceanic and Atmospheric Administration RIN 0648-XA080 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Monkfish Fishery Management Plan Amendment 6; Scoping Hearings; Request...

  4. 76 FR 70420 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-14

    ... Fisheries Training Center lyle.e.kessler@uscg.mil with ``I plan to attend the gear stowage workshop'' in the... hold a Commercial Fishing Gear Stowage Workshop to consider actions affecting New England fisheries in... a.m. ADDRESSES: The meeting will be held at the Northeast Regional Fisheries Training Center,...

  5. 78 FR 6305 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... discussion in the committee's agenda are as follows: The Recreational Advisory Panel (RAP) will meet to... 2013. Measures may need to be modified because of reduced quotas for these two stocks. The RAP will... reductions. The RAP's advice will be provided to the New England Fishery Management Council and its...

  6. 75 FR 62507 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... Development Team in October 2010 to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will be brought to the full Council for formal... Development Team to discuss management alternatives related to minimizing the adverse effects of fishing...

  7. 77 FR 16540 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will... coral zones. Other issues related to these options/alternatives will also be discussed. The Council will... presentation from Stellwagen Bank National Marine Sanctuary staff regarding an ecological research area...

  8. 76 FR 55645 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... Council's (Council), it's Groundfish Advisory Panel and Plan Development Team along with its Scientific... agenda are as follows: The New England Fishery Management Council (NEFMC) will host a ``lessons learned... 16 to the Northeast Multispecies (Groundfish) Plan. Topics to be discussed include: What elements...

  9. 77 FR 25143 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... Recreational Advisory Panel (RAP) will meet to discuss Northeast Multispecies management measures for ] fishing year 2013 and beyond. RAP members will discuss potential recreational fishing measures for Gulf of...) Recreational Advisory Panel will meet to consider actions affecting New England fisheries in the...

  10. Insights in Public Health

    PubMed Central

    Chosy, Julia; Benson, Katherine; Belen, Dulce; Starr, Ranjani; Lowery St John, Tonya; Starr, Ranjani R; Ching, Lance K

    2015-01-01

    Data form the framework around which important public health decisions are made. Public health data are essential for surveillance and evaluating change. In Hawai‘i, public health data come from a multitude of sources and agencies. The Hawai‘i Health Data Warehouse (HHDW) was created to pull those data into a single location and to present results in a form that is easy for the public to access and utilize. In the years since its creation, HHDW has built a second consumer-focused web site, Hawai‘i Health Matters, and is now introducing new functionality on the original site that allows users to define their own enquiry. The newly adopted Indicator-Based Information System (IBIS) uses a web interface to perform real-time data analysis and display results. This gives users the power to examine health data by a wide range of demographic and socioeconomic dimensions, permitting them to pinpoint the data they need. PMID:26568903

  11. The Ebola epidemic and public health response.

    PubMed

    Moll, R; Reece, S; Cosford, P; Kessel, A

    2016-03-01

    An unprecedented global effort has been required to tackle the Ebola outbreak in West Africa. In this paper, we describe the contribution of Public Health England (PHE) in West Africa and the UK. Public Health England The epidemic has been a humanitarian crisis for the three worst affected countries. PHE contributions have included expertise in outbreak control and microbiology services in West Africa, and UK preparedness for an imported case. National and international systems require change to enhance the response to the next international public health crisis. Legacy planning following the epidemic will be crucial, supporting the recovery of the health and public health systems in West Africa and ensuring that the knowledge gained during this outbreak is put to best use. Ongoing PHE-associated research includes efforts to understand the pathogenicity of Ebola virus disease, improve diagnostic capability, explore therapeutic options and develop new vaccines. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. The national mobile health worker project in England.

    PubMed

    Drayton, Kathryn; Robinson, Karen

    2014-01-01

    Community services provide essential care to many, often vulnerable, people, families and communities along the spectrum from health promotion to end of life care. The Mobile Health Worker Project is part of a larger project, the Transforming Community Services programme, which was established to support providers make changes to service provision that would provide better health outcomes, as well as increasing efficiency through the use of technology. This paper draws on the results of the two phase Mobile Health Worker project which involved 11 sites around England, the aim of which was to understand the requirements of mobile working. The results demonstrate that increased productivity and efficiency can be achieved by making changes to working processes. The project also provides guidance to increase the rate of mobile working adoption by providing a solid economic basis for investment in and deployment of mobile solutions to community organisations.

  13. Market competition in health care markets in the Netherlands: some lessons for England?

    PubMed

    den Exter, André P; Guy, Mary J

    2014-01-01

    This article seeks to establish what lessons might be available to the English health care sector following enactment of the Health and Social Care Act 2012 from the Dutch experience of introducing market competition into health care via a mandatory health insurance scheme implemented by for-profit insurance companies. The existence of the Beveridge NHS model in England, and a Bismarckian insurance system in The Netherlands perhaps suggest that a comparison of the two countries is at best limited, and reinforced by the different Enthoven-inspired competitive models each has adopted. However, we contend that there are positive and negative issues arising from introducing competition into health care-, e.g. concerns about equity and benefits of efficiencies-which go beyond national boundaries and different systems and reflect the global paradigm shift towards the use of market forces in previously non-market areas such as health. The article examines the situation in England following the HSCA 2012 and The Netherlands following the 2006 reforms before analysing two areas of common ground: the focus in both countries on competition on quality (as opposed to price) and integrated care, which is assuming ever greater significance. We suggest that our combined insights (as a health lawyer and competition lawyer respectively) coupled with a comparative approach create a novel contribution to current calls for a wider public debate about the real role of markets in health care over and above simple characterisation as a force for good or bad.

  14. Community water fluoridation and health outcomes in England: a cross-sectional study.

    PubMed

    Young, Nicholas; Newton, John; Morris, John; Morris, Joan; Langford, John; Iloya, Jonathan; Edwards, Diane; Makhani, Semina; Verne, Julia

    2015-12-01

    Six million people in England live in areas where the level of fluoride in water is adjusted to reduce the significant public health burden of dental caries. The dental effects of fluoride are well established, but evidence for suggested adverse health effects is limited, with a lack of rigorous small area population studies that control for confounding. This study aims to test the association between water fluoridation schemes and selected health outcomes using the best available routine data sources. Ecological level exposure to fluoridated water was estimated for standard small areas and administrative districts in England using Geographical Information Systems and digitized boundaries based on known patterns of water supply. The association between fluoridation and dental and nondental health indicators was tested using multivariable regression models including ecological level confounding variables. Health indicator data were obtained from routine sources. There was strong evidence of lower prevalence of dental caries (P < 0.001) among children living in fluoridated areas, they also had fewer teeth affected on average (P < 0.001), and lower admission rates for tooth extraction (55% lower; 95% CI-73%, -27%; P = 0.001). There was no strong evidence of an association between fluoridation and hip fracture, Down syndrome, all-cancer, all-cause mortality or osteosarcoma. Fluoridation was negatively associated with the incidence of renal stones (7.9% lower; 95% CI-9.6%,-6.2%; P < 0.001) and bladder cancer (8.0% lower; 95% CI-9.9%,-6.0%; P < 0.001). This study uses the comprehensive data sets available in England to provide reassurance that fluoridation is a safe and highly effective public health measure to reduce dental decay. Although lower rates of certain nondental outcomes were found in fluoridated areas, the ecological, observational design prohibits any conclusions being drawn regarding a protective role of fluoridation. © 2015 John Wiley & Sons A

  15. Patterns of municipal health expenditure in interwar England and Wales.

    PubMed

    Levene, Alysa; Powell, Martin A; Stewart, John

    2004-01-01

    This article aims to fill a gap in the history of medical services in England and Wales in the interwar period by focusing on the historiographically neglected municipal sector--a relative neglect that is particularly unjustified given that this sector provided an increasingly wide array of medical services over the period. Focusing on the highly urbanized county boroughs, this article investigates whether and how expenditure on municipal health services changed over the interwar period, and whether these patterns were replicated by boroughs across England and Wales. It is found that many of the largest personal health services were experiencing a common pattern of growing investment over the period, but that county boroughs did not act uniformly in their spending decisions. Considered regionally, the Northeast and the West Midlands were found to perform poorly in expenditure terms compared to the data set as a whole, while the large conurbations of Leeds, Manchester, and Liverpool raised the average performance of the Northwest and Yorkshire. Regional patterns are found to be less consistent in the south of the country, where voluntary provision and demands arising from the boroughs' geographical position (for example, seaside resorts) may have exerted significant influences over levels of expenditure on health.

  16. The Future of Public Forests: An Institutional Blending Approach to Forest Governance in England

    ERIC Educational Resources Information Center

    Hodge, Ian D.; Adams, William M.

    2013-01-01

    Early in 2011, the Government initiated a consultation on the potential sale of the Public Forest Estate in England. This proposal leads to vociferous negative public reaction and the consultation was withdrawn and an Independent Panel established. This paper reviews the arguments as to the options and appropriate institutional arrangements for…

  17. The Future of Public Forests: An Institutional Blending Approach to Forest Governance in England

    ERIC Educational Resources Information Center

    Hodge, Ian D.; Adams, William M.

    2013-01-01

    Early in 2011, the Government initiated a consultation on the potential sale of the Public Forest Estate in England. This proposal leads to vociferous negative public reaction and the consultation was withdrawn and an Independent Panel established. This paper reviews the arguments as to the options and appropriate institutional arrangements for…

  18. Health professionals' experiences of tuberculosis cohort audit in the North West of England: a qualitative study.

    PubMed

    Wallis, Selina K; Jehan, Kate; Woodhead, Mark; Cleary, Paul; Dee, Katie; Farrow, Stacey; McMaster, Paddy; Wake, Carolyn; Walker, Jenny; Sloan, D J; Squire, S B

    2016-03-16

    Tuberculosis cohort audit (TBCA) was introduced across the North West (NW) of England in 2012 as an ongoing, multidisciplinary, systematic case review process, designed to improve clinical and public health practice. TBCA has not previously been introduced across such a large and socioeconomically diverse area in England, nor has it undergone formal, qualitative evaluation. This study explored health professionals' experiences of the process after 1515 cases had been reviewed. Qualitative study using semistructured interviews. Respondents were purposively sampled from 3 groups involved in the NW TBCA: (1) TB nurse specialists, (2) consultant physicians and (3) public health practitioners. Data from the 26 respondents were triangulated with further interviews with key informants from the TBCA Steering Group and through observation of TBCA meetings. Interview transcripts were analysed thematically using the framework approach. Participants described the evolution of a valuable 'community of practice' where interprofessional exchange of experience and ideas has led to enhanced mutual respect between different roles and a shared sense of purpose. This multidisciplinary, regional approach to TB cohort audit has promoted local and regional team working, exchange of good practices and local initiatives to improve care. There is strong ownership of the process from public health professionals, nurses and clinicians; all groups want it to continue. TBCA is regarded as a tool for quality improvement that improves patient safety. TBCA provides peer support and learning for management of a relatively rare, but important infectious disease through discussion in a no-blame atmosphere. It is seen as an effective quality improvement strategy which enhances TB care, control and patient safety. Continuing success will require increased engagement of consultant physicians and public health practitioners, a secure and ongoing funding stream and establishment of clear reporting

  19. Health professionals’ experiences of tuberculosis cohort audit in the North West of England: a qualitative study

    PubMed Central

    Jehan, Kate; Woodhead, Mark; Cleary, Paul; Dee, Katie; Farrow, Stacey; McMaster, Paddy; Wake, Carolyn; Walker, Jenny; Squire, S B

    2016-01-01

    Objectives Tuberculosis cohort audit (TBCA) was introduced across the North West (NW) of England in 2012 as an ongoing, multidisciplinary, systematic case review process, designed to improve clinical and public health practice. TBCA has not previously been introduced across such a large and socioeconomically diverse area in England, nor has it undergone formal, qualitative evaluation. This study explored health professionals’ experiences of the process after 1515 cases had been reviewed. Design Qualitative study using semistructured interviews. Respondents were purposively sampled from 3 groups involved in the NW TBCA: (1) TB nurse specialists, (2) consultant physicians and (3) public health practitioners. Data from the 26 respondents were triangulated with further interviews with key informants from the TBCA Steering Group and through observation of TBCA meetings. Analysis Interview transcripts were analysed thematically using the framework approach. Results Participants described the evolution of a valuable ‘community of practice’ where interprofessional exchange of experience and ideas has led to enhanced mutual respect between different roles and a shared sense of purpose. This multidisciplinary, regional approach to TB cohort audit has promoted local and regional team working, exchange of good practices and local initiatives to improve care. There is strong ownership of the process from public health professionals, nurses and clinicians; all groups want it to continue. TBCA is regarded as a tool for quality improvement that improves patient safety. Conclusions TBCA provides peer support and learning for management of a relatively rare, but important infectious disease through discussion in a no-blame atmosphere. It is seen as an effective quality improvement strategy which enhances TB care, control and patient safety. Continuing success will require increased engagement of consultant physicians and public health practitioners, a secure and ongoing

  20. Health, equity and the north of England: a case study on a new approach.

    PubMed

    Johnstone, Paul

    2015-01-01

    In 2013, responsibility for public health returned to local government from the National Health Service (NHS) in England. This article describes, as a case study, a new fresh approach to tackling health inequalities, which built on a desire by local councils in the north of England to rethink approaches and collaborate on new ideas to improving health and reducing health inequalities. The collaboration was supported by an independently commissioned inquiry that assessed the evidence and proposed new policy options. This article describes the context to the collaboration, called Health Equity North, findings from the independent inquiry and emerging impact. Four areas for action were recommended: linking poverty with economic prosperity, devolution and public sector reform, investment in early years and renewed impetus for the health sector. That health service action alone had been limited without addressing the wider determinants of health such as employment, education and housing. The so-called north-south divide appears to be widening, and renewed efforts are needed locally and nationally to tackle these wider determinants of health. This collaborative approach spanning a large geography supported by local and national leaderships, enabled new work locally and influenced policy nationally, such as devolution of power and resources to local areas. Research is needed on the economic returns of investing in the social determinants of health. The examples of local action indicate the need for research on 'asset-based approaches' to improving community health, presented so to empower local lay decision makers such as councillor rather than for technical experts. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Public health and peace.

    PubMed

    Laaser, Ulrich; Donev, Donco; Bjegović, Vesna; Sarolli, Ylli

    2002-04-01

    The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

  2. Social participation in health in Brazil and England: inclusion, representation and authority

    PubMed Central

    Barnes, Marian; Coelho, Vera Schattan

    2009-01-01

    Abstract Aim  This article offers a brief description and analysis of public participation in health in Brazil and England in order to highlight different motivators and tensions within an acceptance of participation as official policy. Sources/methods  The article draws on a range of research in both countries and an analysis of official documents relating to participation. It is based on collaboration between researchers deriving from broad programmes of work on public participation in which the authors are involved. Argument  There is a tension between different principles underpinning collective public involvement in health both within and between countries. Different aspirations or claims have been made about what such participation will achieve and there are trade‐offs between design principles that have consequences for issues such as who takes part and thus also for what can be achieved. The democratic origins of public participation are more evident in the Brazilian situation than in England, but there are still questions about the inclusivity of the practices through which this is achieved. The English picture is both more diverse and dynamic, but formal decision‐making power of participatory forums is less than in Brazil. Whilst social justice claims for participation have been made in both countries, there is as yet limited evidence that these have been realized. PMID:19754687

  3. Children's Health Publications

    EPA Pesticide Factsheets

    Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.

  4. Schisms in the church: National Health Service systems and institutional divergence in England and Wales.

    PubMed

    Hughes, David; Vincent-Jones, Peter

    2008-12-01

    Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.

  5. Public health workforce taxonomy.

    PubMed

    Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J

    2014-11-01

    Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Neighbourhood environment and its association with self rated health: evidence from Scotland and England.

    PubMed

    Cummins, Steven; Stafford, Mai; Macintyre, Sally; Marmot, Michael; Ellaway, Anne

    2005-03-01

    To investigate associations between measures of neighbourhood social and material environment and self rated health. New contextual measures added to cross sectional study of a sample of people from the Health Survey for England and the Scottish Health Survey to provide multilevel data. 13,899 men and women aged 16 or over for whom data on self rated health were available from the Health Survey for England (years 1994-99) and the Scottish Health Survey (years 1995 and 1998). Fair to very bad self rated health was significantly associated with six neighbourhood attributes: poor physical quality residential environment, left wing political climate, low political engagement, high unemployment, lower access to private transport, and lower transport wealth. Associations were independent of sex, age, social class, and economic activity. Odds ratios were larger for non-employed residents than for employed residents. Self rated health was not significantly associated with five other neighbourhood measures: public recreation facilities, crime, health service provision, access to food shops, or access to banks and buildings societies. Some, but not all, features of the neighbourhood environment are associated with self rated health and may be indicators of important causal pathways that could provide a focus for public health intervention strategies. Associations were more pronounced for non-employed residents, perhaps because of greater exposure to the local environment compared with employed people. Operationalizing specific measures of the characteristics of local areas hypothesised to be important for living a healthy life provides a more focused approach than general measures of deprivation in the search for area effects.

  7. Gauging the Health of New England's Lakes and Ponds

    EPA Science Inventory

    The New England Lakes and Ponds Project provides a consistent and first time comprehensive assessment of the ecological and water quality condition of lakes and ponds across the New England region. The project is being conducted by EPA along with the New England Interstate Water...

  8. Gauging the Health of New England's Lakes and Ponds

    EPA Science Inventory

    The New England Lakes and Ponds Project provides a consistent and first time comprehensive assessment of the ecological and water quality condition of lakes and ponds across the New England region. The project is being conducted by EPA along with the New England Interstate Water...

  9. Awareness and Use of mHealth Apps: A Study from England.

    PubMed

    Kayyali, Reem; Peletidi, Aliki; Ismail, Muhammad; Hashim, Zahra; Bandeira, Pedro; Bonnah, Jennifer

    2017-06-14

    Purpose: Mobile health (mHealth) solutions have become an inevitable element of the healthcare landscape. The recommendation and use of mHealth is important, but it is often underutilised. This study was conducted in England. It aimed to determine the use and recommendation of mHealth apps by pharmacists, the public's perceptions of mHealth apps in general, and the awareness and use of health apps by diabetic patients in particular. Methods: The study used a mixed research approach, utilising a sequence of survey-based questionnaires with pharmacists and the general public, followed by semi-structured interviews with diabetic patients. Results: Pharmacists' questionnaires revealed that 56% of the respondents were aware of health apps, 60% of which recommended them to patients. Over 76% of the individuals owned a smartphone. The types of applications that saw the most use from the general public were health and lifestyle apps (24%), social apps (19%), followed by news (18%). Although eight out of nine diabetic patients owned a smartphone, only three used diabetes apps. Diabetic patients also suggested an interest in using diabetes apps to aid in optimising care via the utilisation of visual aids, reminders, recording patient data, social coaching, and remote collaboration with healthcare professionals (HCPs), but time was seen as the biggest obstacle to using a diabetes mHealth application. Conclusion: Despite the growing number of mHealth apps, the level of awareness and usability of such apps by patients and pharmacists was still relatively low. Nevertheless, the majority who used health apps found them to be beneficial, and the public agreed that it helped them to live a healthier lifestyle. Therefore, health apps have great potential in health promotion. Pharmacists are ideally placed to promote them and make patients more aware of them. To increase the use of these apps, it is necessary to first increase awareness and knowledge of these apps, both to the public

  10. What influences the transfer of research into health policy and practice? Observations from England and Australia.

    PubMed

    Nutbeam, D; Boxall, A-M

    2008-08-01

    To explore the role of evidence in the public health policy-making process, and show how the way in which public health problems are defined and measured influences policy outcomes. The policy responses of the Blair Labour Government in the UK and the Howard Coalition Government in Australia to persistent health inequalities over the last decade are examined as a case study. Soon after being elected, the Blair Government commissioned an independent inquiry into health inequalities, signalling the priority it gave to addressing this longstanding challenge. It chose to take a 'whole-of-government' approach, combining actions that addressed both personal risk factors and the social determinants of health. This approach reflects the long-established tradition in England of routinely measuring disparities in health outcomes and correlating them with socio-economic status and underlying social determinants of health. Over the same period, the Howard Government also outlined its 'whole-of-government' approach to addressing the most extreme and persistent health inequalities between indigenous and non-indigenous Australians. In contrast, its approach focused primarily on modifying risk factors and improving service provision. This approach reflects the different historical circumstances in Australia and a different tradition in the collection of health data, focused more on health service access and personal risk factors. This case study offers some insight into the ways in which the production and presentation of evidence can influence and shape governmental responses to public health problems. The usefulness of available evidence is dependent upon the type of data that is produced routinely by government, as well as more deliberate decisions concerning public health research funding. Researchers can maximize the influence of research evidence on the policy process by engaging in the policy-making process, presenting research in ways that fit with the political context of

  11. Insights in Public Health

    PubMed Central

    Nelson-Hurwitz, Denise C; Arakaki, Lee-Ann; Uemoto, Maya

    2017-01-01

    The University of Hawai‘i at Manoa (UHM) has long provided public health graduate education. The University's Office of Public Health Studies (OPHS) has recently started to offer a Bachelor of Arts in Public Health (BA PH) degree in response to the growing need for professionals in the health field. The purpose of this paper is to describe how UHM operates the BA PH and how the program complements OPHS's mission and goals. First, we describe the overall scope of the BA PH within OPHS and within UHM. Then we provide examples of how the BA PH program and past undergraduate student projects align with OPHS's four main goals: (1) education, (2) research, (3) service, and (4) program development. PMID:28352496

  12. Illicit drugs, infectious disease and public health: A historical perspective

    PubMed Central

    Berridge, Virginia; Bourne, Shawna

    2005-01-01

    The present report outlines a presentation by Professor Virginia Berridge at the Second Stanier Lecture held in Halifax, Nova Scotia, on November 5, 2002. The relationship among public health concepts, illicit drug use prevention and policy, and infection control strategies in England and other locations is paralleled over the course of two centuries. This historical journey analyzes changes in public health and demonstrates how history and public health have intersected at various times to result in the public health approaches used today. PMID:18159543

  13. Access to health care for undocumented migrants: a comparative policy analysis of England and the Netherlands.

    PubMed

    Grit, Kor; den Otter, Joost J; Spreij, Anneke

    2012-02-01

    The presence of undocumented migrants is increasing in many Western countries despite wide-ranging attempts by governments to increase border security. Measures taken to control the influx of immigrants include policies that restrict access to publicly funded health care for undocumented migrants. These restrictions to health care access are controversial, and evidence suggests they do not always have the intended effect. This study provides a comparative analysis of institutional, actor-related, and contextual factors that have influenced health care policy development on undocumented migrants in England and the Netherlands. For undocumented migrants, England restricts its access to care at the point of service, while the Netherlands restricts through the payment system for services. The study includes an analysis of policy papers and semistructured, in-depth interviews with various actors in both countries. Findings confirm the influence of such contextual factors as immigration considerations and cost concerns on health care policy making in this area. However, these factors cannot explain the differences between the two countries. Previously enacted policies, especially the organization of the health care system, affected the kind of restrictions for undocumented migrants. Concerns about the side effects of generous treatment of undocumented migrants on other groups played a substantial role in formulating restrictive policies in both countries. Evidently, policy development and implementation is critically affected by institutional rules, which govern the degree of influence that doctors and professional medical associations have on the policy process.

  14. Insights in Public Health

    PubMed Central

    Pitt, Ruth

    2016-01-01

    Hawai‘i had high insurance coverage rates even before the Affordable Health Care Act and continues to have a high percentage of the population with health insurance today. However, high insurance rates can disguise wide variation in what is covered and what it costs. In this essay, an Australian Masters in Public Health student from the University of Hawai‘i considers the strengths and weaknesses of insurance coverage in the US health-care system when her friend “Peter” becomes seriously ill. PMID:27688955

  15. Sexual health service providers' perceptions of transgender youth in England.

    PubMed

    Lefkowitz, Ayla R F; Mannell, Jenevieve

    2017-01-23

    Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings.

  16. Health needs of detainees in police custody in England and Wales. Literature review.

    PubMed

    Rekrut-Lapa, Tatyana; Lapa, Alexander

    2014-10-01

    The aim of this systematic is to review and analyse the literature concerned with the health needs of detainees in police custody in England and Wales. The healthcare of detainees in police custody is regulated by the England and Wales Police and Criminal Evidence Act 1984. The Faculty of Forensic and Legal Medicine of the Royal College of Physicians also sets quality standards for the provision of custodial healthcare. The provision of healthcare in custody presents a number of challenges including the patient group, the setting and the overlap between the legal and medical concerns that are addressed by the medical team. Currently, care to the detainees in custody is delivered by a mixture of private organisations, police-led forensic medical services and the NHS. A search of the PUBMED, EMBASE and PsycINFO databases undertaken using the search terms: (police custody) OR (detainees) OR (police detainees) yielded 830 publications. All of the titles were screened to identify potentially relevant publications concerned with the health needs of detainees in police custodies in England and Wales. There were no design specific criteria set for inclusion of the studies in this literature review. 77 articles were initially identified as relevant and obtained in full. After further analysis 28 publications were included in this literature review. A total sample of over 12,000 detainees was examined in this literature review. Approximately 20% of detainees seen by health care teams suffer from psychiatric conditions. On average, 50% of patients claim that they have problems with drugs and alcohol. Physical health conditions are also highly prevalent with up to 74% of detainees requiring regular medication. Forensic medical issues included the management of detainees who were restrained using handcuffs, irritant sprays and TASER. Detainees who are suspected of internal drug concealment also require intensive medical input. Injury documentation in custody is often requested

  17. The Reliability of Results from National Tests, Public Examinations, and Vocational Qualifications in England

    ERIC Educational Resources Information Center

    He, Qingping; Opposs, Dennis

    2012-01-01

    National tests, public examinations, and vocational qualifications in England are used for a variety of purposes, including the certification of individual learners in different subject areas and the accountability of individual professionals and institutions. However, there has been ongoing debate about the reliability and validity of their…

  18. The Reliability of Results from National Tests, Public Examinations, and Vocational Qualifications in England

    ERIC Educational Resources Information Center

    He, Qingping; Opposs, Dennis

    2012-01-01

    National tests, public examinations, and vocational qualifications in England are used for a variety of purposes, including the certification of individual learners in different subject areas and the accountability of individual professionals and institutions. However, there has been ongoing debate about the reliability and validity of their…

  19. Private Schools and Public Funding: A Comparison of Recent Policies in England and Australia.

    ERIC Educational Resources Information Center

    Edwards, Tony; And Others

    1985-01-01

    Examines government policies in England and Australia toward nongovernment schools, compares forms of direct and indirect support which such schools and their pupils receive from public funds, and looks at ways in which state aid for nonstate schools has been justified and condemned. (JHZ)

  20. Public awareness of the link between alcohol and cancer in England in 2015: a population-based survey.

    PubMed

    Buykx, Penny; Li, Jessica; Gavens, Lucy; Hooper, Lucie; Lovatt, Melanie; Gomes de Matos, Elena; Meier, Petra; Holmes, John

    2016-11-30

    Public knowledge of the association between alcohol and cancer is reported to be low. We aimed to provide up-to-date evidence for England regarding awareness of the link between alcohol and different cancers and to determine whether awareness differs by demographic characteristics, alcohol use, and geographic region. A representative sample of 2100 adults completed an online survey in July 2015. Respondents were asked to identify which health outcomes, including specific cancers, may be caused by alcohol consumption. Logistic regressions explored whether demographic, alcohol use, and geographic characteristics predicted correctly identifying alcohol-related cancer risk. Unprompted, 12.9% of respondents identified cancer as a potential health outcome of alcohol consumption. This rose to 47% when prompted (compared to 95% for liver disease and 73% for heart disease). Knowledge of the link between alcohol and specific cancers varied between 18% (breast) and 80% (liver). Respondents identified the following cancers as alcohol-related where no such evidence exists: bladder (54%), brain (32%), ovarian (17%). Significant predictors of awareness of the link between alcohol and cancer were being female, more highly educated, and living in North-East England. There is generally low awareness of the relationship between alcohol consumption and cancer, particularly breast cancer. Greater awareness of the relationship between alcohol and breast cancer in North-East England, where a mass media campaign highlighted this relationship, suggests that population awareness can be influenced by social marketing.

