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1.

Background

Research provides an important evidence base for public health practice. This was the basis for a comparison of current support for public health research within European countries.

Methods

Within a collaborative study SPHERE (Strengthening Public Health Research in Europe) an e-mail questionnaire concerning current priorities in public health research was developed, which was sent to 93 representatives of national member associations of the European Public Health Association (EUPHA). The answers were compared with reference to three macro-areas: Northern, Southern and Eastern Europe.

Results

Responses were received from 22 out of 39 European countries (56% country response rate). Current priorities at national level were health services and patient safety for Northern Europe, infectious diseases, health services and cardiovascular diseases for Southern Europe and food safety and nutrition, environmental and occupational health for Eastern Europe. Respondents reported fewer priorities in international research. In Northern Europe the priorities emphasized were health promotion, prevention and education (26.3%), injuries and alcohol habits (26.3%), in Southern and Eastern Europe health economics, health impact assessment and evaluations of services and programmes were prioritized by 30% and 41.7%, respectively.

Conclusions

Support for public health research differs across Europe, and barriers to undertaking better research include structural obstacles and insufficient personnel. National public health associations and public authorities should cooperate in order to find effective answers to common problems.  相似文献   

2.
The transition countries in the region of South Eastern Europe (SEE) share the historical burden of communism and four centuries of Ottoman dominance. In spite of deep, inherited rifts, they are going to develop multilateral collaboration as expressed in the Dubrovnik Declaration of 2001. Recently, a common public health strategy was drafted and a regional Forum for Public Health agreed upon. This special issue of the Journal of Public Health provides an overview of relevant developments in SEE with reference to new schools of public health and national public health associations.  相似文献   

3.

Background

Despite the attention the situation of the Roma in Central and Eastern Europe has received in the context of European Union enlargement, research on their access to health services is very limited, in particular with regard to child health services.

Methods

50 qualitative in-depth interviews with users, providers and policy-makers concerned with child health services in Bulgaria, conducted in two villages, one town of 70,000 inhabitants, and the capital Sofia.

Results

Our findings provide important empirical evidence on the range of barriers Roma children face when accessing health services. Among the most important barriers are poverty, administrative and geographical obstacles, low levels of parental education, and lack of ways to accommodate the cultural, linguistic and religious specifics of this population group.

Conclusion

Our research illustrates the complexity of the problems the Roma face. Access to health care cannot be discussed in isolation from other problems this population group experiences, such as poverty, restricted access to education, and social exclusion.  相似文献   

4.

Background

Emerging environmental pressures resulting from climate change and globalization challenge the capacity of health information systems (HIS) in the Pacific to inform future policy and public health interventions. Ciguatera, a globally common marine food-borne illness, is used here to illustrate specific HIS challenges in the Pacific and how these might be overcome proactively to meet the changing surveillance needs resulting from environmental change.

Objectives

We review and highlight inefficiencies in the reactive nature of existing HIS in the Pacific to collect, collate, and communicate ciguatera fish poisoning data currently used to inform public health intervention. Further, we review the capacity of existing HIS to respond to new data needs associated with shifts in ciguatera disease burden likely to result from coral reef habitat disruption.

Discussion

Improved knowledge on the ecological drivers of ciguatera prevalence at local and regional levels is needed, combined with enhanced surveillance techniques and data management systems, to capture environmental drivers as well as health outcomes data.

Conclusions

The capacity of public HIS to detect and prevent future outbreaks is largely dependent on the future development of governance strategies that promote proactive surveillance and health action. Accordingly, we present an innovative framework from which to stimulate scientific debate on how this might be achieved by using existing larger scale data sets and multidisciplinary collaborations.  相似文献   

5.

Background

Climate change is also a challenge to public health.

Methods

Commissioned by the Austrian Ministry for the Environment recommendations for public health actions within the framework of the national adaptation strategy were developed. This was done by an extensive survey conducted among leading national experts and by supporting workshops.

Results

Direct health effects of climate change with a high prognostic certainty were seen as the most pressing topics for adaptation measures. These effects include the acute impact of extreme temperatures, especially heat waves in urban areas, and heavy rainfalls with flooding, mud flows and landslides. High precipitation events can have long-term effects like post-traumatic stress syndrome, damage to infrastructure and buildings with impact on health, and migration which also should be in the focus of public health planning.  相似文献   

6.

Objective/methods

The need for public health ethics and ethics in epidemiology has recently become more obvious. In this article a methodological and normative framework for public health ethics is discussed.

Results

Some of the prevalent approaches of public health ethics and ethics in epidemiology are missing a systematic philosophical account and/or norms that are relevant and enlightening for the ethical discussion in public health. For an approach of public health ethics one can learn from bioethics and adopt methodologies that have been applied and elaborated in this field. However, there is a need for a set of principles in public health ethics that differs from the bioethical principles. Ethical codes and guidelines are already applied in the practice of epidemiology and public health without relating these to ethical principles. This is a deficit for goal-oriented ethical reasoning in public health and epidemiology.

