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Mapping national capacity to engage in health promotion: overview of issues and approaches discount fosamax amex womens health danbury ct. Multiplying health gains: the critical role of capacity-building within health promotion programs best buy for fosamax women's health center presbyterian hospital. Paper presented at meeting organised by the Directorate General for Health & Consumers; 2011 buy generic fosamax on line women's health center hershey pa. National standards for culturally and linguistically appropriate services in health care. Health Communication Unit at the Centre for Health Promotion, University of Toronto. Community-acquired pneumonia mortality: a potential link to antibiotic prescribing trends in general practice. Advocacy for poverty eradication and empowerment: ways forward for advocacy impact assessment. The challenge of assessing advocacy: strategies for a prospective approach to evaluating policy change and advocacy. One key definition is offered for each term although a multiplicity of definitions exists in many instances. The definitions that are used reflect the use of the term in the context of the project. Crisis communication: a spontaneous and reactive process, often occurring in unexpected emergency situations [2-6]; messages are based on what is known and not known about a current state or condition (for example, its magnitude, immediacy, duration, control, cause, blame, consequences) . E-health: e-health is the transfer of health resources and healthcare by electronic means. It encompasses three main areas, including the delivery of health information (for health professionals and health consumers) through the internet and telecommunication . Emerging diseases: one that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or geographic range . Epidemic: the occurrence in a community or region of cases of an illness, specific health-related behaviour, or other health-related events clearly in excess of normal expectancy . Evaluation: the systematic application of research procedures to understand the conceptualisation, design, implementation, and utility of interventions [11, 12]. Process evaluation: where campaign exposure and target audience feedback is monitored to inform any necessary mid-point campaign improvements [12-14]. Implementation evaluation: monitors the fidelity of the programme or technology delivery . Outcome evaluation: investigates whether the programme or technology caused demonstrable effects on specifically defined target outcomes . Impact evaluation: assess the overall or net effects (intended or unintended) of the programme or technology as a whole . Formative evaluation: helps to guide campaign development by gaining a deeper understanding of the values, attitudes, and beliefs of the target population [1, 11, 14]. Cost effectiveness evaluation: seeks to determine the costs and effectiveness of surveillance and response strategies and activities. It can be used to compare similar or alternative strategies and activities to determine the relative degree to which they will obtain the desired objectives or outcomes. The preferred strategy or action is one that has the least cost to produce a given level of effectiveness, or provides the greatest effectiveness for a given level of cost . Hard-to-reach: is a term sometimes used to describe those sections of the community that are difficult to involve in public participation . Health advocacy: a combination of individual and social actions designed to gain the political commitment, policy support, social acceptance and systems support for a particular health goal or programme . Health communication: the use of mass and multimedia and other technological innovations to disseminate useful health information to the public; health communication increases awareness of specific aspects of individual and collective health as well importance of health in development . Health education: health education comprises consciously constructed opportunities for learning, involving some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health . Health literacy: the degree to which individuals have the capacity to obtain, process and understand the basic health information and services needed to make appropriate health decisions . Health outcomes: a change in the health status of an individual, group or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status . Health promotion: a combination of educational, political, regulatory, and organisational supports for actions and conditions for healthy living of individuals, groups, or communities . Issues management: an organisation’s formulation of strategic plans and actions based on predictions of future trends . Mass communication: the dissemination of specified information to large sectors of the public through the mass media . Media relations: an organisation’s efforts to work with the media to inform the public of its policies and messages, with the aim of fostering credibility . Message source and credibility: the plausibility and reliability of communicators and the ideas they