  1. Responsibilities and resources of on-call public health doctors.

    PubMed

    Sarangi, J; Mackenzie, I; Pearson, N

    1995-01-01

    We investigated the resource available for public health doctors to carry out statutory responsibilities out-of-hours by a postal questionnaire survey of consultants in communicable disease control (CsCDC) in England and Wales. The questionnaire requested details of local District Health Authority (DHA) population profile, major incident and outbreak policies, the background of the CCDC, out-of-hours communication, access and resources, reference materials and medical equipment carried by the public health doctor on duty. The CsCDC from 96% (121/126) DHAs in England and Wales responded. Whilst 85% (101/119) of public health doctors carried policies on infectious disease when on duty, only 28% (32/116) carried policies on dealing with chemical incidents and 25% (28/111) carried the District policy to deal with radiation hazards. Twenty-six per cent (32/121) of public health physicians had no access to their District headquarters. There is a wide variation in the standard of resources available to on-call public health doctors in England and Wales; following Department of Health and Department of the Environment guidance, Health Authorities need to ensure that they have adequate arrangements in the event of any major incident or outbreak.

  2. Public value at risk from Phytophthora ramorum and Phytophthora kernoviae spread in England and Wales.

    PubMed

    Drake, Ben; Jones, Glyn

    2017-04-15

    Heritage gardens, heathland and woodland are increasingly under threat from the non-native tree and plant diseases Phytophthora ramorum and Phytophthora kernoviae. However, there exist only limited literature that estimates the public non-market value that may be lost from a continued spread of Phytophthora ramorum and Phytophthora kernoviae into these habitats. This paper therefore uses a contingent valuation survey to assess the non-extractive public use and non-use values at risk from an uncontrolled spread of these diseases in England and Wales. Results estimate that £1.446bn of public value is at risk in England and Wales per year from an uncontrolled spread of Phytophthora ramorum and Phytophthora kernoviae. The greatest public value at risk, of £578  m/year, is from an uncontrolled spread of these diseases to heritage gardens, while the lowest public value at risk, of £386  m/year, is from disease spread to heathland. The findings of this paper should help policymakers make informed decisions as to the public resources to dedicate towards Phytophthora ramorum and Phytophthora kernoviae control in England and Wales. In this regard, the current control programme to contain these diseases appears cost-effective in light of the public value at risk estimates produced by this paper. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Lessons from England's health care workforce redesign: no quick fixes.

    PubMed

    Bohmer, Richard M J; Imison, Candace

    2013-11-01

    In 2000 the English National Health Service (NHS) began a series of workforce redesign initiatives that increased the number of doctors and nurses serving patients, expanded existing staff roles and developed new ones, redistributed health care work, and invested in teamwork. The English workforce redesign experience offers important lessons for US policy makers. Redesigning the health care workforce is not a quick fix to control costs or improve the quality of care. A poorly planned redesign can even result in increased costs and decreased quality. Changes in skill mix and role definitions should be preceded by a detailed analysis and redesign of the work performed by health care professionals. New roles and responsibilities must be clearly defined in advance, and teamwork models that include factors common in successful redesigns such as leadership, shared objectives, and training should be promoted. The focus should be on retraining current staff instead of hiring new workers. Finally, any workforce redesign must overcome opposition from professional bodies, individual practitioners, and regulators. England's experience suggests that progress is possible if workforce redesigns are planned carefully and implemented with skill.

  4. Insights in Public Health

    PubMed Central

    Canyon, Deon V

    2013-01-01

    The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in Public Health, the World Health Organization, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. This paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and public health to achieve the reason it was adopted in the first place. PMID:24377080

  5. Transforming Public Health?

    PubMed Central

    ALDOUS, Chris

    2008-01-01

    Historical assessments of the Occupation’s efforts to tackle enteric diseases (cholera, typhoid, paratyphoid and dysentery) have generally reflected a celebratory narrative of US-inspired public health reforms, strongly associated with the head of the Public Health and Welfare Section, Crawford F. Sams. Close inspection of the documentary record, however, reveals much greater continuity with pre-war Japanese public health practices than has hitherto been acknowledged. Indeed, there are strong grounds for disputing American claims of novelty and innovation in such areas as immunisation, particularly in relation to typhoid vaccine, and environmental sanitation, where disparaging comments about the careless use of night soil and a reluctance to control flies and other disease vectors reveal more about the politics of public health reform than the reality of pre-war practices. Likewise, the representation of American-inspired sanitary teams as clearly distinct from and far superior to traditional sanitary associations (eisei kumiai) was closer to propaganda than an accurate rendering of past and present developments. PMID:19048809

  6. Public Health Pest Control.

    ERIC Educational Resources Information Center

    Arizona Univ., Tucson. Cooperative Extension Service.

    This manual supplies information helpful to individuals wishing to become certified in public health pest control. It is designed as a technical reference for vector control workers and as preparatory material for structural applicators of restricted use pesticides to meet the General Standards of Competency required of commercial applicators. The…

  7. Public Health Pest Control.

    ERIC Educational Resources Information Center

    Arizona Univ., Tucson. Cooperative Extension Service.

    This manual supplies information helpful to individuals wishing to become certified in public health pest control. It is designed as a technical reference for vector control workers and as preparatory material for structural applicators of restricted use pesticides to meet the General Standards of Competency required of commercial applicators. The…

  8. Neuroenhancing public health.

    PubMed

    Shaw, David

    2014-06-01

    One of the most fascinating issues in the emerging field of neuroethics is pharmaceutical cognitive enhancement (CE). The three main ethical concerns around CE were identified in a Nature commentary in 2008 as safety, coercion and fairness; debate has largely focused on the potential to help those who are cognitively disabled, and on the issue of 'cosmetic neurology', where people enhance not because of a medical need, but because they want to (as many as 25% of US students already use nootropic cognitive enhancers such as ritalin). However, the potential for CE to improve public health has been neglected. This paper examines the prospect of improving health outcomes through CE among sections of the population where health inequalities are particularly pronounced. I term this enhancement of the public's health through CE 'neuroenhancing health'. It holds great promise, but raises several ethical issues. This paper provides an outline of these issues and related philosophical problems. These include the potential effectiveness of CE in reducing health inequalities; issues concerning autonomy and free will; whether moral enhancement might be more effective than CE in reducing health inequalities; and the problem of how to provide such CE, including the issue of whether to provide targeted or universal coverage.

  9. Globalisation and public health.

    PubMed

    Bettcher, D; Lee, K

    2002-01-01

    At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

  10. HIV testing practices among New England college health centers

    PubMed Central

    2013-01-01

    Background The prevalence of human immunodeficiency virus (HIV) continues to increase among certain populations including young men who have sex with men (MSM). College campuses represent a potential setting to engage young adults and institute prevention interventions including HIV testing. The purpose of this study was to evaluate testing practices for HIV and other sexually transmitted infections (STIs) on college campuses. Methods Medical directors at four-year residential baccalaureate college health centers in New England were surveyed from June, 2011 to September, 2011. Thirty-one interviews were completed regarding experiences with HIV testing, acute HIV infection, other STI testing, and outreach efforts targeting specific at-risk groups such as MSM. Results Among schools that responded to the survey, less than five percent of students were tested for HIV at their local college health center in the past academic year (2010–2011). Significant barriers to HIV testing included cost and availability of rapid antibody testing. One-third of college health medical directors reported that their practitioners may not feel comfortable recognizing acute HIV infection. Conclusions Improved HIV testing practices are needed on college campuses. Programs should focus on outreach efforts targeting MSM and other at-risk populations. PMID:23496891

  11. Public health ethics: informing better public health practice.

    PubMed

    Carter, Stacy M; Kerridge, Ian; Sainsbury, Peter; Letts, Julie K

    2012-01-01

    Public health ethics has emerged and grown as an independent discipline over the last decade. It involves using ethical theory and empirical analyses to determine and justify the right thing to do in public health. In this paper, we distinguish public health ethics from clinical ethics, research ethics, public health law and politics. We then discuss issues in public health ethics including: how to weigh up the benefits, harms and costs of intervening; how to ensure that public health interventions produce fair outcomes; the potential for public health to undermine or promote the rights of citizens; and the significance of being transparent and inclusive in public health interventions. We conclude that the explicit and systematic consideration of ethical issues will, and should, become central to every public health worker's daily practice.

  12. Does public transport use prevent declines in walking speed among older adults living in England? A prospective cohort study.

    PubMed

    Rouxel, Patrick; Webb, Elizabeth; Chandola, Tarani

    2017-09-28

    Although there is some evidence that public transport use confers public health benefits, the evidence is limited by cross-sectional study designs and health-related confounding factors. This study examines the effect of public transport use on changes in walking speed among older adults living in England, comparing frequent users of public transport to their peers who did not use public transport because of structural barriers (poor public transport infrastructure) or through choice. Prospective cohort study. England, UK. Older adults aged ≥60 years eligible for the walking speed test. 6246 individuals at wave 2 (2004-2005); 5909 individuals at wave 3 (2006-2007); 7321 individuals at wave 4 (2008-2009); 7535 individuals at wave 5 (2010-2011) and 7664 individuals at wave 6 (2012-2013) of the English Longitudinal Study of Ageing. The walking speed was estimated from the time taken to walk 2.4 m. Fixed effects models and growth curve models were used to examine the associations between public transport use and walking speed. Older adults who did not use public transport through choice or because of structural reasons had slower walking speeds (-0.02 m/s (95% CI -0.03 to -0.003) and -0.02 m/s (95% CI -0.03 to -0.01), respectively) and took an extra 0.07 s to walk 2.4 m compared with their peers who used public transport frequently. The age-related trajectories of decline in walking speed were slower for frequent users of public transport compared with non-users. Frequent use of public transport may prevent age-related decline in physical capability by promoting physical activity and lower limb muscle strength among older adults. The association between public transport use and slower decline in walking speed among older adults is unlikely to be confounded by health-related selection factors. Improving access to good quality public transport could improve the health of older adults. © Article author(s) (or their employer(s) unless otherwise stated in the text

  13. Nanotechnology and public health.

    PubMed

    Matsudai, Masami; Hunt, Geoffrey

    2005-11-01

    Nanotechnology is developing very quickly, and Japan is in many respects leading the world in this convergence of nanoscale engineering techniques. The public health community in Japan must start to think about the public health impacts of nanotechnology over the next 20 years. The responsibility for the benefits and the harms of nanotechnology lies with government, with corporations and the business community, with scientists and specialists in all related fields, and with NPOs and the public. There are very many questions of public health which are not yet being asked about nanotechnology. If nanoparticles are to be used in cosmetics, food production and packaging, how will they react or interact with the human skin and organs? What chemical-toxic effects on life might there be from the nanoparticles in car tires and vehicle plastic mouldings when they are disposed of by incineration? Will they pass into the soil and groundwater and enter into the food-chain? It is now an urgent ethical demand, based on the precautionary principle, that Japan join the governments of the world to take an intergovernmental initiative to intervene in the further development, production and marketing of nanotechnological products with precautionary research and regulation.

  14. What's the future for health promotion in England? The views of practitioners.

    PubMed

    White, Judy; Wills, Jane

    2011-01-01

    Specialized health promotion is an internationally recognized occupation and field of activity which has had a chequered history in England. After flourishing briefly in some areas in the early years of the New Labour government it has been in decline in most parts of the country. The last survey of practice conducted in 2005 found that the specialized health promotion workforce was unevenly distributed and much in need of advocacy and development. Since then there has been another major reorganization of primary care trusts (PCTs) and a split between commissioning and provider functions. Practitioners' views on the impact of this on health promotion were gathered in a survey in 2008-2009. Participants comprised 36 people attending a Shaping the Future workshop in the North of England and 40 practitioners studying a masters course in health promotion. The findings reveal that organizational structure has a major impact on the nature of health promotion activity: the split between commissioning and provider functions of PCTs has presented huge challenges to practitioners irrespective of the arm in which they are placed, as one of the strengths of health promotion has always been its ability to straddle both strategic and operational levels and offer a joined-up approach to tackling the causes of ill health. For the specialized health promotion workforce, there has been a loss of identity and critical mass as the discipline is increasingly reduced and fragmented, a trend that looks set to worsen following further reorganization and reductions in public sector spending introduced by the new coalition government.

  15. 76 FR 9755 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... will be held at the Radisson Hotel Providence Airport, 2081 Post Road, Warwick, RI 02886; telephone... this meeting, the Advisors will review public comments and the recommendations of the Industry...

  16. 78 FR 30868 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... Council may identify preferred alternatives at a later date, before taking the DEIS out to public hearing... disabilities. Requests for sign language interpretation or other auxiliary aids should be directed to Thomas A...

  17. 76 FR 77214 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... held at the Hotel Providence, 139 Mathewson Street, Providence, RI 02903; telephone: (401) 861-8000... Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Scallop...

  18. Public health law research: exploring law in public health systems.

    PubMed

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott

    2012-11-01

    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  19. Using real-time syndromic surveillance to assess the health impact of the 2013 heatwave in England.

    PubMed

    Elliot, Alex J; Bone, Angie; Morbey, Roger; Hughes, Helen E; Harcourt, Sally; Smith, Sue; Loveridge, Paul; Green, Helen K; Pebody, Richard; Andrews, Nick; Murray, Virginia; Catchpole, Mike; Bickler, Graham; McCloskey, Brian; Smith, Gillian

    2014-11-01

    Heatwaves are a seasonal threat to public health. During July 2013 England experienced a heatwave; we used a suite of syndromic surveillance systems to monitor the impact of the heatwave. Significant increases in heatstroke and sunstroke were observed during 7-10 July 2013. Syndromic surveillance provided an innovative and effective service, supporting heatwave planning and providing early warning of the impact of extreme heat thereby improving the public health response to heatwaves. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  20. Insights in Public Health

    PubMed Central

    Chock, Linda R; Hayes, Donald K; Tomiyasu, Danette Wong

    2014-01-01

    The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a proven, cost-effective investment in strengthening families. As part of the United States Department of Agriculture's (USDA) 15 federal nutrition assistance programs for the past 40 years, WIC has grown to be the nation's leading public health nutrition program. WIC serves as an important first access point to health care and social service systems for many limited resource families, serving approximately half the births in the nation as well as locally. By providing nutrition education, breastfeeding promotion and foods in addition to referrals, WIC plays a crucial role in promoting lifetime health for women, infants and children. WIC helps achieve national public health goals such as reducing premature births and infant mortality, increasing breastfeeding, and reducing maternal and childhood overweight. Though individuals and families can self-refer into WIC, physicians and allied health professionals have the opportunity and are encouraged to promote awareness of WIC and refer families in their care. PMID:25285258

  1. Change of government: one more big bang health care reform in England's National Health Service.

    PubMed

    Hunter, David J

    2011-01-01

    Once again the National Health Service (NHS) in England is undergoing major reform, following the election of a new coalition government keen to reduce the role of the state and cut back on big government. The NHS has been undergoing continuous reform since the 1980s. Yet, despite the significant transaction costs incurred, there is no evidence that the claimed benefits have been achieved. Many of the same problems endure. The reforms follow the direction of change laid down by the last Conservative government in the early 1990s, which the recent Labour government did not overturn despite a commitment to do so. Indeed, under Labour, the NHS was subjected to further market-style changes that have paved the way for the latest round of reform. The article considers the appeal of big bang reform, questions its purpose and value, and critically appraises the nature and extent of the proposed changes in this latest round of reform. It warns that the NHS in its current form may not survive the changes, as they open the way to privatization and a weakening of its public service ethos.

  2. Embedding economic relationships through social learning? The limits of patient and public involvement in healthcare governance in England.

    PubMed

    Vincent-Jones, Peter

    2011-01-01

    The strategy for NHS modernization in England is privileging individual choice over collective voice in the governance of healthcare. This paper explores the tension between economic and democratic strands in the current reform agenda, drawing on sociological conceptions of embeddedness and on theories of reflexive governance. Building on a Polanyian account of the disembedding effects of the increasing commercialization of health services, we consider the prospects for re-embedding economic relationships in this field. An analysis is provided of the limits of the present legal and regulatory framework of Patient and Public Involvement (PPI) in establishing the democratic and pragmatist conditions of social learning necessary for effective embedding. We show how the attainment of reflexive governance in the public interest is dependent on such conditions, and on the capacities of patients and the public to contribute to debate and deliberation in decision making, including on fundamental policy questions such as how services are provided and by whom.

  3. Insights in Public Health

    PubMed Central

    Whelen, A Christian; Kitagawa, Kent; Maddock, Jay; Hayes, Donald; St John, Tonya Lowery; Rajan, Ranjani

    2013-01-01

    Chronically understaffed public health laboratories depend on a decreasing number of employees who must assume broader responsibilities in order to sustain essential functions for the many clients the laboratories support. Prospective scientists considering a career in public health are often not aware of the requirements associated with working in a laboratory regulated by the Clinical Laboratory Improvement Amendments (CLIA). The purpose of this pilot internship was two-fold; introduce students to operations in a regulated laboratory early enough in their academics so that they could make good career decisions, and evaluate internship methodology as one possible solution to workforce shortages. Four interns were recruited from three different local universities, and were paired with an experienced State Laboratories Division (SLD) staff mentor. Students performed tasks that demonstrated the importance of CLIA regulations for 10–15 hours per week over a 14 week period. Students also attended several directed group sessions on regulatory lab practice and quality systems. Both interns and mentors were surveyed periodically during the semester. Surveys of mentors and interns indicated overall positive experiences. One-on-one pairing of experienced public health professionals and students seems to be a mutually beneficial arrangement. Interns reported that they would participate if the internship was lower paid, unpaid, or for credit only. The internship appeared to be an effective tool to expose students to employment in CLIA-regulated laboratories, and potentially help address public health laboratory staffing shortfalls. Longer term follow up with multiple classes of interns may provide a more informed assessment. PMID:23386992

  4. Change in Health Insurance Coverage in Massachusetts and Other New England States by Perceived Health Status: Potential Impact of Health Reform

    PubMed Central

    Zack, Matthew M.; Strine, Tara W.; Druss, Benjamin G.; Simoes, Eduardo

    2013-01-01

    Objectives. We examined the impact of Massachusetts health reform and its public health component (enacted in 2006) on change in health insurance coverage by perceived health. Methods. We used 2003–2009 Behavioral Risk Factor Surveillance System data. We used a difference-in-differences framework to examine the experience in Massachusetts to predict the outcomes of national health care reform. Results. The proportion of adults aged 18 to 64 years with health insurance coverage increased more in Massachusetts than in other New England states (4.5%; 95% confidence interval [CI] = 3.5%, 5.6%). For those with higher perceived health care need (more recent mentally and physically unhealthy days and activity limitation days [ALDs]), the postreform proportion significantly exceeded prereform (P < .001). Groups with higher perceived health care need represented a disproportionate increase in health insurance coverage in Massachusetts compared with other New England states—from 4.3% (95% CI = 3.3%, 5.4%) for fewer than 14 ALDs to 9.0% (95% CI = 4.5%, 13.5%) for 14 or more ALDs. Conclusions. On the basis of the Massachusetts experience, full implementation of the Affordable Care Act may increase health insurance coverage especially among populations with higher perceived health care need. PMID:23597359

  5. Change in health insurance coverage in Massachusetts and other New England States by perceived health status: potential impact of health reform.

    PubMed

    Dhingra, Satvinder S; Zack, Matthew M; Strine, Tara W; Druss, Benjamin G; Simoes, Eduardo

    2013-06-01

    We examined the impact of Massachusetts health reform and its public health component (enacted in 2006) on change in health insurance coverage by perceived health. We used 2003-2009 Behavioral Risk Factor Surveillance System data. We used a difference-in-differences framework to examine the experience in Massachusetts to predict the outcomes of national health care reform. The proportion of adults aged 18 to 64 years with health insurance coverage increased more in Massachusetts than in other New England states (4.5%; 95% confidence interval [CI] = 3.5%, 5.6%). For those with higher perceived health care need (more recent mentally and physically unhealthy days and activity limitation days [ALDs]), the postreform proportion significantly exceeded prereform (P < .001). Groups with higher perceived health care need represented a disproportionate increase in health insurance coverage in Massachusetts compared with other New England states--from 4.3% (95% CI = 3.3%, 5.4%) for fewer than 14 ALDs to 9.0% (95% CI = 4.5%, 13.5%) for 14 or more ALDs. On the basis of the Massachusetts experience, full implementation of the Affordable Care Act may increase health insurance coverage especially among populations with higher perceived health care need.

  6. 75 FR 43928 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-27

    ... Council (Council) is scheduling a public meeting of its Red Crab Committee in August, 2010 to consider... review the status of the red crab fishery and recent developments in processing, marketing, and cooperative research. The Committee will also review Draft Amendment 3 to the Red Crab Fishery Management Plan...

  7. 75 FR 47268 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... Council (Council) is scheduling a public meeting of its Scientific and Statistical Committee, on August 24...-0492. SUPPLEMENTARY INFORMATION: Tuesday, August 24, 2010 The Scientific and Statistical Committee (SSC... appropriateness of Local Indicators of Spatial Association or LISA, spatial analysis methods for defining clusters...

  8. 77 FR 14735 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... 29, 2012 at 8:30 a.m. ADDRESSES: The meeting will be held at the Providence Biltmore Hotel, 11.... SUPPLEMENTARY INFORMATION: Agenda The Groundfish Committee will meet to continue development of two...

  9. 77 FR 66072 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-01

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... will be held at the Seaport Hotel, One Seaport Lane, Boston, MA 02210; telephone: (617) 385-4000; fax... Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Scientific...

  10. 75 FR 78681 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... held at the Clarion Hotel, 1230 Congress Street, Portland, ME 04102; telephone: (207) 774-5611; fax... Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Oversight...

  11. 75 FR 78680 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... held at the Radisson Airport Hotel, 2081 Post Road, Warwick, RI 02886: telephone: (401) 739-3000; fax... Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Whiting...

  12. 77 FR 29595 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... 6, 2012 at 8:30 a.m. ADDRESSES: The meeting will be held at the Radisson Hotel Plymouth Harbor, 180...: (978) 465-0492. SUPPLEMENTARY INFORMATION: The items of discussion in the committee's agenda are...

  13. 78 FR 30869 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... 10 a.m. ADDRESSES: Meeting address: The meeting will be held at the Providence Biltmore Hotel, 11...: (978) 465-0492. SUPPLEMENTARY INFORMATION: The items of discussion in the committee's agenda are...

  14. 77 FR 16810 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ...; Public Hearings AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... hearings will be held from April 9 through April 16, 2012. For specific dates and times, see SUPPLEMENTARY...; Plymouth, MA; Portsmouth, NH and Providence, RI. For specific locations, see SUPPLEMENTARY...

  15. 75 FR 70722 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... at 9:30 a.m. ADDRESSES: The meeting will be held at the Sheraton Harborside Hotel, 250 Market Street.... ] SUPPLEMENTARY INFORMATION: The items of discussion in the committee's agenda are as follows: The Committee...

  16. 77 FR 66441 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... held at the Seaport Hotel, One Seaport Lane, Boston, MA 02210; telephone: (617) 385-4000; fax: (617... Fishery Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: The SSC will meet...

  17. 77 FR 29595 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... the Clarion Hotel, 1230 Congress Street, Portland, ME 04102; telephone: (207) 774-561; fax: (207) 871... Management Council; telephone: (978) 465-0492. SUPPLEMENTARY INFORMATION: There are three major topics...

  18. 77 FR 58982 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-25

    ...; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... a.m. ADDRESSES: The meeting will be held at the Ashworth by the Sea Hotel, 295 Ocean Boulevard...: (978) 465-0492. SUPPLEMENTARY INFORMATION: The items of discussion in the committee's agenda are...

  19. 77 FR 21752 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... emergency. Special Accommodations This meeting is physically accessible to people with disabilities... on measures proposed for inclusion in Amendment 5 to the Atlantic Herring Fishery Management Plan... meetings, to obtain public comments on measures under consideration for inclusion in Amendment 5 to the...

  20. 77 FR 56813 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    .... The panel will: Review FY 2011 catches and potential FY 2013 recreational allocations; receive a report on a model developed for crafting recreational measures; discuss potential recreational fishing... Council (Council) is scheduling a public meeting of its Recreational Advisory Panel to consider...

  1. 75 FR 12505 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ... Council (Council) is scheduling a joint public meeting of its Habitat Committee, Advisory Panel and Plan... implementation and outputs of the Swept Area Seabed impact (SASI) model, and then to discuss and recommend management alternatives based on model outputs. Committee motions on alternatives for analysis in EFH...

  2. Insights in Public Health

    PubMed Central

    Hayes, Donald K; Calhoun, Candice R; Joseph, Lin; Farnsworth, JoAnn Y; Arakaki, Kimberly B

    2016-01-01

    The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, public health planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566

  3. Canada: public health genomics.

    PubMed

    Little, J; Potter, B; Allanson, J; Caulfield, T; Carroll, J C; Wilson, B

    2009-01-01

    Canada has a diverse population of 32 million people and a universal, publicly funded health care system provided through provincial and territorial health insurance plans. Public health activities are resourced at provincial/territorial level with strategic coordination from national bodies. Canada has one of the longest-standing genetics professional specialty organizations and is one of the few countries offering master's level training designed specifically for genetic counselors. Prenatal screening is offered as part of routine clinical prenatal services with variable uptake. Surveillance of the effect of prenatal screening and diagnosis on the birth prevalence of congenital anomalies is limited by gaps and variations in surveillance systems. Newborn screening programs vary between provinces and territories in terms of organization and conditions screened for. The last decade has witnessed a four-fold increase in requests for genetic testing, especially for late onset diseases. Tests are performed in provincial laboratories or outside Canada. There is wide variation in participation in laboratory quality assurance schemes, and there are few regulatory frameworks in Canada that are directly relevant to genetics testing services or population genetics. Health technology assessment in Canada is conducted by a diverse range of organizations, several of which have produced reports related to genetics. Several large-scale population cohort studies are underway or planned, with initiatives to harmonize their conduct and the management of ethical issues, both within Canada and with similar projects in other countries.

