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PubMed1981

A reappraisal of the extent of world hunger.

The variation between different estimates of the magnitude of the world food problem are enormous. The author questions the basis of the major surveys of FAO, the World Bank, and USDA, and suggests that they have grossly overestimated the extent of world hunger. By analyzing the connection between population, food, and economic participation, a more realistic view is obtained, suggesting a return to targeted assistance programs for the improvement of maternal and child health.

Conservation of Natural Resources↗
PubMed2005

The importance of evidence-based disaster planning.

Disaster planning is only as good as the assumptions on which it is based. However, some of these assumptions are derived from a conventional wisdom that is at variance with empirical field disaster research studies. Knowledge of disaster research findings might help planners avoid common disaster management pitfalls, thereby improving disaster response planning. To illustrate the point, this article examines several common assumptions about disasters, compares them with research findings, and discusses the implications for planning. These assumptions are that: 1. Dispatchers will hear of the disaster and send emergency response units to the scene. 2. Trained emergency personnel will carry out field search and rescue. 3. Trained emergency medical services personnel will carry out triage, provide first aid or stabilizing medical care, and--if necessary--decontaminate casualties before patient transport. 4. Casualties will be transported to hospitals by ambulance. 5. Casualties will be transported to hospitals appropriate for their needs and in such a manner that no hospitals receive a disproportionate number. 6. Authorities at the scene will ensure that area hospitals are promptly notified of the disaster and the numbers, types, and severities of casualties to be transported to them. 7. The most serious casualties will be the first to be transported to hospitals. The current status and limitations of disaster research are discussed, and potential interventions to response problems are offered that may be of help to planners and practitioners and that may serve as hypotheses for future research.

Disaster Planning↗
PubMed2006

Appropriate use of estrogen replacement therapy in adolescents and young adults with Turner syndrome and hypopituitarism in light of the Women's Health Initiative.

Adolescents and young adult females who are hypoestrogenic need gonadal hormone therapy for sexual development, enhancement of growth, and maintenance of reproductive tissues, cyclic menses, and psychosocial health. In addition, prevention of chronic disease, specifically bone loss and possibly early heart disease, needs to be addressed in these patients. The etiology of hypopituitarism should also be considered when evaluating therapeutic options. The issues concerning estrogen replacement therapy (ERT), including the doses used and the length of therapy, are different for young patients than for postmenopausal women. The highly publicized findings of the Women's Health Initiative have identified risks of combined progestin-estrogen therapy; these risks, found in much older women, have raised questions regarding the appropriateness of ERT in adolescents with hypopituitarism and Turner syndrome. It is therefore appropriate to examine the relative risks and benefits of ERT in these populations.

Adolescent↗
PubMed2006

Implementing holistic practices in mental health nursing: a national consultation.

BACKGROUND: A national consultation exercise was held as part of a review of mental health nursing in England. OBJECTIVES: To gather views as to how best to develop mental health nursing to support a holistic approach to care, taking into account psychological, physical social and spiritual needs. DESIGN: National open consultation by email over a 3-month period. PARTICIPANTS: 326 written replies were received. The largest group of responses was from National Health Service (NHS) organisations (n=92, 28.2%); 69.9% of responses were from groups or organisations (n=225). METHODS: A consultation document was devised by a national reference group, including four questions relating to the development of practice in the four domains of: psychological, physical, social and spiritual care. RESULTS: The majority of responses supported mental health nurses (MHNs) providing psychological therapies (n=271, 95.1%). To support this happening, responders most frequently described a need for appropriate specialist training post-registration (n=114). To improve physical well-being of service users, the most frequent suggestion was that MHNs should promote healthy lifestyles, e.g. by encouraging physical activity and advising on ways to reduce illicit drug, alcohol and tobacco use (n=152). Responders most frequently cited the need for MHNs to understand resources to support social inclusion (n=110), e.g. knowing how to access local resources, benefits, housing and employment advice. MHNs were most frequently seen as requiring appropriate training to help them support spiritual/religious needs (n=96). CONCLUSIONS: The consultation was successful in obtaining views, in particular, of organisations and groups. These subsequently influenced national recommendations made by the Chief Nursing Officer's Review of Mental Health Nursing.

