Munchausen by internet: current research and future directions.

The Internet has revolutionized the health world, enabling self-diagnosis and online support to take place irrespective of time or location. Alongside the positive aspects for an individual's health from making use of the Internet, debate has intensified on how the increasing use of Web technology might have a negative impact on patients, caregivers, and practitioners. One such negative health-related behavior is Munchausen by Internet

Glu: An Online Type 1 Diabetes Information Community

This research paper examines the online health community Glu (MyGlu.org), a type 1 diabetes social media site. Type 1 diabetes is a chronic medical condition that requires constant and specialized medical attention. Online health communities like Glu, are an important part of maintaining a healthy lifestyle for many of its members. This study discusses the composition of this information community, the motivations of its members, and the benefits members gain through their participation. It describes the major characteristics of the community and focuses on the information needs of type 1 diabetics. It concludes with reflections on how libraries and LIS professionals can better serve the information needs of health communities like Glu and accommodate their needs in the physical space of the library

Chronic illness care for Aboriginal and Torres Strait Islander people: final report

This project engage a range of stakeholders across different levels of the primary health care system, including service providers, management, policy-makers and researchers and capture their knowledge on the barriers and enablers to addressing the identified priority-evidence practice gaps and their suggestions on strategies for improvement. Overview The purpose of this project is to engage key stakeholders in the use of aggregate continuous quality improvement (CQI) data to identify and address system-wide evidence-practice gaps in Aboriginal and Torres Strait Islander chronic illness care. We aimed to engage a range of stakeholders across different levels of the primary health care (PHC) system, including service providers, management, policy-makers and researchers and capture their knowledge on the barriers and enablers to addressing the identified priority-evidence practice gaps and their suggestions on strategies for improvement. Our research has highlighted the wide variation in performance between different aspects of care and between health centres. While many aspects of care are being done well in many health centres, there are important gaps between evidence and practice in some aspects of PHC. System-wide gaps are likely to be due to deficiencies in the broader (PHC) system, indicating that system-level action is required to improve performance. Such system-level action should be developed with a deep understanding of the holistic nature of Aboriginal and Torres Strait islander wellbeing beyond just physical health (including healthy connections to culture, community and country), of the impact of Australian colonist history on Aboriginal and Torres Strait Islander people, and of how social systems – including the health system - should be shaped to meet the needs of Aboriginal and Torres Strait Islander people. This project aims to build on the collective strengths within PHC services in order to continue improving the quality of care for Aboriginal and Torres Strait Islander communities

National Aboriginal and Torres Strait Islander health plan 2013-2023

In 2008 Australian Governments committed to work with Aboriginal and Torres Strait Islander people on an incredibly important task - to achieve equality in health status and life expectancy between Aboriginal and Torres Strait Islander people and non-Indigenous Australians by the year 2031. The commitment – in the form of the Close the Gap Statement of Intent – creates the platform for this National Aboriginal and Torres Strait Islander Health Plan, which has been developed in partnership with Aboriginal and Torres Strait Islander people and their representatives. This Health Plan provides a long-term, evidence-based policy framework as part of the overarching Council of Australian Governments’ (COAG) approach to Closing the Gap in Indigenous disadvantage, which has been set out in the National Indigenous Reform Agreement (NIRA) signed in 2008. The NIRA has established a framework of national targets and policy building blocks. Two of the Closing the Gap targets, to halve the gap in child mortality by 2018 and close the life expectancy gap by 2031, go directly to health outcomes, while others address social determinants of health such as education and employment. The Health Plan builds on the United Nations Declaration on the Rights of Indigenous Peoples. It adopts a strengths-based approach to ensure policies and programs improve health, social and emotional wellbeing, and resilience and promote positive health behaviours. It emphasises the centrality of culture in the health of Aboriginal and Torres Strait Islander people and the rights of individuals to a safe, healthy and empowered life. The Health Plan also builds on existing strategies and planning approaches to improving Aboriginal and Torres Strait Islander health,

The dilemmas of providing welfare in an ethnically diverse state : seeking reconciliation in the role of a 'reflexive practitioner'

Despite an increasing commitment to tackle disadvantage and discrimination, welfare states in the West struggle to provide accessible and appropriate health and social care to people of minority ethnic populations. This article analyses the dilemmas of welfare provision in an ethnically diverse state by drawing on empirical findings from a qualitative study exploring the perceptions and experiences of family life and social support for people of Pakistani origin living in the UK, and its interface with the state as a site of potentially competing and conflicting sets of social values. We conclude by suggesting that a notion of 'reflexive practitioner' is fundamental to generating a critical insight that can deal with the tensions posed by diversity for a welfare state