  4. The Public Health Responsibility Deal: brokering a deal for public health, but on whose terms?

    PubMed

    Panjwani, Clare; Caraher, Martin

    2014-02-01

    Coalitions of multinational food and drink businesses have pledged to reformulate their products and to market them responsibly. Largely business-led and self-regulated, the integrity of these voluntary initiatives has been questioned. The Public Health Responsibility Deal in England is an example of a voluntary initiative that is government-led. Does this approach provide evidence that with public leadership there is potential for voluntary actions to deliver meaningful results for public health? The subject of the research is the calorie reduction initiative of the Responsibility Deal. Source material was obtained primarily through a series of UK Freedom of Information requests and comprises previously unpublished Department of Health documentation relating to relevant meetings held during 2011 and 2012. The Responsibility Deal approach to calorie reduction deliberately involves the food industry in the specification of the measures it is to implement (reformulation and portion control). Finding the common ground between private and public interests has resulted in the deflection of public health objectives and the preclusion of adequate monitoring and evaluation. The Responsibility Deal approach is fundamentally flawed in its expectation that industry will take voluntary actions that prioritise public health interests above its own. Being government-led counts for little in the absence of sanctions to drive compliance. Instead the initiative affords private interests the opportunity to influence in their favour the public health policies and strategies that affect their products. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Insights in Public Health

    PubMed Central

    Fan, Victoria Y; Le‘au, Ruth Faioso

    2015-01-01

    Independent and American Samoa have a shared cultural, genetic, ethnolinguistic, and historical background but have been politically separated since 1899. In this essay, we examine the health of these two polities and identify two key health patterns that have emerged even as American Samoa has achieved a higher per capita income than Independent Samoa. Whereas the gender gap in life expectancy at birth has narrowed in Independent Samoa, this gap has not narrowed in American Samoa and its male life expectancy now lags behind that of Independent Samoa. Neonatal mortality rates in American Samoa are slightly higher than in Independent Samoa. These patterns may be linked to the higher rates of obesity and urbanization observed in American Samoa compared to Independent Samoa, as well as the differing political and institutional arrangements of the two polities. Limited data remains a persistent challenge to conducting analysis of public health in the Pacific islands, particularly in American Samoa. PMID:26019989

  6. Public health ethics. Public justification and public trust.

    PubMed

    Childress, J F; Bernheim, R Gaare

    2008-02-01

    Viewing public health as a political and social undertaking as well as a goal of this activity, the authors develop some key elements in a framework for public health ethics, with particular attention to the formation of public health policies and to decisions by public health officials that are not fully determined by established public policies. They concentrate on ways to approach ethical conflicts about public health interventions. These conflicts arise because, in addition to the value of public health, societies have a wide range of other values that sometimes constrain the selection of means to achieve public health goals. The authors analyze three approaches for resolving these conflicts (absolutist, contextualist, and presumptivist), argue for the superiority of the presumptivist approach, and briefly explicate five conditions for rebutting presumptions in a process of public justification. In a liberal, pluralistic, democratic society, a presumptivist approach that engages the public in the context of a variety of relationships can provide a foundation for public trust, which is essential to public health as a political and social practice as well as to achieving public health goals.

  7. Health, climate change and energy vulnerability: a retrospective assessment of strategic health authority policy and practice in England.

    PubMed

    Richardson, J; Kagawa, F; Nichols, A

    2008-11-17

    A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA) is part of the National Health Service (NHS) in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability. The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA) to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability. A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents. Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development. Results indicate that many SHAs in England have yet to embrace sustainability, or to integrate

  8. Health, Climate Change and Energy Vulnerability: A Retrospective Assessment of Strategic Health Authority Policy and Practice in England

    PubMed Central

    Richardson, J.; Kagawa, F.; Nichols, A.

    2008-01-01

    Background: A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA) is part of the National Health Service (NHS) in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability. Aim: The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA) to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability. Methods: A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents. Results: Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development. Results indicate that many SHAs in England have yet to

  9. Public health, public trust and lobbying.

    PubMed

    Wynia, Matthew K

    2007-06-01

    Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust.

  10. Evaluation of the Role of Public Outreach and Stakeholder Engagement in Stormwater Funding Decisions in New England

    EPA Pesticide Factsheets

    A detailed report examining the role of public outreach and stakeholder engagement in stormwater funding decisions based on the experiences of eleven small and medium-sized communities in New England.

  11. Improving accountability through alignment: the role of academic health science centres and networks in England

    PubMed Central

    2014-01-01

    Background As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the “unlinked partners” model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. Discussion This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. Summary At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from

  12. Improving accountability through alignment: the role of academic health science centres and networks in England.

    PubMed

    Ovseiko, Pavel V; Heitmueller, Axel; Allen, Pauline; Davies, Stephen M; Wells, Glenn; Ford, Gary A; Darzi, Ara; Buchan, Alastair M

    2014-01-20

    As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the "unlinked partners" model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from the bottom up. It remains to be

  13. Evolution and public health

    PubMed Central

    Omenn, Gilbert S.

    2009-01-01

    Evolution and its elements of natural selection, population migration, genetic drift, and founder effects have shaped the world in which we practice public health. Human cultures and technologies have modified life on this planet and have coevolved with myriad other species, including microorganisms; plant and animal sources of food; invertebrate vectors of disease; and intermediate hosts among birds, mammals, and nonhuman primates. Molecular mechanisms of differential resistance or susceptibility to infectious agents or diets have evolved and are being discovered with modern methods. Some of these evolutionary relations require a perspective of tens of thousands of years, whereas other changes are observable in real time. The implications and applications of evolutionary understanding are important to our current programs and policies for infectious disease surveillance, gene–environment interactions, and health disparities globally. PMID:19966311

  14. The Public Health Responsibility Deal: how should such a complex public health policy be evaluated?

    PubMed

    Petticrew, Mark; Eastmure, Elizabeth; Mays, Nicholas; Knai, Cecile; Durand, Mary Alison; Nolte, Ellen

    2013-12-01

    The Public Health Responsibility Deal (RD) in England was launched in 2011 as a public-private partnership which aims to 'tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment'. It has come under criticism from public health advocates and others, who have suggested that it will be ineffective or perhaps even harmful. Like many public health policies, there have also been demands to know whether it 'works'. We conducted a scoping review and used this, supplemented with interviews with stakeholders, to develop a detailed logic model of the RD (presented here) to help understand its likely outcomes and the pathways by which these may be achieved as a basis for planning an evaluation. Evaluations of complex interventions require not just assessment of effects (including outcomes), but also a clear conceptualization of the intervention and its processes. The way the RD and the pledges made by participant organizations has been presented makes it difficult at this stage to evaluate whether the RD 'works' in terms of improving health. Instead, any evaluation needs to put together a jigsaw of evidence about processes, mechanisms and potential future health and non-health impacts, in part using the current scientific evidence. This task is ongoing.

  15. [Phonoaudiology in public health].

    PubMed

    Freire, R M

    1992-06-01

    An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of public health, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greater proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Free bus passes, use of public transport and obesity among older people in England.

    PubMed

    Webb, Elizabeth; Netuveli, Gopalakrishnan; Millett, Christopher

    2012-02-01

    All residents of England aged 60 years and older became entitled to free travel on local buses on 1 April 2006. This study examines the impact of this policy on public transport use, a mode of active transport and levels of obesity. Logistic regression analyses using three waves of data (2004, 2006 and 2008) from the English Longitudinal Study of Ageing. Our main outcome measures were changes in self-reported public transport use, body mass index, waist circumference and obesity. Eligibility for free bus travel was associated with increased use (adjusted odds ratio (AOR) 1.51, 95% CI 1.14 to 2.00) of public transport among older people. Older people who used public transport had reduced odds of being obese in 2008 compared with those who did not (AOR 0.75, 95% CI 0.65 to 0.86), as did those who were eligible for free local bus travel (AOR 0.75, 95% CI 0.59 to 0.97). Older people who used public transport had reduced odds of becoming obese between 2004 and 2008 (AOR 0.79, 95% CI 0.63 to 0.98). The introduction of free bus travel for older residents of England appears to have increased public transport use and may have conferred a protective effect against obesity.

  17. Insights in Public Health

    PubMed Central

    Oshiro, Peter

    2015-01-01

    Reducing the occurrence of and influencing the rapid correction of food illness risk factors is a common goal for all governmental food regulatory programs nationwide. Foodborne illness in the United States is a major cause of personal distress, preventable illness, and death. To improve public health outcomes, additional workforce was required due to long standing staffing shortages and was obtained partially through consolidation of the Hawai‘i Department of Health's (HDOH) two food safety programs, the Sanitation Branch, and the Food & Drug Branch in July 2012, and through legislation that amended existing statutes governing the use of food establishment permit fees. Additionally, a more transparent food establishment grading system was developed after extensive work with industry partners based on three possible placards issued after routine inspections: green, yellow, and red. From late July 2014 to May 2015, there were 6,559 food establishments inspected statewide using the placard system with 79% receiving a green, 21% receiving a yellow, and no red placards issued. Sufficient workforce to allow timely inspections, continued governmental transparency, and use of new technologies are important to improve food safety for the public. PMID:26279966

  18. Public health, health promotion and the health of people in prison.

    PubMed

    Condon, Louise; Hek, Gill; Harris, Francesca

    2006-01-01

    Recent policy changes in England and Wales have transferred commissioning and funding of prison healthcare from the prison service to the National Health Service for the first time in its history. Most health services in prisons are now provided by primary care trusts (PCTs), with the consequence that PCTs have a new highly vulnerable population for whom health needs must be assessed and services provided. This article describes what is currently known about the health needs of prisoners and the subsequent implications for public health and health promotion. Following a brief discussion of national and international policy on health promotion in prisons, an overview is given of recent national and local initiatives on public health issues.

  19. Feminism and public health ethics

    PubMed Central

    Rogers, W A

    2006-01-01

    This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health. PMID:16731735

  20. Feminism and public health ethics.

    PubMed

    Rogers, W A

    2006-06-01

    This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

  1. Recommodification, Unemployment, and Health Inequalities: Trends in England and Sweden 1991-2011.

    PubMed

    Farrants, Kristin; Bambra, Clare; Nylen, Lotta; Kasim, Adetayo; Burstrom, Bo; Hunter, David

    2016-01-01

    Recommodification, the withdrawal of social welfare, has been going on for some decades in both Sweden and England. Recommodification disproportionately affects the unemployed because of their weak market position. We investigated the impact recommodification has had on health inequalities between the employed and unemployed in Sweden and England. Using national surveys, odds ratios for the likelihood of reporting less than good health between the employed and unemployed were computed annually between 1991 and 2011. The correlation between these odds ratios and net replacement rates was then examined. Health inequalities between the employed and unemployed were greater in 2011 than in 1991 in both countries. Sweden began with smaller health inequalities, but by 2011, they were in line with those in England. Sweden experienced more recommodification than England during this period, although it started from a much less commodified position. Correspondingly, correlation between unemployment benefit generosity and health inequalities was stronger in Sweden than in England. Recommodification is linked to ill health among the unemployed and to the health gap between the employed and unemployed. We propose that further recommodification will be associated with increased health inequalities between the employed and unemployed.

  2. NHV and child public health.

    PubMed

    Köhler, Lennart

    2015-08-01

    One of the main interests of the Nordic School of Public Health (NHV) in both education and research was child public health, i.e. an area based on the broad World Health Organisation (WHO) health ideology and on public health methods, while concentrating on the special needs and characteristics of children. The fields of study and action, training, research and service, had the ultimate task to consider the health of children in their full social, economic and political context. Regular courses on child public health were offered as part of the general program in Public Health from 1979 until the closing down of the school, named: Social Paediatrics; Child Health; Child Public Health; and finally, Measuring Children's Health - A Public Health Perspective. Numerous national, Nordic and international conferences were held, and several textbooks were written and edited. A major research project, NordChild, was initiated as a cross-sectional postal study of a random sample of children aged 2-17 years from the five Nordic countries, performed in 1984, 1996 and 2011. So far, 10 doctoral theses and more than 130 other publications from the studies have been produced. Furthermore, the Nordic Network on Research of Refugee Children was created, and a special interest has been devoted to indicators for children's health, both internationally, nationally and locally, which has been demonstrated in major EU projects as well as locally in Sweden and Greenland. © 2015 the Nordic Societies of Public Health.

  3. "Cultivating health": therapeutic landscapes and older people in northern England.

    PubMed

    Milligan, Christine; Gatrell, Anthony; Bingley, Amanda

    2004-05-01

    While gardening is seen, essentially, as a leisure activity it has also been suggested that the cultivation of a garden plot offers a simple way of harnessing the healing power of nature (The therapeutic garden, Bantam Press, London, 2000). One implication of this is that gardens and gardening activity may offer a key site of comfort and a vital opportunity for an individual's emotional, physical and spiritual renewal. Understanding the extent to which this supposition may be grounded in evidence underpins this paper. In particular, we examine how communal gardening activity on allotments might contribute to the maintenance of health and well being amongst older people. Drawing on recently completed research in northern England, we examine firstly the importance of the wider landscape and the domestic garden in the lives of older people. We then turn our attention to gardening activity on allotments. Based on the findings of our study, we illustrate the sense of achievement, satisfaction and aesthetic pleasure that older people can gain from their gardening activity. However, while older people continue to enjoy the pursuit of gardening, the physical shortcomings attached to the aging process means they may increasingly require support to do so. Communal gardening on allotment sites, we maintain, creates inclusionary spaces in which older people benefit from gardening activity in a mutually supportive environment that combats social isolation and contributes to the development of their social networks. By enhancing the quality of life and emotional well being of older people, we maintain that communal gardening sites offer one practical way in which it may be possible to develop a 'therapeutic landscape'.

  4. Developing a speciality: regearing the specialist public health workforce.

    PubMed

    Chapman, J; Abbott, S; Carter, Y H

    2005-03-01

    To identify issues surrounding the future training needs of the specialist public health workforce following the most recent restructuring of the National Health Service (NHS) in England. All directors of public health (DsPH) based in strategic health authorities and nine senior staff working in public health at the regional level were invited to participate in a semi-structured telephone interview. Twenty-six people were interviewed. Many interviewees expressed concern that because consultants and specialists in public health will be working in much smaller teams than hitherto, they will have to generalize their skills to cover a much wider range of functions (including board-level duties). This may result in a loss of specialist expertise. Successful public health practice in the new structures will require new ways of interorganizational working that will add an administrative burden to specialists in public health. Also, the creation of a board-level post in each primary care trust (PCT) has resulted in more time spent on corporate responsibilities and less on public health for DsPH, who are often the only fully trained specialist in public health in their PCT. Furthermore, interviewees expressed their anxiety about the lack of diversity in the posts available to specialists in public health and particularly to those newly completing their specialist training. Generally, interviewees felt that traditional public health roles and responsibilities were being eclipsed by corporate and managerial ones. Professional development activities were being carried out, but in a rather ad-hoc fashion. Interviewees were hopeful that public health networks would lead professional development initiatives once they were more established. It is important that excellence in public health is maintained through a set of accreditable standards, whilst corporate skills, essential to successful public health practice in the new UK NHS, are developed among specialists in public health.

  5. Recent trends in children's exposure to second-hand smoke in England: cotinine evidence from the Health Survey for England.

    PubMed

    Jarvis, Martin J; Feyerabend, Colin

    2015-09-01

    To examine changes in children's exposure to second-hand tobacco smoke in England since 1998. Repeated cross-sectional surveys of the general population in England. The Health Survey for England. A total of 37 038 children participating in surveys from 1998 to 2012, 13 327 of whom were aged 4-15 years, had available cotinine and were confirmed non-smokers. The proportion of children with smoking parents; the proportion of children living in homes reported to be smoke-free; the proportion of children with undetectable concentrations of cotinine; linear and quadratic trend estimates of geometric mean cotinine across years. By 2012, 87.3% of children lived in a home that was smoke-free {97.2% [95% confidence interval (CI) = 95.9-98.1] when parents were non-smokers, 61.3% (95% CI = 55.5-66.8) when one or both parents smoked}. A total of 68.6% (95% CI = 64.3-72.6%) of children had undetectable cotinine in 2012, up from 14.3% (95% CI = 12.7-16.0%) in 1998. There was a highly significant linear trend across years (with a small but significant quadratic term) to declining geometric mean cotinine in all children from 0.52 ng/ml (95% CI = 0.48-0.57) in 1998 to 0.11 ng/ml (95% CI = 0.10-0.12) in 2012. Children from routine/manual backgrounds were more exposed, but experienced similar gains across years to those from non-manual backgrounds. In England, children's exposure to second-hand smoke has declined by 79% since 1998, with continuing progress since smoke-free legislation in 2007. An emerging social norm in England has led to the adoption of smoke-free homes not only when parents are non-smokers, but also when they smoke. © 2015 Society for the Study of Addiction.

  6. Public relations effectiveness in public health institutions.

    PubMed

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  7. [Prostitution and public health].

    PubMed

    Aron, E; Froge, E

    1991-03-01

    The attitude of public services concerning prostitution was inspired by the fear of venereal diseases. In regimenting prostitution, the state recognised that they were trying to control it. This law was a total failure and was abolished in 1946. The worrying development of sexually contagious diseases (AIDS) will start again the that was dormant with the victory of antibiotherapy on venereal diseases. The proposition to return to regimentation with there opening of "maisons closes" will also restart the debate. These measures will be inefficient against illicit prostitution and are in contradiction with our convictions and morals, and of course with our international obligations. Prostitution is now part of our society and is longer illegal, but soliciting in a public place is still an offence. The prostitute is judged as being permanently in breach of the law, contrary to the opposite sex where no responsibility is acknowledged. We proposed to associate judges, doctors, police force and prostitutes to give some consideration and think of this problem so that this part of the population do not stay on the fringe of our society and that they can have the same rights, particularly the right for housing and health services, as, unfortunately the majority of prostitutes do not have "social security".

  8. Public health and media advocacy.

    PubMed

    Dorfman, Lori; Krasnow, Ingrid Daffner

    2014-01-01

    Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.

  9. Did smokefree legislation in England reduce exposure to secondhand smoke among nonsmoking adults? Cotinine analysis from the Health Survey for England.

    PubMed

    Sims, Michelle; Mindell, Jennifer S; Jarvis, Martin J; Feyerabend, Colin; Wardle, Heather; Gilmore, Anna

    2012-03-01

    On 1 July 2007, smokefree legislation was implemented in England, which made virtually all enclosed public places and workplaces smokefree. We examined trends in and predictors of secondhand smoke exposure among nonsmoking adults to determine whether exposure changed after the introduction of smokefree legislation and whether these changes varied by socioeconomic status (SES) and by household smoking status. We analyzed salivary cotinine data from the Health Survey for England that were collected in 7 of 11 annual surveys undertaken between 1998 and 2008. We conducted multivariate regression analyses to examine secondhand smoke exposure as measured by the proportion of nonsmokers with undetectable levels of cotinine and by geometric mean cotinine. Secondhand smoke exposure was higher among those exposed at home and among lower-SES groups. Exposure declined markedly from 1998 to 2008 (the proportion of participants with undetectable cotinine was 2.9 times higher in the last 6 months of 2008 compared with the first 6 months of 1998 and geometric mean cotinine declined by 80%). We observed a significant fall in exposure after legislation was introduced--the odds of having undetectable cotinine were 1.5 times higher [95% confidence interval (CI): 1.3, 1.8] and geometric mean cotinine fell by 27% (95% CI: 17%, 36%) after adjusting for the prelegislative trend and potential confounders. Significant reductions were not, however, seen in those living in lower-social class households or homes where smoking occurs inside on most days. We found that the impact of England's smokefree legislation on secondhand smoke exposure was above and beyond the underlying long-term decline in secondhand smoke exposure and demonstrates the positive effect of the legislation. Nevertheless, some population subgroups appear not to have benefitted significantly from the legislation. This finding suggests that these groups should receive more support to reduce their exposure.

  10. Socioeconomic Inequalities in Health in Older Adults in Brazil and England

    PubMed Central

    De Oliveira, Cesar; Macinko, James; Marmot, Michael

    2012-01-01

    Objectives. We examined socioeconomic inequalities in health among older adults in England and Brazil. Methods. We analyzed nationally representative samples of residents aged 50 years and older in 2008 data from the Brazilian National Household Survey (n = 75 527) and the English Longitudinal Study of Ageing (n = 9589). We estimated prevalence ratios for self-rated health, functional limitations, and reported chronic diseases, by education level and household income tertiles. Results. Brazilians reported worse health than did English respondents. Country-specific differences were higher among the poorest, but also affected the wealthiest persons. We observed a strong inverse gradient of similar magnitude across education and household income levels for most health indicators in each country. Prevalence ratios (lowest vs highest education level) of poor self-rated health were 3.24 in Brazil and 3.50 in England; having 2 or more functional limitations, 1.81 in Brazil and 1.96 in England; and having 1 or more diseases, 1.14 in Brazil and 1.36 in England. Conclusions. Socioeconomic inequalities in health affect both populations, despite a less pronounced absolute difference in household income and education in Brazil than in England. PMID:22698020

  11. Public Health Department Accreditation Implementation: Transforming Public Health Department Performance

    PubMed Central

    Bender, Kaye; Lownik, Elizabeth

    2012-01-01

    In response to a call for improved quality and consistency in public health departments, the Public Health Accreditation Board (PHAB) is leading a voluntary public health accreditation initiative in the United States. The public health department accreditation system will implement a comprehensive set of standards that set uniform performance expectations for health departments to provide the services necessary to keep communities healthy. Continuous quality improvement is a major component of PHAB accreditation, demonstrating a commitment to empower and encourage public health departments to continuously improve their performance. The accreditation process was tested in 30 health departments around the country in 2009 and 2010, and was launched on a national level in September 2011 at the National Press Club in Washington, DC. PMID:22390438

  12. Insights in Public Health

    PubMed Central

    Kimura, Lisa J; McGee, Amelia; Baird, Shelagh; Viloria, Joanne; Nagatsuka, Melissa

    2015-01-01

    Healthy Mothers, Healthy Babies Coalition of Hawai‘i (HMHB) is a local nonprofit organization dedicated to eliminating health disparities and improving Hawai‘i's maternal, child, and family health though collaborative efforts in public education, advocacy, and partner development. A review of HMHB services revealed overwhelming requests for both breastfeeding and postpartum depression (PPD) support. The purpose of this article is to present the findings of two surveys that highlight the awareness of existing breastfeeding and PPD resources based on both parents and health care providers; perceptions of where and how care is accessed; and whether mothers throughout Hawai‘i have equitable access to support. Results helped assess gaps in resources and determine barriers to care, as well as provide suggestions for new services or resources. Web-based surveys were sent to 450 providers and 2,955 parents with response rates of 8.9% and 4.0%, respectively. Less than half of parent participants reported that their health provider discussed PPD with them. Participants identified a number of barriers to increasing access and utilization of PPD support resources, including: not feeling like symptoms were server enough, feeling embarrassed to seek help, not knowing where to find support/information, and not able to afford or insurance wouldn't cover PPD support. Only 40% of providers reported screening for PPD and 33% felt they had not received adequate training. Barriers identified by providers were a lack of trained providers, lack of PPD specific support groups, cultural stigma, and lack of PPD awareness among providers. Of the women who did not exclusively breastfeed for the full six-month recommendation, the most common breastfeeding concerns included: perceptions of low milk supply; lack of lactation support; medical reasons; and pain. Providers described an environment of uneven distribution of resources, general lack of awareness of available resources, along

  13. Native Americans in Public Health.

    ERIC Educational Resources Information Center

    Westberg, Jane

    2003-01-01

    The Family Spirit Project provides health and parenting education and in-home support to Navajo and Apache teen parents. The public-health careers of Native professionals allied with the project are described, including a public health administrator, a trainer of field workers, and a medical researcher specializing in communicable diseases that…

  14. Public Health Education in Florida.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee.

    This report documents issues related to the work of the Florida Comprehensive Health Professions Education Plan. Public health education prepares students for initial employment or advancement in a number of positions. While the public health work force is primarily employed in various units in local, state, and federal governments, industry also…

  15. Health for all: a public health vision.

    PubMed Central

    McBeath, W H

    1991-01-01

    The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals. PMID:1746649

  16. Social marketing in public health.

    PubMed

    Grier, Sonya; Bryant, Carol A

    2005-01-01

    Social marketing, the use of marketing to design and implement programs to promote socially beneficial behavior change, has grown in popularity and usage within the public health community. Despite this growth, many public health professionals have an incomplete understanding of the field. To advance current knowledge, we provide a practical definition and discuss the conceptual underpinnings of social marketing. We then describe several case studies to illustrate social marketing's application in public health and discuss challenges that inhibit the effective and efficient use of social marketing in public health. Finally, we reflect on future developments in the field. Our aim is practical: to enhance public health professionals' knowledge of the key elements of social marketing and how social marketing may be used to plan public health interventions.

  17. The Professions of Public Health

    PubMed Central

    Fox, Daniel M.

    2001-01-01

    Law has been an essential tool of public health practice for centuries. From the 19th century until recent decades, however, most histories of public health described, approvingly, the progression of the field from marginally useful policy, made by persons learned in law, to effective policy, made by persons employing the methods of biomedical and behavioral science. Historians have recently begun to change this standard account by documenting the centrality of law in the development of public health practice. The revised history of public health offers additional justification for the program of public health law reform proposed in this issue of the Journal by Gostin and by Moulton and Matthews, who describe the new program in public health law of the Centers for Disease Control and Prevention. PMID:11527756

  18. Climate Change and Public Health.

    PubMed

    Ciesielski, Timothy

    2017-05-01

    It is clear that the public health community is concerned about the human health impacts of climate change, but are we inadvertently underestimating the scope of the problem and obfuscating potentially useful interventions by using a narrow intellectual frame in our discussions with policy makers? If we take a more holistic approach, we see that the public health impacts of climate change are only one subset of the enormous public health impacts of fossil fuel burning. This broader perspective can provide a more accurate and comprehensive assessment that is more useful for decision making in public policy settings.

  19. Promoting stair climbing in public-access settings: an audit of intervention opportunities in England.

    PubMed

    Webb, Oliver J; Smith, Lee

    2011-10-01

    Introducing message prompts at the 'point-of-choice' (POC) between stairs and escalators increases stair choice in 'public-access' settings (e.g. malls). For nationwide campaigns, plentiful POCs appear needed. We audited the availability of POCs in public-access settings across England. Boundaries for 25 urban areas (population=6,829,874) were verified using Ordinance Survey maps, which showed all airports and train/tram stations. Malls and bus stations were identified from commercial listings and local authority web-pages. From September 2010-March 2011 two investigators visually inspected all venues (N=410), counting 'true' POCs and 'quasi' POCs (i.e. instances where stairs were visible from, but not adjacent to, escalators). 5% of venues had ≥1 true POC (quasi POC=3%). Aggregating across areas, there was a true and quasi POC for every 243,924 and 379,437 people, respectively. There were regional variations; one area had 10 true/quasi POCs, whilst 10/24 remaining areas had none. POCs were more common in airports (4/6 venues) than malls (11/85) and train stations (4/215). Although public-access POCs reach sizeable audiences, their availability in England is sporadic, precluding nationwide campaigns. Interventions should be considered locally, based on available POCs. Work/community venues (e.g. offices, hospitals), where pedestrians choose between stairs and elevators, may provide greater intervention opportunities. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Public support in England for raising the price of cigarettes to fund tobacco control activities.

