Making life better: Monitoring the wider social determinants of health and well being - key indicators 2015

This report monitors progress against the key indicators of Northern Ireland’s public health strategy ‘Making Life Better’ launched by the Department of Health, Social Services & Public Safety (DHSSPS) in 2014. In addition to presenting the revised baseline positions for each of the key indicators of the framework, the report also monitors progress against each indicator by comparing the latest position with the baseline.

Falls and the Social Isolation of Older Adults in the National Health and Aging Trends Study

Thesis (Ph.D.)--University of Washington, 2016-08

Structured professional judgement approach to risk assessment: generalisability across patient groups for the prediction of adverse outcomes in secure mental health care

This is a redacted version of the the final thesis. Copyright material has been removed to comply with UK Copyright Law.

INTERNATIONAL EDUCATION & RESEARCH FOR OH. Experiences of international networks for collaborative education and research using the One Health approach.

The Authors describe first-hand experiences carried out within the framework of selected International projects aimed at developing collaborative research and education using the One Health (OH) approach. Special emphasis is given to SAPUVETNET, a series of projects co-financed under the EU-ALFA program, and aimed to support an International network on Veterinary Public Health (VPH) formed by Veterinary Faculties from Latin-America (LA) and Europe (EU). SAPUVETNET has envisaged a series of objectives/activities aimed at promoting and enhancing VPH research/training and intersectoral collaboration across LA and EU using the OH approach, as well as participating in research and/or education projects/networks under the OH umbrella, namely EURNEGVEC-European Network for Neglected Vectors & Vector-Borne Infections, CYSTINET-European Network on Taeniosis/Cysticercosis, and NEOH-Network for Evaluation of One Health; the latter includes expertise in multiple disciplines (e.g. ecology, economics, human and animal health, epidemiology, social and environmental sciences, etc.) and has the primary purpose of enabling quantitative evaluation of OH initiatives by developing a standardized evaluation protocol. The Authors give also an account of the ongoing creation of OHIN-OH International Network, founded as a spin-off result of SAPUVETNET. Finally, some examples of cooperation development projects characterised by an OH approach are also briefly mentioned.

The Theory of Social Representations in Brazilian Health Researches: a Bibliometric Profile

The study aimed to characterizing the production of national articles on health, the time frame of the past 10 years, available in the database LILACS and MEDLINE Virtual Health Library that used the Theory of Social Representations in its searches, using as descriptors the words: social representations and health. It is a descriptive study, developed in the context of ibliometrics. Of the 158 units found, 122 were considered and analyzed after removal of those that did not include the stablished inclusion criteria: articles in Portuguese,available in full and that mentioned the expression "social representations", either in the title or abstract. The journal that most published researches about the Theory of Social Representations was Science & Public Health; being the largest number of articles published in 2011. The most frequent area of knowledge covering about the Theory of Social Representations was the Public Health, with the participant group most cited health professionals. Among the data collection instruments used, the semi-structured interview was the most frequent and the kind of qualitative analysis the content analysis was the most common. Noteworthy is the growing interest for the theory and the need for greater criteria in the preparation of abstracts, considering its importance in the spread of scientific production.

Formação de profissionais de saúde no Brasil: uma análise no período de 1991 a 2008

Estudo conduzido com o objetivo de contribuir para o planejamento e implementação de políticas de qualificação profissional no campo da saúde. Foram analisados 14 cursos de graduação da área da saúde: biomedicina, ciências biológicas, educação física, enfermagem, farmácia, fisioterapia, fonoaudiologia, medicina, medicina veterinária, nutrição, odontologia, psicologia, serviço social e terapia ocupacional, no período de 1991 a 2008. Dados sobre número de ingressantes, taxa de ocupação de vagas, distribuição de concluintes por habitante, gênero e renda familiar foram coletados a partir dos bancos do Ministério da Educação. Para o curso de medicina, a relação foi de 40 candidatos por vaga nas instituições públicas contra 10 nas privadas. A maioria dos ingressantes era composta por mulheres. A região Sudeste concentrou 57% dos concluintes, corroborando o desequilíbrio de distribuição regional das oportunidades de formação de profissionais de saúde e indicando a necessidade de políticas de incentivo à redução dessas desigualdades.