Social networks : the future for health care delivery

With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network – patients and providers – with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is considerable expertise in assessing, combining and exploiting information. Social networking is providing a new landscape for patients to assemble health information, relatively free from the constraints of traditional health care. However, health information from social networks currently complements traditional sources rather than substituting for them. Networking among health care provider organisations is enabling greater exploitation of health information for health care planning. The platforms of interaction are also changing. Patient-doctor encounters are now more permeable to influence from social networks and professional networks. Diffuse and temporary platforms of interaction enable discourse between patients and professionals, and include platforms controlled by patients. We argue that social networking has the potential to change patterns of health inequalities and access to health care, alter the stability of health care provision and lead to a reformulation of the role of health professionals. Further research is needed to understand how network structure combined with its dynamics will affect the flow of information and potentially the allocation of health care resources

Slacktivists or Activists?: Identity Work in the Virtual Disability March

Protests are important social forms of activism, but can be inaccessible to people with disabilities. Online activism, like the 2017 Disability March, has provided alternative venues for involvement in accessible protesting and social movements. In this study, we use identity theory as a lens to understand why and how disabled activists engaged in an online movement, and its impact on their self-concepts. We interviewed 18 disabled activists about their experiences with online protesting during the Disability March. Respondents' identities (as both disabled individuals and as activists) led them to organize or join the March, evolved alongside the group's actions, and were reprioritized or strained as a result of their involvement. Our findings describe the values and limitations of this activism to our respondents, highlight the tensions they perceived about their activist identities, and present opportunities to support further accessibility and identity changes by integrating technology into their activist experiences

Locating ethnicity and health: exploring concepts and contexts

With the rapid development of ethnicity and health as a field of sociological research, this paper seeks to re-evaluate the development of ideas around ethnicity, 'race' and culture and consider how they have been applied to the question of health. Ethnicity as a social characteristic is contingent on the situation in which it is manifest. The process of marking 'other' ethnic groups includes stereotyping and racialisation, a process through which 'racial' or ethnic differences predominate to the exclusion of a consideration of social, economic and power relations. In the British context, the history of empire and medicine's justification of racist treatment of enslaved and colonised people, is relevant to understanding how ethnic and cultural differences have come to be essentialised and pathologised. Immigration to Britain only became a mass phenomenon after World War II, with settlement patterns following employment opportunities and kinship alliances. The state has a longstanding history of 'managing' diversity, sometimes essentialising differences between groups, at other times tackling disadvantage and discrimination experiences through policy action. Sociologists of health were slow to study ethnicity, with initial research coming from tropical disease specialists. The tendency of medicine to pathologise minority cultures is explored through case studies of the approach to rickets and the assessment of health risks associated with consanguineous marriage. Anti-racist approaches have encouraged the consideration of discrimination against and socioeconomic position of minorities. The field has developed with work on nomenclature and the operationalisation of ethnic identity, necessary to study health inequalities between ethnic groups and paying due heed to the contribution of socioeconomic position and racism to group experiences. Research into chronic conditions with complex analysis of a number of distinct contributory variables has been published of late. However, the excessive focus on South Asians and the record of measuring, analysing, but not necessarily tackling health disadvantage, are problems that remain to be addressed

An Assessment of the Impact of Climate Change on Human Health in New Hampshire

Climate change threatens human health in many ways. The negative impacts of climate change on human health are likely to increase in both magnitude and frequency as the climate continues to change in response to ever increasing global emissions of heat-trapping gases released from a variety of human activities.The Centers for Disease Control and Prevention (CDC) Building Resilience Against Climate Effects (BRACE) framework provides guidance to states and cities to develop strategies and programs to confront the health implications of climate change. This report serves to address Steps 1 and 2 of the BRACE framework via an assessment of past and future climate change across New Hampshire combined with an assessment of the impact of climate change on human health. A key component of the BRACE framework is building resilience. In public health, resilience is a measure of a community’s ability to utilize available resources to respond to, withstand, and recover from adverse situations. More generally, people think of resilience as the ability to recover, persist, or thrive amid change. The New Hampshire Climate and Health Workgroup has tentatively developed the following definition: Resilience is the ability and capacity to anticipate, prepare for, respond to, and recover from significant threats with minimum damage to human health and well-being, the economy, and the environment. The importance of the way we plan our built environment—including land use, transportation, and water management decisions, as well as how we interact with our natural environment and preserve its life-supporting functions—must be emphasized as pivotal points of intersection as we develop climate adaptation strategies. Notably, a resilience-based approach to climate change adaptation should align with New Hampshire’s transformative State Health Improvement Plan. That plan underscores the importance of cross-sector collaboration and coordinated strategies to address the social and environmental determinants of health. These strategies not only support healthy communities for all New Hampshire residents, but they are also critically important for reducing health care costs and reducing the burden of disease