人工流产与生殖健康及健康教育

人工流产是避孕失败后终止妊娠的有效措施[1] 。生殖健康是在生命所有阶段的生殖功能和过程中的身体、心理和社会适应的完好状态 ,而不只是无疾病或功能失调[2 ] 。健康教育是指通过一系列系统的、有组织、有计划的教育活动 ,促使人们自觉采纳有益于健康的行为和生活方式 ,消除或减轻影响健康的危险因素 ,预防疾病、促进健康、提高生活质量[3 ] 。我们知道 ,人工流产对妇女的生殖健康均有不同程度的影响。实施健康教育 ,可以消除或减轻这种影响。本文将从 3个方面论述三者之间的关系及影响过程。人工流产的现状人工流产 (简称人流 )虽说已被…     

Garnering Partnerships to Bridge Gaps Among Mental Health,Health Care,and Public Health

Integrating mental health and public health chronic disease programs requires partnerships at all government levels. Four examples illustrate this approach: 1) a federal partnership to implement mental health and mental illness modules in the Behavioral Risk Factor Surveillance System; 2) a state partnership to improve diabetes health outcomes for people with mental illness; 3) a community-level example of a partnership with local aging and disability agencies to modify a home health service to reduce depression and improve quality of life among isolated, chronically ill seniors; and 4) a second community-level example of a partnership to promote depression screening and management and secure coverage in primary care settings. Integration of mental health and chronic disease public health programs is a challenging but essential and achievable task in protecting Americans'' health.     

Enhancing Health Knowledge,Health Beliefs,and Health Behavior in Poland through a Health Promoting Television Program Series

This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 151 viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward health behavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors.     

Health Policy,Ethics, and the Kansas Legislative Health Academy

We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans.To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships.Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views.Health policy often elicits controversy. Recent examples include the uproar over recommendations for mammography screening for women 40 to 49 years old and human papillomavirus vaccination for adolescent girls and boys. Perhaps the most dramatic controversy relates to the passage of the Patient Protection and Affordable Care Act (Pub L No. 111-148); despite being signed into law in 2010 and found substantially constitutional by the US Supreme Court in 2012 (Medicaid expansion was made optional for states), this legislation remains subject to vigorous dissent. Such controversies, although no doubt a function of interest-driven politics, also reflect deep differences in ethical values.Ethical values and premises underpin all public policy.1,2 Ideas about individual liberty, personal responsibility, solidarity, justice, and the role of the government are just a few of the moral constructs that often clash in the making of policy. Policy analysis often ignores these dimensions of policy-making, although that is beginning to change.3–5Here we describe a project based in part on the premise that training policymakers to recognize and talk openly about the ethical values entailed in health policy might improve its content and process. This project, the Kansas Legislative Health Academy (hereafter Health Academy), brought together state legislators from across the political spectrum to build their capacity to respond to complex health policy challenges in Kansas. To that end, the curriculum sought to help legislators develop new skills in 3 areas: health policy ethics, systems thinking, and civic leadership. The Health Academy also sought to foster an environment of open, respectful dialogue and to build new cross-chamber and cross-party relationships.To our knowledge, the Health Academy is a unique program. Many educational programs exist for legislators to focus on leadership development or specific health policy issues, but none we are aware of are specifically designed to cover a broad range of health policy issues while also addressing underlying barriers to effective policy-making within legislative bodies. In what follows, we describe the Health Academy’s origins, structure, substance, and lessons learned.     