Stress at Work among Electric Utility Workers

In the last decades there was an increase in stress at work and its effects on workers' health. These issues are still little studied in the electric utility sector. This study aims to evaluate factors associated with stress at work and to verify its associations with health status among workers of an electric company in Sao Paulo State, Brazil. A cross-sectional study was conducted with 474 subjects (87.5% of the eligible workers). Data were collected using self-reported questionnaires. A descriptive analysis, a multiple linear hierarchical regression analysis and a correlation analysis were performed. The majority of participants were males (91.1%) and the mean age was 37.5 yr. The mean score of stress level was 2.3 points (scale ranging from 1.0 to 5.0). Hierarchical multiple analyses showed that: regular practice of physical activities (p=0.025) and individual monthly income (p=0.002) were inversely associated with stress level; BMI was marginally associated with the stress level (p=0.074). The demographic characteristics were not associated with stress. Stress at work was significantly associated with physical and mental health status (p<0.001). To improve health of electric utility workers, actions are suggested to decrease stress by remuneration and an appropriate practice of physical activity aiming reduction of BMI.

Living with osteoarthritis: Patient expenditures, health status, and social impact

Objective. To determine out-of-pocket expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. Methods. A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded. Results. Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. Conclusion. Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.

Who supports? The providers of social support to dual-parent families caring for young children

Previous research points to the importance of both kin and non-kin ties within social networks as sources of social support. This study examines the kin and non-kin providers of specific types of support to dual-parent low-income Australian families caring for young children. The study highlights the importance of family and friends as support providers. Study Participants tended to rely on family, including parents, siblings and other family members, and friends for emotional and information support. Parents also tended to provide material and practical support. While neighbors and community agencies offered some emotional and information support, overall, these sources were minimal. (C) 2002 Wiley Periodicals, Inc.

Psychologists as mental health case managers

The results of two independent surveys of professionals working in government-funded adult community mental health services were examined with a view to considering how psychologists rate their capacities as mental health case managers. Professional competency and personal efficacy self-report profiles for psychologists were compared with those of other professionals in related roles. The results obtained suggested that psychologists identified their strengths as being in traditional practice roles as individual clinicians. Relative to other professions, psychologists reported weaknesses in team and community-focused practice roles. The implications for professional practice and training are discussed.

The impact of night work on subjective reports of well-being: an exploratory study of health care workers from five nations

OBJECTIVE: To carry out a survey data collection from health care workers in Brazil, Croatia, Poland, Ukraine and the USA with two primary goals: (1) to provide information about which aspects of well-being are most likely to need attention when shiftwork management solutions are being developed, and (2) to explore whether nations are likely to differ with respect to the impacts of night work on the well-being of workers involved in health care work. METHODS: The respondents from each nation were sorted into night worker and non-night worker groups. Worker perceptions of being physically tired, mentally tired, and tense at the end of the workday were examined. Subjective reports of perceived felt age were also studied. For each of these four dependent variables, an ANCOVA analysis was carried out. Hours worked per week, stability of weekly work schedule, and chronological age were the covariates for these analyses. RESULTS: The results clearly support the general proposal that nations differ significantly in worker perceptions of well-being. In addition, perceptions of physical and mental tiredness at the end of the workday were higher for night workers. For the perception of being physically tired at the end of a workday, the manner and degree to which the night shift impacts the workers varies by nation. CONCLUSIONS: Additional research is needed to determine if the nation and work schedule differences observed are related to differences in job tasks, work schedule structure, off-the-job variables, and/or other worker demographic variables.

Beyond the income inequality hypothesis and human health: a worldwide exploration

OBJECTIVE: To analyze whether the relationship between income inequality and human health is mediated through social capital, and whether political regime determines differences in income inequality and social capital among countries. METHODS: Path analysis of cross sectional ecological data from 110 countries. Life expectancy at birth was the outcome variable, and income inequality (measured by the Gini coefficient), social capital (measured by the Corruption Perceptions Index or generalized trust), and political regime (measured by the Index of Freedom) were the predictor variables. Corruption Perceptions Index (an indirect indicator of social capital) was used to include more developing countries in the analysis. The correlation between Gini coefficient and predictor variables was calculated using Spearman's coefficients. The path analysis was designed to assess the effect of income inequality, social capital proxies and political regime on life expectancy. RESULTS: The path coefficients suggest that income inequality has a greater direct effect on life expectancy at birth than through social capital. Political regime acts on life expectancy at birth through income inequality. CONCLUSIONS: Income inequality and social capital have direct effects on life expectancy at birth. The "class/welfare regime model" can be useful for understanding social and health inequalities between countries, whereas the "income inequality hypothesis" which is only a partial approach is especially useful for analyzing differences within countries.

Free-trade agreements: challenges for global health

In this study new free-trade agreements are discussed, which are based on the breaking down of tariff and technical barriers and normally exclude most of the poorest countries in the world. Considering the current context of economic globalization and its health impacts, seven controversial points of these treaties and their possible implications for global public health are presented, mainly regarding health equity and other health determinants. Finally, this research proposes a greater social and health professionals participation in the formulation and discussion of these treaties, and a deeper insertion of Brazil in this important international agenda.