Search results

Primary care (PC) is a strong determinant of overall health care. Children make up around a fifth of the population of the European Union and European Economic Area and have their own needs and uptake of PC. However, there is little research into how well PC services address their needs. There are large differences in childhood mortality and morbidity patterns in the EU and EEA countries, and there has been a major epidemiological shift in the past half century from predominantly communicable disease, to non-communicable diseases presenting and increasingly managed in PC. This increase in multifactorial morbidities, such as obesity and learning disability, has led to the need for PC systems to adapt to accommodate these changes. Europe presents a challenging picture of unexplained variation in health care delivery and style and of children’s different health experiences and health-related behaviour. The Models of Child Health Appraised (MOCHA) project aimed to describe the PC systems in detail, analyse their components and appraise them from a number of different viewpoints, including professional, public, political and economic lenses. It did this through nine work packages supported by a core management team, and a network of national agents, individuals in each MOCHA country who had the expertise in research and knowledge of their national health care system to answer a wide range of questions posed by the MOCHA scientific teams.

The study examined the utilisation patterns of healthcare services among tea garden workers and analysed the factors influencing utilisation in an Indian context.

The authors employed a mixed-method approach and an explanatory sequential design for the study. A survey was conducted in the beginning followed by in-depth interviews in a north-eastern state of India (Assam). Andersen health behaviour model was used to explore the factors influencing healthcare utilisation. The sample size for the survey and in-depth interviews were 300 and 19, respectively, recruited employing multistage random and purposive sampling techniques.

Out of 300 workers surveyed, 169 (56.3%) were females, 257 (85.7%) were married, 77 (25.7%) were illiterates and 229 (76.3%) had monthly household income less than 100 US$. The survey also found that 47.3% and 15.3% had non-communicable and communicable disease respectively. Most of the workers (67.3%) utilised government facilities, and close to one third (28.7%) utilised tea garden hospitals. About 63.3% had health insurance, but a majority (78.9%) did not use it previously. The analyses of interviews explored the need, enabling, predisposing factors under three important themes influencing utilisation of healthcare services among the workers.

The study generates evidence to strengthen the Indian Plantation Labour Act, 1951 for tea garden worker's welfare protection and warrants transition from colonial-era policies to contemporary industry realities in order to improve their living, employment, nutritional and health conditions.

The research adds to the existing literature on overall healthcare services utilisation (including coverage and utilisation of health insurance) among blue collar workers who usually lack access to healthcare facilities and explores important factors that determine utilisation in the Indian context.

In order to assess the state of health of Europe’s children, or to appraise the systems and models of healthcare delivery, data about children are essential, with as much precision and accuracy as possible by small group characteristic. Unfortunately, the experience of the Models of Child Health Appraised (MOCHA) project and its scientists shows that this ideal is seldom met, and thus the accuracy of appraisal or planning work is compromised. In the project, we explored the data collected on children by a number of databases used in Europe and globally, to find that although the four quinquennial age bands are common, it is impossible to represent children aged 0–17 years as a legally defined group in statistical analysis. Adolescents, in particular, are the most invisible age group despite this being a time of life when they are rapidly changing and facing increasing challenges. In terms of measurement and monitoring, there is little progress from work of nearly two decades ago that recommended an information system, and no focus on the creation of a policy and ethical framework to allow collaborative analysis of the rich anonymised databases that hold real-world people-based data. In respect of data systems and surveillance, nearly all systems in European society pay lip service to the importance of children, but do not accommodate them in a practical and statistical sense.

The purpose of this paper is to focus on ethical and judicial themes related to technology and the older adults.

Different consecutive phases in technology design and allocation will be discussed from a range of perspectives.

Longevity is one of the greatest achievements of contemporary science and a result of development of social relations. Currently, various non-communicable diseases affect older adults and impose the greatest burden on global health. There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for good quality of life (QOL). The concept of assisting the older adult through the use of technology so as to access healthcare services has enormous potential. Although the potential of technology in healthcare is widely recognised, technology use can have its downsides. Professionals need to be aware of the risks, namely, those related to the privacy of the older person, which may accompany technology use.

By 2050, there will be more people aged over 65 than there are children. This phenomenon of global ageing constitutes a massive challenge in the area of health protection.

Professionals need to be aware of the risks, for example, related to the privacy of the older person, that may accompany technology use.

There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for QOL.