    PubMed

    Gardner, Benjamin; West, Robert

    2010-08-01

    Increasing the price of cigarettes reduces consumption, with a global price elasticity of approximately -0.4. In the UK where the cost of cigarettes is already relatively high, there is an issue surrounding public acceptance of further price rises ahead of the inflation rate. Previous research suggests that price increases may be supported where funds are dedicated to tobacco control. This study assessed public support in England for such a policy. A cross-sectional household survey was conducted in England between August 2008 and January 2009. A representative sample of 8736 respondents aged 16+, of whom 1900 (22%) were cigarette smokers at the time of the survey, was recruited. The primary outcome measure was support for a 20p (4%) price increase on a pack of cigarettes with proceeds going to fund tobacco control activities. 6216 participants (71%), including half (47%) of current cigarette smokers, indicated that they would support a 20p price increase if funds were dedicated to tobacco control activities. Levels of support among smokers were similar across the social gradient and gender. Younger smokers were more likely to support the increase. Smokers who smoked 0-10 cigarettes per day were more supportive of the increase than heavier smokers. There is broad public support for raising the cost of cigarettes with funds being used for tobacco control activities. The absence of a social gradient among smokers concurs with other research showing that more disadvantaged smokers are as engaged with tobacco control objectives as more affluent smokers.

  1. Reproductive health and public health ethics.

    PubMed

    Dickens, B M; Cook, R J

    2007-10-01

    Individuals' reproductive choices are private matters, but sexual conduct and pregnancy impose significant public health burdens. Ethical principles of public health are distinguishable from principles applied in modern bioethics. Bioethical principles have been developed at the clinical or microethical level, affecting relations among individuals, whereas pubic health ethics applies at the population-based or macroethical level. Resolution of issues, for instance of consent to healthcare interventions and preservation of privacy, is different in public health practice from in clinical medicine. Public health aspects of human reproduction concern reduction of maternal mortality and morbidity, particularly in resource-poor countries, and the contribution to high rates of each of unsafe abortion, most prevalent where abortion laws are restrictive. Further aspects of public health ethics concern limited access to contraceptive services, the spread of sexually transmitted infections (STIs), including HIV, causes of infertility, especially due to STIs, and responses to each of these concerns.

  2. Sporadic Cryptosporidiosis Decline after Membrane Filtration of Public Water Supplies, England, 1996–2002

    PubMed Central

    Goh, Stella; Casemore, David P.; Verlander, Neville Q.; Charlett, André; Chalmers, Rachel M.; Knowles, Margaret; Pennington, Anthony; Williams, Joy; Osborn, Keith; Richards, Sarah

    2005-01-01

    The incidence of sporadic cryptosporidiosis among 106,000 residents of 2 local government districts in northwest England before and after installation of membrane filtration of public water supplies was compared to that of 59,700 residents whose public water supplies remained unchanged. A national outbreak of foot and mouth disease in livestock during 2001 was associated with a decline in sporadic human cryptosporidiosis in all regions of the United Kingdom. In a Poisson regression model, membrane filtration was associated with an estimated 79% reduction (incidence ratio 0.207, 95% confidence intervals 0.099–0.431, p < 0.0001) after adjustment for the interval of the foot and mouth disease epidemic and the water source. Despite the confounding effect of that epidemic, membrane filtration of the public water supply was effective in reducing the risk for sporadic human Cryptosporidium infection in this population. PMID:15752443

  3. Reenergizing Public Health Through Precaution

    PubMed Central

    Kriebel, David; Tickner, Joel

    2001-01-01

    The precautionary principle has provoked a spirited debate among environmentalists worldwide, but it is equally relevant to public health and shares much with primary prevention. Its central components are (1) taking preventive action in the face of uncertainty; (2) shifting the burden of proof to the proponents of an activity; (3) exploring a wide range of alternatives to possibly harmful actions; and (4) increasing public participation in decision making. Precaution is relevant to public health, because it can help to prevent unintended consequences of well-intentioned public health interventions by ensuring a more thorough assessment of the problems and proposed solutions. It can also be a positive force for change. Three aspects are stressed: promoting the search for safer technologies, encouraging greater democracy and openness in public health policy, and stimulating reevaluation of the methods of public health science. PMID:11527753

  4. Zoning should promote public health.

    PubMed

    Hirschhorn, Joel S

    2004-01-01

    Legally, governments use their police powers to protect public health, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote public health, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.

  5. [Terrorism, public health and health services].

    PubMed

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

    2009-01-01

    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  6. Liberalism and Public Health Ethics.

    PubMed

    Rajczi, Alex

    2016-02-01

    Many public health dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard public health interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in public health; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of public health ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in public health. © 2015 John Wiley & Sons Ltd.

  7. Public health week: marketing the concept of public health.

    PubMed

    Evans, C A; Margolis, L A

    1992-01-01

    The Public Health Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding public health services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual Public Health Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of public health programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in Public Health Week include a professional lecture series and the honoring of an outstanding public health activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of Public Health Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities.

  8. Another Side to the Coin: The Unintended Effects of the Publication of School Performance Data in England and France.

    ERIC Educational Resources Information Center

    Karsten, Sjoerd; Visscher, Adrie; De Jong, Tim

    2001-01-01

    Publication of school rankings based on raw data for various performance indicators was found to influence school choice and mobility strategies for elite and middle-class parents in England and France. Rather than promoting school improvement, publication led to unintended school coping strategies, such as marketing activities, student exclusion…

  9. Another Side to the Coin: The Unintended Effects of the Publication of School Performance Data in England and France.

    ERIC Educational Resources Information Center

    Karsten, Sjoerd; Visscher, Adrie; De Jong, Tim

    2001-01-01

    Publication of school rankings based on raw data for various performance indicators was found to influence school choice and mobility strategies for elite and middle-class parents in England and France. Rather than promoting school improvement, publication led to unintended school coping strategies, such as marketing activities, student exclusion…

  10. Crossing the quality chasm: lessons from health care quality improvement efforts in England

    PubMed Central

    2002-01-01

    The second report from the US Institute of Medicine Crossing the Quality Chasm, highlighted the deficiencies in health care quality in the USA, analyzed the contributory factors, and proposed 13 recommendations for improvements. Clearly, the challenges are enormous. Can anything be learned from the experiences of other countries? This article describes the author's experiences of health care quality improvement efforts in the National Health Service in England and their implications for the USA and for Baylor Health Care System. PMID:16333409

  11. Social media in public health.

    PubMed

    Kass-Hout, Taha A; Alhinnawi, Hend

    2013-01-01

    While social media interactions are currently not fully understood, as individual health behaviors and outcomes are shared online, social media offers an increasingly clear picture of the dynamics of these processes. Social media is becoming an increasingly common platform among clinicians and public health officials to share information with the public, track or predict diseases. Social media can be used for engaging the public and communicating key public health interventions, while providing an important tool for public health surveillance. Social media has advantages over traditional public health surveillance, as well as limitations, such as poor specificity, that warrant additional study. Social media can provide timely, relevant and transparent information of public health importance; such as tracking or predicting the spread or severity of influenza, west nile virus or meningitis as they propagate in the community, and, in identifying disease outbreaks or clusters of chronic illnesses. Further work is needed on social media as a valid data source for detecting or predicting diseases or conditions. Also, whether or not it is an effective tool for communicating key public health messages and engaging both, the general public and policy-makers.

  12. Working together for public health.

    PubMed

    Martelli, Pompeo

    2009-06-01

    Italy's recent economic growth and strategic position in the Mediterranean Sea have made it a prime destination for immigrants and asylum seekers in Europe. Despite its well-developed health care system, statistics on foreign citizens' health are worrisome. In 1998 public health services were extended to illegal immigrants, giving them the right to necessary urgent and non-urgent medical assistance, even for a prolonged period. This paper examines a two-year joint intervention project between Centre for the Study and Research of Public Health (Mental Health), Local Health Agency ROMA E (LHA RME) and the non-governmental organization Médecins Sans Frontières (MSF) in Rome.

  13. Trust, terrorism and public health.

    PubMed

    McKee, Martin; Coker, Richard

    2009-12-01

    Policies to promote public health are based on trust. There is a danger that public trust may be lost, especially where policies are seen to be influenced by vested interests or conflict with available evidence. Although trust in public health policies in the UK is high, some commentators have questioned recent responses to the threat of pandemic flu, suggesting that they may be driven, in part, by those seeking to profit from health scares, and drawing a direct comparison with terrorist scares. We argue that the approach to evidence by the public health and counter-terrorist communities differ markedly. Public health professionals must ensure that their actions do not undermine their credibility, in particular those involved in response to the threat of bioterrorism.

  14. When Public Health Becomes Politicized.

    PubMed

    Lerner, Barron H

    2017-09-01

    Perhaps nothing symbolizes the current polarized political climate in the United States more than the world of public health. Public health schools and health departments are full of "true believers," people willing to crusade for any program designed to reduce morbidity and mortality. But in the "real world," proven programs and strategies-such as gun-control measures, universal vaccination, and improved traffic safety-are routinely thwarted. Why do critics oppose efforts to improve the public's health? History can provide some answers. © 2017 The Hastings Center.

  15. NCDs, health promotion and public health.

    PubMed

    McQueen, David V

    2013-12-01

    Though not necessarily using the same terminology historically, people concerned with the public's health have long been addressing the social context of non-communicable diseases (NCDs) and the actions of promoting health. This commentary places the current interest in NCDs within that history and discusses the challenges that continue to face institutions in dealing with NCDs. It makes a particular plea for the role of health promotion as the area of public health that takes actions to address the global burden of NCDs. Without a health promotion focus, we will just continue to describe the NCD burden rather than reduce it.

  16. The twenty-year war over England's National Health Service: a report from the battlefield.

    PubMed

    Klein, Rudolf

    2013-08-01

    This article analyzes the latest battle in the twenty-year war to change England's National Health Service (NHS), starting with the internal market reforms introduced by the Thatcher government and now carried one step farther by David Cameron's coalition government. The government's program of change is characterized by (1) its wide scope and the organizational upheavals involved and (2) the fact that it is being introduced at a time when the NHS faces unprecedented fiscal pressures. The legislation faced strong political, public, and professional hostility both from those who saw it as a crime against the founding principles of the NHS and from those who saw it as a disruptive blunder that created more problems than it solved. This article asks three questions. Why did the coalition government embark on a policy course guaranteed to lose it votes? How will the much-amended legislation work out in practice: what are the risks and uncertainties? What will be the program's impact: will it, like previous waves of change, disappoint both the prophets of doom and the visionaries of transformation? The conclusion drawn is that the essential, defining characteristics of the NHS are not under threat. It continues to be a publicly funded service, freely available to all. It is not being privatized. But it is moving toward the kind of pluralistic system that would have been established by Britain's last, wartime coalition government, had not Aneurin Bevan nationalized the hospital service in 1948.

  17. Public health and human values

    PubMed Central

    Häyry, M

    2006-01-01

    The ends and means of public health activities are suggested to be at odds with the values held by human individuals and communities. Although promoting longer lives in better health for all seems like an endeavour that is obviously acceptable, it can be challenged by equally self‐evident appeals to autonomy, happiness, integrity and liberty, among other values. The result is that people's actual concerns are not always adequately dealt with by public health measures and assurances. PMID:16943332

  18. PERSONAL HEALTH BUDGETS IN ENGLAND: MOOD MUSIC OR DEATH KNELL FOR THE NATIONAL HEALTH SERVICE?

    PubMed

    Scott-Samuel, Alex

    2015-01-01

    Personal health budgets in England are National Health Service (NHS) funds that can be allocated to certain groups of patients to allow them, together with their NHS support staff, to purchase services or equipment that they believe will enhance their health and well-being. Some see this as a welcome personalization of health care that increases people's control over their health. However, personal health budgets are being introduced at a time when rapid privatization of the English NHS is taking place and when restrictions are being placed on people's access to health care. As a result, many view their introduction as a diversionary gimmick designed to help pave the way for the conversion of the NHS into the insurance-based system, which many believe is the intention of the U.K. government. This article describes the research and policy context in which this controversial intervention is being introduced and presents recent expert debate between proponents and opponents of personal health budgets, from e-mail discussion lists.

  19. Opportunities for Public Relations Research in Public Health.

    ERIC Educational Resources Information Center

    Wise, Kurt

    2001-01-01

    Considers how communication researchers have developed a solid body of knowledge in the health field but know little about the activities of public relations practitioners in public health bodies. Suggests that public relations scholarship and practice have much to offer the field of public health in helping public health bodies meet their…

  20. Barriers to Partnership Working in Public Health: A Qualitative Study

    PubMed Central

    Taylor-Robinson, David Carlton; Lloyd-Williams, Ffion; Orton, Lois; Moonan, May; O'Flaherty, Martin; Capewell, Simon

    2012-01-01

    Background Public health provision in England is undergoing dramatic changes. Currently established partnerships are thus likely to be significantly disrupted by the radical reforms outlined in the Public Health White Paper. We therefore explored the process of partnership working in public health, in order to better understand the potential opportunities and threats associated with the proposed changes. Methodology/Principal Findings 70 participants took part in an in-depth qualitative study involving 40 semi-structured interviews and three focus group discussions. Participants were senior and middle grade public health decision makers working in Primary Care Trusts, Local Authorities, Department of Health, academia, General Practice and Hospital Trusts and the third sector in England. Despite mature arrangements for partnership working in many areas, and much support for joint working in principle, many important barriers exist. These include cultural issues such as a lack of shared values and language, the inherent complexity of intersectoral collaboration for public health, and macro issues including political and resource constraints. There is particular uncertainty and anxiety about the future of joint working relating to the availability and distribution of scarce and diminishing financial resources. There is also the concern that existing effective collaborative networks may be completely disrupted as the proposed changes unfold. The extent to which the proposed reforms might mitigate or potentiate these issues remains unclear. However the threats currently remain more salient than opportunities. Conclusions The current re-organisation of public health offers real opportunity to address some of the barriers to partnership working identified in this study. However, significant threats exist. These include the breakup of established networks, and the risk of cost cutting on effective public health interventions. PMID:22238619

  1. Nanny or steward? The role of government in public health.

    PubMed

    Jochelson, Karen

    2006-12-01

    The past year has witnessed contentious debates about public health in England around smoking bans, alcohol licencing, food labelling and junk food advertising. Some people argue that any government intervention in these areas is 'nanny statist'--an unnecessary intrusion into people's lives and what they do, eat and drink. Others argue that only the state can alter the environment that shapes people's decisions and behaviour. This paper suggests that there is a strong argument to be made for government intervention to safeguard public health. Legislation brings about changes that individuals on their own cannot, and sets new standards for the public good. Rather than condemning such activity as 'nanny statist', it might be more appropriate to view it as a form of 'stewardship'. The paper draws on international evidence about alcohol use, smoking and road safety to show how taxation, advertising bans, regulations proscribing behaviour and education create a public health framework and shape individual choices towards healthier and safer behaviour.

  2. Prioritising public health: a qualitative study of decision making to reduce health inequalities

    PubMed Central

    2011-01-01

    Background The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. Methods We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. Results The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. Conclusions It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health

  3. Pathways in dental public health.

    PubMed

    Silverstein, Steven J

    2005-07-01

    Dental public health is one of the nine specialties of dentistry recognized by the American Dental Association Commission on Dental Accreditation. Dental public health has been defined as the "science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than as an individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis." This article will describe the many career and educational pathways dentists may follow to become irvolved in the practice of dental public health.

  4. Ethics in Public Health Research

    PubMed Central

    Myers, Julie; Frieden, Thomas R.; Bherwani, Kamal M.; Henning, Kelly J.

    2008-01-01

    Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies. PMID:18382010

  5. Alaska public health law reform.

    PubMed

    Meier, Benjamin Mason; Hodge, James G; Gebbie, Kristine M

    2008-04-01

    The Turning Point Model State Public Health Act (Turning Point Act), published in September 2003, provides a comprehensive template for states seeking public health law modernization. This case study examines the political and policy efforts undertaken in Alaska following the development of the Turning Point Act. It is the first in a series of case studies to assess states' consideration of the Turning Point Act for the purpose of public health law reform. Through a comparative analysis of these case studies and ongoing legislative tracking in all fifty states, researchers can assess (1) how states codify the Turning Point Act into state law and (2) how these modernized state laws influence or change public health practice, leading to improved health outcomes.

  6. Veterans Health Administration and Medicare Outpatient Health Care Utilization by Older Rural and Urban New England Veterans

    ERIC Educational Resources Information Center

    Weeks, William B.; Bott, David M.; Lamkin, Rebecca P.; Wright, Steven M.

    2005-01-01

    Older veterans often use both the Veterans Health Administration (VHA) and Medicare to obtain health care services. The authors sought to compare outpatient medical service utilization of Medicare-enrolled rural veterans with their urban counterparts in New England. The authors combined VHA and Medicare databases and identified veterans who were…

  7. Veterans Health Administration and Medicare Outpatient Health Care Utilization by Older Rural and Urban New England Veterans

    ERIC Educational Resources Information Center

    Weeks, William B.; Bott, David M.; Lamkin, Rebecca P.; Wright, Steven M.

    2005-01-01

    Older veterans often use both the Veterans Health Administration (VHA) and Medicare to obtain health care services. The authors sought to compare outpatient medical service utilization of Medicare-enrolled rural veterans with their urban counterparts in New England. The authors combined VHA and Medicare databases and identified veterans who were…

  8. Expert searching in public health

    PubMed Central

    Alpi, Kristine M.

    2005-01-01

    Objective: The article explores the characteristics of public health information needs and the resources available to address those needs that distinguish it as an area of searching requiring particular expertise. Methods: Public health searching activities from reference questions and literature search requests at a large, urban health department library were reviewed to identify the challenges in finding relevant public health information. Results: The terminology of the information request frequently differed from the vocabularies available in the databases. Searches required the use of multiple databases and/or Web resources with diverse interfaces. Issues of the scope and features of the databases relevant to the search questions were considered. Conclusion: Expert searching in public health differs from other types of expert searching in the subject breadth and technical demands of the databases to be searched, the fluidity and lack of standardization of the vocabulary, and the relative scarcity of high-quality investigations at the appropriate level of geographic specificity. Health sciences librarians require a broad exposure to databases, gray literature, and public health terminology to perform as expert searchers in public health. PMID:15685281

  9. Redesign and commissioning of sexual health services in England - a qualitative study.

    PubMed

    Walker, I F; Leigh-Hunt, N; Lee, A C K

    2016-10-01

    Responsibility for the commissioning of sexual and reproductive health (SRH) services transferred from the National Health Service to local authorities in England in 2013. This transfer prompted many local authorities to undertake new procurements of these SRH services. This study was undertaken to capture some of the lessons learnt in order to inform future commissioning and system redesign. A qualitative study was carried out involving semi-structured interviews. Interviews were conducted with 13 local authority sexual health commissioners in Yorkshire and the Humber from 11 interviews. Thematic analysis was used to identify themes from transcripts of the interviews with the 13 participants. Key themes identified were as follows: the challenge and complexity to those new to clinical commissioning; the prerequisites of robust infrastructural inputs to undertake the process, including technical expertise, a dependable project team, with clarity over the timescales and the budget; the requirement for good governance, stakeholder engagement and successful management of relationships with the latter; and the need to focus on the outcomes, aiming for value for money and improved system performance. Several key issues emerged from our study that significantly influenced the outcome of the redesign and commissioning process for sexual health services. An adapted model of the Donabedian evaluation framework was developed to provide a tool to inform future system redesign. Our model helps identify the key determinants for successful redesign in this context which is essential to both mitigate potential risks and maximize the likelihood of successful outcomes. Our model may have wider applications. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. [Anomie and public mental health].

    PubMed

    Parales-Quenza, Carlos J

    2008-01-01

    This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to public health based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.

  11. Global Trade and Public Health

    PubMed Central

    Shaffer, Ellen R.; Waitzkin, Howard; Brenner, Joseph; Jasso-Aguilar, Rebeca

    2005-01-01

    Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date. PMID:15623854

  12. Global trade and public health.

    PubMed

    Shaffer, Ellen R; Waitzkin, Howard; Brenner, Joseph; Jasso-Aguilar, Rebeca

    2005-01-01

    Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization's General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date.

  13. Public Health Perspectives on Aquaculture.

    PubMed

    Gormaz, Juan G; Fry, Jillian P; Erazo, Marcia; Love, David C

    2014-01-01

    Nearly half of all seafood consumed globally comes from aquaculture, a method of food production that has expanded rapidly in recent years. Increasing seafood consumption has been proposed as part of a strategy to combat the current non-communicable disease (NCD) pandemic, but public health, environmental, social, and production challenges related to certain types of aquaculture production must be addressed. Resolving these complicated human health and ecologic trade-offs requires systems thinking and collaboration across many fields; the One Health concept is an integrative approach that brings veterinary and human health experts together to combat zoonotic disease. We propose applying and expanding the One Health approach to facilitate collaboration among stakeholders focused on increasing consumption of seafood and expanding aquaculture production, using methods that minimize risks to public health, animal health, and ecology. This expanded application of One Health may also have relevance to other complex systems with similar trade-offs.

  14. Changes in health promotion practice in hospitals across England: the National Health Promotion in Hospital Audit 2009 and 2011.

    PubMed

    Lee, Deborah J; Knuckey, Steven; Cook, Gary A

    2014-12-01

    There is increasing focus on hospitals to provide health promotion (HP) to patients who smoke, misuse alcohol, are obese or physically inactive, yet there is little published literature on assessment and HP in English hospitals. Thirty hospitals participated in national audits, both in 2009 and 2011, to assess HP in hospitalized patients. Random samples of 100 patients were selected per hospital per year. Between the 2009 and 2011 audit, assessment rates increased for smoking (82 versus 86%; P < 0.001) and obesity (38 versus 53%; P < 0.001), alcohol assessments remained similar (71 versus 73%; P = 0.123) and physical activity assessments decreased (34 versus 28%; P < 0.001). Provision of HP was similar in both audits for smoking (22 versus 26%; P = 0.17), alcohol misuse (47 versus 44%; P = 0.12) and physical inactivity (43 versus 44%; P = 0.865), but fell for obesity (26 versus 14%; P < 0.001). Few hospitals met the standards for assessment and HP for each risk factor. Whilst patients are being assessed for most lifestyle risk factors, and despite an increased policy focus, there remains little evidence of HP practice in English hospitals. There is potential for health gain across England that could be exploited through wider provision of HP for hospitalized patients. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. The impact of partial smokefree legislation on health inequalities: evidence from a survey of 1150 pubs in North West England.

    PubMed

    Tocque, Karen; Edwards, Richard; Fullard, Brenda

    2005-09-01

    The UK government claims that between 10 and 30% of pubs and bars will be exempt from proposed legislation to achieve smokefree enclosed public places across England. This arises from the contentious inclusion that pubs and bars that do not prepare and serve food and private members clubs, will be able to allow smoking. We aimed to survey pubs and bars across the North West of England to assess smoking policies and the proportion and variations by deprivation level of venues preparing and serving food. We carried out a telephone survey of 1150 pubs and bars in 14 local authorities across the North West of England. The main data items were current smoking policy, food preparation and serving status, and intention to change food serving and smoking status in the event of implementation of the proposed English partial smokefree legislation. 29 pubs and bars (2.5%) were totally smoke-free, 500 (44%) had partial smoking restrictions, and 615 (54%) allowed smoking throughout. Venues situated in the most deprived quintiles (4 and 5) of deprivation were more likely to allow unrestricted smoking (62% vs 33% for venues in quintiles 1 and 2). The proportion of pubs and bars not preparing and serving food on the premises was 44% (95% CI 42 to 46%), and ranged from 21% in pubs and bars in deprivation quintile 1 to 63% in quintile 5. The proportion of pubs and bars which do not serve food was far higher than the 10-30% suggested by the UK government. The proportion of pubs allowing unrestricted smoking and of non-food venues was higher in more disadvantaged areas, suggesting that the proposed UK government policy of exempting pubs in England which do not serve food from smokefree legislation will exacerbate inequalities in smoking and health.

  16. Personalism for public health ethics.

    PubMed

    Petrini, Carlo; Gainotti, Sabina; Requena, Pablo

    2010-01-01

    In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

  17. Did Smokefree Legislation in England Reduce Exposure to Secondhand Smoke among Nonsmoking Adults? Cotinine Analysis from the Health Survey for England

    PubMed Central

    Mindell, Jennifer S.; Jarvis, Martin J.; Feyerabend, Colin; Wardle, Heather; Gilmore, Anna

    2011-01-01

    Background On 1 July 2007, smokefree legislation was implemented in England, which made virtually all enclosed public places and workplaces smokefree. Objectives We examined trends in and predictors of secondhand smoke exposure among nonsmoking adults to determine whether exposure changed after the introduction of smokefree legislation and whether these changes varied by socioeconomic status (SES) and by household smoking status. Methods We analyzed salivary cotinine data from the Health Survey for England that were collected in 7 of 11 annual surveys undertaken between 1998 and 2008. We conducted multivariate regression analyses to examine secondhand smoke exposure as measured by the proportion of nonsmokers with undetectable levels of cotinine and by geometric mean cotinine. Results Secondhand smoke exposure was higher among those exposed at home and among lower-SES groups. Exposure declined markedly from 1998 to 2008 (the proportion of participants with undetectable cotinine was 2.9 times higher in the last 6 months of 2008 compared with the first 6 months of 1998 and geometric mean cotinine declined by 80%). We observed a significant fall in exposure after legislation was introduced—the odds of having undetectable cotinine were 1.5 times higher [95% confidence interval (CI): 1.3, 1.8] and geometric mean cotinine fell by 27% (95% CI: 17%, 36%) after adjusting for the prelegislative trend and potential confounders. Significant reductions were not, however, seen in those living in lower-social class households or homes where smoking occurs inside on most days. Conclusions We found that the impact of England’s smokefree legislation on secondhand smoke exposure was above and beyond the underlying long-term decline in secondhand smoke exposure and demonstrates the positive effect of the legislation. Nevertheless, some population subgroups appear not to have benefitted significantly from the legislation. This finding suggests that these groups should receive more

  18. Public expenditure costs of carers leaving employment in England, 2015/2016.

    PubMed

    Pickard, Linda; King, Derek; Brimblecombe, Nicola; Knapp, Martin

    2017-09-14

    In the context of global population ageing, the reconciliation of employment and unpaid caring is becoming an important social issue. The estimation of the public expenditure costs of carers leaving employment is a valuable measure that is of considerable interest to policy makers. In 2012, the Personal Social Services Research Unit estimated that the public expenditure costs of unpaid carers leaving employment in England were approximately £1.3 billion a year, based on the costs of Carer's Allowance and lost tax revenues on forgone incomes. However, this figure was known to be an underestimate partly because it did not include other key benefits that carers who have given up work to care may receive. This paper presents a new estimate of the public expenditure costs of carers leaving employment. Key sources of information are the 2009/2010 Survey of Carers in Households, 2011 Census and 2015/2016 costs data. As well as Carer's Allowance, the estimate also now includes the costs of other benefits that carers leaving work may receive, namely, Income Support and Housing Benefit. The results show that the estimated numbers of carers who have left employment because of caring have increased from approximately 315,000 to 345,000. Due mainly to the inclusion of a wider range of benefits, the public expenditure costs of carers leaving employment in England are now estimated at £2.9 billion a year. The new estimate comprises £1.7 billion in social security benefits paid to people who have left their jobs because of unpaid caring, plus another £1.2 billion in taxes forgone on this group's lost earnings. The paper concludes that, if there was greater public investment in social care, such as "replacement care" to support carers in employment, and fewer carers then left employment, public spending on benefits would be lower and revenues from taxation would be higher. © 2017 John Wiley & Sons Ltd.

