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PubMed2006

Sanitary and phytosanitary measures and food safety: challenges and opportunities for developing countries.

Because of fast-growing demand, export markets can absorb high value added products and offer high returns; for many developing countries export market development is thus a key requirement for rural income generation and rural growth. Although developing countries face increasingly strict sanitary and phytosanitary standards in their export markets, they can maintain and improve market access--and improve domestic food safety and agricultural productivity--by adopting a strategic approach to food safety, agricultural health and trade. High-income countries should increase development flows to help developing countries build the capacity to plan and execute the necessary strategies. The first proposal in this paper is to make two existing sets of guidelines widely available to interested parties, in particular through the World Bank and the World Organisation for Animal Health (OIE). The first covers the broad process of problem assessment, strategy development and action plan formulation; the second set deals with institutional analysis and training of staff of the official sanitary control services. The second proposal is that interested countries and donors should speed up the ongoing development of guidelines, computer software tools and training material to help countries quantify the importance and impact of food safety issues. The focus here is on a 'multipurpose agricultural data analysis and modelization system'. The third proposal is to carry out a case study to help demonstrate that a number of animal health issues related to food safety should be treated as relating to 'global public goods' and thus require intervention on a global scale. Possible candidates are foot and mouth disease and highly pathogenic avian influenza.

Agriculture↗
PubMed2006

Local health departments and the challenge of chronic disease: lessons from California.

The essential role local health departments have played in the control of infectious diseases has not been matched with an equivalent contribution in prevention of chronic diseases. Local health departments have attempted to define and build that capacity, but they have been confronted with budget cuts and competing public health priorities, most notably bioterrorism preparedness. This article is based on interviews with local health officials and describes some of the common ways local health departments in California have forged ahead to develop the capacity to engage in comprehensive approaches to chronic disease prevention in spite of the challenges. Additionally, the article highlights future considerations that need to be addressed if these promising trends in chronic disease prevention are to become more widespread.

California↗
PubMed1991

Demonstration projects for the integrated prevention and control of noncommunicable diseases (INTERHEALTH programme): epidemiological background and rationale. INTERHEALTH Sterring Committee.

Noncommunicable diseases--cardiovascular and cerebrovascular disease, pulmonary diseases, liver disease, cancer, diabetes, osteoporosis and trauma--constitute the major cause of death in developed countries and are predictably emerging as significant threats to health in countries at intermediate stages of the epidemiological transition. Based on the philosophy that diseases with common risk factors (inadequate prevention/control services, smoking, fat/salt diet, alcohol use, etc.) require common preventive strategies, the INTERHEALTH demonstration projects are designed to build regional capacities and to exchange social and medical technologies for broad-gauged noncommunicable disease prevention and control. Projects are at various stages of planning and implementation in all WHO regions: Africa (Mauritius, United Republic of Tanzania); the Americas (Chile, Cuba, United States); Eastern Mediterranean (Cyprus); Europe (Finland, Malta, USSR); South-East Asia (Sri Lanka, Thailand); the Western Pacific (Australia, China, Fiji, Japan). This article presents selected data which illustrate the long-term mortality trends and present noncommunicable disease risk-factor levels in participating countries at different stages of the epidemiological transition. The shift towards noncommunicable diseases as a cause of death is readily apparent and combinations of risk factors are present in each of the populations studied in the baseline phase of this research and demonstration programme. The use of data to estimate the noncommunicable disease-related mortality burden from different lifestyles and risk factors is illustrated and findings from the most advanced demonstration studies are briefly outlined.

Global Health↗
PubMed1982

Hygienic condition of marine waters and sediments in the Gulf of Naples.

Faecal indicators of pollution were analysed in water and sediment samples which were collected in stations located in the gulf of Naples. Results showed the generalised build-up capacity typical of the sediments. Analyses stressed the extent of the pollution in the gulf: sediments might be polluted also in zones where the overlying waters remained faecally uncontaminated.

Feces↗
PubMedDate not supplied

Transferability of electro-convulsive shock induced short term memory impairment by brain homogenates in rats.

Six rats were subjected to a series of five electro-convulsive shocks. Their brain extracts were injected intraperitoneally into six other rats trained to perform a short term memory task. They showed a significant short term memory impairment after twentyfour hours and fortyeight hours and also, a difficulty in learning the task. The controls which consisted of rats injected with brain extracts of rats not subjected to any fits showed good memory trace and capacity to build up their memory. In this connection a new single-trial technique for short term memory was devised and standardised based on rat-trap principle and avoidance of unpleasant experience. Further, it was noticed that rats subjected to direct fits ate less and consumed less water. Those injected with brain homogenates of convulsed rats however, seemed not to deviate from the normal.

Animals↗
PubMedDate not supplied

Legislative Cardiovascular Health Check: a multidisciplinary health promotion experience for South Carolina lawmakers.