propagate through various channels, as observed and interpreted by receivers. Source trustworthiness and expertise have an impact on the receivers’ likelihood of persuasion . Online health consumer and health seekers: in the context of studies on health information seeking online, ‘health consumers’ can be broadly defined as patients, patients’ friends/relatives, and citizens in general ; ‘health seekers’ have been defined as ‘internet users who search online for information on health topics, whether they are acting as consumers, caregivers or e-patients’ [6, 22]. Organisational performance: a measure of an organisation’s actual results compared to its goals or objectives . Personalised communication: communication which in some way aims to make a personally relevant appeal to individuals, for example using direct contact or individually addressed correspondence . Public health: refers to all organised measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases . Risk: an evaluation of the probability of occurrence and the magnitude of the consequences of any given hazard, i. Risk analysis: the process of identifying, defining and analysing potential threats and uncertainties that may adversely affect the public. Risk communication: engaging communities, including those who could be negatively affected, in discussions about environmental and other health risks and about approaches to deal with them . Science communication: aims to promote awareness and generate positive opinions towards the related science . Segmentation: the communicative process of targeting specific messages to a particular group of individuals rather than the public at large . Social marketing: the application of marketing theories and techniques to the planning, implementation, and evaluation of programmes and interventions to influence pro-social voluntary behaviour change in order to improve personal welfare, and the welfare of society . Stakeholder management: the process of identifying and engaging with stakeholders (individuals or organisations who are affected by an outcome) to help an organisation to achieve its strategic goals . Sustainability: [health promotion actions] that can maintain their benefits for communities and populations beyond their initial stage of implementation.
Ideally effective fosamax 70mg pregnancy apps, these values should be derived from cross-country correlation of uncertainty 70mg fosamax with amex menstrual bleeding icd 9. The broad pat- empirical data among representative populations (Salomon terns of the uncertainty ranges for causes across regions and others 2003) purchase 70 mg fosamax fast delivery womens health zone link health. Numerous challenges are associated with provide useful additional guidance to policy makers in population-based data collection for the purpose of health interpreting regional differences, particularly in judging state valuations, particularly given the broad scope of valua- which policy questions these estimates can help address tions required for a comprehensive assessment of disease and for which the uncertainty levels are too great to allow burden. Note: Cross-country correlations in uncertainty distributions for countries without vital registration data were varied from 0 percent (left-hand bar) to 25 percent (middle bar) and 50 percent (right-hand bar) for each region. The logit transformation is valuations to overall uncertainty in burden of disease esti- given by logit(x) ln[x (1 x)]. We speciﬁc sequelae requires an understanding of (a) the distri- chose a value of 0. Although the single index value that captures the overall level of health variability in country means may reﬂect a range of different associated with a given health state (Salomon and others factors, including the possibility of real valuation hetero- 2003). A constant value in logit space yields absolute comparisons, computing disability weights based on an ranges that widen at the midpoint of the interval and nar- average global valuation function is the most appropriate row as the disability weight approaches 0 or 1 (ﬁgure 5. The need to under- In relative terms, the uncertainty is greatest for the smallest stand variation in the distribution of health states among disability weights and narrows as more severe weights are people living with given sequelae highlights the critical link attained (ﬁgure 5. Given that the current set of dis- (for the 622 sequelae included in the calculations). For each ability weights reﬂects the accumulation of a wide array of of the sequelae we applied a given sampled value as a perturba- different empirical inputs rather than the result of the tion of all age, sex, and region estimates of logit-transformed comprehensive and standardized approach deﬁned earlier as the ideal, we operationalize our analysis of uncertainty in terms of error around the disability weights by sequelae 1. Among the other top 10 causes, the Disability weight disability weight uncertainty could change the rankings of Source: Authors’ calculations. This method implies the sim- to zero, particularly for health states with high prevalence in plifying