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Dental programme for smoke-free promotion: attitudes and activities of dentists, hygienists, and therapists at training and 1 year later.

Dentists, hygienists, and therapists in Auckland, who had attended a training programme designed to discourage smoking in their patients, were surveyed to determine their current anti-smoking activities. After the training course, those surveyed were more aware of the importance of smoking-cessation counselling, and were taking a much more active role in such activities. The activities of dental therapists with child patients indicate that this is a potentially important addition to their health education role.

Adolescent↗

Who has a choice of health plans?

Policy makers are concerned that consumers have no voice in the changing health care system. They debate, however, whether the consumers' voice should be heard through regulation, such as patient protections, or the marketplace. For market forces to work in the consumers' interest, consumers must have a choice of plans and detailed information on which to base their choice. New survey data from the Center for Studying Health System Change (HSC) suggest that more consumers have a choice of plans than is generally believed, and that the proportion of consumers who have plan choice is increasing. According to HSC's 1998-1999 Household Survey, 64 percent of families have a choice of health plans--two percentage points higher than two years ago.

Choice Behavior↗

Acceptability of health status questionnaire screening and vaccination among Kosovar refugees.

During 1999, following the war in Kosovo, thousands of Kosovar refugees were received by different countries. The public health reception protocols for these refugees varied widely between and within reception countries. We surveyed a group of Kosovar refugees received in Bolton to assess the acceptability of vaccination and health status questionnaire screening. We also examined the refugees' opinions about the confidentiality of their medical history and their willingness to take part in research. Fifteen out of 29 people responded. Most respondents were happy with the interventions.

Adult↗

Reproductive health: conceptual and operationalization challenges.

This review article is a teaching material for those who are engaged in reproductive health (RH) service delivery, managers, policy makers, professionals and the RH community. It also aims at addressing the RH concept and indicates some of the operationalization modalities, challenges and attempts to promote the realization of RH and population programmes in the country. It has been shown time and again that even five years after the International Conference on Population and Development (ICPD), policy makers, administrators and service providers still lack an understanding of not only the integrated approach of RH services, but the concept of RH also. In addition, the majority poorly perceives the RH rights notion. It is imperative that issues like understanding of the integrated approach of RH services, ensuring the adequacy of the information or choices offered to women and emphasis on the quality of care offered to clients have to be addressed urgently and adequately. The conceptualization and operationalization of RH will require full understanding of the health, population and women policies, legal and institutional implications of these concepts and the actions needed to convert them into reality. In order to achieve better results, commitment not only of relevant governmental agencies but also by non-governmental organizations (NGOs) and the RH community is a prerequisite. This includes allocation of adequate resources and proper interpretation of the RH concept in the Ethiopian context.

Child↗

North Carolina's TBI project ACCESS. Assuring coordinated care, education, and support for survivors of pediatric brain injury.

Over the past three years, families, school staff, and healthcare personnel in our state have benefited from an innovative service delivery system designed to demonstrate that we can improve the lives of children with TBI. Project ACCESS has used hospital-based pediatric brain injury Community Transition Coordinators to identify, coordinate care, educate, support, and generally improve the lives of thousands of children with TBI. The project also uncovered a host of barriers that adversely affect the future of many of North Carolina's most vulnerable children. We hope that this article helps delineate the challenges faced by our state's healthcare and educational systems, and contributes to the adoption of a statewide model system of care for children with brain injury.

Adolescent↗

Improving influenza immunisation coverage in 2000-2001: a baseline survey, review of the evidence and sharing of best practice.

In May 2000 a new government target of 70% uptake in people aged 65 and over was introduced for influenza immunisation, with a minimum of 60% uptake in 2000-2001. A postal survey of influenza immunisation coverage in over 75 year olds during 1999-2000 was undertaken in our district's general practices. The evidence on interventions which improve coverage was compared to local practice. General Practitioners and their Primary Care Groups/Trust received feedback on their performance, and best practice was shared. The findings were used to inform the immunisation campaign for 2000-01. The survey response rate was 74%. The district coverage was 50%, ranging from 7% to 97% between practices. Practices achieving high coverage rates combined good patient identification with personalised patient invitation and well-organised clinics. The work that went on in the district achieved an overall influenza immunisation coverage of 62% in 2000-01.

Aged↗

[Cancer networks].

The complexity of legislation and the obstacle race run by all promoters in search of approval and funding for their projects could have greatly hindered the development of healthcare networks in France, or at least discouraged many promoter. Yet social and health professionals, along with certain healthcare service staff, considered these networks highly useful for decompartmentalising the French healthcare system. They would favour patient-oriented projects. It is not a surprise that the number of networks in the field of oncology is expanding rapidly, with more than 60 projects registered by public authorities by the end of 1999. Cancers are chronic diseases which often bring into play the patient's vital prognosis, as well as psychological and social consequences - sometimes dreadful - for patients and their relatives. Cancer patient management calls for a multidisciplinary approach in elaborating the therapeutic project and providing psychological support. Continuity and consistency of care require a partnership between different care providers from different specialities, with different medical practice and environments - hospital or home care, public or private practice. Though so much information has become available in the medical literature, quality of care demands that each healthcare professional keeps fully aware of the latest diagnostic or therapeutic findings and techniques in his/her field. Certain cancer networks have become a place where care providers and establishments can share methods and medical practice. Network promoters and members have thus been able to regain control over the functioning and the future of their profession. Patients have also obtained a place in decisions concerning their own health. Setting up healthcare networks will certainly shake up the tranquil system which the WHO has reported as the world's best health care system at the dawn of this century. However, this will also probably contribute to maintaining this excellence.

Ethics↗