Conclusion

An applied ethical discourse in public health can be helpful for public health and epidemiology. Ethical principles facilitate coherent reasoning that enriches the discussion of ethical problems as opposed to only relying on very specific moral rules as in codes and guidelines.  相似文献   

7.

Objectives

In 2002, the WHO Regional Office for Europe developed a strategic plan for measles in the WHO European Region. WHO recommends that at least 95% of children receive two doses of measles vaccine. This plan targeted the elimination of measles for the year 2010 and is supported by the Federal Republic of Germany.

Methods

Questionnaire survey, serological tests and check-up of the certificates of vaccination were offered to second year medical students of Goethe University Frankfurt/Main, Germany.

Results

Only 62.3% of medical students had received two doses of measles vaccine. Serological data showed that 23.1% were not immune against measles. Important gaps of knowledge were identified in the knowledge test of the survey; less than one third of the students (n=95/324) were able to answer more than 50% of the questions correctly.

Discussion

The suboptimum measles-vaccination coverage shows that the goal of eliminating measles will not be met across Europe by the target year 2010. Both occupational and public health measures need to make sure that vaccination programs should achieve a minimum of 95% coverage with two doses. In addition, the obligation to notify the authorities even of suspected cases serve the same purpose and measures to improve the knowledge of medical students are required. Consequent surveillance systems are necessary to investigate chains of measles infections. Healthcare workers play a decisive role in this issue.  相似文献   

8.

Background

Environmental justice deals with social and regional disparities in environmental exposures, such as air pollution and noise, and their public health relevance. In Germany, there is still little discussion on this topic; however, it is very important for understanding social inequalities in health. To demonstrate the need for interventions, the empirical information must be quantified as accurately as possible (“data for actions”).

Methods

There are just a few comprehensive systematic reviews concerning the empirical studies in this field, but they are the basis for further advancing the scientific discussion. To perform a systematic review, publications with original studies were systematically identified and selected by explicit methods. The selected publications were critically evaluated, and the relevant results were extracted and summarised in tables.

Results

Here we present the results of a systematic review including 29 studies from Western Europe and the United States. With regard to the content, most studies report an increased prevalence of air pollution and noise for low-status groups. With regard to methods, the message of the studies is constrained by the fact that very different study designs and methods for data analysis were used, and some designs and methods could be more appropriate than others.

Conclusions

Some recommendations for future empirical studies can be derived from these findings. To our knowledge, no comparable comprehensive review has been published in Western Europe concerning empirical studies on environmental justice.  相似文献   

9.

Background

Strengthening health research is an important objective for international health organisations, but there has been less attention to support for health research in Europe. We describe the public-health (population and organisational level) research systems in the 27 European Union countries.

Methods

We developed a typology for describing health research structures based on funding streams and strategies. We drew data from internet sources and asked country informants to review these for consistency and completeness. The structures were described as organograms and narratives in country profiles for each of the 27 EU member states. National public-health research structures included public and independent funding organisations, 'mixed' institutions (which receive funds, and both use and allocate them) and provider institutions.

Results

Most health research is funded through ministries of science or science councils (and sometimes foundations), while parliaments and regions may also contribute. National institutes of public health are usually funded by ministries of health. Many national research organisations both determine research programmes and undertake health research, but there is a move towards public-health sciences within the universities, and a transition from internal grants to competitive funding. Of 27 national research strategies, 17 referred to health and 11 to public health themes. Although all countries had strategies for public health itself, we found little coherence in public-health research programmes. The European Commission has country contact points for both EU research and health programmes, but they do not coordinate with national health-research programmes.

Conclusions

Public-health research is broadly distributed across programmes in EU countries. Better understanding of research structures, programmes and results would improve recognition for public health in Europe, and contribute to practice. EU ministries of health should give greater attention to national public-health research strategies and programmes, and the European Union and the World Health Organisation can provide coordination and support.  相似文献   

10.

Background

Syphilis, a known major public health issue for soldiers during periods of conflict, is exacerbated in the Democratic Republic of Congo due to widespread sexual violence. However, there has been no previous study to determine the extent of this problem. Therefore, we determined the prevalence of syphilis among young demobilized soldiers.

Methods

Screening of syphilis using the rapid plasma reagin test and the Treponema pallidum hemagglutination assay was conducted in three transit sites of soldier reintegration in 2005. The Fisher Exact probability test was used to compare results.

Results

The prevalence of syphilis was found to be 3.4%, with almost equal distribution in respect to sex, location.

Conclusion

Syphilis continues to be highly prevalent in demobilized child soldiers in Eastern Congo. Syphilis screening tests are recommended.  相似文献   

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