  19. Social marketing for public health.

    PubMed

    Walsh, D C; Rudd, R E; Moeykens, B A; Moloney, T W

    1993-01-01

    Marketing techniques and tools, imported from the private sector, are increasingly being advocated for their potential value in crafting and disseminating effective social change strategies. This paper describes the field of social marketing as it is used to improve the health of the public. A disciplined process of strategic planning can yield promising new insights into consumer behavior and product design. But the "technology" cannot simply be transferred without some translation to reconcile differences between commercial marketing and public health.

  20. Insights in Public Health

    PubMed Central

    Tong, Michelle; Sentell, Tetine

    2017-01-01

    Chinese Americans constitute the largest percentage of Asian Americans. In Hawai‘i, Chinese Americans make up approximately 4.7% of the total state population. Accurately assessing health disparities across specific Asian American subgroups is critically important to health research and policy, as there is often substantial variability in risk and outcomes. However, even for Chinese Americans, the largest of the Asian American subgroups, such analyses can present challenges in population-based surveys. This article considers these challenges generally and then specifically in terms of the issue of health literacy and heart disease in Chinese Americans using existing population-based survey data sets in the United States, California, and Hawai‘i. PMID:28090401

  1. Protecting health through public health law.

    PubMed

    Griffith, Richard

    The report into the outbreak of measles in the Swansea area in 2013 has recommended that public health law be used as a routine response to minimising the spread of infectious diseases. In this article, the author considers what powers are available to health and local authorities to minimise the spread of an infectious disease outbreak.

  2. Ethical analysis in public health.

    PubMed

    Roberts, Marc J; Reich, Michael R

    2002-03-23

    Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.

  3. Insights in Public Health

    PubMed Central

    Delafield, Rebecca; Wright, Tricia E

    2016-01-01

    Substance use can have serious consequences for the health and well-being of individuals. The problem is of particular concern when it involves pregnant women due to health risks for the mother and the fetus. In utero exposure to either legal (eg, alcohol, cigarettes, and certain prescription drugs) or illicit (eg, amphetamines, cocaine, and opioids) substances can result in potentially serious and long-lasting health problems for infants. Available data from Hawai‘i indicate that substance use among pregnant women is higher than national targets, which reflect the fact that there is essentially no acceptable rate of use of these substances. Developing an effective system to support virtual elimination of substance use in pregnancy requires broad-based strategies. Progress is being made in Hawai‘i to better identify and address substance use in pregnancy. These efforts are being guided by a variety of stakeholders who are dedicated to improving the healthcare and health outcomes for this population. However, significant challenges to the system remain, including provider shortages, lack of local investment, and limited capacity of appropriate, individualized treatment. PMID:27920946

  4. American Public Health Association

    MedlinePlus

    ... Infectious Diseases has a new Spanish language website! https://t.co… RT @CDCgov: Know when you need ... Together we can fight antibiotic resistance. Be #AntibioticSmart. https://t.… RT @AMJPublicHealth: Whiteness of the #opioidepidemic is ...

  5. Disasters and public health

    PubMed Central

    Lechat, M. F.

    1979-01-01

    Studies on the health effects of disasters have shown that epidemiological indices can be of value in planning preventive and relief measures and in evaluating their effectiveness. Mortality rates naturally vary considerably, but in earthquakes, for example, the number of deaths per 100 houses destroyed can give an indication of the adequacy of building techniques. Age-specific mortality rates can help to identify particularly vulnerable groups and perhaps indicate what form of education would be valuable. Except in earthquakes, the number of casualties after a disaster is usually low in relation to the number of deaths, and study of the distribution and types of lesions would help in planning the amounts and types of relief supplies and personnel required. Disasters also affect the general level of morbidity in a district because of either interruption of normal health care services or of spraying or other disease control measures. Mental health and nutrition following disasters are particular problems that require further investigation. Study of all these features of disasters has been handicapped by a lack of data, particularly concerning the health situation immediately after the impact. The provision of surveillance teams in disaster-prone areas would appear to be a field in which international cooperation could yield immense benefits. PMID:311707

  6. Insights in Public Health

    PubMed Central

    Yoshimoto, D Kaulana; Robertson, N Tod; Hayes, Donald K

    2014-01-01

    Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985–2008, home visiting services in Hawai‘i were provided primarily through state funding of the Hawai‘i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai‘i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4

  7. Testing, Training and Tensions: The Expression of Health within Physical Education Curricula in Secondary Schools in England and Wales

    ERIC Educational Resources Information Center

    Harris, Jo; Leggett, Gemma

    2015-01-01

    This paper utilises critical discourse analysis to explore and discuss the expression of health within physical education (PE) curricula in secondary schools in England and Wales. The study adopted a case study approach, involving three state secondary schools in England and two in Wales. Data were drawn from interviews with PE teachers and…

  8. Testing, Training and Tensions: The Expression of Health within Physical Education Curricula in Secondary Schools in England and Wales

    ERIC Educational Resources Information Center

    Harris, Jo; Leggett, Gemma

    2015-01-01

    This paper utilises critical discourse analysis to explore and discuss the expression of health within physical education (PE) curricula in secondary schools in England and Wales. The study adopted a case study approach, involving three state secondary schools in England and two in Wales. Data were drawn from interviews with PE teachers and…

  9. Stigmatization and public health ethics.

    PubMed

    Courtwright, Andrew

    2013-02-01

    Encouraged by the success of smoking denormalization strategies as a tobacco-control measure, public health institutions are adopting a similar approach to other health behaviors. For example, a recent controversial ad campaign in New York explicitly aimed to denormalize HIV/AIDS amongst gay men. Authors such as Scott Burris have argued that efforts like this are tantamount to stigmatization and that such stigmatization is unethical because it is dehumanizing. Others have offered a limited endorsement of denormalization/stigmatization campaigns as being justified on consequentialist grounds; namely, that the potential public health benefits outweigh any stigmatizing side effects. In this paper, I examine and reject the blanket condemnation of stigmatization efforts in public health. I argue that the moral status of such efforts are best evaluated within a contractualist, as opposed to a consequentialist, framework. Contractualism in public health ethics asks whether a particular stigmatizing policy could be justified to reasonable individuals who do not know whether they will be affected by that policy. Using this approach, I argue that it is sometimes permissible for public health institutions to engage in health-related stigmatization.

  10. An Analysis of the Stakeholder Model of Public Boards and the Case of School Governing Bodies in England and Wales

    ERIC Educational Resources Information Center

    Connolly, Michael; Farrell, Catherine; James, Christopher

    2017-01-01

    This article analyses the stakeholder model of boards that is widely used in public and third sector institutions in England and Wales. The central tenet of this model is that such institutions should be strategically led by individuals who are representative of and from the groups that have an interest in them. The article focuses in particular…

  11. An Analysis of the Stakeholder Model of Public Boards and the Case of School Governing Bodies in England and Wales

    ERIC Educational Resources Information Center

    Connolly, Michael; Farrell, Catherine; James, Christopher

    2017-01-01

    This article analyses the stakeholder model of boards that is widely used in public and third sector institutions in England and Wales. The central tenet of this model is that such institutions should be strategically led by individuals who are representative of and from the groups that have an interest in them. The article focuses in particular…

  12. Insiders and incomers: how lay public health workers' knowledge might improve public health practice.

    PubMed

    Yoeli, Heather; Cattan, Mima

    2017-03-28

    Since 2005, health trainers and other lay public health workers (LPHWs) have been increasingly active in the UK. Although elsewhere in the world LPHWs are expected to come from the communities within which they work and know that their knowledge is valued, neither is the case for LPHWs in the UK. This study sought to discover the lay knowledge of health trainers and other LPHWs, aiming to ascertain how this knowledge might more effectively be utilised within UK public health services. This paper describes a participatory and ethnographic case study research project undertaken on an anonymised urban estate in North East England. Findings were generated by a range of means including by participant observation and semi-structured interviews. Seven LPHWs took part, as did 32 other community members. This study found that the lay health knowledge of an individual UK LPHW is determined primarily by his or her position within, or in relation to, the community within which he or she works. Insider LPHWs possess an embodied knowledge and incomer LPHWs possess an experiential knowledge which, although different from one another, are essentially interpersonal in nature. Lay health knowledge can take different forms, and different LPHWs can provide different forms of lay health knowledge. Public health structures and services in the UK should make better use of all forms of LPHW knowledge, and should seek from LPHWs training on how to engage the most 'hard-to-reach' or 'difficult-to-engage' groups. Services recruiting LPHWs should decide whether they are seeking embodied insider LPHW knowledge, experiential incomer LPHW knowledge or a mixture of both.

  13. Modeling indoor TV/screen viewing and adult physical and mental health: Health Survey for England, 2012.

    PubMed

    Shiue, Ivy

    2016-06-01

    The aim of the present study was to model indoor TV/screen viewing and a series of adult health conditions and cognitive performance in a country-wide, population-based setting in recent years. Data was retrieved from Health Survey for England, 2012. Information on demographics, lifestyle factors, self-reported health conditions, and TV and/or screen watching hours in adults was collected by household interviews. Chi-square test and survey-weighted logistic and multi-nominal modeling were performed. Of 8114 English adults aged 18-98, 4138 people (51.1 %) watched TV and/or screen daily for 2 h or more on average. Two thousand five-hundred people (30.9 %) watched for 3 h or more. TV and/or screening watching for 2+ hours was associated with endocrine or metabolic disorders, diabetes, mental disorders (including poor scores in General Health Questionnaire and Warwick-Edinburgh Mental Well-being Scale), nervous system disorders, eye complaints, circulatory system disorders, respiratory system disorders, musculoskeletal system disorders, and self-rated health. TV and/or screen watching for 3+ hours was associated with digestive disorders and clotting disorder. TV and/or screen watching for 5+ hours was associated with cancer. TV and/or screen watching for 6+, 8+, or 11+ hours was associated with bladder disease, genito-urinary system disorders or bowel disease, respectively. There were no risk associations (within 20 h) found with ear complaints, infectious disease, and blood system disorders. Future educational and public health programs minimizing TV and/or screen viewing in order to protect from physical inactivity and X-radiation might be needed while research on the combined effect of physical inactivity and X-radiation should be explored.

  14. Keeping the "public" in schools of public health.

    PubMed

    Freudenberg, Nicholas; Klitzman, Susan; Diamond, Catherine; El-Mohandes, Ayman

    2015-03-01

    In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation's public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities.

  15. Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy.

    PubMed

    Latif, Asam; Waring, Justin; Watmough, Deborah; Barber, Nick; Chuter, Anthony; Davies, James; Salema, Nde-Eshimuni; Boyd, Matthew J; Elliott, Rachel A

    Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients' adherence to newly prescribed medicines for a long-term condition. This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-to-one, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analyzed thematically and guided by Damschroder's consolidated framework for implementation research. The NMS workload had been implemented and absorbed into pharmacists' daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients' medicines. GPs were generally

  16. Perspectives on the place of environmental health and protection in public health and public health agencies.

    PubMed

    Kotchian, S

    1997-01-01

    The field of environmental health and protection and the entire field of public health have repeatedly found themselves isolated from one another, unable to articulate the definition, mission, and goals of public health and the essential role for environmental health and protection in the provision of a healthy ecological and human environment. Environmental agencies often forget that they, too, are public health agencies; public health agencies that have had environmental health functions have divided and abdicated their environmental responsibilities, considering these to be "regulatory" rather than public health. This article reviews the history of environmental health and protection, its involvement within the field of public health, its eventual separation from other public health programs with resulting benefits and consequences, and what the future may hold for environmental health and protection activities as well as for the broader scope of public health of which these activities are a part.

  17. Digital government and public health.

    PubMed

    Fountain, Jane E

    2004-10-01

    Digital government is typically defined as the production and delivery of information and services inside government and between government and the public using a range of information and communication technologies. Two types of government relationships with other entities are government-to-citizen and government-to-government relationships. Both offer opportunities and challenges. Assessment of a public health agency's readiness for digital government includes examination of technical, managerial, and political capabilities. Public health agencies are especially challenged by a lack of funding for technical infrastructure and expertise, by privacy and security issues, and by lack of Internet access for low-income and marginalized populations. Public health agencies understand the difficulties of working across agencies and levels of government, but the development of new, integrated e-programs will require more than technical change - it will require a profound change in paradigm.

  18. Recording and measuring public health effect.

    PubMed

    2017-08-30

    It is important to record and measure public health impact, not least because they highlight the work of healthcare professionals, encourage continued investment in public health and demonstrate the value of public health services to commissioners.

  19. USGS Science Serves Public Health

    USGS Publications Warehouse

    Buxton, Herbert T.

    2010-01-01

    Human health so often depends on the health of the environment and wildlife around us. The presence of naturally occurring or human environmental contaminants and the emergence of diseases transferred between animals and humans are growing concerns worldwide. The USGS is a source of natural science information vital for understanding the quantity and quality of our earth and living resources. This information improves our understanding not only of how human activities affect environmental and ecological health, but also of how the quality of our environment and wildlife in turn affects human health. USGS is taking a leadership role in providing the natural science information needed by health researchers, policy makers, and the public to safeguard public health

  20. Undergraduate Environmental Public Health Education.

    PubMed

    Ahonen, Emily Q; Lacey, Steven E

    2017-05-01

    Environmental, occupational, and public health in the United States are practiced across a fragmented system that makes work across those areas more difficult. A large proportion of currently active environmental and occupational health professionals, advocates, policy makers, and activists are nearing retirement age, while some of our major health challenges are heavily influenced by aspects of environment. Concurrently, programs that educate undergraduate college students in environmental health are faced with multiple, often competing demands which can impede progressive movement toward dynamic curricula for the needs of the twenty-first century. We describe our use of developmental evaluation to negotiate these challenges in our specific undergraduate education program, with the dual aims of drawing attention to developmental evaluation as a useful tool for people involved in environmental and occupational health advocacy, policy-making, activism, research, or education for change, as well as to promote discussion about how best to educate the next generation of environmental public health students.

  1. Public participation in soil surveys: lessons from a pilot study in England.

    PubMed

    Bone, James; Archer, Michael; Barraclough, Declan; Eggleton, Paul; Flight, Dee; Head, Martin; Jones, David T; Scheib, Catherine; Voulvoulis, Nikolaos

    2012-04-03

    In many countries there are policies in place that impact on soils, but very few legislative or policy tools specifically for the protection of soil. Recent EU legislative proposals on soil protection have been met with opposition on the grounds of excessive cost and resource demands. With the need for evidence based policy, and recognition that involving the public in environmental monitoring is an effective way of increasing understanding and commitment, there has been growing interest in soil surveys. In addition, it is accepted that the success of environmental policies depends greatly on how effectively scientists, regulators, stakeholders, and society communicate. This paper presents the Open Air Laboratories (OPAL) Soil and Earthworm Survey as an example of public participation in soil surveys that aims to integrate the above. It is demonstrated how such surveys generate data that can be used to prioritise soil assessment, in order to address some of the concerns and objections to soil protection policies. Lessons from this pilot study in England highlight that with strategic planning of civic participation activities, this approach can deliver improvements in the quality of the evidence collected and allow for effective public involvement in policymaking and implementation, on top of direct educational benefits.

  2. Targeted marketing and public health.

    PubMed

    Grier, Sonya A; Kumanyika, Shiriki

    2010-01-01

    Targeted marketing techniques, which identify consumers who share common needs or characteristics and position products or services to appeal to and reach these consumers, are now the core of all marketing and facilitate its effectiveness. However, targeted marketing, particularly of products with proven or potential adverse effects (e.g., tobacco, alcohol, entertainment violence, or unhealthful foods) to consumer segments defined as vulnerable raises complex concerns for public health. It is critical that practitioners, academics, and policy makers in marketing, public health, and other fields recognize and understand targeted marketing as a specific contextual influence on the health of children and adolescents and, for different reasons, ethnic minority populations and other populations who may benefit from public health protections. For beneficial products, such understanding can foster more socially productive targeting. For potentially harmful products, understanding the nature and scope of targeted marketing influences will support identification and implementation of corrective policies.

  3. Health education and public policy.

    PubMed

    Service, A

    1986-01-01

    The UK's Minister for Health has again raised the debate about the role of health educators, and in particular that of the Health Education Council, in what is termed public policy work. 1 possible definition of public policy work as regards health education is that aspect that seeks to establish certain health promoting principles as part of the conscious factors always to be considered by individuals, by opinion leaders, by manufacturers, by employers and trade unions, by service providers, by local authorities, and by central government in their plans and decisions. The Health Education Council (HEC) has no power to make or impose public policy; the Department of Health and Social Security (DHSS) has that task. The world of health education providers includes the Health Education Officers working for the Health Authorities and with the Education Authorities, an increasing number of important academic workers in the field, the HEC, the Scottish Health Education Group (SHEG), the DHSS, and some of the members of various professions who provide health education to the public as part of their daily work. Most of the HEC's work consists of providing these people with health educational tools. If the HEC begins to do more in the public policy field, it will not be at the cost of providing health educational tools. At the HEC a staff of 4 liaison workers is responsible for keeping field workers informed about future and imminent HEC work programs. They also assess needs and ideas by holding periodic meetings with Health Education Officers and others in various parts of the country. HEC's efforts have contributed substantially to increasing attention to preventive health measures on the part of the DHSS, parliamentary committees, the Royal Colleges, other professional bodies, and the media. In regard to the future, several paths deserve exploration as part of the HEC's education of decision-makers and opinion-formers. These include: local authorities, relevant

  4. Public health re-energised: what the new White Paper will mean.

    PubMed

    Wood, Antonia

    2011-01-01

    The Coalition Government has set out its intended strategy for public health in England in the White Paper "Healthy Lives, Healthy People" (November 2010). This aims to tackle high levels of "lifestyle" health problems such as obesity, alcohol misuse and smoking, and to reduce health inequalities. Policies will be evidence-based and the emphasis will be on outcomes rather than targets. The focus will be local and will include wider dimensions of public health such as tobacco control and transport. Mental health will have greater prominence. Local government will play a major part, with Directors of Public Health and public health budgets transferring from Primary Care Trusts to Local Authorities. Public health funding will be ring-fenced. A dedicated public health service, Public Health England, will be established in the Department of Health, to provide disease control and support local innovation. There will be greater investment in the early years of life, and an increase in health visitor numbers and Family Nurse Partnerships. The public health role of school nurses is likely to increase under a forthcoming review of school nursing.

  5. Insights in Public Health

    PubMed Central

    Donohoe Mather, Carolyn M; McGurk, Meghan D

    2014-01-01

    Over half of the adults in Hawai‘i are overweight or obese, exposing them to increased risk for chronic diseases and resulting in higher health care expenses. Poor dietary habits and physical inactivity are important contributors to obesity and overweight. Because adults spend most of their waking hours at work, the workplace is an important setting for interventions to solve this growing problem. Changing the nutrition environment to support healthy eating is a recommended practice for worksite wellness interventions. Following this recommendation, the Hawai‘i State Department of Health (DOH) launched the Choose Healthy Now! Healthy Vending Pilot Project to increase access to healthy options in worksites. Choose Healthy Now! utilized an education campaign and a traffic light nutrition coding system (green = go, yellow = slow, red = uh-oh), based on federal nutrition guidelines, to help employees identify the healthier options in their worksite snack shops. Inventory of healthy items was increased and product placement techniques were used to help make the healthy choice the easy choice. DOH partnered with the Department of Human Services' Ho‘opono Vending Program to pilot the project in six government buildings on O‘ahu between May and September of 2014. Vendors added new green (healthy) and yellow (intermediate) options to their snack shop and cafeteria inventories, and labeled their snacks and beverages with green and yellow point-of-decision stickers. The following article outlines background and preliminary findings from the Choose Healthy Now! pilot. PMID:25414808

  6. Achievements of the first wave personal medical services (PMS) pilots in England. A health authority perspective.

    PubMed

    Leese, Brenda; Petchey, Roland

    2003-01-01

    Personal medical services pilots were introduced in England in 1998 to provide increased flexibility to general practitioners practising in deprived areas, to improve service provision and reduce inequalities. The aim of this study was to identify health authority perspectives of the achievements of their pilots. Less than half of the health authorities agreed that their pilots' original objectives had been completely achieved. Support, commitment and enthusiasm from within and outside the pilots, and the ability to be flexible, were helpful in promoting change management. Obstacles were financial difficulties and a lack of understanding of personal medical services. The opinion was that personal medical services had made a highly regarded contribution to the local health economy, especially in the provision of new services and the promotion of new staff roles. The results provide lessons for primary care organisations in England and elsewhere in terms of the factors required to successfully implement change.

  7. Citizen Science for public health.

    PubMed

    Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie

    2016-12-23

    Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for public health, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in public health might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants.

  8. Prepared salads and public health.

    PubMed

    Little, C L; Gillespie, I A

    2008-12-01

    In recent years the importance of prepared salads as potential vehicles of gastrointestinal infection has been highlighted by several large outbreaks both nationally and across international boundaries. Between 1992 and 2006, 2274 foodborne general outbreaks of infectious intestinal disease were reported in England and Wales, of which 4% were associated with the consumption of prepared salads. In total, 3434 people were affected, with 66 hospitalizations and one death reported. The attribution of prepared salad types and pathogens among prepared salad associated outbreaks are presented and discussed. Findings from UK studies on salad vegetables, fruit and mixed salads from 1995 to 2007 (21 247 samples) indicate that most bacteria of concern with regard to human health are relatively rare in these products (98.6% of satisfactory quality); however, outbreaks of salmonellosis were uncovered associated with bagged salad leaves and fresh herbs during two such studies. Although it is known that fresh salad vegetables, herbs or fruit may become contaminated from environmental sources, only in recent years has the association of foods of nonanimal origin, such as salad vegetables, with foodborne illness become evident and recurrent, demonstrating that major health problems can arise from consumption of contaminated prepared salads if hygiene practices breakdown.

  9. Prioritizing Sleep Health: Public Health Policy Recommendations.

    PubMed

    Barnes, Christopher M; Drake, Christopher L

    2015-11-01

    The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders.

  10. Training Physicians for Public Health Careers

    ERIC Educational Resources Information Center

    Hernandez, Lyla M., Ed.; Munthali, A. Wezi, Ed.

    2007-01-01

    Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges.…

  11. Training Physicians for Public Health Careers

    ERIC Educational Resources Information Center

    Hernandez, Lyla M., Ed.; Munthali, A. Wezi, Ed.

    2007-01-01

    Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges.…

  12. Public health. A tale of two counties.

    PubMed

    Griffiths, S; Wright, J; Grice, D

    2001-02-22

    The development of primary care trusts requires health authority public health departments to work in new ways. Reviews of the public health function in two counties found widely varying views. A common understanding of organisations' responsibilities is crucial when developing public health in primary care. Public health networks can play a key role. Significant investment in training is required.

  13. Insights in Public Health

    PubMed Central

    Choy, Lehua B; Smith, Heidi Hansen; Espiritu, Justine; Higa, Earl; Lee, Thomas; Maddock, Jay

    2015-01-01

    Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166

  14. Overcoming Inertia: Increasing Public Health Departments’ Access to Evidence-Based Information and Promoting Usage to Inform Practice

    PubMed Central

    Dahlen, Karen; Gabella, Barbara A.; Juhl, Ashley L.; Martin, DA, Elaine

    2014-01-01

    In 2010, the New England Region–National Network of Libraries of Medicine at University of Massachusetts Medical School received funding to improve information access for public health departments in 6 New England states and Colorado. Public health departments were provided with desktop digital access to licensed e-resources available through special pricing. In January through mid-April 2012, we evaluated the effectiveness of providing access to and training for using e-resources to public health department staff to motivate usage in practice. We found that additional strategies are needed to accomplish this. PMID:24228662

  15. Overcoming inertia: increasing public health departments' access to evidence-based information and promoting usage to inform practice.

    PubMed

    LaPelle, Nancy R; Dahlen, Karen; Gabella, Barbara A; Juhl, Ashley L; Martin, Elaine

    2014-01-01

    In 2010, the New England Region-National Network of Libraries of Medicine at University of Massachusetts Medical School received funding to improve information access for public health departments in 6 New England states and Colorado. Public health departments were provided with desktop digital access to licensed e-resources available through special pricing. In January through mid-April 2012, we evaluated the effectiveness of providing access to and training for using e-resources to public health department staff to motivate usage in practice. We found that additional strategies are needed to accomplish this.

  16. School Nurses' perspectives on the role of the school nurse in health education and health promotion in England: a qualitative study.

    PubMed

    Hoekstra, Beverley A; Young, Vicki L; Eley, Charlotte V; Hawking, Meredith K D; McNulty, Cliodna A M

    2016-01-01

    The role of the school nurse is complex with many possible elements identified by previous research. The aim of this study is to understand perceptions of the role of the school nurse in order to support school nurses in the delivery of health education. The study used an inductive, qualitative research design involving semi-structured interviews and focus groups. Participants were recruited from four NHS trusts across England and final sample size was thirty one school nurses. Three focus groups and two interviews took place in person, and three interviews were over the phone. Data was thematically analysed. School nurses described six main themes. Four themes directly related to the school nurse role: the main roles of a school nurse, school nurses' role in health education, prioritisation of workload and activities, and community work. A further two other themes related to the delivery of health education: the school nursing system and educational resources. The role of the school nurse in England is very diverse and the school nurse role in health education is primarily to advise and support schools, rather than to directly deliver education. The study identified that tailored public health educational resources are needed to support school nurses.

  17. The career journeys of health trainers in two health trainer services in England.

    PubMed

    Rahman, Em; Wills, Jane

    2013-07-01

    This study follows the career journeys of health trainers and explores their reasons for becoming a health trainer, their experiences of being a health trainer and where and what they go on to. The study used biographical research methods to explore the experiences of seven individuals in two health trainer services. Individual maps were drawn up to preserve the uniqueness and individuality of each biographical story within its social context. Semi-structured interviews explored their journey using a narrative approach, focusing on the stages of becoming, being and moving forward as a health trainer. Thematic analysis of these interviews identified common themes and differences in the experience. The start of each health trainer's journey is different but there is a remarkable similarity in the experience of being a health trainer. Being a health trainer affirmed the participants' values about 'giving back' to their community. It resulted in improved confidence as well as improved status in the community. All expressed a similar desire to progress within a health field but expressed frustration at being unable to develop a career. This study explored the motivations for lay people to become health trainers using the concept of career anchors. It shows how the role strengthens desires to continue working within a health-related field thus creating a potential future public health workforce. However, the lack of progression routes for individuals creates an obstacle for them to progress. This study raises implications for how policy makers, commissioners and workforce planners can appropriately support this public health workforce.