assumption that errors are uncorrelated between many populations, such as mild to moderate sense organ sequelae but perfectly correlated for all estimates within a impairment or mild to moderate anemia. These assess- considerable uncertainty in case fatality rates for most low- ments took into account not only typical levels of measure- and middle-income countries and in models used to infer ment error in the input data sets, but also expert judgment the burden of nonfatal disease from mortality. Thesummarytablesprovidedinchap- cent to 90 percent, with a median value of 41 percent. A full uncertainty analysis of such burden older age groups; estimates has not yet been carried out, but would involve • uncertainty associated with estimating joint effects of assessment of the following additional types of uncertainty: risk factors. In one taxonomy,risk assessment uncertainty can mortality and incidence associated with speciﬁc expo- be divided into parameter uncertainty and model uncertainty Sensitivity and Uncertainty Analyses for Burden of Disease and Risk Factor Estimates | 421 (National Research Council 1994). Parameter uncertainty is of available data, such risk factors were represented using often quantiﬁable using random variable methods, for exam- indirect or aggregate indicators, for instance, smoking impact ple, uncertainty due to sample size or measurement error. Furthermore, for some risks multiple data causal relationships or the form of the exposure-response sources allowed limiting the range of exposure estimates. For relationship (for instance, threshold versus continuous or example, in the absence of alcohol surveys, information linear versus nonlinear), the level of bias in measurement, on total alcohol production, trade, and unrecorded con- and so on. Deﬁned broadly, model uncertainty also includes sumption provided upper bounds on the fraction of the pop- extrapolation of exposure or hazard from one population to ulation that would be in the highest consumption category. Model uncertainty dominates uncertainty in risk Finally, some of the risk factors examined in chapter 4 were assessment, a result of difﬁculty in carrying out direct stud- represented using continuous exposure variables such as high ies on exposure, hazard, and background disease burden. Others used categorical variables, for This has motivated innovative assumptions and extrapola- example, indoor smoke from household use of solid fuels, tions even in the case of the most widely studied risk factors childhood underweight, and physical inactivity, even though like smoking (Peto and others 1992). This choice Uncertainty around disease causation (Evans 1978; Hill reﬂected the availability of exposure data and hazard esti- 1965) was, in practice, secondary to uncertainty around haz- mates in categories. In such cases, the contribution to disease ard size, for example, relative risk, because when causality within the baseline category would not have been captured. Collective scientiﬁc level, approaching 100 percent asymptotically, that is, the knowledge from disciplines such as social and behavioral rate of increase declines with increasing relative risk or sciences, physiology and neuroscience, and epidemiology prevalence (ﬁgure 5. Therefore, if a risk factor or group would conﬁrm the possibility of a causal relationship in the of risk factors individually or jointly account for large foregoing cases, but would shift the uncertainty to hazard size. As a result, for some risk factors, we could only quantify the contribution to a subset of disease outcomes because 1. Chapter 6 subject to uncertainty, which varies across risk factors and presents some empirical evidence in making the case for a geographical regions. For further discussion of sources and stronger form of age weighting for infants and younger chil- quantiﬁcation of uncertainty for speciﬁc risk factors see dren, that is, age weights that depart further from unity than Ezzati and others (2004). The validity and reliability, and duration of life lived with the sequelae of diseases and hence the utility, of burden of disease studies for public injuries, and some quantiﬁcation of the severity of disability policy depend much more strongly on the quality and avail- assessed according to a common framework. The major effect of discounting and age comprehensive set of causes of death and disability results in weighting is to enhance the importance of neuropsychiatric estimates that are much less likely to be biased than those conditions and sexually transmitted infections. While disease that emerge from an examination of speciﬁc health condi- rankings are relatively unaffected, the share of the burden tions in isolation. It also avoids the tendency to assume that due to disability, the age distribution of the burden, and the if no data are available or the data are highly uncertain, then distribution of the burden by broad cause group are sensitive there is no disease burden. We maintain that providing large volumes of chronic diseases of older ages and somewhat less weight unsynthesized, biased, and incomplete data relating to pop- being