Attitude of Health Personnel↗
PubMed2005

Charting a course for health services research at the National Institute on Drug Abuse.

Through research, we continue to develop and refine an array of safe and efficacious interventions to prevent and treat drug abuse; however, these interventions have not led to widespread improvements in prevention and treatment services in nonresearch settings. In addition, investigator-initiated research rarely examine or refine interventions that practitioners have found relevant and that are widely practiced. To address these problems, the National Institute on Drug Abuse convened a blue ribbon task force to examine its health services research program. The report served as a catalyst for the institute to promote a vigorous program of research that seeks to examine prevention and treatment intervention delivery systems and policies that facilitate provision of effective care in a range of real world settings. Findings from this research should help address the translational bottleneck of bringing evidence-based interventions into the community.

Health Planning Guidelines↗
PubMed2006

From passive subject to active agent: the potential of Citizens' Juries for nursing research.

The nursing profession needs to have a greater appreciation of how techniques such as Citizens' Juries can be used in nursing research. This paper explains the concept of Citizens' Juries and how it is being used as a form of social research, that can simultaneously increase public participation in policy making. Participation has become a key component of the discourse in policy making, and public participation initiatives can be one way of bridging the democratic deficit. For nursing, Citizens' Juries offer a way of discovering lay people's considered judgment on key policy issues, while also providing a potentially powerful platform for citizens to express their concerns and priorities, thereby influencing the services they receive. A Citizens' Jury brings together a small group of people over a period of time and presents them with a policy question. The jurors listen to expert witnesses, examine the evidence, deliberate on the issues and arrive at a policy decision or set of recommendations. In this paper we argue that any ordinary person given the opportunity, enough time and the necessary resources can make decisions about complex policy matters. Key findings from two Citizens' Juries on genetics in Wales are offered as case studies.

Committee Membership↗
PubMedDate not supplied

The content of prenatal care. Update 2005.

INTRODUCTION: The Content of Prenatal Care report of the US Preventative Health Service (USPHS) Expert Panel established an important benchmark when published in 1989, but has not been significantly updated since that time. METHODS: The literature since 1989 is reviewed to assess which recommendations have been validated and/or implemented. Additionally, new findings that support the recommendations put forth or expand the scope of prenatal care outlined in the 1989 report are examined and discussed. RESULTS: The USPHS recommendation of a reduced prenatal visit schedule has support, and new content for the preconception visit has been identified, although this preconception visit has not been validated or widely implemented. CONCLUSIONS: We identified new opportunities and initiatives for the content of prenatal care, particularly improvement in the electronic medical record, attention to multidisciplinary approaches to patient education and improved patient literacy, and an extended maternal life span approach, including postgestation visits.

Benchmarking↗
PubMed2005

"Back to sleep": parents compliance with the recommendation on the most appropriate sleeping position of infants, Haifa District, Israel, 2001.

BACKGROUND: In 1993, the Israel Ministry of Health issued a formal recommendation to avoid placing healthy infants to sleep in the prone position in order to prevent sudden infant death. The objective of the study was to study parents' compliance with this recommendation and to identify characteristics of noncompliant parents of infants aged less than 6 months old. METHODS: The study population consisted of 1912 parents of infants aged 0-12 months who visited the Haifa District primary preventive health centers during the study week and answered the self-administered questionnaire. RESULTS: 15.6% of infants younger than 1 year were placed to sleep in the prone position: 12.4% among infants younger than 3 months, and 17.6% among infants 3-6 months old. Surprisingly, multiple logistic regression analysis demonstrated that Israeli-born Jewish mothers were more likely to place their babies prone than Israeli-born Arab mothers or mothers born in the former Soviet Union who had immigrated to Israel after 1990. CONCLUSIONS: At-risk behaviors are usually associated with minority and immigrant populations. Culture specific and other possible reasons for our unusual findings are discussed.

Adult↗