Public Health Psychology: A Conceptual and Practical Framework

Introduction For many years concern for public health has transcended the boundaries of the medical sciences and epidemiology. For the last 50 years or so psychologists have been increasingly active in this field. Recently, psychologists have not only begun to see the need to take action to mould health promoting behaviours in individuals, but have also pointed out the need to join in an effort to develop appropriate social, political, economic and institutional conditions which would help to improve the state of public health. Psychologists have postulated the need to distinguish a new subdiscipline of psychology called public health psychology which, together with other disciplines, would further the realization of this goal. In the following article the historical and international context of health psychology and the changing nature of public health are put forward as having important implications for the establishment of a ‘public health psychology’. These implications are addressed in later sections of the article through the description of conceptual and practical framework of public health psychology in which theory, methods and practice are considered. Many aspects of the conceptual and practical framework of public health psychology have relevance to the health social sciences more generally and forming a basis for interdisciplinary work. The framework of public health psychology, together with the obstacles that need to be overcome, are critically examined within an overall approach that contends it is necessary to increase and improve the contribution of health psychology to public health.

Population health planning and health promotion: Opportunities and challenges to improve social determinants

Complex social factors and health issues challenge equitable health outcomes for many people, in particular those living in marginalised communities. Primary health care promises solutions through population health and health promotion approaches to improve social conditions (determinants) affecting health with emphasis on change at systems levels. Yet short-term efficiency focus policy decisions without long-term planning can undermine the effectiveness of primary health care. The workshop goal is to explore opportunities and share ideas about population health planning in Primary Health Networks and other community health care settings, so as to draw out opportunities, challenges and forward thinking health planning and health promotion strategies.

Patient decision aids in routine maternity care: Benefits, barriers, and new opportunities

Background and aim Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. Discussion A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing campaigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. Conclusions The potential of social marketing campaigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation.

Food Literacy: Key Concepts for Health and Education

Globally, the food system and the relationship of the individual to that system, continues to change and grow in complexity. Eating is an everyday event that is part of everyone’s lives. There are many commentaries on the nature of these changes to what, where and how we eat and their socio-cultural, environmental, educational, economic and health consequences. Among this discussion, the term "food literacy" has emerged to acknowledge the broad role food and eating play in our lives and the empowerment that comes from meeting food needs well. In this book, contributors from Australia, China, United Kingdom and North America provide a review of international research on food literacy and how this can be applied in schools, health care settings and public education and communication at the individual, group and population level. These varying perspectives will give the reader an introduction to this emerging concept. The book gathers current insights and provides a platform for discussion to further understanding and application in this field. It stimulates the reader to conceptualise what food literacy means to their practice and to critically review its potential contribution to a range of outcomes.

Young Children and the Environment : Early Learning for Sustainability

This world-first text book on early childhood edcuation for sustainabilty tackles one of the biggest contemporary issues of our times - the changing environmment - and demonstrates how early education can contribute to sustainable living. An essential text for students in early childhood teacher education and a practcial resource for child care practitioners and primary school teachers, it is designed to promote edcuation for sustainabilty from birth to eight years. the text refers to national and international initiatives such as 'sustainable Schools', 'Child Friendly Cities' and 'Health Promoting Schools' and explores their existing and potential links with early childhood education. Groundbreaking content draws on recent literature in the areas of organisational, educational and cultural chnage, and environmental sustainabilty. Specific chapters explore ethical challenges and the use of ICT to advance learning. Case studies and vignettes exemplify leadership in practice and 'provocations' are integrated throughout to inspire new ways of thinking about the environment, the wider world, young children and the transformative power of early edcuation.

Somatoform and dissociative disorders

• The somatoform disorders are psychiatric illnesses that present as physical disorders. • The somatoform disorders are not to be confused with malingering, which is the intentional production of symptoms to avoid some responsibility or duty. • Somatisation is a method of expressing anxiety and distress and is found in all cultural groups. • The distress and suffering experienced by clients with a somatoform disorder are real, although the medical basis for their symptoms is not. • Clients with a somatoform disorder are most frequently encountered in primary health care settings. • The dissociative disorders are marked by an abrupt, temporary change in consciousness, cognition, memory, identity or behaviour.

Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission : a randomised controlled trial

Objective: During hospitalisation older people often experience functional decline which impacts on their future independence. The objective of this study was to evaluate a multifaceted transitional care intervention including home-based exercise strategies for at-risk older people on functional status, independence in activities of daily living, and walking ability. Methods: A randomised controlled trial was undertaken in a metropolitan hospital in Australia with 128 patients (64 intervention, 64 control) aged over 65 years with an acute medical admission and at least one risk factor for hospital readmission. The intervention group received an individually tailored program for exercise and follow-up care which was commenced in hospital and included regular visits in hospital by a physiotherapist and a Registered Nurse, a home visit following discharge, and regular telephone follow-up for 24 weeks following discharge. The program was designed to improve health promoting behaviours, strength, stability, endurance and mobility. Data were collected at baseline, then 4, 12 and 24 weeks following discharge using the Index of Activities of Daily Living (ADL), Instrumental Index of Activities of Daily Living (IADL), and the Walking Impairment Questionnaire (Modified). Results: Significant improvements were found in the intervention group in IADL scores (p<.001), ADL scores (p<.001), and WIQ scale scores (p<.001) in comparison to the control group. The greatest improvements were found in the first four weeks following discharge. Conclusions: Early introduction of a transitional model of care incorporating a tailored exercise program and regular telephone follow-up for hospitalised at-risk older adults can improve independence and functional ability.

The influence of fatalistic beliefs on risky road use behavior in developing countries

There is little discussion of fatalism in the road safety literature, and limited research. However, fatalism is a potential barrier to participation in health-promoting behaviours, particularly among the populations of developing countries and to some extent in developed countries. Many people still believe in divine discretion and magical powers as causes of road crashes in different parts of the world. Fatalistic beliefs and beliefs in mystical powers and superstition appear to influence perceptions of crash risk and consequently lead people to take risks and neglect safety measures. Fatalistic beliefs may cause individuals to be resigned to risks because they cannot do anything to reduce these risks.

Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

Estimation on the mortality and disease burden attributed to selected risk factors in Shandong province [山东省主要危险因素的归因死亡和疾病负担分析]

Objective: To determine the major health related risk factors and provide evidence for policy-making,using health burden analysis on selected factors among general population from Shandong province. Methods: Based on data derived from the Third Death of Cause Sampling Survey in Shandong. Years of life lcrat(YLLs),yearS Iived with disability(YLDs)and disability-adjusted life years(DALYs) were calculated according to the GBD ethodology.Deaths and DALYs attributed to the selected risk factors were than estimated together with the PAF data from GBD 2001 study.The indirect method was employed to estimate the YLDs. Results: 51.09%of the total dearlls and 31.83%of the total DALYs from the Shandong population were resulted from the 19 selected risk factors.High blood pre.ure,smoking,low fruit and vegetable intake,aleohol consumption,indoor smoke from solid fuels,high cholesterol,urban air pollution, physical inactivity,overweight and obesity and unsafe injections in health care settings were identified as the top 10 risk faetors for mortality which together caused 50.21%of the total deaths.Alcohol use,smoking,high blood pressure,Low fruit and vegetable intake, indoor smoke from solid fuels, overweight and obesity,high cholesterol, physical inactivity,urban air pollution and iron-deficiency anemia were proved as the top 10 risk factors related to disease burden and were responsible for 29.04%of the total DALYs. Conclusion: Alcohol use.smoking and high blood pressure were determined as the major risk factors which influencing the health of residents in Shandong. The mortality and burden of disease could be reduced significantly if these major factors were effectively under control.

Prevalence of malnutrition risk and its relationship with risk factors of hospital re-admission in older adults

Background: Risk of malnutrition in older people continues to be a global problem. Malnutrition is often unrecognized and under-treated across health care settings and may result in undesirable health consequences, impaired recovery from illness and a poorer quality of life. Aim: This study aimed to determine the prevalence of malnutrition risk in a sample of older people at high risk of hospital re-admission. The association between risk factors of hospital re-admission and risk of malnutrition were also explored. Methods: One hundred and twenty five hospitalised patients aged 65 years and older at risk of hospital readmission (24% male, 76% female, mean age 77 ± 6 years) were recruited from a tertiary metropolitan hospital in Australia. The valid and reliable Malnutrition Screen Tool (MST) was employed to screen for malnutrition risk. It consists of two questions related to recent weight loss and appetite. Results: Prevalence of older adults at risk of malnutrition was 27.4%. Risk of malnutrition was not associated with age, gender and living arrangement. However, among risk factors of hospital readmission, lack of social support (χ2 = 4.18, N = 125, p = 0.028), and fair –poor self-rating of health (χ2 = 4.13, N = 125, p = 0.042) were statistically significant associated with risk of malnutrition. Conclusion: Risk of malnutrition in older people continues to be a concern in health care, and increasing psycho social support may help shed light on reducing risk of malnutrition.