given to mental disorders and injuries, which affect ulation health does not generally allow policy makers to younger adults disproportionately. However, they do give some indications that ing data from multiple studies or making adjustments for new evidence is becoming available for child deaths, and biases in relation to population, age groups, or time periods. The assessment of trends between 1990 and 2001 is tainty associated with extrapolating from a set of studies in a much more difﬁcult task, as discussed in chapter 2. The subpopulations to the regional population is related to comparability of best point in time estimates is difﬁcult to potential systematic (selection) biases and is much more dif- assess given changes in both the availability of data and in ﬁcult to quantify than the uncertainty associated with sto- the methods used to synthesize those data for many of the chastic variation due to sample size or measurement error. Murray, Mathers, and Salomon (2003) discuss this Estimates of deaths from speciﬁc causes undergo contin- issue in more detail and conclude that to assess change or ual revision as new data and syntheses become available, yet evaluate programs, extrapolating current levels of burden of drawing a time cutoff is a necessary (if somewhat arbitrary) disease from past measurements is inadequate, and that the condition for preparing any volume such as this which assessment must include measurements carried out at both reports comprehensive and consistent global and regional points in time or explicit measurement of the relevant estimatesof deathsandburdenof disease(seealsoannex6C). This has the advantage that the deaths by cause (Bryce and others 2005), based on recent effects of changing preferences can be readily explored comprehensive reviews of epidemiological data, these analy- through sensitivity analysis, as illustrated in this chapter. Another is the need for a more rational assess- sistency between incidence, prevalence and mortality esti- ment of priority data for the health care sector that places mates for speciﬁc causes. The level are differ substantially for tetanus (46% higher), lower burden of disease framework, based on the estimated distri- respiratory infections (56% higher), and are somewhat bution and duration of health states resulting from incident lower for measles, malaria, low birthweight and noncom- cases, would beneﬁt greatly from wider availability of linked municable diseases. It is not possible at this stage, to con- data sets on health outcomes and further longitudinal 424 | Global Burden of Disease and Risk Factors | Colin D. Salomon, Majid Ezzati, and others research into health state transition probabilities following base using novel methods that communicate what we do on from speciﬁc disease or injury causes (Kelman and Bass know, as well, if not more convincingly, than what we do not 2002). We might This uncertainty must be taken into account when making well take solace in the comments of a prominent medical cross-national comparisons, and needs to be carefully com- statistician who once cautioned that “Making the best the municated and interpreted by epidemiologists and policy enemy of the good is a sure way to hinder any statistical makers alike. The scientiﬁc purist who will wait for medical functioning vital registration systems for causes of death statistics until they are nosologically exact is no wiser than will always be substantially more uncertain than those Horace’s rustic waiting for the river to flow away” derived from systems where all deaths are registered and (Greenwood 1948, p. Despite the progress of the past decade, the incremental We wish to acknowledge stimulating discussions with and gains in advancing knowledge and understanding of global advice from Christopher J. Finally, we thank two referees for extremely lations (Murray, Lopez, and Wibulpolprasert 2004). Health intelligence is an essential ingredient Eastern Stroke and Coronary Heart Disease Collaborative Research Group.
No cheap fosamax uk menstruation returns after menopause, unless the child is not feeling well and/or Call your Healthcare Provider has diarrhea buy fosamax with paypal breast cancer tattoo design. Prevention Wash hands after using the toilet or changing diapers and before preparing food or eating discount 70mg fosamax with visa menopause in men. This usually occurs when the immune system is weakened for various reasons, including certain illnesses or conditions, or treatments, or aging. Although shingles usually occurs in adulthood, children who were infected with varicella in utero or during infancy may develop shingles during childhood. Clusters of blisters appear soon after, usually on one side of the body and closer together than in chickenpox. Shingles is a milder illness in children than in adults, but it can be a serious illness in those who have weakened immune systems. When people who have not had chickenpox have contact with the fluid from the shingles blisters, they can develop chickenpox. Persons with severe, disseminated shingles should be excluded regardless of whether the sores can be covered. Wash