The South Carolina Department of Health and Environmental Control has conducted a Legislative Cardiovascular Health Check for the past 4 years. The primary purpose of the event, held in the lobby of the State Capitol Building, is to increase the awareness of State legislators about the leading causes of death in South Carolina and about community-based health promotion services that are available. The health check emphasizes the relationship between modifiable risk factors and the development of heart disease, cancer, and stroke. These legislative events are organized by State health department staff members, but they are conducted by local health department personnel from throughout South Carolina. This approach is intended to build the capacity of these local staff members to communicate more effectively with their legislators and to carry out similar events at the county or community level. The health check is staffed by a trained multidisciplinary team, including persons designated as legislative liaisons. The liaison people contact legislators prior to the event and provide them with health status data specific to their respective districts. The Legislative Cardiovascular Health Checks have been attended by members of the General Assembly and their staffs, members of the Governor's staff and the Lieutenant Governor's office, and other employees of the State Capitol. An average of 380 people have participated annually. Screening activities have included blood pressure and blood cholesterol checks, with risk factor counseling and educational materials provided to each screened participant. During the past year, activities were expanded to include a variety of interactive exhibits related to nutrition, exercise, and smoking. Feedback from participants has been positive. The Legislative Cardiovascular Health Check is encouraged and supported by the upper management of the State health department and is now established as an annual event of mutual benefit to legislators and to State and local health department staff members.

Blood Pressure↗
PubMed1993

Addressing Arkansas' rural primary care challenges.

Universal health coverage may become a reality by the year 2000 and implies a greater need for primary care physicians in rural Arkansas in the 21st century. We can start this decade to build the capacity for an outstanding rural primary care system for the next century. The number of rural primary care physicians can be increased by 1) placing a high priority on recruiting more students to primary care, 2) improving the attractiveness of rural practice, and 3) improving the long-term financial viability of rural primary care. The quality of rural primary care will be greatly influenced by changes in information technology. Medical outreach activities from urban centers to rural communities and changes in rural medical infrastructures will be necessary as we approach the year 2000.

Area Health Education Centers↗
PubMed1997

The role of health services research in the renaissance of the dental profession.

Health services research may play a critical role in achieving the recommendations of the IOM study. Toward this end, the field of health services research is defined. Applications of health services research to health outcomes, patient care, and other IOM directives are reviewed. Alternative approaches to building the capacities of dental schools to conduct health services research are presented.

Dental Health Services↗
PubMed1997

Child health services research. Challenges and opportunities.

The characteristics of childhood as a unique developmental stage of life, the continuity of child health with adult health, and a distinctive child health care system justify a separate focus of health services research on children. Child health services research (CHSR) currently lacks the tools necessary to monitor the impact of health system change on children's health and health care and to compare the effectiveness of alternative treatment modalities. There is an urgent need to build the research capacity of this field of inquiry. Ignoring or minimizing attention to CHSR is both shortsighted and ultimately costly for families and the entire nation. We present arguments for why children merit a separate focus in health services research, identify factors that have led to the failure of appropriate development of CHSR, and offer a set of strategies for how to build the research capacity of the field.

Child↗
PubMed2005

International School Health Network: an informal network for advocacy and knowledge exchange.

In Canada, researchers, policy-makers and non-governmental organisations have re-conceptualized the school setting as being an ecological entity, linked to parallel ecologies of the homes and the community it serves. The school, public health and other systems that seek to deliver programs in that setting are open, loosely coupled and bureaucratic. This reconceived view of the school as a setting for health promotion leads to an emphasis on building organizational, system, professional and community capacity. One of the most effective ways of building such capacities when resources are scarce is to invest in a variety of formal and informal networks that can sustain themselves with little or no external resources. A number of recognised researchers from the health and education sectors have emphasized this systems-based approach and the need to build supportive, small-scale networks or learning communities. In recent health promotion research, networking at various levels, across sectors and within communities is viewed as a key strategy within new, more effective health promotion strategies. In education, the notion of networking for educational change has been described as "learning communities" for continuous school improvement. The authors suggest that this strategy of networking be used at the international level to address several global challenges: There is no single, convenient way to obtain basic information about the status and nature of national and state/provincial school health programs around the world. There is no global research agenda in school health promotion, despite the obvious value of sharing such research and knowledge. There is no global mechanism to facilitate the development of common or shared tools for surveillance of child/youth health and monitoring of school health policies and programs, despite the excellent work being done in individual countries and by the European Network of Health Promoting Schools. There is no international mechanism with a focus on school health that brings together the following stakeholders: educational organisations with public health organisations; researchers with government officials and practitioners; those who work in Spanish, English, French and other languages; issue-specific networks with health generalists. An invitation is given to government officials, researchers and national school health associations to join an informal International School Health Network (ISHN) (soon available at: www.internationalschoolhealt.org). Discussions about the formation of the ISHN have been held with a number of participants at several international meetings and have culminated in a fledgling network that will focus on electronic and web-based exchanges of information, developing a global school health research agenda, exchanging effective materials and tools, informing policy-makers about effective practices, policies and programs. This network would build on and not duplicate the work of existing networks and include participation from WHO, OECD, UNESCO, the IUHPE and the World Bank. The next large meeting of the ISHN will occur at the IUHPE 2007 Conference in Vancouver, Canada (www.iuhpe conference.org). Before then the ISHN will organise several on-line projects and teleconferences. For more information, contact dmccall@jcsh-cces.ca.