  18. Reported and intended behaviour towards those with mental health problems in the Czech Republic and England.

    PubMed

    Winkler, P; Csémy, L; Janoušková, M; Mladá, K; Bankovská Motlová, L; Evans-Lacko, S

    2015-09-01

    This is one of the first studies, which compares the level of stigmatizing behaviour in countries that used to be on the opposite sides of the Iron Curtain. The aim was to identify the prevalence of reported and intended stigmatizing behaviour towards those with mental health problems in the Czech Republic and to compare these findings with the findings from England. The 8-item Reported and Intended Behaviour Scale (RIBS) was used to assess stigmatising behaviour among a representative sample of the Czech population (n=1797). Results were compared with the findings of an analogous survey from England (n=1720), which also used the RIBS. The extent of reported behaviour (i.e., past and present experiences with those with mental health problems) was lower in the Czech Republic than in England. While 12.7% of Czechs reported that they lived, 12.9% that they worked, and 15.3% that they were acquainted with someone who had mental health problems, the respective numbers for England were 18.5%, 26.3% and 32.5% (P<0.001 in each of these items). On the other hand, the extent of intended stigmatizing behaviour towards those with mental health problems is considerably higher in the Czech Republic. Out of maximum 20 points attached to possible responses to the RIBS items 5-8, Czechs had a lower total score (x=11.0, SD=4.0) compared to English respondents (x=16.1, SD=3.6), indicating lower willingness to accept a person with mental health problems (P<0.001). The prevalence of stigmatizing behaviour in the Czech Republic is worrying. Both, further research and evidence based anti-stigma interventions, should be pursued in order to better understand and decrease stigmatizing behaviour in the Czech Republic and possibly across the post-communist countries in Central and Eastern Europe. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Public health financial management competencies.

    PubMed

    Honoré, Peggy A; Costich, Julia F

    2009-01-01

    The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

  20. Causal inference in public health.

    PubMed

    Glass, Thomas A; Goodman, Steven N; Hernán, Miguel A; Samet, Jonathan M

    2013-01-01

    Causal inference has a central role in public health; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in public health this framework is more suitable, providing an estimate of an action's consequences rather than the less precise notion of a risk factor's causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex public health challenges of our globalized world.

  1. Crowdsourcing applications for public health.

    PubMed

    Brabham, Daren C; Ribisl, Kurt M; Kirchner, Thomas R; Bernhardt, Jay M

    2014-02-01

    Crowdsourcing is an online, distributed, problem-solving, and production model that uses the collective intelligence of networked communities for specific purposes. Although its use has benefited many sectors of society, it has yet to be fully realized as a method for improving public health. This paper defines the core components of crowdsourcing and proposes a framework for understanding the potential utility of crowdsourcing in the domain of public health. Four discrete crowdsourcing approaches are described (knowledge discovery and management; distributed human intelligence tasking; broadcast search; and peer-vetted creative production types) and a number of potential applications for crowdsourcing for public health science and practice are enumerated. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  2. National implementation of a mental health service model: A survey of Crisis Resolution Teams in England.

    PubMed

    Lloyd-Evans, Brynmor; Paterson, Bethan; Onyett, Steve; Brown, Ellie; Istead, Hannah; Gray, Richard; Henderson, Claire; Johnson, Sonia

    2017-01-11

    In response to pressures on mental health inpatient beds and a perceived 'crisis in acute care', Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions. Eighty-eight percent (n = 192) of CRT managers in England participated in an online survey. CRT service organization and delivery was highly variable. Nurses were the only professional group employed in all CRT staff teams. Almost no teams adhered fully to government implementation guidance. CRT managers identified several aspects of CRT service delivery as desirable but not routinely provided. A national policy mandate and government guidance and standards have proved insufficient to ensure CRT implementation as planned. Development and testing of resources to support implementation and monitoring of a complex mental health intervention is required.

  3. [Public health education in Austria. An overview].

    PubMed

    Diem, Günter; Dorner, Thomas Ernst

    2014-04-01

    The future challenges for the Austrian health care system require an increasing number of public health experts of different professions in all fields of public health. In this article the offer of public health education in Austrian universities and universities for applied sciences was searched based on the predominantly online available information on web platforms of the schools. Currently (2013), there are three postgraduate public health university courses and two public health doctoral programs in Austria. Additionally, 34 degree programmes could be identified, in which parts of public health are covered. But also in medical curricula at Austrian medical schools, public health contents have found their place. In Austria, there is already a multifaceted offer for public health education. However, to build an appropriate public health work force, capable to manage the public health challenges in all its dimensions in terms of health in all policies, this offer should still be intensified.

  4. Public support in England for a total ban on the sale of tobacco products.

    PubMed

    Shahab, Lion; West, Robert

    2010-04-01

    This study aimed to determine the level of support for a sales ban on tobacco in England to provide a benchmark against which any changes over time can be assessed. 8735 people from England who participated in one of five monthly cross-sectional household surveys in 2008 were asked to indicate whether they would support the statement that 'the government should work towards banning the sale of tobacco completely within the next 10 years'. In addition, sociodemographic and smoking characteristics were assessed. A substantial proportion of the total sample (44.5%; 95% CI 43.5% to 45.6%) would support a move towards a complete ban. While never smokers (OR 2.02; 95% CI 1.82 to 2.25) and ex-smokers (OR 1.41; 95% CI 1.21 to 1.65) were more likely to support this idea, even among current smokers, a third would favour moving towards a sales ban of tobacco products. Adjusting for other background characteristics, younger, female participants, those living in London and those from lower socioeconomic groups were most likely to support a ban. Among smokers, a higher cigarette consumption, smoking enjoyment and contentment with being a smoker were associated with opposition to a ban, while feeling uncomfortable being a smoker, wanting to be a non-smoker and being worried about future health consequences of smoking were associated with support for a ban. Support for movement towards a ban on the sale of tobacco is higher than might be imagined. It is conceivable that as smoking prevalence falls further and smoking becomes more socially unacceptable, support might grow to a point where such a policy could become feasible.

  5. Obesity: a public health approach.

    PubMed

    Novak, Nicole L; Brownell, Kelly D

    2011-12-01

    Obesity is an epidemic that likely will worsen without substantive changes to the current environment. Although treatment of the individual has conventionally been the focus of the obesity field, prevention using a public health model will be essential for making progress on a population level. There are encouraging signs that communities across the country are acknowledging the complex causes of obesity and making impressive reforms to improve their health and that of their children. Public policy changes long have been used to combat infectious and chronic diseases and will be vital in the attempt to reduce the toll of poor diet, physical inactivity, and obesity.

  6. Systemic Intervention for Public Health

    PubMed Central

    Midgley, Gerald

    2006-01-01

    Many calls have been made for a systems approach to public health. My response is to offer a methodology for systemic intervention that (1) emphasizes the need to explore stakeholder values and boundaries for analysis, (2) challenges marginalization, and (3) draws upon a wide range of methods (from the systems literature and beyond) to create a flexible and responsive systems practice. I present and discuss several well-tested methods with a view to identifying their potential for supporting systemic intervention for public health. PMID:16449577

  7. Zoological medicine and public health.

    PubMed

    Chomel, Bruno B; Osburn, Bennie I

    2006-01-01

    Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of public health into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or public health with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in public health and wildlife management.

  8. EPA Awards $10.3 Million to Clean Up New England Brownfield Sites, Protect Health in Communities

    EPA Pesticide Factsheets

    EPA has awarded more than $10.3 million in Brownfield grants to municipalities and organizations working to protect people's health by assessing and cleaning up contaminated parcels in New England communities.

  9. Changes in the Demand for Public Land-Grant Universities in New England, 1976-1999. AIR 2000 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Toutkoushian, Robert K.

    This study focuses on initial student interest in or demand for public, land-grant universities (PLGUs) within the six New England states for the years 1976-99. The study has three distinguishing features. First, time-series data for the six New England states are combined into a panel data set, and fixed effects and random effects models are used…

  10. Application of PHEL - ‘Public Health Epidemiological Logic’ of Public Health Intervention and Public Health Impact

    PubMed Central

    Patil, Rajan R.

    2013-01-01

    There is a growing tendency where medicalization of public health through mass therapeutics and secondary preventive measures are being substituted for primary preventive activity. Scaled-up mass therapeutic intervention in the community is being confused with public health intervention. The objective of this paper is to provide a broad public health and epidemiological criteria for public health intervention and public health impact PMID:24404371

  11. Commissioning health care in England: an evolving story.

    PubMed

    O'Flynn, Norma; Potter, Jonathan

    2011-10-04

    The general election in the United Kingdom in May 2010 resulted in the election of a new government, a coalition between Conservative and Liberal Democrat parties. Six weeks after the election, a white paper, "Equity and Excellence: Liberating the NHS," that proposed profound changes to the structure and organization of the health service was published. The change that generated the most discussion was the proposal that general practitioners be placed at the center of the system and given control of about 80% of the National Health Service's £100 billion budget. The proposals were greeted with considerable concern by many health care professionals, patient representatives, and the media. In response, the government organized an independent review, and proposals have been altered in response. This article outlines the current organization of the National Health Service, the rationale for change, and government proposals.

  12. Lesbian and bisexual women's human rights, sexual rights and sexual citizenship: negotiating sexual health in England.

    PubMed

    Formby, Eleanor

    2011-11-01

    Lesbian and bisexual women's sexual health is neglected in much Government policy and practice in England and Wales. This paper examines lesbian and bisexual women's negotiation of sexual health, drawing on findings from a small research project. Themes explored include invisibility and lack of information, influences on decision-making and sexual activities and experiences of services and barriers to sexual healthcare. Key issues of importance in this respect are homophobic and heterosexist social contexts. Drawing on understandings of lesbian, gay and bisexual human rights, sexual rights and sexual citizenship, it is argued that these are useful lenses through which to examine and address lesbian and bisexual women's sexual health and related inequalities.

  13. Multicultural mental health services: projects for minority ethnic communities in England.

    PubMed

    Fernando, Suman

    2005-09-01

    Black and minority ethnic (BME) communities form 7.8% of the total population of the U.K. Many of these communities face a variety of disadvantages when they access, or are forced to access, statutory mental health services under the National Health Service. Efforts have been made to address these problems by developing projects both within statutory mental health services and in the non-governmental ('voluntary') sector. This article describes some of these projects located in England, drawing out the themes and models that underlie their approaches, and discusses the lessons that can be learned from the U.K. experience.

  14. The Politics of PISA: The Media, Policy and Public Responses in Norway and England

    ERIC Educational Resources Information Center

    Hopfenbeck, Therese N.; Görgen, Kristine

    2017-01-01

    Using the PISA 2015 releases in Norway and England, this article explores how PISA has been presented in the media and how the policy level has responded to the results. England will be used as an example for comparison. The article presents early media responses from the 20 most circulated daily newspapers in the two countries and discusses them…

  15. Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study.

    PubMed

    Li, Jessica; Lovatt, Melanie; Eadie, Douglas; Dobbie, Fiona; Meier, Petra; Holmes, John; Hastings, Gerard; MacKintosh, Anne Marie

    2017-03-01

    The harmful effects of heavy drinking on health have been widely reported, yet public opinion on governmental responsibility for alcohol control remains divided. This study examines UK public attitudes towards alcohol policies, identifies underlying dimensions that inform these, and relationships with perceived effectiveness. A cross-sectional mixed methods study involving a telephone survey of 3477 adult drinkers aged 16-65 and sixteen focus groups with 89 adult drinkers in Scotland and England was conducted between September 2012 and February 2013. Principal components analysis (PCA) was used to reduce twelve policy statements into underlying dimensions. These dimensions were used in linear regression models examining alcohol policy support by demographics, drinking behaviour and perceptions of UK drinking and government responsibility. Findings were supplemented with a thematic analysis of focus group transcripts. A majority of survey respondents supported all alcohol policies, although the level of support varied by type of policy. Greater enforcement of laws on under-age sales and more police patrolling the streets were strongly supported while support for pricing policies and restricting access to alcohol was more divided. PCA identified four main dimensions underlying support on policies: alcohol availability, provision of health information and treatment services, alcohol pricing, and greater law enforcement. Being female, older, a moderate drinker, and holding a belief that government should do more to reduce alcohol harms were associated with higher support on all policy dimensions. Focus group data revealed findings from the survey may have presented an overly positive level of support on all policies due to differences in perceived policy effectiveness. Perceived effectiveness can help inform underlying patterns of policy support and should be considered in conjunction with standard measures of support in future research on alcohol control policies.

  16. Sexual minorities in England have poorer health and worse health care experiences: a national survey.

    PubMed

    Elliott, Marc N; Kanouse, David E; Burkhart, Q; Abel, Gary A; Lyratzopoulos, Georgios; Beckett, Megan K; Schuster, Mark A; Roland, Martin

    2015-01-01

    The health and healthcare of sexual minorities have recently been identified as priorities for health research and policy. To compare the health and healthcare experiences of sexual minorities with heterosexual people of the same gender, adjusting for age, race/ethnicity, and socioeconomic status. Multivariate analyses of observational data from the 2009/2010 English General Practice Patient Survey. The survey was mailed to 5.56 million randomly sampled adults registered with a National Health Service general practice (representing 99 % of England's adult population). In all, 2,169,718 people responded (39 % response rate), including 27,497 people who described themselves as gay, lesbian, or bisexual. Two measures of health status (fair/poor overall self-rated health and self-reported presence of a longstanding psychological condition) and four measures of poor patient experiences (no trust or confidence in the doctor, poor/very poor doctor communication, poor/very poor nurse communication, fairly/very dissatisfied with care overall). Sexual minorities were two to three times more likely to report having a longstanding psychological or emotional problem than heterosexual counterparts (age-adjusted for 5.2 % heterosexual, 10.9 % gay, 15.0 % bisexual for men; 6.0 % heterosexual, 12.3 % lesbian and 18.8 % bisexual for women; p < 0.001 for each). Sexual minorities were also more likely to report fair/poor health (adjusted 19.6 % heterosexual, 21.8 % gay, 26.4 % bisexual for men; 20.5 % heterosexual, 24.9 % lesbian and 31.6 % bisexual for women; p < 0.001 for each). Adjusted for sociodemographic characteristics and health status, sexual minorities were about one and one-half times more likely than heterosexual people to report unfavorable experiences with each of four aspects of primary care. Little of the overall disparity reflected concentration of sexual minorities in low-performing practices. Sexual minorities suffer both poorer health and worse healthcare

  17. Ethical tensions associated with the promotion of public health policy in health visiting: a qualitative investigation of health visitors' views.

    PubMed

    Greenway, Julie Catherine; Entwistle, Vikki Ann; terMeulen, Ruud

    2013-04-01

    To explore whether and how health visitors experience ethical tensions between the public health agenda and the need to be responsive to individual clients. Current health policy in England gives health visitors a key role in implementing the government's public health agenda. Health visitors are also required by their Professional Code to respond to the health-related concerns and preferences of their individual clients. This may generate tensions. A total of 17 semi-structured individual interviews covering participants' experiences of implementing public health interventions and perceptions of the ethical tensions involved were conducted. Interviews were audio-recorded, transcribed and analysed thematically using a Framework approach. Health visitors raised a number of ethical concerns, which they attributed to organisational resource allocation and the introduction of protocols and targets relating to public health goals. They did not always regard it as appropriate to raise topics that employing organisations had identified as public health priorities with particular clients for whom they were not priorities, or who had other more pressing needs. They noted that resources that were allocated towards reaching public health targets were unavailable for clients who needed support in other areas. Organisational protocols designed to monitor performance put pressure on health visitors to prioritise achieving targets and undermined their ability to exercise professional judgement when supporting individual clients. This had implications for health visitors' sense of professionalism. Health visitors saw trusting relationships as key to effective health visiting practice, but the requirement to implement public health priorities, combined with a lack of resources in health visiting, eroded their ability to form these. Policies need to be evaluated with regard to their impact upon a broader range of processes and outcomes than public health goals. The erosion of health

  18. LEGAL BASES FOR DISCLOSING CONFIDENTIAL PATIENT INFORMATION FOR PUBLIC HEALTH: DISTINGUISHING BETWEEN HEALTH PROTECTION AND HEALTH IMPROVEMENT

    PubMed Central

    Taylor, Mark J.

    2015-01-01

    The disclosure of confidential patient data without an individual's explicit consent should be for purposes that persons have reason to both expect and accept. We do not currently have the required level of clarity or consistency in understanding regarding the disclosure of confidential patient information for public health purposes to support effective public dialogue. The Health Service (Control of Patient Information) Regulations 2002 establish a legal basis in England and Wales for data to be disclosed for public health purposes without patient consent. Under the Regulations, there is more than one potential route towards lawful processing: Data may be processed for public health purposes under both Regulations 3 and 5. The alternatives have different safeguards and conditions attached, and their respective applicability to processing for purposes of public health improvement is currently unclear and subject to review. Beyond the need for clarity regarding the safeguards applicable to processing for particular public health purposes, there are reasons to prefer recognition that Regulation 5 is the most appropriate legal basis for disclosure when the purpose is public health improvement rather than public health protection. Where health improvement, rather than protection, is the aim, there is no justification for discarding the additional safeguards associated with processing under Regulation 5. PMID:25995294

  19. Public Health Systems: A Social Networks Perspective

    PubMed Central

    Wholey, Douglas R; Gregg, Walter; Moscovice, Ira

    2009-01-01

    Objective To examine the relationship between public health system network density and organizational centrality in public health systems and public health governance, community size, and health status in three public health domains. Data Sources/Study Setting During the fall and the winter of 2007–2008, primary data were collected on the organization and composition of eight rural public health systems. Study Design Multivariate analysis and network graphical tools are used in a case comparative design to examine public health system network density and organizational centrality in the domains of adolescent health, senior health, and preparedness. Differences associated with public health governance (centralized, decentralized), urbanization (micropolitan, noncore), health status, public health domain, and collaboration area are described. Data Collection/Extraction Methods Site visit interviews with key informants from local organizations and a web-based survey administered to local stakeholders. Principal Findings Governance, urbanization, public health domain, and health status are associated with public health system network structures. The centrality of local health departments (LHDs) varies across public health domains and urbanization. Collaboration is greater in assessment, assurance, and advocacy than in seeking funding. Conclusions If public health system organization is causally related to improved health status, studying individual system components such as LHDs will prove insufficient for studying the impact of public health systems. PMID:19686252

  20. Community Public Health Fact Sheet

    EPA Pesticide Factsheets

    EPA’s Community Public Health (CPH) project in the Office of Research and Development (ORD) produces high quality science and tools to understand and assess environmental risks and ecosystem goods and services (EGS) to decision-makers at all levels.

  1. Mental health service user involvement in England: lessons from history.

    PubMed

    Rush, B

    2004-06-01

    This historical analysis draws attention to differing assumptions, which promote or limit user involvement in nursing practice. The meaning of the term 'user involvement' is analyzed with reference to varying models. A continuum is offered to illustrate the relationship between assumptions about people with mental health problems and their involvement in care. It is argued that the range of views concerning recipients of mental health services, from being dangerous and irrational to being considered equal partners with health professionals, creates an unresolved tension that has existed through the ages. The key to resolving this tension is for all parties openly to acknowledge conflicts between their views and those of others and engage in meaningful dialogue about them. In this way the lessons from history may be learned.

  2. Public Health and Epidemiology Informatics.

    PubMed

    Flahault, A; Bar-Hen, A; Paragios, N

    2016-11-10

    The aim of this manuscript is to provide a brief overview of the scientific challenges that should be addressed in order to unlock the full potential of using data from a general point of view, as well as to present some ideas that could help answer specific needs for data understanding in the field of health sciences and epidemiology. A survey of uses and challenges of big data analyses for medicine and public health was conducted. The first part of the paper focuses on big data techniques, algorithms, and statistical approaches to identify patterns in data. The second part describes some cutting-edge applications of analyses and predictive modeling in public health. In recent years, we witnessed a revolution regarding the nature, collection, and availability of data in general. This was especially striking in the health sector and particularly in the field of epidemiology. Data derives from a large variety of sources, e.g. clinical settings, billing claims, care scheduling, drug usage, web based search queries, and Tweets. The exploitation of the information (data mining, artificial intelligence) relevant to these data has become one of the most promising as well challenging tasks from societal and scientific viewpoints in order to leverage the information available and making public health more efficient.

  3. [Cellular phones and public health].

    PubMed

    Leventhal, Alex; Karsenty, Eric; Sadetzki, Siegal

    2004-08-01

    The increased use of mobile cellular phone by the public is associated with a wave of contradictory reports about the possible health effects, due to the exposure of the users to electromagnetic non-ionizing radiation. This article reviews the state of the art of the present knowledge concerning the biological and medical effects of exposure to cellular phones, with an emphasis on its possible carcinogenic effect. Health conditions, which have been ascribed to the use of mobile phones mainly include some types of cancer and changes of brain activity. However, the balance of evidence from available studies has not yet supported these claims. Following the recommendation of special international expert committees, the IARC (International Association for Research on Cancer) is conducting a multi-center study to determine the possible effect of cellular phone use on brain and salivary gland tumors. Israel is one of the participants of this study. The only established health effect associated with the use of such technology is an increased risk for road accidents, unrelated to the amount of radiation emitted by phone. The challenge posed by this new technology to health authorities all over the world has lead to the definition of a new principle, the so-called "prudent avoidance", used as guidelines for the definition of an adequate public health policy. The public policy in Israel has used the prudent avoidance principles, while awaiting the results of the multi-national epidemiological studies.

  4. Chaos, criticality, and public health.

    PubMed Central

    Fullilove, R. E.; Edgoose, J. C.; Fullilove, M. T.

    1997-01-01

    Self-organized criticality offers more than a descriptive model or a doomsday forecast. We have tried to suggest that it is a paradigm for understanding the interconnections between apparently complex processes. At best, it suggests a method for finding the pressure points that can be used to bring unstable systems of public health services into greater levels of stability. The model enjoins us to understand that our goal is not to achieve equilibrium--that perfect match between the demand for health services and its delivery--but rather stability (or, more precisely, metastability). As is true of the sandpile, our systems of public health are constantly evolving. If we are correct, then the mechanism driving this ostensibly complex pattern of change and growth reflects the existence of simpler and, hopefully, more manageable processes. By monitoring these processes, it may be increasingly possible to adapt to change and even manage it effectively. PMID:9170831

  5. A national public health service.

    PubMed Central

    Galbraith, N S

    1981-01-01

    The development of the British public health services is briefly reviewed and it is suggested that two types of epidemiologist (Community Physician) are necessary in each locality: one concerned with medical administration and health care planning-the medical administrator, and the other with the prevention of disease-the clinical epidemiologist. A new nation public health service is proposed to revive disease prevention with four main features: (1) A district Clinical Epidemiologist who is a member of the district department of community medicine with responsibility for prevention but with no district administrative duties. (2) A District Epidemiology Unit comprising other appropriate staff. (3) National specialist epidemiology units within the NHS with service roles to support and coordinate the District Clinical Epidemiologists. (4) A national authority within the NHS with responsibility for prevention and for administering the national specialist units. PMID:7007637

  6. Civil society and the Health and Social Care Act in England and Wales: theory and praxis for the twenty-first century.

    PubMed

    Scambler, Graham; Scambler, Sasha; Speed, Ewen

    2014-12-01

    In this paper we revisit the notion of civil society in the light of recent attempts to privatize health care in England via the passing of the Health and Social Care Act of 2013. This legislation promises a re-commodification of the National Health Service (NHS) in England. The Bill was bitterly contested during its passage through parliament, most vigorously in 2011. Much of the opposition occurred at a time of widespread, global rebellion, most notably in the 'Arab uprisings' and through the 'occupy movement'. Despite a plethora of protests, we argue, a non-porous boundary between what we call the 'protest sector' of civil society and the wider public sphere of the lifeworld has become apparent in England. A good deal of collective action, whether campaign-focused (like opposition to the Health and Social Care Bill) or more generalized (like rejections of corporate greed), has so far proved ineffective, at least in the short-term; no crisis of legitimation is apparent. We highlight a new 'class/command dynamic', leading to oligarchic rule, in the present era of financial capitalism. We use this health care case-study to re-examine the notion of civil society and its changing properties in what Castells calls a 'networked society'. The contribution ends with a discussion of the role of the sociologist re-civil society and the advocacy of both 'action' and 'foresight sociologies'.

  7. Mental health, sexual violence and the work of Sexual Assault Referral centres (SARCs) in England.

    PubMed

    Brooker, Charlie; Durmaz, Emma

    2015-04-01

    There is a clear link between mental health status both before and after rape. It is known, for example, that approximately 40% of attendees to a Sexual Assault Referral centre (SARC) are already known to mental health services. Sexual Violence can also lead to the development of a mental illness. SARCs have been established, inter alia, to provide healthcare to the victims of rape where a mental health risk assessment should be undertaken. All 37 SARCs in England where asked to complete a short survey and a response rate of 68% was achieved. A high proportion (40%) of SACRs clients are already known to mental health services, however, only just under half of SARCs routinely assess mental health and when such an assessment is completed this is by an FME and substance misuse issues are not always included. Almost two-thirds of SARC services report problems in referring on to mental health services for a variety of reasons. More research is needed in this important area and NHS England should fully define the skills required to undertake a mental health risk assessment when someone has been the victim of rape.

  8. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

    PubMed

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care.

  9. Public Health Educational Information Other Resources

    EPA Pesticide Factsheets

    This page provides educational information and resources to assist public health officials, air quality managers, health care providers and others in providing information on the health effects of wildfire and wildland fire smoke to the public.

  10. Health effects of home energy efficiency interventions in England: a modelling study

    PubMed Central

    Milner, James; Chalabi, Zaid; Das, Payel; Jones, Benjamin; Shrubsole, Clive; Davies, Mike; Wilkinson, Paul

    2015-01-01

    Objective To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets. Design Health impact modelling study. Setting England. Participants English household population. Intervention Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance. Main outcome Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures. Results The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10 000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM2.5). Scenario (2) resulted in a negative impact of −728 (95% CI −864 to −592) QALYs per 10 000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in −539 (95% CI −678 to -399) QALYs per 10 000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants. Conclusions If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful

  11. Health effects of home energy efficiency interventions in England: a modelling study.

    PubMed

    Hamilton, Ian; Milner, James; Chalabi, Zaid; Das, Payel; Jones, Benjamin; Shrubsole, Clive; Davies, Mike; Wilkinson, Paul

    2015-04-27

    To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets. Health impact modelling study. England. English household population. Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance. Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures. The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10,000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM₂.₅). Scenario (2) resulted in a negative impact of -728 (95% CI -864 to -592) QALYs per 10,000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in -539 (95% CI -678 to -399) QALYs per 10,000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants. If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of

  12. Mental health legislation and human rights in England, Wales and the Republic of Ireland.

    PubMed

    Kelly, Brendan D

    2011-01-01

    In 2005, the World Health Organization (WHO) published its Resource Book on Mental Health, Human Rights and Legislation (Geneva: WHO) presenting a detailed statement of human rights issues which need to be addressed in national legislation relating to mental health. The purpose of this paper is to determine the extent to which revised mental health legislation in England, Wales (2007) and Ireland (2001) accords with these standards (excluding standards relating solely to children or mentally-ill offenders). Legislation in England and Wales meets 90 (54.2%) of the 166 WHO standards examined, while legislation in Ireland meets 80 standards (48.2%). Areas of high compliance include definitions of mental disorder, relatively robust procedures for involuntary admission and treatment (although provision of information remains suboptimal) and clarity regarding offences and penalties Areas of medium compliance relate to competence, capacity and consent (with a particular deficit in capacity legislation in Ireland), oversight and review (which exclude long-term voluntary patients and require more robust complaints procedures), and rules governing special treatments, seclusion and restraint. Areas of low compliance relate to promoting rights (impacting on other areas within legislation, such as information management), voluntary patients (especially non-protesting, incapacitated patients), protection of vulnerable groups and emergency treatment. The greatest single deficit in both jurisdictions relates to economic and social rights. There are four key areas in need of rectification and clarification in relation to mental health legislation in England, Wales and Ireland; these relate to (1) measures to protect and promote the rights of voluntary patients; (2) issues relating to competence, capacity and consent (especially in Ireland); (3) the role of "common law" in relation to mental health law (especially in England and Wales); and (4) the extent to which each jurisdiction

  13. Law and public health at CDC.

    PubMed

    Goodman, Richard A; Moulton, A; Matthews, G; Shaw, F; Kocher, P; Mensah, G; Zaza, S; Besser, R

    2006-12-22

    Public health law is an emerging field in U.S. public health practice. The 20th century proved the indispensability of law to public health, as demonstrated by the contribution of law to each of the century's 10 great public health achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential tool in public health practice. Public health laws are any laws that have important consequences for the health of defined populations. They derive from federal and state constitutions; statutes, and other legislative enactments; agency rules and regulations; judicial rulings and case law; and policies of public bodies. Government agencies that apply public health laws include agencies officially designated as "public health agencies," as well as health-care, environmental protection, education, and law enforcement agencies, among others.