hands thoroughly with soap and warm running water after contact with fluid from blisters or sores. Getting varicella vaccine within 3 days, and possibly up to 5 days, of exposure may prevent chickenpox in these people. If you think your child Symptoms has Shingles: At first, your child may have a lot of pain and itching. Childcare and School: Spread No, if blisters can be covered with clothing or Shingles does not spread from person-to-person as bandage. If someone who has not had chickenpox in the past touches the fluid from the shingles blisters they may Yes, if blisters cannot be get chickenpox. When staph is present on or in the body without causing illness, it is called colonization. Because staph is so often present on skin, it is the leading cause of skin and soft tissue infections. Examples of localized infections are boils, impetigo, wound infections, and infections of hair follicles (folliculitis). Such infections can result in a pustule (bump on the skin filled with pus) that can become reddened, hard, and painful. Most infections are uncomplicated, but the bacteria can get into the bloodstream and other body sites and cause severe illness. A long delay may occur between colonization with staph and when the symptoms of infection begin. Activities: Children with draining sores should not participate in activities where skin-to-skin contact is likely to occur until their sores are healed. Childcare/school personnel should notify parents/guardians when possible skin infections are detected. Wash hands thoroughly with soap and warm running water after touching body secretions or skin drainage of an infected or colonized person. They should take care to keep their skin clean and dry and do first aid care when an injury (cut, scrape, etc. If you think your child Symptoms has a Staph Infection: Your child may have infected areas that are red and warm Thell your childcare with or without pus. Examples are boils, impetigo, wound provider or call the infections, and infections of hair follicles. This means that the bacteria may be there but it Childcare and School: does not cause infection or harm. Yes, if draining sores If your child is infected, the time it will take for symptoms to cannot be completely start will vary by type of infection. Contagious Period Activities: As long as the infection or colonization is present. A child Avoid activities where who has draining infections has more bacteria and is more skin-to-skin contact is contagious than a child who is only colonized. Put used bandages in a plastic bag, close the plastic bag, and put it in the trash. Wash clothes, bed sheets, and blankets in hot water with detergent and dry in a hot dryer. The rash appears most often on the neck, chest, elbow, and groin, and in the inner thigh and folds of the armpit. These illnesses are usually not serious; however, rare problems such as rheumatic fever (which can damage heart valves) or kidney disease may develop if children do not receive proper antibiotic treatment. Children without symptoms, regardless of a positive throat culture, do not need to be excluded from childcare or school. Persons who have strep bacteria in their throats and do not have any symptoms (carriers) appear to be at little risk of spreading infection to those who live, go to childcare or school, or work around them. Check with your local environmental health department to see if people with skin lesions need to be excluded from food handling. Strep may be identified in the throat either by using a rapid strep test, which can provide results the same day, or by throat culture. Treatment may be dependent on how severe the infection is and will help prevent more serious illness such as rheumatic fever. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth. If you think your child Symptoms has Strep Throat: Strep throat - Your child may have a fever that starts suddenly, red sore throat, and swollen glands. The rash is most often on the neck, Childcare and School: chest, elbow, and groin and in the inner thigh and folds of the armpit. Children who test Spread positive for strep but do not show symptoms do - By coughing or sneezing. They are unlikely to Contagious Period spread the infection to Until 24 hours after antibiotic treatment begins. Tularemia is also spread by infected meat and blood of animals such as rabbits and cat bites. Follow tick precautions: Wear light colored clothing, wear insect repellants, and do tick check of the full body every night after being in tick infested areas. The Centers for Disease Control and Prevention recommends that confirmation testing be done in addition to the screening test to ensure more accurate results. Wear long pants, tuck pants into socks, wear a long sleeved shirt tucked into pants, and wear light-colored clothing so ticks are easier to see. Always grasp the tick by the head or mouth parts and gently but steadily pull straight back. The risk of developing tuberculosis disease is highest during the 6 months after infection and remains high for 2 years; however, many years can elapse between initial tuberculosis infection and tuberculosis disease.