The concept of assisting the older adult through the use of technology to avail of healthcare has enormous potential. Assistive technology, social media use and augmentative and alternative communication can have a positive effect on the QOL of older people, as long as they are supported enough in use of these technologies. However, ethical and juridical considerations are at stake as well.

The purpose of this research aimed to identify the risk factors for non-communicable diseases (NCDs) and determine their prevalence and characteristics in a semi-urban community in Thailand.

The survey was designed to determine the type and prevalence of risk factors for NCDs among populations in semi-urban areas in the Takianleurn subdistrict of Nakhonsawan, Thailand. A stratified random sampling design was used to select 352 subjects, aged over 15 years and living in this region. Data were collected by questionnaire and analyzed to show frequency, percentage, mean, standard deviation, chi-squared, prevalence rate and prevalence rate ratio with significance indicated by p-value < 0.05 and confidence interval 95 percent.

The implications for the future study are as follows: (1) a comparative study between rural and urban or rural and semi-urban or urban and semi-urban should be studied to understand how risk factors cause NCDs and (2) Participatory action research should be introduced to assess the effectiveness of the decrease in NCDs risk factors management in the community.

(1) To scale up public health interventions measures to promote and prevent NCDs should be focused on behavioral risk factors of NCDs such as eating habits, physical activity, smoking and alcohol consumption. (2) Health promotion and disease prevention for decrease in NCDs should consist of reducing alcohol consumption and enhancing healthy eating habits and (3) To manage unmodified risk factors such as age, gender, educational level, etc. should be focused on surveillance and physical health examination yearly.

The results revealed a prevalence of NCDs of 14.8 percent. The main unmodifiable risk factors affecting NCD prevalence were gender, age, low level of education and poverty; behavioral risk factors included not eating enough fruit and vegetables, high alcohol consumption, a high-fat fast-food diet and smoking.

The prevention of NCDs requires more focus on changing the eating behavior of high-risk groups and providing easily accessible health care information and services. The entire family should be involved in the process of maintaining good health and disease prevention for all family members.

The purpose of this paper is to investigate the trend of life expectancy in Bangladesh and find the effect of eliminating the causes of diseases on life expectancy statistics.

Data consisted of 1,530 deaths in 2000, 1,582 deaths in 2004 and 1,514 deaths in 2008 that were collected from the Health and Demographic Surveillance System of International Centre for Diarrheal Disease Research, Bangladesh. Trends in life expectancy after eliminating the cause of diseases were examined by a Single Decrement Life table.

The expectation of life for both male and female presented differing patterns. Results showed that life expectancies were greatly reduced in the presence of all groups of non-communicable diseases (NCDs) in the community, whilst life expectancies were significantly improved if all NCDs within all disease groups were completely eliminated. The life expectancies in the presence of NCDs showed lowest expected years among all the present diseases groups and the life expectancies eliminating NCDs showed highest expected years among all the eliminating diseases groups. The results indicated that 10.99 years of life would be added to life expectancy at birth for the male population and 8.82 years for the female population in 2008 if NCDs were eliminated.

The findings of this study provide useful information which could contribute to a more effective allocation of targeted funding for developing public health programs. Lowering mortality by eliminating major groups of diseases results in higher life expectancy ratings. Specifically, the relative impacts of eliminating cardiovascular diseases and respiratory diseases, as compared with eliminating neoplasms.

One of the priorities of the health system is community health promotion. In this regards, proper development of programs and plans is needed to create a responsive system which leads to health promotion. The aim of this study was to identify the requirements for developing non-communicable disease (NCDs) programs based on CIPP (context, input, process and product) model.

This is a qualitative study. Data were collected through semi-structured interviews with 40 experienced informants in the field of NCDs. The interviewees were selected bases on pre-determined criteria which then were completed by snowball sampling. Analysis was carried out using a content analysis approach that led to identifying program development requirements in four dimensions of context, input, process and product.

Twenty-nine requirements of developing program were categorized in four domains of context, input, process and product. These requirements comprised of pilot studies, the existence of appropriate needs assessment, evidence-based programs, promoting organizational culture, adequacy of resources, identification of stakeholders and comprehensive cooperation and existence of an appropriate evaluation system.

Since this study was performed through a qualitative method, it is possible, some prerequisites of program development may not be encountered. But the extreme effort has been made to perceive diversity and different aspects.

The first study was in the field of appropriate requirements for program development in the context of a centralized health system in a developing country.

This paper aims to review the known and anticipated medical geology problems in Ghana, to highlight the impact of some trace elements on human health and to reveal some essential aspects of medical geology on health.