  14. Public Health Ethics and Liberalism

    PubMed Central

    Radoilska, Lubomira

    2009-01-01

    This paper defends a distinctly liberal approach to public health ethics and replies to possible objections. In particular, I look at a set of recent proposals aiming to revise and expand liberalism in light of public health's rationale and epidemiological findings. I argue that they fail to provide a sociologically informed version of liberalism. Instead, they rest on an implicit normative premise about the value of health, which I show to be invalid. I then make explicit the unobvious, republican background of these proposals. Finally, I expand on the liberal understanding of freedom as non-interference and show its advantages over the republican alternative of freedom as non-domination within the context of public health. The views of freedom I discuss in the paper do not overlap with the classical distinction between negative and positive freedom. In addition, my account differentiates the concepts of freedom and autonomy and does not rule out substantive accounts of the latter. Nor does it confine political liberalism to an essentially procedural form. PMID:19655049

  15. Public Health Ethics and Liberalism.

    PubMed

    Radoilska, Lubomira

    2009-07-01

    This paper defends a distinctly liberal approach to public health ethics and replies to possible objections. In particular, I look at a set of recent proposals aiming to revise and expand liberalism in light of public health's rationale and epidemiological findings. I argue that they fail to provide a sociologically informed version of liberalism. Instead, they rest on an implicit normative premise about the value of health, which I show to be invalid. I then make explicit the unobvious, republican background of these proposals. Finally, I expand on the liberal understanding of freedom as non-interference and show its advantages over the republican alternative of freedom as non-domination within the context of public health. The views of freedom I discuss in the paper do not overlap with the classical distinction between negative and positive freedom. In addition, my account differentiates the concepts of freedom and autonomy and does not rule out substantive accounts of the latter. Nor does it confine political liberalism to an essentially procedural form.

  16. Preparedness for a major incident: creation of an epidemiology protocol for a health protection register in England.

    PubMed

    Close, R M; Maguire, H; Etherington, G; Brewin, C R; Fong, K; Saliba, V; Barker, R M; Leonardi, G S

    2014-11-01

    Large incidents and natural disasters are on the increase globally. They can have a major impact lasting many years or decades; and can affect large groups of people including those that are more susceptible to adverse consequences. Following a major incident, it may be considered necessary to establish a register of those people affected by the incident to provide appropriate advice on relevant immediate and longer-term public health interventions that may be required, provide reassurance to the public that their care is paramount, to reassure the worried well to avoid them inappropriately overwhelming local services, and to facilitate epidemiological investigations. Arrangements for the prompt follow-up of populations after large incidents or disasters have been agreed in England and a protocol for establishing a register of individuals potentially affected by a large incident has been developed. It is important for countries to have a protocol for implementing a health register if the circumstances require one to be in place, and are supported by Public Health Authorities. Health registers facilitate the initial descriptive epidemiology of exposure and provide the opportunity of carrying out long term analytical studies on the affected population. Such epidemiological studies provide a greater understanding of the impact that a large incident can have on health, which in turn helps in the planning of health care provision. Registers can also assist more directly in providing access to individuals in need of physical and mental health interventions. The challenge that still remains is to formally pilot the register in the field and refine it based on that experience.

  17. Burden of child and adolescent obesity on health services in England.

    PubMed

    Viner, Russell M; Kinra, Sanjay; Nicholls, Dasha; Cole, Tim; Kessel, Anthony; Christie, Deborah; White, Billy; Croker, Helen; Wong, Ian C K; Saxena, Sonia

    2017-08-01

    To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England. Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data. Data on CYP aged 2-18 years from the Health Survey for England 2006 to 2013. Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99.86th centile); family history of cardiovascular disease or type 2 diabetes; obesity comorbidities defined as primary care detectable (hypertension, orthopaedic or mobility problems, bullying or psychological distress) or secondary care detectable (dyslipidaemia, hyperinsulinaemia, high glycated haemoglobin, abnormal liver function). 11.2% (1.22 million) of CYP in England were eligible for primary care assessment and for community lifestyle modification. 2.6% (n=283 500) CYP were estimated to be likely to attend primary care. 5.1% (n=556 000) were eligible for secondary care referral. Among those aged 13-18 years, 8.2% (n=309 000) were eligible for antiobesity drug therapy and 2.4% (90 500) of English CYP were eligible for bariatric surgery. CYP from the most deprived quintile were 1.5-fold to 3-fold more likely to be eligible for obesity management. There is a mismatch between population burden and available data on service use for obesity in CYP in England, particularly among deprived young people. There is a need for consistent evidence-based commissioning of services across the childhood obesity pathway based on population burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. NHS health checks: an update on the debate and program implementation in England.

    PubMed

    Abdalrahman, Bayad; Soljak, Michael

    2015-01-01

    Cardiovascular disease is the leading cause of mortality and morbidity worldwide. In England, the government has adopted a population-wide prevention program for cardiovascular disease, the NHS Health Check program. The program has sparked controversies over the evidence base and feasibility of implementation. We aim to provide an update on the debate and program implementation. In conclusion, the evidence base for the NHS Health Check program has a number of uncertainties and program delivery has been suboptimal. It is important to continue monitoring and evaluating the program to provide the evidence base for future policy direction.

  19. [Social marketing and public health].

    PubMed

    Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G

    2013-01-01

    Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

  20. England's legislation on smoking in indoor public places and work-places: impact on the most exposed children.

    PubMed

    Sims, Michelle; Bauld, Linda; Gilmore, Anna

    2012-11-01

    To examine whether English legislation to make virtually all indoor public places and work-places smoke-free on 1 July 2007 displaced smoking into the home and hence increased the proportion of children exposed to levels of second-hand smoke known to be detrimental to health. Repeated cross-sectional study with data from 10 annual surveys undertaken from 1996 to 2008. England. Nationally representative samples of non-smoking children aged 4-15 years old living in private households. Salivary cotinine, parental smoking status, whether smoking is allowed within the house, socio-demographic variables. The proportion of children exposed to damaging levels of second-hand smoke (defined as those with cotinine levels >1.7 ng/ml) has fallen over time, from 23.5% in 1996 to 12.6% in 2008. The legislation was not associated with further changes in the proportion of children above this threshold-the odds of having cotinine >1.7 ng/ml did not change after adjustment for the pre-legislative trend and confounders (odds ratio: 1.0, 95% confidence interval: 0.78, 1.4). Non-significant associations were also found when examining children by parental or household smoking status. Legislation to prohibit smoking in indoor public places and work-places does not increase the proportion of children exposed to damaging levels of second-hand smoke. Even in a country with a strong tobacco control climate, a significant proportion of children remain highly exposed to second-hand smoke and future policies need to include interventions to reduce exposure among these children. © 2012 University of Bath.

  1. Jails, public health, and generalizability.

    PubMed

    Potter, Roberto Hugh

    2010-10-01

    This article outlines and discusses five categories of information about individual jails that should be considered before making general statements about jails. These are (a) the process by which individuals come to and are processed through the jail, (b) the size of the jail, (c) the region of the country where the jail is situated, (d) classification/assessment techniques, and (e) architecture and supervision styles. It is hoped that this discussion will generate a better understanding of the complexity of jail systems across the nation and help public health professionals better target their research, programs, and policies directed at the jail/community health nexus.

  2. Ethics in Public Health Research

    PubMed Central

    Curtis, Valerie A.; Garbrah-Aidoo, Nana; Scott, Beth

    2007-01-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

  3. Public Health Impact of Osteoporosis

    PubMed Central

    2013-01-01

    Objective. To describe the public health impact of osteoporosis including the magnitude of the problem and important consequences of osteoporotic fractures. Methods. Literature review of key references selected by author. Results. Current demographic trends leading to an increased number of individuals surviving past age 65 will result in an increased number of osteoporotic fractures. Important consequences of osteoporotic fractures include an increased mortality that for hip fractures extends to 10 years after the fracture. Increased mortality risk also extends to major and minor fractures, especially, in those over 75 years. Hip and vertebral fractures have important functional consequences and reductions in quality of life. The economic impact of osteoporotic fractures is large and growing. Significant health care resources are required for all fractures. Conclusions. To alleviate the public and private burden of osteoporosis related fractures, assessment of risk and reduction of individual risk is critical. PMID:23902935

  4. Causal Inference in Public Health

    PubMed Central

    Glass, Thomas A.; Goodman, Steven N.; Hernán, Miguel A.; Samet, Jonathan M.

    2014-01-01

    Causal inference has a central role in public health; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in public health this framework is more suitable, providing an estimate of an action’s consequences rather than the less precise notion of a risk factor’s causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex public health challenges of our globalized world. PMID:23297653

  5. [Internal medicine and public health].

    PubMed

    2009-08-01

    A special Committee on Internal Medicine and Public Health was established by Sociedad Médica de Santiago (Chilean Society of Internal Medicine) in April 2007 with the duty to write a Consensus Paper on the interaction between both branches of medical profession. The main objective was to find the common grounds on which to construct a positive approach to regain space for Internal Medicine, based on prevalent epidemiológical features related to adult health issues. The authors describe the reasons to explain the gap between clinical medicine and population health and identify the nature and evolution of chronic diseases as the point of encounter between both. With Chilean health surveys data, they state that chronic diseases explain the high proportion of burden of disease, mortality and disability, and stress that by the year 2025 one in every five inhabitants will be over 65 years of age, with ageing as another main problem for the health care sector. Population with multiple risks and multimorbidity is the most important challenge for the Chilean Health Care System. A new model of care is needed to tackle this scenario with new skills regarding psychosocial determinants of health. The leading role of internists and ideally geriatricians, will be crucial in this process and will help the implementation of sound population based interventions. Both individual and community level interventions will help to improve quality of life of Chilean families.

  6. Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

    PubMed

    Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

    2013-01-01

    Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

  7. Local government health services in interwar England: problems of quantification and interpretation.

    PubMed

    Gorsky, Martin

    2011-01-01

    This article provides a critical discussion of recent work on local government health care and health services in interwar England. A literature review examines case study approaches and comparative quantitative surveys, highlighting conventional and revisionist interpretations. Noting the differing selection criteria evident in some works, it argues that studies based upon a limited number of personal health services provide an insufficient basis for assessing local health activity and policy. There follows a regional study demonstrating various discrepancies between health financing data in local sources and those in nationally collated returns. These in turn give rise to various problems of assessment and interpretation in works relying on the latter, particularly with respect to services for schoolchildren and long-stay patients. The case study points to the importance of integrating poor law medical services in evaluations, and of learning more about the role of government subsidy in supporting expanding services.

  8. Reconfiguring the health supplier market: changing relationships in the primary care supplier market in England.

    PubMed

    Sugden, Bob; Wilson, Rob; Cornford, James

    2008-06-01

    The multi-billion NHS Connecting for Health programme in England has completely reconfigured the relationships between the Department of Health, the National Health Service (NHS), primary care computing suppliers and healthcare professionals (including general practitioners). The implications of this reconfiguration are now becoming apparent and have potentially significant effects on the delivery of information and information systems in the health context. This article explores the changes in these relationships by drawing on comparisons with the previous system for procurement of primary care computing systems, which ran for much of the 1990s. The article also comments on characteristics of the CfH procurement/contracting process, the differing responses of suppliers, and the role of the existing installed base as an actor in building a new infrastructure for health records.

  9. An Evaluation of the Implementation and Impact of England's Mandated School-Based Mental Health Initiative in Elementary Schools

    ERIC Educational Resources Information Center

    Wolpert, Miranda; Humphrey, Neil; Deighton, Jessica; Patalay, Praveetha; Fugard, Andrew J. B.; Fonagy, Peter; Belsky, Jay; Vostanis, Panos

    2015-01-01

    We report on a randomized controlled trial of Targeted Mental Health in Schools (TaMHS), which is a nationally mandated school-based mental health program in England. TaMHS aimed to improve mental health for students with, or at risk of, behavioral and emotional difficulties by providing evidence-informed interventions relating to closer working…

  10. The public health workforce, 2006: new challenges.

    PubMed

    Gebbie, Kristine M; Turnock, Bernard J

    2006-01-01

    Efforts to develop the public health workforce since 2001 have benefited from increased funding resulting from concerns over terrorism and other public health threats. This largesse has been accompanied by the need for greater accountability for results. The size, composition, and distribution of the public health workforce have long been policy concerns. Production and retention of public health workers remain important issues, although new dimensions of readiness are also taking center stage. We offer here policy recommendations in the areas of assessing the public health workforce and its needs, organizing development efforts around essential competencies for public health practice, credentialing workers, and accrediting agencies.

  11. Prescription Tracking and Public Health

    PubMed Central

    2008-01-01

    INTRODUCTION Monitoring and modifying physicians’ prescribing behavior through prescription tracking is integral to pharmaceutical marketing. Health information organizations (HIOs) combine prescription information purchased from pharmacies with anonymized patient medical records purchased from health insurance companies to determine which drugs individual physicians prefer for specific diagnoses and patient populations. This information is used to tailor marketing strategies to individual physicians and to assess the effect of promotions on prescribing behavior. DISCUSSION The American Medical Association (AMA) created the Prescription Data Restriction Plan in an attempt to address both the privacy concerns of physicians and industry concerns that legislation could compromise the availability of prescribing data. However, the PDRP only prohibits sales representatives and their immediate supervisors from accessing the most detailed reports. Less than 2% of US physicians have registered for the PDRP, and those who have signed up are not the physicians who are targeted for marketing. CONCLUSION Although it has been argued that prescription tracking benefits public health, data gathered by HIOs is designed for marketing drugs. These data are sequestered by industry and are not generally available for genuine public health purposes. PMID:18473146

  12. Noise exposure and public health.

    PubMed Central

    Passchier-Vermeer, W; Passchier, W F

    2000-01-01

    Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and birth defects, the evidence is limited. Most public health impacts of noise were already identified in the 1960s and noise abatement is less of a scientific but primarily a policy problem. A subject for further research is the elucidation of the mechanisms underlying noise-induced cardiovascular disorders and the relationship of noise with annoyance and nonacoustical factors modifying health outcomes. A high priority study subject is the effects of noise on children, including cognitive effects and their reversibility. Noise exposure is on the increase, especially in the general living environment, both in industrialized nations and in developing world regions. This implies that in the twenty-first century noise exposure will still be a major public health problem. Images Figure 2 PMID:10698728

  13. The rise of the regulatory state in health care: a comparative analysis of The Netherlands, England and Italy.

    PubMed

    Helderman, Jan-Kees; Bevan, Gwyn; France, George

    2012-01-01

    In a relatively short time, regulation has become a significant and distinct feature of how modern states wish to govern and steer their economy and society. Whereas the former 'dirigiste' state used to be closely related to public ownership (e.g. hospitals), planning (volume and capacity planning) and centralised administration (e.g. fixed prices and budgets), the new regulatory state relies mainly on the instrument of regulation to achieve its objectives. In this paper, we wish to relate the rise of the 'regulatory state' to the path-dependent trajectories and institutional legacies of discrete European health-care systems. For this purpose, we compared the Dutch corporatist social health insurance system, the strongly centralised National Health Service (NHS) of England and federal regionalised NHS system of Italy. Comparing these three different health-care systems suggests that it is indeed possible to identify a general trend towards the rise of the regulatory state in health care in the last two decades. However, although the three countries examined in this paper face similar problems of multilevel governance of networks of third-party payers and providers, each system also gives rise to its own distinct regulatory challenges.

  14. Comparison of Health Examination Survey Methods in Brazil, Chile, Colombia, Mexico, England, Scotland, and the United States.

    PubMed

    Mindell, Jennifer S; Moody, Alison; Vecino-Ortiz, Andres I; Alfaro, Tania; Frenz, Patricia; Scholes, Shaun; Gonzalez, Silvia A; Margozzini, Paula; de Oliveira, Cesar; Sanchez Romero, Luz Maria; Alvarado, Andres; Cabrera, Sebastián; Sarmiento, Olga L; Triana, Camilo A; Barquera, Simón

    2017-09-15

    Comparability of population surveys across countries is key to appraising trends in population health. Achieving this requires deep understanding of the methods used in these surveys to examine the extent to which the measurements are comparable. In this study, we obtained detailed protocols of 8 nationally representative surveys from 2007-2013 from Brazil, Chile, Colombia, Mexico, the United Kingdom (England and Scotland), and the United States-countries that that differ in economic and inequity indicators. Data were collected on sampling frame, sample selection procedures, recruitment, data collection methods, content of interview and examination modules, and measurement protocols. We also assessed their adherence to the World Health Organization's "STEPwise Approach to Surveillance" framework for population health surveys. The surveys, which included half a million participants, were highly comparable on sampling methodology, survey questions, and anthropometric measurements. Heterogeneity was found for physical activity questionnaires and biological samples collection. The common age range included by the surveys was adults aged 18-64 years. The methods used in these surveys were similar enough to enable comparative analyses of the data across the 7 countries. This comparability is crucial in assessing and comparing national and subgroup population health, and to assisting the transfer of research and policy knowledge across countries. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Electromagnetic fields and public health.

    PubMed Central

    Aldrich, T E; Easterly, C E

    1987-01-01

    A review of the literature is provided for the topic of health-related research and power frequency electromagnetic fields. Minimal evidence for concern is present on the basis of animal and plant research. General observation would accord with the implication that there is no single and manifest health effect as the result of exposure to these fields. There are persistent indications, however, that these fields have biologic activity, and consequently, there may be a deleterious component to their action, possibly in the presence of other factors. Power frequency electromagnetic field exposures are essentially ubiquitous in modern society, and their implications in the larger perspective of public health are unclear at this time. Electromagnetic fields represent a methodological obstacle for epidemiologic studies and a quandary for risk assessment; there is need for more data. PMID:3319560

  16. Monitoring the effect of air pollution episodes on health care consultations and ambulance call-outs in England during March/April 2014: A retrospective observational analysis.

    PubMed

    Elliot, Alex J; Smith, Sue; Dobney, Alec; Thornes, John; Smith, Gillian E; Vardoulakis, Sotiris

    2016-07-01

    There is an increasing body of evidence illustrating the negative health effects of air pollution including increased risk of respiratory, cardiac and other morbid conditions. During March and April 2014 there were two air pollution episodes in England that occurred in close succession. We used national real-time syndromic surveillance systems, including general practitioner (GP) consultations, emergency department attendances, telehealth calls and ambulance dispatch calls to further understand the impact of these short term acute air pollution periods on the health seeking behaviour of the general public. Each air pollution period was comparable with respect to particulate matter concentrations (PM10 and PM2.5), however, the second period was longer in duration (6 days vs 3 days) and meteorologically driven 'Sahara dust' contributed to the pollution. Health surveillance data revealed a greater impact during the second period, with GP consultations, emergency department attendances and telehealth (NHS 111) calls increasing for asthma, wheeze and difficulty breathing indicators, particularly in patients aged 15-64 years. Across regions of England there was good agreement between air quality levels and health care seeking behaviour. The results further demonstrate the acute impact of short term air pollution episodes on public health and also illustrate the potential role of mass media reporting in escalating health care seeking behaviour.

  17. Surfing the net for public health resources.

    PubMed

    Angell, C; Hemingway, A; Hartwell, H

    2011-08-01

    To identify public health open educational resources (OER) available online, map the identified OER to The Public Health Skills and Career Framework (PHSCF), and triangulate these findings with public health practitioners. Systematic online search for public health OER. An online search was undertaken using a pre-defined set of search terms and inclusion/exclusion criteria. Public health OER were then mapped against the UK PHSCF. The findings of the search were discussed with public health specialists to determine whether or not they used these resources. A number of public health OER were identified, located on 42 websites from around the world. Mapping against the UK PHSCF demonstrated a lack of coverage in some areas of public health education. It was noted that many of the OER websites identified were not those generally used in practice, and those sites preferred by public health specialists were not identified by the online search. Public health OER are available from a number of providers, frequently universities and government organizations. However, these reflect a relatively small pool of original OER providers. Tagging of websites does not always identify their public health content. In addition, users of public health OER may not use search engines to identify resources but locate them using other means. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Issues in public health entomology.

    PubMed

    Spielman, A; Pollack, R J; Kiszewski, A E; Telford, S R

    2001-01-01

    Public health entomology focuses on the population biology of vector-borne infections, seeking to understand how such pathogens perpetuate over time and attempting to devise methods for reducing the burden that they impose on human health. As public health entomology passes its centennial, a series of pervasive research themes and spirited debates characterize the discipline, many reflecting a tension between field and laboratory research. In particular, institutional support for population-based research and training programs has fallen behind that for those using modern lab-based approaches. Discussion of modes of intervention against vector-borne infections (such as deployment of genetically modified vectors, the role of DDT in malaria control, host-targeted acaricides for Lyme disease risk reduction, and truck-mounted aerosol spraying against West Nile virus transmission) illustrates the discipline's need for strengthening population-based research programs. Even with the advent of molecular methods for describing population structure, the basis for anophelism without malaria (or its eastern North American counterpart, ixodism without borreliosis) remains elusive. Such methods have not yet been extensively used to examine the phylogeography and geographical origins of zoonoses such as Lyme disease. Basic ecological questions remain poorly explored: What regulates vector populations? How may mixtures of pathogens be maintained by a single vector? What factors might limit the invasion of Asian mosquitoes into North American sites? Putative effects of "global warming" remain speculative given our relative inability to answer such questions. Finally, policy and administrative issues such as the "no-nits" dictum in American schools, the Roll Back Malaria program, and legal liability for risk due to vector-borne infections serve to demonstrate further the nature of the crossroads that the discipline of public health entomology faces at the start of the 21st Century.

  19. Nutrigenomics, individualism and public health.

    PubMed

    Chadwick, Ruth

    2004-02-01

    Issues arising in connection with genes and nutrition policy include both nutrigenomics and nutrigenetics. Nutrigenomics considers the relationship between specifc nutrients or diet and gene expression and, it is envisaged, will facilitate prevention of diet-related common diseases. Nutrigenetics is concerned with the effects of individual genetic variation (single nucleotide polymorphisms) on response to diet, and in the longer term may lead to personalised dietary recommendations. It is important also to consider the surrounding context of other issues such as novel and functional foods in so far as they are related to genetic modification. Ethical issues fall into a number of categories: (1) why nutrigenomics? Will it have important public health benefits? (2) questions about research, e.g. concerning the acquisition of information about individual genetic variation; (3) questions about who has access to this information, and its possible misuse; (4) the applications of this information in terms of public health policy, and the negotiation of the potential tension between the interests of the individual in relation to, for example, prevention of conditions such as obesity and allergy; (5) the appropriate ethical approach to the issues, e.g. the moral difference, if any, between therapy and enhancement in relation to individualised diets; whether the 'technological fix' is always appropriate, especially in the wider context of the purported lack of public confidence in science, which has special resonance in the sphere of nutrition.

  20. [Parmentier hygiene and public health].

    PubMed

    Lafont, O

    2014-05-01

    The legend about Parmentier is quite reductive when it limits his activity to the promotion of potato. This military pharmacist intended mainly to make science serve human being, whatever could be his various activities. Actor of the foundation of food chemistry, reorganizer of military pharmacy, he has always been highly concerned with hygiene and public health. He then studied the quality of water, particularly in the case of river Seine, or the purity of air, especially in hospitals. The affair of Dunkerque exhumations or that of cesspools, or the utilisation of human excrements in agriculture were parts of the occurrences for which he had the opportunity to find a scientific approach allowing to solve the difficult questions that were asked to him, for the best benefit of public health. The exhaustive study he published in "Bulletin de pharmacie" for the conservation of meat shows that he did not ignore anything about freezing of food in order to preserve it. It is necessary not to forget the important role he played, as soon as he were informed of Jenner's discovery, for the diffusion of vaccination in France. It is simply astounding to observe how modern were the questions he solved and how intense was his spirit of dedication to the public good, when exerting his functions in "Comité de Salubrité de la Seine" or "Conseil de Santé des Armées", as well as outside these prestigious institutions. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Epidemiology of Toxocariasis in England and Wales.

    PubMed

    Halsby, K; Senyonjo, L; Gupta, S; Ladbury, G; Suvari, M; Chiodini, P; Morgan, D

    2016-11-01

    Toxocara infection occurs through ingestion of parasite eggs excreted by dogs and cats, and can cause severe morbidity. The burden of disease in England and Wales is not well described, and the impact of public health campaigns conducted in the mid-1990s is uncertain. This paper uses data from two extensive databases to explore the trends in this disease in England and Wales from the 1970s to 2009. © 2016 Blackwell Verlag GmbH.

  2. Does More Public Health Spending Buy Better Health?

    PubMed

    Marton, James; Sung, Jaesang; Honore, Peggy

    2015-01-01

    In this article, we attempt to address a persistent question in the health policy literature: Does more public health spending buy better health? This is a difficult question to answer due to unobserved differences in public health across regions as well as the potential for an endogenous relationship between public health spending and public health outcomes. We take advantage of the unique way in which public health is funded in Georgia to avoid this endogeneity problem, using a twelve year panel dataset of Georgia county public health expenditures and outcomes in order to address the "unobservables" problem. We find that increases in public health spending lead to increases in mortality by several different causes, including early deaths and heart disease deaths. We also find that increases in such spending leads to increases in morbidity from heart disease. Our results suggest that more public health funding may not always lead to improvements in health outcomes at the county level.

  3. Enhancing public health law communication linkages.

    PubMed

    Silverman, Ross D

    2008-01-01

    Although interest in the field of public health law has dramatically increased over the past two decades, there remain significant challenges in communicating and sharing public health law-related knowledge. Access to quality information, which may assist in a public health department's efforts to protect the public's health, welfare, and safety, varies widely from jurisdiction to jurisdiction, and interjurisdictional communication remains at best a patchwork quilt with many holes. What follows is an analysis of several approaches the Public Health Law Association or other public health law-related organizations might undertake to serve as a conduit for the identification, gathering, and dissemination of extant public health law information, as well as the development of new public health law-related content, with a particular focus on the use of electronic means for such efforts.