Obesity,Health at Every Size,and Public Health Policy

Obesity is associated with chronic diseases that may negatively affect individuals’ health and the sustainability of the health care system. Despite increasing emphasis on obesity as a major health care issue, little progress has been made in its treatment or prevention. Individual approaches to obesity treatment, largely composed of weight-loss dieting, have not proven effective. Little direct evidence supports the notion of reforms to the “obesogenic environment.” Both these individualistic and environmental approaches to obesity have important limitations and ethical implications. The low levels of success associated with these approaches may necessitate a new non–weight-centric public health strategy. Evidence is accumulating that a weight-neutral, nutrition- and physical activity–based, Health at Every Size (HAES) approach may be a promising chronic disease-prevention strategy.Obesity is defined as having a body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) in excess of 30. Obesity is associated with numerous chronic health conditions, including diabetes, hypertension, heart disease, and certain cancers.1 The directionality of such associations is largely unknown, confounding may be present, and causality has only definitely been assigned to obesity with respect to osteoarthritis and ovarian cancer.2 Despite these limitations, to counter the health effects of obesity-associated conditions, individuals frequently are encouraged to lose weight to improve individual and population health. However, diet-induced weight loss stimulates somatic and psychological ‘homeostatic pressures’ that induce weight regain.3 These mechanisms include hormonal alterations, reduced satiety and energy expenditure, and increased hunger.3,4 These adaptations stimulate weight regain in more than 90% of weight losers.5,6 In acknowledgment of the limited effectiveness of individual approaches to weight loss, increasing emphasis has been placed on environmental reforms. However, when weight loss is the key motivator of such changes, they are hindered by a limited evidence base and ethical difficulties. These concerns suggest public health would benefit from a shift in focus from weight loss to disease prevention for individuals of all ages and sizes, with a focus on health rather than weight-loss outcomes, and environmental reforms devoted to enhancing livability, accessibility, and equity. Evidence is accumulating that a weight-neutral, nutrition- and physical activity–based, Health at Every Size (HAES) approach may be a promising chronic-disease prevention, and overall well-being, strategy.     

Managed Care, School Health Programs, and Adolescent Health Services: Opportunities for Health Promotion

ABSTRACT: The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care — and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs     

Free Library of Health: Consumer Health Information,Health Literacy,and Library Programming in Philadelphia

In 2016, the Free Library of Philadelphia reopened the newly renovated South Philadelphia Library. This full-service neighborhood library is co-located with pediatric primary care services, a city-run health center, and a recreation center in a first-of-its-kind facility called the Community Health and Literacy Center. The South Philadelphia Library aims to improve health literacy in the community through the provision of consumer health information and health programming, and the co-location with health care and recreation services provides unique opportunities to partner and offer health-based library services. A community health librarian certified in consumer health information assists customers with accessing reliable health information, and health programming covers many areas of interest. Partnerships with nearby health organizations also allow the library to connect customers with vetted neighborhood services. By combining health services with traditional library programming, customers are able to increase their health literacy when they visit the library.     

Health Care Reform,Behavioral Health,and the Criminal Justice Population

The 2010 Patient Protection and Affordable Care Act (ACA) has a number of important features for individuals who are involved with the criminal justice system. Among the most important changes is the expansion of Medicaid to more adults. The current study estimates that 10% of the total Medicaid expansion could include individuals who have experienced recent incarceration. The ACA also emphasizes the importance of mental health and substance abuse benefits, potentially changing the landscape of behavioral health treatment providers willing to serve criminal justice populations. Finally, it seeks to promote coordinated care delivery. New care delivery and appropriate funding models are needed to address the behavioral health and other chronic conditions experienced by those in criminal justice and to coordinate care within the complex structure of the justice system itself.     

PrenWomen,Health, and Books

A new series of techniques has recently been developed, by which a pregnant woman can find out whether or not she carries a child with a neural tube defect. A fairly simple screening technique has now been put into effect in Nassau County, New York, by which 10 to 20 thousand pregnant women will be routinely tested in the next two years. As it is likely that this particular form of antenatal diagnosis will become more universally administered in this country, the matter of neural tube defects (NTD) is reviewed here.     

Women,Health, and Films

No abstract available for this article.     

Women,Health, and Books

A new series of techniques has recently been developed, by which a pregnant woman can find out whether or not she carries a child with a neural tube defect. A fairly simple screening technique has now been put into effect in Nassau County, New York, by which 10 to 20 thousand pregnant women will be routinely tested in the next two years As it is likely that this particular form of antenatal diagnosis will become more universally administered in this country, the matter of neural tube defects (NTD) is reviewed here.     

Women,Health, and Films

No abstract available for this article.     

Women,Health, and Films

No abstract available for this article.