Economics and health promotion

Health promotion activities consume a growing proportion of health sector spending in most developed countries. Yet, there is still considerable debate in the non-economic literature about exactly what health promotion constitutes and precisely how its role is to be conceived. This paper provides one economic answer to such questions. It sets out an argument that health promotion may be viewed, through the lens of traditional welfare economics, as a response to problems of market failure. A Grossman-type health investment model is invoked to analyse individual deviations from equilibrium and the possible instruments and targets of health promotion policy. The paper concludes by suggesting some of the alternative conceptual approaches that might be brought to bear, as well as some ideas for empirical research.

The WOMAC knee and hip osteoarthritis indices: Development, validation, globafization and influence on the development of the AUSCAN hand osteoarthritis indices

Clinical measurement in both clinical research and clinical practice requires tools and techniques that are valid, reliable and responsive. Patient-centred self-reported measures provide opportunity to evaluate consequences of osteoarthritis, that are important and relevant to patients with the condition. The WOMAC and AUSCAN Indices are health status measurement questionnaires that are valid, reliable and responsive, easy to complete, simple to score and available in multiple language forms and scaling formats. They provide opportunities to capture patient relevant information, relating to the impact of interventions, in clinical research and clinical practice environments. WOMAC data have also contributed to the development of proposed definitions for responder criteria and state-attainment criteria in osteoarthritis.

ICP-MS Trace Element Analysis of Song Dynasty Porcelains from Ding, Jiexiu and Guantai kilns, North China

Bodies of Ding kiln white porcelains and their imitations from Guantai and Jiexiu kilns of the Chinese Song dynasty (960-1279 AD) were analysed for 40 trace elements by inductively coupled plasma mass spectrometry (ICP-MS). Numerous trace element compositions and ratios allow these visually similar products to be distinguished, and a Ding-style shard of uncertain origin is identified as a likely genuine Ding product. In Jiexiu kiln, Ding-style products have trace element features distinctive from blackwares of an inferior quality intended for the lower end market. Based on geochemical behaviour of these trace elements, we propose that geochemically distinctive raw materials were used for Ding-style products of a higher quality, which possibly also underwent purification by levigation prior to use. Capable of analysing over 40 elements with a typical long term precision of < 2%, this high precision ICP-MS method proves to be very powerful for grouping and characterising archaeological ceramics. Combined with geochemical interpretation, it can provide insights into the raw materials and techniques used by ancient potters. (C) 2004 Elsevier Ltd. All rights reserved.

Working with involuntary clients: Perceptions and experiences of outreach social workers in Hong Kong

The outreach social work service is one of the dominant youth work approaches in dealing with delinquents and youths 'at-risk' in Hong Kong. Yet this approach presents particular challenges. Outreach social workers usually play an active role in initiating and establishing contacts with young people, yet young people are reluctant to engage with the outreach social workers and are resistant towards therapeutic change. To date, little is known about what strategies and techniques are most effective in dealing with client resistance in this context. The aims of this paper are to gain a better understanding of the common resistant behaviours that outreach social workers usually encounter in their day-to-day practice, and to investigate how the outreach social workers respond to their clients' resistance with reference to case examples given in the in-depth interviews. The findings of this study provide evidence that whilst client resistance is common in the outreach social work setting, social workers' patience as well as sensitivity are essential in resolving resistance and building up a rapport with clients.