Literature and empirical studies relating to medical geological issues in Ghana were reviewed. Secondary data were used in the present study such as case studies, reports, geological bulletins and published research studies.

High levels of heavy metals including arsenic, cadmium and mercury in gold extraction processes through artisanal small-scale mining have contributed to high concentrations of toxic elements in the environment. The distribution and availability of these elements in the environment are facilitated by the geological, chemical and local environmental activities that are irregularly spread exposing people mining areas to pollutions. Exposures to these elements in above and below baseline levels contributed to health implications including fluorosis, intellectual or developmental disability and death in some regions of Ghana. Cardiovascular and cerebrovascular diseases linked to mining activities were also presented in this study. Similarly, non-communicable diseases can affect many people if correct measures are not considered. Following the geometric increase in mining activities, it is anticipated that deleterious environmental and health impacts associated with mining may persist in mining areas in Ghana. Reported implications and continuous contamination of water bodies in mining areas could result in high pollution levels beyond treatment for human use or destroy aquatic habitats and aquatic lives through acid drainage. Above-threshold concentrations of heavy metals in soils could bio-accumulate in crops, and this could pose deleterious public health implications on consumers. Continuous effects posed on the environment and public health may prompt communities, regulatory institutions and government to reduce or ban mineral development.

This review has significantly revealed potential public health issues from the impact on the natural environment and recommends that medical geologists work together with medical workers to devise preventive and therapeutic techniques to address many geology-related-health issues in Ghana.

The purpose of this paper is to compare the outcome of a smoking cessation program based on the protection motivation theory and a brief intervention among Royal Thai Air Force (RTAF) officers, with non-communicable disease (NCD) risks.

This quasi-experimental study involved sixty RTAF officers, with NCD risks. The first 30 participants were assigned to a control group and the latter 30 to an experimental group. The control group received brief advice on quitting smoking while the experimental group took part in an eight-week motivational program. The primary outcome was biochemically verified seven-day point prevalence abstinence from smoking. A measurement of carbon monoxide (CO)<8 ppm in exhaled breath was considered indicative of abstinence.

Most participants were non-commissioned officers, with an age range of 21–59 years and a mean age of 38.27 years (SD=10.59). No significant difference in the Fagerström test for nicotine dependence scores between control and experimental groups was observed. The proportion of the participants reporting the seven-day point prevalence abstinence verified by exhaled CO was significantly higher in the experiment group than in the control group (20.0 percent vs 3.3 percent; p<0.05). Numbers of cigarettes per day decreased from 12.87±7.23 and 10.53 ± 7.45 at the baseline to 7.23 ± 5.90 and 8.83 ± 6.13 at the end of study in experimental and control group, respectively.

This motivation-based program to quit smoking had a promising outcome in terms of smoking abstinence and smoking reduction.

The purpose of this study was to define and outline areas prone to disease causing elements by analyzing the spatial distribution and concentration of toxic and essential elements in a section of the Voltaian sedimentary basin.

A total of 2,668 soil samples were analysed by the inductively coupled plasma mass spectrometry technique and were re-appraised by comparing with baseline values of elements accepted globally to be in soils. The concentrations of arsenic (As), chromium (Cr), iron (Fe) and magnesium (Mg) were evaluated. Factor analysis, hierarchical cluster analysis and principal component analysis multivariate techniques were used to identify the source patterns of the elements in the soils. The Getis-Ord Gi method was used to generate the optimised maps for these selected elements. These maps spatially defined and outlined high value clusters which imply potential pollution or areas with high background values (hotspots), whereas the low value clusters imply areas with low background values (cold-spots).

The multivariate analysis supports a dominant geogenic source of these heavy elements with obvious influences from variably metamorphosed mafic–ultramafic rocks known to have contributed to the deposition of sediments in the basin. The hotspots for As were located around Nalerigu and to the east of Nawchugu. A Cr hotspot was located to the east of Nawchugu with Cr cold-spots located within Nalerigu and Yunyuo. Fe hotspots were observed to the south of Nalerigu and the east of Nawchugu with Fe cold-spots around Yunyuo, Bongo-Da and Nagbo. The spatial maps demonstrated the presence of toxic and deficient areas of all the selected elements used in the investigation. Therefore, it suggested the likely health implications depending on the exposed elements, their pathways and recommended the usefulness of using the results displayed in the spatial maps to guide in devising appropriate remediation techniques.

This paper fulfils an identified need to study the distribution of elements and the possible effects it may have on the health and livelihoods of those residing in these areas.