  4. [1946: hygienics and public health].

    PubMed

    Bucci, Roberto

    2002-01-01

    In Italy, the year 1946 was characterized, on one hand, by the growing concern for the lack of public structures and, on the other, by the hopes placed in the research sector, namely the apparently inexhaustible properties of penicillin and antibiotics. Consistently, Igiene e Sanità Pubblica reflected the general mood of the hygienists, swinging between the strong protests against a far too slow political system incapable of spurring scientific research, and the constant engagement aimed at enhancing the future role of public health. Besides facing many institutional problems, such as claiming an official recognition for their profession, hygienists also managed to make Italians understand the real value of a discipline conceived for the community service.

  5. ALL IN IT TOGETHER? THE EFFECTS OF RECESSION ON POPULATION HEALTH AND HEALTH INEQUALITIES IN ENGLAND AND SWEDEN, 1991-2010.

    PubMed

    Copeland, Alison; Bambra, Clare; Nylén, Lotta; Kasim, Adetayo; Riva, Mylène; Curtis, Sarah; Burström, Bo

    2015-01-01

    This article is the first to comparatively examine the effects of two recessions on population health and health inequalities in the two historically contrasting welfare states of England and Sweden. Data from 1991-2010 on self-reported general health, age, gender, and educational status were obtained from the Health Survey for England, the Swedish Survey of Living Conditions, and the European Union Survey of Income and Living Conditions, for individuals aged over 16. Generalized linear models were used to test the effects of recessions on self-reported health and educational inequalities in health. Overall, recessions had a significant positive effect on the health of women--but not men-in both England (4%) and Sweden (7%). In England, this improvement was only enjoyed by the most educated women, with the health of less educated women declining during recession. In contrast, in Sweden, the health of all women improved significantly during recession regardless of their educational status, although the most educated benefitted the most. Relative educational inequalities in self-reported health therefore increased during recessions in both countries by 14 percent (England) and 17 percent (Sweden) but for different reasons. This study suggests that Sweden's welfare state protects the health of all during recessions.

  6. The case for transforming governmental public health.

    PubMed

    Salinsky, Eileen; Gursky, Elin A

    2006-01-01

    Changing threats to the public's health necessitate a profound transformation of the public health enterprise. Despite recent attention to the biodefense role of public health, policymakers have not developed a clear, realistic vision for the structure and functionality of the governmental public health system. Lack of leadership and organizational disconnects across levels of government have prevented strategic alignment of resources and undermined momentum for meaningful change. A transformed public health system is needed to address the demands of emergency preparedness and health protection. Such transformation should include focused, risk-based resource allocation; regional planning; technological upgrades; workforce restructuring; improved integration of private-sector assets; and better performance monitoring.

  7. Public health ethics: the voices of practitioners.

    PubMed

    Bernheim, Ruth Gaare

    2003-01-01

    Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type of ethics education and support they believe may be helpful.

  8. Economic growth and health progress in England and Wales: 160 years of a changing relation.

    PubMed

    Tapia Granados, José A

    2012-03-01

    Using data for England and Wales during the years 1840-2000, a negative relation is found between economic growth--measured by the rate of growth of gross domestic product (GDP)--and health progress--as indexed by the annual increase in life expectancy at birth (LEB). That is, the lower is the rate of growth of the economy, the greater is the annual increase in LEB for both males and females. This effect is much stronger, however, in 1900-1950 than in 1950-2000, and is very weak in the 19th century. It appears basically at lag zero, though some short-lag effects of the same negative sign are found. In the other direction of causality, there are very small effects of the change in LEB on economic growth. These results add to an emerging consensus that in the context of long-term declining trends, mortality oscillates procyclically during the business cycle, declining faster in recessions. Therefore, LEB increases faster during recessions than during expansions. The investigation also shows how the relation between economic growth and health progress changed in England and Wales during the study period. No evidence of cointegration between income--as indexed by GDP or GDP per capita--and health--as indexed by LEB--is found.

  9. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England

    PubMed Central

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Background Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. Objective To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Methods Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Results Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Conclusion Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a

  10. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England.

    PubMed

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists' perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a better awareness of what the public, especially

  11. Health trajectories in regeneration areas in England: the impact of the New Deal for Communities intervention.

    PubMed

    Walthery, Pierre; Stafford, Mai; Nazroo, James; Whitehead, Margaret; Dibben, Christopher; Halliday, Emma; Povall, Sue; Popay, Jennie

    2015-08-01

    A large body of evidence documents the adverse relationship between concentrated deprivation and health. Among the evaluations of regeneration initiatives to tackle these spatial inequalities, few have traced the trajectories of individuals over time and fewer still have employed counterfactual comparison. We investigate the impact of one such initiative in England, the New Deal for Communities (NDC), which ran from 1999 to 2011, on socioeconomic inequalities in health trajectories. Latent Growth Curve modelling of within-person changes in self-rated health, mental health and life satisfaction between 2002 and 2008 of an analytical cohort of residents of 39 disadvantaged areas of England in which the NDC was implemented, compared with residents of comparator, non-intervention areas, focusing on: (1) whether differences over time in outcomes can be detected between NDC and comparator areas and (2) whether interventions may have altered socioeconomic differences in outcomes. No evidence was found for an overall improvement in the three outcomes, or for significant differences in changes in health between respondents in NDC versus comparator areas. However, we found a weakly significant gap in life satisfaction and mental health between high and low socioeconomic status individuals in comparator areas which widened over time to a greater extent than in NDC areas. Change over time in the three outcomes was non-linear: individual improvements among NDC residents were largest before 2006. There is limited evidence that the NDC moderated the impact of socioeconomic factors on mental health and life satisfaction trajectories. Furthermore, any NDC impact was strongest in the first 6 years of the programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Health trajectories in regeneration areas in England: the impact of the New Deal for Communities intervention

    PubMed Central

    Walthery, Pierre; Stafford, Mai; Nazroo, James; Whitehead, Margaret; Dibben, Christopher; Halliday, Emma; Povall, Sue; Popay, Jennie

    2015-01-01

    Background A large body of evidence documents the adverse relationship between concentrated deprivation and health. Among the evaluations of regeneration initiatives to tackle these spatial inequalities, few have traced the trajectories of individuals over time and fewer still have employed counterfactual comparison. We investigate the impact of one such initiative in England, the New Deal for Communities (NDC), which ran from 1999 to 2011, on socioeconomic inequalities in health trajectories. Methods Latent Growth Curve modelling of within-person changes in self-rated health, mental health and life satisfaction between 2002 and 2008 of an analytical cohort of residents of 39 disadvantaged areas of England in which the NDC was implemented, compared with residents of comparator, non-intervention areas, focusing on: (1) whether differences over time in outcomes can be detected between NDC and comparator areas and (2) whether interventions may have altered socioeconomic differences in outcomes. Results No evidence was found for an overall improvement in the three outcomes, or for significant differences in changes in health between respondents in NDC versus comparator areas. However, we found a weakly significant gap in life satisfaction and mental health between high and low socioeconomic status individuals in comparator areas which widened over time to a greater extent than in NDC areas. Change over time in the three outcomes was non-linear: individual improvements among NDC residents were largest before 2006. Conclusions There is limited evidence that the NDC moderated the impact of socioeconomic factors on mental health and life satisfaction trajectories. Furthermore, any NDC impact was strongest in the first 6 years of the programmes. PMID:26085649

  13. Public Health Interventions for School Nursing Practice

    ERIC Educational Resources Information Center

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  14. Where Is the Public Health Pharmacist?

    ERIC Educational Resources Information Center

    Bush, Patricia J.; Johnson, Keith W.

    1979-01-01

    It is argued that not nearly enough pharmacists are now engaged in public health activities, and that pharmacy education has failed to recognize the potential for pharmacists in public health as well as to acquaint pharmacy students with role models in public health. Suggestions are offered to remedy the situation. (JMD)

  15. Public Health Interventions for School Nursing Practice

    ERIC Educational Resources Information Center

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  16. [Social medicine, public health and governance for health].

    PubMed

    Holčík, Jan

    Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

  17. Public health in China: 1978.

    PubMed

    Alderman, M H; Reader, G G

    1979-07-01

    Only a generation ago, health conditions in China were similar to those found in the least developed nations; but today, Chinese mortality rates resemble those found in the most highly industrialized nations. The incidence of infectious diseases and other diseases associated with deprivation has decreased markedly, especially in urban areas, and degenerative diseases are now a major health concern in China. In Peking cardiac disease is the leading cause of death and 45% of these deaths are due to strokes. While China has made great strides in improving sanitation and hygiene standards, efforts to control chronic diseases have not been as effective. Little effort has been made to collect information on health problems at the national level, and this dearth of information prevents effective planning for the continuing services needed for the treatment of individuals with chronic disease. These observations on the state of public health in China were made by 2 groups of medical personnel who visited China for several weeks in 1978 and toured medical facilities in 7 cities and 3 communes. The visitors also noted that most deliveries of babies in rural areas are performed by trained midwives and that most urban women deliver at hospitals. In the urban areas many women are sterilized after the 2nd birth. Most childhood diseases are under control, but respiratory tract infections and mastoiditis are still common problems. Acupuncture as an anesthetic for major surgery is widely used. A table comparing cardiovascular and cancer mortality rates in China and the U.S. is included.

  18. Influences on the Expression of Health within Physical Education Curricula in Secondary Schools in England and Wales

    ERIC Educational Resources Information Center

    Harris, Jo; Leggett, Gemma

    2015-01-01

    This paper presents selected findings from a wider study on the expression of health within physical education (PE) curricula in secondary schools in England and Wales. The study revealed that the expression of health in PE broadly reflected ideologies associated with promoting "fitness for life" and "fitness for performance"…

  19. Pre-Service Teacher Training in Health and Well-Being in England: The State of the Nation

    ERIC Educational Resources Information Center

    Byrne, J.; Shepherd, J.; Dewhirst, S.; Pickett, K.; Speller, V.; Roderick, P.; Grace, M.; Almond, P.

    2015-01-01

    This paper presents findings from a survey of pre-service teacher training institutions in England with regard to the provision of health and well-being education. It examines factors affecting the inclusion of health and well-being, and explores educational implications in light of the changing landscape of pre-service teacher education in…

  20. Pre-Service Teacher Training in Health and Well-Being in England: The State of the Nation

    ERIC Educational Resources Information Center

    Byrne, J.; Shepherd, J.; Dewhirst, S.; Pickett, K.; Speller, V.; Roderick, P.; Grace, M.; Almond, P.

    2015-01-01

    This paper presents findings from a survey of pre-service teacher training institutions in England with regard to the provision of health and well-being education. It examines factors affecting the inclusion of health and well-being, and explores educational implications in light of the changing landscape of pre-service teacher education in…

  1. Influences on the Expression of Health within Physical Education Curricula in Secondary Schools in England and Wales

    ERIC Educational Resources Information Center

    Harris, Jo; Leggett, Gemma

    2015-01-01

    This paper presents selected findings from a wider study on the expression of health within physical education (PE) curricula in secondary schools in England and Wales. The study revealed that the expression of health in PE broadly reflected ideologies associated with promoting "fitness for life" and "fitness for performance"…

  2. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

  3. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  4. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  5. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  6. 42 CFR 90.9 - Public health advisory.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of...

  7. Uses of electronic health records for public health surveillance to advance public health.

    PubMed

    Birkhead, Guthrie S; Klompas, Michael; Shah, Nirav R

    2015-03-18

    Public health surveillance conducted by health departments in the United States has improved in completeness and timeliness owing to electronic laboratory reporting. However, the collection of detailed clinical information about reported cases, which is necessary to confirm the diagnosis, to understand transmission, or to determine disease-related risk factors, is still heavily dependent on manual processes. The increasing prevalence and functionality of electronic health record (EHR) systems in the United States present important opportunities to advance public health surveillance. EHR data have the potential to further increase the breadth, detail, timeliness, and completeness of public health surveillance and thereby provide better data to guide public health interventions. EHRs also provide a unique opportunity to expand the role and vision of current surveillance efforts and to help bridge the gap between public health practice and clinical medicine.

  8. The impact of car ownership and public transport usage on cancer screening coverage: Empirical evidence using a spatial analysis in England.

    PubMed

    Wang, Chao

    2016-10-01

    A spatial analysis has been conducted in England, with the aim to examine the impact of car ownership and public transport usage on breast and cervical cancer screening coverage. District-level cancer screening coverage data (in proportions) and UK census data have been collected and linked. Their effects on cancer screening coverage were modelled by using both non-spatial and spatial models to control for spatial correlation. Significant spatial correlation has been observed and thus spatial model is preferred. It is found that increased car ownership is significantly associated with improved breast and cervical cancer screening coverage. Public transport usage is inversely associated with breast cancer screening coverage; but positively associated with cervical cancer screening. An area with higher median age is associated with higher screening coverage. The effects of other socio-economic factors such as deprivation and economic activity have also been explored with expected results. Some regional differences have been observed, possibly due to unobserved factors. Relevant transport and public health policies are thus required for improved coverage. While restricting access to cars may lead to various benefits in public health, it may also result in worse cancer screening uptake. It is thus recommended that careful consideration should be taken before implementing policy interventions.

  9. Public health workforce: challenges and policy issues

    PubMed Central

    Beaglehole, Robert; Dal Poz, Mario R

    2003-01-01

    This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce. PMID:12904251

  10. Ten years of jointly commissioning health and social care in England

    PubMed Central

    Hudson, Bob

    2011-01-01

    Introduction Over the past two decades, the service delivery landscape across health and social care in England has been reshaped in order to separate the commissioning of services from their delivery. Policy/practice The market ethic that underpinned this move has depicted the previously roles as unresponsive to the needs of service users and dominated by provider interests. As well as seeming to offer commissioners the chance to change the nature of provision and type of provider, this policy model also created a further new opportunity—for joint commissioning across organisational boundaries. The logic here is that if two or more commissioners can jointly shape their programmes then they will be better able to secure integrated provision across a range of separate agencies and professions. Conclusion This article reviews the experience of joint commissioning across health and social care over the past decade in England. It contrasts the proliferation of policies against the paucity of achievements, seeks explanations for this situation, and offers pointers for future development. PMID:21677843

  11. Ten years of jointly commissioning health and social care in England.

    PubMed

    Hudson, Bob

    2011-01-01

    Over the past two decades, the service delivery landscape across health and social care in England has been reshaped in order to separate the commissioning of services from their delivery. The market ethic that underpinned this move has depicted the previously roles as unresponsive to the needs of service users and dominated by provider interests. As well as seeming to offer commissioners the chance to change the nature of provision and type of provider, this policy model also created a further new opportunity-for joint commissioning across organisational boundaries. The logic here is that if two or more commissioners can jointly shape their programmes then they will be better able to secure integrated provision across a range of separate agencies and professions. This article reviews the experience of joint commissioning across health and social care over the past decade in England. It contrasts the proliferation of policies against the paucity of achievements, seeks explanations for this situation, and offers pointers for future development.

  12. Navigating uncharted waters? How international experience can inform the funding of mental health care in England.

    PubMed

    Mason, Anne; Goddard, Maria; Myers, Lindsey; Verzulli, Rossella

    2011-06-01

    Activity-based funding mechanisms are widely used in acute care. In England, payment by results is being extended to mental health care, but its financial viability is unclear. To identify international examples of activity-based funding systems for mental health care and to inform the development of a national tariff in England. The international literature on payment systems for mental healthcare services was reviewed. Payment systems were appraised from an economic perspective. Variations in cost between English mental healthcare providers were explored using routine inpatient data on length of stay in 2007/8. The review identified activity-based mental healthcare payment systems in five countries. International experience highlights the need for gradual and stepwise implementation; the use of budget neutrality adjustments; top-slicing of budgets to stabilise provider income; and use of the classification system to drive improvements in quality and cost-effectiveness. All systems adjusted for length of stay, but methods varied. Comparing English mental healthcare providers, median length of stay ranged from 2 to 42 days for emergency admissions and from 0 to 56 days for elective admissions. New payment systems must account for the economic incentives they embody, and appropriate adjustments for variations in length of stay are essential.

  13. Disability from a public health perspective.

    PubMed

    Möller, Anders

    2015-08-01

    At the Nordic School of Public Health (NHV), methods to alleviate problems with disability have been seen as an important part of actions to support public health. A programme for universal design was started in 2006. Some issues of public health perspectives on disability are presented in this paper, based on discussions from a PhD course held at the NHV. During the course, the students presented papers in which they reflected on the relationship between disability and public health. These essays were collected and published in 2012 at NHV. © 2015 the Nordic Societies of Public Health.

  14. A National Agenda for Public Health Informatics

    PubMed Central

    Yasnoff, William A.; Overhage, J. Marc; Humphreys, Betsy L.; LaVenture, Martin

    2001-01-01

    The AMIA 2001 Spring Congress brought together members of the the public health and informatics communities to develop a national agenda for public health informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes—that all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health. PMID:11687561

  15. A Journey in Public Health Ethics.

    PubMed

    Kass, Nancy E

    2017-01-01

    While medical ethics has a long history, and research ethics guidance emerged more formally in the 1960s and 1970s, frameworks for public health ethics began to appear in the 1990s. The author's thinking about public health ethics evolved from consideration of some of the ethics and policy questions surfacing regularly in the HIV/AIDS epidemic. This essay discusses some of the shared commitments of public health and ethics, as well as how one might apply an ethics lens to public health programs, both generally and in the contexts of public health preparedness and obesity prevention.

  16. Physical Education's Role in Public Health.

    ERIC Educational Resources Information Center

    Sallis, James F.; McKenzie, Thomas L.

    1991-01-01

    Analyzes contributions physical education makes to child and adult health. Topics discussed are current levels of U.S. children's physical activity; status of elementary physical education programs; health-related physical activity interventions; public health analysis of elementary physical education; and public health role and goal for physical…

  17. Public Criticism of Health Science Policy

    ERIC Educational Resources Information Center

    Hutt, Peter Barton

    1978-01-01

    Major criticisms of health science policy are that (1) health science research is not presently designed to help the public which pays for it; (2) the public should have greater control over health science research; and (3) federal funding of training for health science research is an inappropriate use of tax funds. (Author/DB)

  18. Language Learning in the Public Eye: An Analysis of Newspapers and Official Documents in England

    ERIC Educational Resources Information Center

    Graham, Suzanne; Santos, Denise

    2015-01-01

    This article considers the issue of low levels of motivation for foreign language learning in England by exploring how language learning is conceptualised by different key voices in that country through the examination of written data: policy documents and reports on the UK's language needs, curriculum documents and press articles. The extent to…

  19. Camper characteristics differ at public and commercial campgrounds in New England

    Treesearch

    Wilbur F. LaPage

    1967-01-01

    Early findings from a 5-year panel survey of New England campers' changing leisure habits are reported. A significant number of campers interviewed at four commercial campgrounds differed in their camping behavior from campers at four state park and national forest campgrounds. The most apparent differences are the higher degree of mobility and the larger dollar...

  20. Language Learning in the Public Eye: An Analysis of Newspapers and Official Documents in England

    ERIC Educational Resources Information Center

    Graham, Suzanne; Santos, Denise

    2015-01-01

    This article considers the issue of low levels of motivation for foreign language learning in England by exploring how language learning is conceptualised by different key voices in that country through the examination of written data: policy documents and reports on the UK's language needs, curriculum documents and press articles. The extent to…

  1. Test Theories, Educational Priorities and Reliability of Public Examinations in England

    ERIC Educational Resources Information Center

    Baird, Jo-Anne; Black, Paul

    2013-01-01

    Much has already been written on the controversies surrounding the use of different test theories in educational assessment. Other authors have noted the prevalence of classical test theory over item response theory in practice. This Special Issue draws together articles based upon work conducted on the Reliability Programme for England's…

  2. Upholding Public Trust: An Examination of Teacher Professionalism and the Use of Teachers' Standards in England

    ERIC Educational Resources Information Center

    Goepel, Janet

    2012-01-01

    This paper considers the nature of teacher professionalism in England today, tracing how it has changed and developed according to the impact of government policy and the introduction of standards for teachers. It examines the recently published Teachers' Standards with their emphasis on classroom practice together with the requirement for…

  3. Analysis of Academic Journals in Education: A Comparison of Publication Patterns in England and Germany

    ERIC Educational Resources Information Center

    Ertl, Hubert; Zierer, Klaus; Phillips, David; Tippelt, Rudolf

    2013-01-01

    This article outlines some of the findings of a project funded by the German Research Association which conducted an analysis of six leading journals of education in Germany and England. All articles published in these journals between 2001 and 2009 were analysed according to thematic foci, methodological approaches and characteristics of authors.…

  4. Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

    ERIC Educational Resources Information Center

    Hilton, Warren

    2013-01-01

    This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

  5. Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

    ERIC Educational Resources Information Center

    Hilton, Warren

    2013-01-01

    This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

  6. Enhancing crisis leadership in public health emergencies.

    PubMed

    Deitchman, Scott

    2013-10-01

    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  7. Public Health, the APHA, and Urban Renewal

    PubMed Central

    2009-01-01

    Joint efforts by fields of public health in the last decade have advocated use of the built environment to protect health. Past involvement by public health advocates in urban policy, however, has had mixed results. Although public health has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American Public Health Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core public health activities. PMID:19608955

  8. Public health, the APHA, and urban renewal.

    PubMed

    Lopez, Russ P

    2009-09-01

    Joint efforts by fields of public health in the last decade have advocated use of the built environment to protect health. Past involvement by public health advocates in urban policy, however, has had mixed results. Although public health has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American Public Health Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core public health activities.

  9. The Courts, Public Health, and Legal Preparedness

    PubMed Central

    Stier, Daniel D.; Nicks, Diane; Cowan, Gregory J.

    2007-01-01

    The judicial branch’s key roles, as guardian of civil liberties and protector of the rule of law, can be acutely relevant during public health emergencies when courts may need to issue orders authorizing actions to protect public health or restraining public health actions that are determined to unduly interfere with civil rights. Legal preparedness for public health emergencies, therefore, necessitates an understanding of the court system and how courts are involved in public health issues. In this article we briefly describe the court system and then focus on what public health practitioners need to know about the judicial system in a public health emergency, including the courts’ roles and the consequent need to keep courts open during emergencies. PMID:17413084

  10. PERSPECTIVES ON MONITORING MENTAL HEALTH LEGISLATION IN ENGLAND: A VIEW FROM THE FRONT LINE.

    PubMed

    Laing, Judy M

    2015-01-01

    This article discusses the findings of an exploratory study involving semi-structured interviews with a sample of Mental Health Act (MHA) Commissioners. MHA Commissioners are employed by the Care Quality Commission (CQC) in England to monitor patients who are deprived of their liberty under the Mental Health Act 1983 (as amended by the Mental Health Act 2007). The study was designed to examine the impact of the transfer of responsibility of mental health detention monitoring in April 2009 from the Mental Health Act Commission to the CQC. The interviews were devised around the United Nations Optional Protocol to the Convention Against Torture (OPCAT) framework, which provides a useful benchmark for effective monitoring of deprivations of liberty to national inspection bodies (known as National Preventive Mechanisms), such as the CQC. Article 18 of the OPCAT advises a regular system of preventive visits by independent expert monitors, as well focussing on the promotion and protection of human rights. There is paucity of data on the work of MHA Commissioners in England to date and the author was unable to locate any previous studies on the subject. This study is timely and important as the CQC has been heavily criticised following the abuses uncovered at Winterbourne View care home and in the wake of the Mid Staffordshire Inquiry. Consequently, in 2012, the CQC undertook a major strategic review. The findings of this study suggest that, whilst there is some evidence of compliance, the CQC still has some way to go to effectively fulfil its monitoring duties in line with the provisions of the OPCAT.

  11. Public Health Ethics Related Training for Public Health Workforce: An Emerging Need in the United States

    PubMed Central

    Kanekar, A; Bitto, A

    2012-01-01

    Background Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results: Results indicated a variable amount of ethics’ related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties’ needing separate ethical frameworks to guide decision making. Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice. PMID:23113159

  12. Public health ethics related training for public health workforce: an emerging need in the United States.

    PubMed

    Kanekar, A; Bitto, A

    2012-01-01

    Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making. Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.

  13. Measuring the Value of Public Health Systems: The Disconnect Between Health Economists and Public Health Practitioners

    PubMed Central

    Jacobson, Peter D.; Palmer, Jennifer A.

    2008-01-01

    We investigated ways of defining and measuring the value of services provided by governmental public health systems. Our data sources included literature syntheses and qualitative interviews of public health professionals. Our examination of the health economic literature revealed growing attempts to measure value of public health services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture “intangibles” (e.g., social justice and reassurance value). Academic researchers evaluating the economics of public health investments should increase focus on the working needs of public health professionals. PMID:18923123

  14. Climate change and ecological public health.

    PubMed

    Goodman, Benny

    2015-02-17

    Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological public health. This article briefly outlines climate change and the concept of ecological public health, and discusses a 2012 review of the role of the nurse in health promotion.

  15. "It's a complex mesh"- how large-scale health system reorganisation affected the delivery of the immunisation programme in England: a qualitative study.

    PubMed

    Chantler, Tracey; Lwembe, Saumu; Saliba, Vanessa; Raj, Thara; Mays, Nicholas; Ramsay, Mary; Mounier-Jack, Sandra

    2016-09-15

    The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observations (immunisation board/committee meetings) occurred between December 2014 and June 2015, and September and December 2015. Interviews were audio recorded and transcribed verbatim and written accounts of observed events compiled. Data was imported into NVIVO 10 and analysed thematically. The new immunisation programme in the new health system was described as fragmented, and significant effort was expended to regroup. National tripartite arrangements required joint working and accountability; a shift from the simpler hierarchical pre-reform structure, typical of many public health programmes. New local inter-organisational arrangements resulted in ambiguity about organisational responsibilities and hindered data-sharing. Whilst making immunisation managers responsible for larger areas supported equitable resource distribution and strengthened service commissioning, it also reduced their ability to apply clinical expertise, support and evaluate immunisation providers' performance

  16. Feminism and public health nursing: partners for health.

    PubMed

    Leipert, B D

    2001-01-01

    It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

  17. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    PubMed Central

    2012-01-01

    Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness

  18. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.

    PubMed

    Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M

    2012-02-23

    In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.

  19. Strengths, weaknesses, opportunities and threats of the pig health monitoring systems used in England.

    PubMed

    Stärk, K D C; Nevel, A

    2009-10-17

    Several systems are being used in England to record information about the health of pigs. The British Pig Health Scheme (BPHS), the National Animal Disease Information System (NADIS), the Zoonoses Action Plan (ZAP) for Salmonella and the Veterinary Investigation Diagnosis Analysis (VIDA) system have been assessed to make recommendations for their future separate or joint development. The structure, organisation, processes, data quality, dissemination, utilisation and acceptance of each system have been assessed. Information was extracted from documents and websites, and informal interviews were conducted with technical experts and stakeholders. The systems covered a broad range of objectives, used variable approaches and operated at very different scales and budgets. There was a high level of awareness and involvement by the industry. Common weaknesses of the systems were the lack of in-depth quantitative analysis of the data, the lack of assessment of each system's impact, and the unknown level of bias as a result of the voluntary or selective participation in them.

  20. Nuclear education in public health and nursing

    SciTech Connect

    Winder, A.E.; Stanitis, M.A.

    1988-08-01

    Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.