Locomotor activation by theacrine, a purine alkaloid structurally similar to caffeine : involvement of adenosine and dopamine receptors

Purine compounds, such as caffeine, have many health-promoting properties and have proven to be beneficial in treating a number of different conditions. Theacrine, a purine alkaloid structurally similar to caffeine and abundantly present in Camellia kucha, has recently become of interest as a potential therapeutic compound. In the present study, theacrine was tested using a rodent behavioral model to investigate the effects of the drug on locomotor activity. Long Evans rats were injected with theacrine (24 or 48 mg/kg, i.p.) and activity levels were measured. Results showed that the highest dose of theacrine (48 mg/kg, i.p.) significantly increased locomotor activity compared to control animals and activity remained elevated throughout the duration of the session. To test for the involvement of adenosine receptors underlying theacrine's motor-activating properties, rats were administered a cocktail of the adenosine A₁ agonist, N⁶-cyclopentyladenosine (CPA; 0.1 mg/kg, i.p.) and A(2A) receptor agonist 2-p-(2-carboxyethyl)phenethylamino-5'-N-ethylcarboxamidoadenosine (CGS-21680; 0.2 mg/kg, i.p.). Pre-treatment with theacrine significantly attenuated the motor depression induced by the adenosine receptor agonists, indicating that theacrine is likely acting as an adenosine receptor antagonist. Next, we examined the role of DA D₁ and D₂ receptor antagonism on theacrine-induced hyperlocomotion. Both antagonists, D₁R SCH23390 (0.1 or 0.05 mg/kg, i.p.) and D₂R eticlopride (0.1 mg/kg, i.p.), significantly reduced theacrine-stimulated activity indicating that this behavioral response, at least in part, is mediated by DA receptors. In order to investigate the brain region where theacrine may be acting, the drug (10 or 20 μg) was infused bilaterally into nucleus accumbens (NAc). Theacrine enhanced activity levels in a dose-dependent manner, implicating a role of the NAc in modulating theacrine's effects on locomotion. In addition, theacrine did not induce locomotor sensitization or tolerance after chronic exposure. Taken together, these findings demonstrate that theacrine significantly enhances activity; an effect which is mediated by both the adenosinergic and dopaminergic systems.

Fatalism and its implications for risky road use and receptiveness to safety messages : a qualitative investigation in Pakistan

Given the increasing vehicle numbers and expanding road construction in developing countries, the importance of safe road user behaviour is critical. Road traffic crashes (RTC) are a significant problem in Pakistan, however the factors that contribute to RTC in Pakistan are not well-researched. Fatalistic beliefs are a potential barrier to the enhancement of road safety, especially participation in health-promoting and injury prevention behaviours, and also contribute to risk-taking. Fatalistic beliefs relating to road safety have been found in some developing countries, although again research is scarce and indicates that the nature and extent of fatalism differs in each country. Qualitative research was undertaken with a range of drivers, religious orators, police and policy makers to explore associations between fatalism, risky road use and associated issues. Findings indicate that fatalistic beliefs are pervasive in Pakistan, are strongly linked with religion, present a likely barrier to road safety messages and contribute to risky road use. Fatalism appears to be a default attribution of RTC and the intensity of belief in fate surpasses the kinds of fatalism noted in the limited existing literature. These findings have importance to developing road safety countermeasures in countries where fatalistic beliefs are strong.

Achieving safe road use in a rapidly motorising country : The influence of longstanding beliefs on risky driver behaviour in Pakistan

Road crashes are one of the most significant public health problems in Pakistan; however the factors that contribute to road crashes in Pakistan are not well-researched. Traditional beliefs and values can act as a barrier to health-promoting and injury prevention behaviours, in general and especially in relation to road safety, and may also contribute to risk-taking behaviours. Such beliefs can present significant challenges for health advocates who aim to change behaviour in order to avert road crashes and diminish their consequences. Qualitative research was undertaken in Islamabad, Rawalpindi and Lahore with a range of drivers, religious orators, police and policy makers to explore cultural and religious beliefs and their association with risky road use, and to understand how they might affect development of road safety interventions. The findings highlight a range of issues, including the identification of aspects of beliefs that have complex social implications when designing safety intervention strategies. The pervasive nature of religious and superstitious beliefs in Pakistan can affect road user behaviour by reinforcing the presumption that the individual has no part to play in safety, thereby supporting continued risk taking behaviour. It is anticipated that the findings could be used to inform the design of interventions aimed at influencing broad-spectrum health attitudes and practices among the communities where such beliefs are prevalent.