Communication↗
PubMed2005

The CDRC principles of international health research.

The Comprehensive Drug Research Center (CDRC) at the University of Miami was established in the early 1970s. Through the decades, investigators from the CDRC have worked with investigators from several countries to establish joint research efforts. Countries often do not have the infrastructure or monetary resources to carry out research on their own. Collaborating with institutions in these countries to build a sustainable capacity for research is a worthwhile and satisfying endeavor, and it presents a method for initiating research and building the necessary research structures. However, working with other countries presents a unique set of challenges and ethical dilemmas. This article presents some of the specific challenges encountered in these research efforts and describes what we have done to resolve the problems and work more effectively and efficiently with foreign investigators.

Biomedical Research↗
PubMed2001

The Saskatchewan dissemination story.

The Saskatchewan Heart Health Program (SHHP) Dissemination Phase "Building Health Promotion Capacity" is a five-year program funded by Health Canada, Saskatchewan Health and the Heart and Stroke Foundation of Saskatchewan. This phase began in July 1998 and builds on two previous SHHP phases: the provincial heart health survey (Saskatchewan Health, 1990), and the community demonstration projects (SHHP, 1998a, b, c, d). The evolution of the SHHP has occurred in a dynamic provincial context. Saskatchewan is a Canadian prairie province of one million people with most living in the southern and central parts of the province. The population is ageing and urbanizing, and the economy is shifting away from agricultural production toward a diversified service sector. In 1993, health reform created 30 Districts in southern and central Saskatchewan; the formation of three northern Districts followed five years later. All but two Districts are rural-based. Population served ranges from 2,261 to 237,274; total area ranges from 4,019 to 133,900 square kilometers.

Cardiovascular Diseases↗
PubMed2005

Project Employ: engineering hope and breaking down barriers to homelessness.

The homeless population in the US has dramatically increased in the past two decades. People who are homeless often lack skills sets such as stress management and social skills, independent living skills, and skills for vocational and leisure engagement. Best practice vocational education and training programs for individuals who are homeless recognize that success in the worker role often hinges on a person's capacity to manage day-to-day living. Life skills and pre-employment training are essential components of vocational programs but no more important than interpersonal skill development including anger management, developing self esteem and motivation, building goal setting capacity, and skills for money management, personal budgeting and self-advocacy. These areas of performance have all been traditionally included in occupational therapy's domain of practice. This article describes Project Employ, a grant funded supportive employment program that has grown out of collaboration between Duquesne University's Department of Occupational Therapy and Bethlehem Haven, an emergency shelter and residential recovery program and primary service provider for homeless people in Pittsburgh, Pennsylvania. The purpose of this article is to describe the history, structure and outcomes of Project Employ.

Community Health Services↗
PubMed2006

Understanding surge capacity: essential elements.

As economic forces have reduced immediately available resources, the need to surge to meet patient care needs that exceed expectations has become an increasing challenge to the health care community. The potential patient care needs projected by pandemic influenza and bioterrorism catapulted medical surge to a critical capability in the list of national priorities, making it front-page news. Proposals to improve surge capacity are abundant; however, surge capacity is poorly defined and there is little evidence-based comprehensive planning. There are no validated measures of effectiveness to assess the efficacy of interventions. Before implementing programs and processes to manage surge capacity, it is imperative to validate assumptions and define the underlying components of surge. The functional components of health care and what is needed to rapidly increase capacity must be identified by all involved. Appropriate resources must be put into place to support planning factors. Using well-grounded scientific principles, the health care community can develop comprehensive programs to prioritize activities and link the necessary resources. Building seamless surge capacity will minimize loss and optimize outcomes regardless of the degree to which patient care needs exceed capability.

Bioterrorism↗
PubMed2002

Building complementary and alternative health care research capacity: workshop report.

Lack of research into the safety and efficacy of CAM has been identified as a barrier to collaboration between conventional and CAM practitioners. As an initial step to address this issue, Health Canada held an invitational roundtable discussion with researchers, practitioners and policy makers to explore specific issues related to CAM research capacity and literacy. The objectives of this workshop were to identify and prioritize CAM research infrastructure and training needs; and to identify strategies for meeting high priority needs. Eleven individuals representing three CAM groups, university-based researchers with experience in CAM research, and policy makers attended. Discussion focussed around research literacy, capacity, funding and leadership. Several recommendations were made including an advisory group, a needs assessment, support for research networks, development of learning modules, a review of existing research programmes, support for centres of excellence in CAM research, and funding for research meetings.

Canada↗