[Health promoting in hospitals. The German network of health promotion in hospitals needs a new accent].
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During the last decade there has been a new orientation in public health policies. The question of prevention is gaining importance and has assumed social and political dimensions alongside the traditional medical issues. In future the public health service will increasingly recognise the value of an interdisciplinary approach, as was emphasised in a Resolution by the 64th German State Health Ministers' Conference. The need for cooperation and coordination in important future fields of action--especially the area of Self-Help--is presented as a major challenge for the Public Health Department. Details are given on the new requirements in terms of organisation, staffing and facilities.
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The ultimate objective of the successful aging paradigm is to improve the quality of life among the elderly. Although the aging process is currently immutable, primary care providers can modify the pathology and mitigate the expression of disease through prevention and treatment. Avoiding disease and disability, maintaining mental function and maintaining physical function are cornerstones of this approach. Recommendations about eating right, eating less, and exercising more are to make , but they are not easy to adopt for geriatric patients. Our elderly patients need far more physician mentoring and guidance in order to attain the goal of a healthier and higher quality of life that is implied by strategies for successful aging.
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A realistic aim for a preventive programme is to reduce dental plaque to levels compatible with rates of progression of periodontal disease which will allow functional and aesthetically and socially acceptable dentitions to be maintained throughout life. Since tooth cleaning is mainly influenced by socialization, and most people do brush their teeth, the objective of health education is to improve the effectiveness of oral hygiene behaviour. However, most dental health education programmes, whether directed at individuals or groups, are based upon an incorrect concept. Instead of attempting to change the commonly used scrub technique, encouragement should be given to use the scrub method more effectively. Oral health should be integrated with programmes dealing with general hygiene and grooming; a diversity of approaches and maximal participation by the community, individuals and professionals should be encouraged. The dentist/hygienist-centred strategy is not likely to be effective in reducing periodontal disease at a community level. Social and educational strategies directed at groups are more likely to be useful. Programmes should concentrate on educating significant individuals in the community, educating educators and educating the dental team. The programme should be continuous and low key and refrain from victim-blaming exhortations to clean teeth with devices of questionable usefulness.
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