630 research outputs found
Using practice development methodology to develop childrenâs centre teams: Ideas for the future
The Childrenâs Centre Programme is a recent development in the UK and brings together
multi-agency teams to work with disadvantaged families. Practice development methods
enable teams to work together in new ways. Although the term practice development
remains relatively poorly defined, its key properties suggest that it embraces engagement,
empowerment, evaluation and evolution. This paper introduces the Childrenâs Centre
Programme and practice development methods and aims to discuss the relevance of using
this method to develop teams in childrenâs centres through considering the findings from an
evaluation of a two-year project to develop inter-agency public health teams.
The evaluation showed that practice development methods can enable successful team
development and showed that through effective facilitation, teams can change their practice to
focus on areas of local need. The team came up with their own process to develop a strategy
for their locality
The Impact of Children on Australian Couples' Wealth Accumulation
Existing estimates of the cost of children focus on what parents spend on their children, which has limited relevance to parentsâ financial capacity to meet those costs. An alternative indicator of the affordability of children, their impact upon couplesâ wealth accumulation, is estimated using the lifecycle model and Australian household panel data. The results suggest children have a very small impact upon wealth accumulation, seemingly at odds with the large âcostsâ implied from expenditure-based estimates. In reconciling these highly divergent estimates we argue that the net-wealth approach is an intuitively more appealing indicator of the financial impost of children
Developing a model to estimate the potential impact of municipal investment on city health
This article summarizes a process which exemplifies the potential impact of municipal investment on the burden of cardiovascular disease (CVD) in city populations. We report on Developing an evidence-based approach to city public health planning and investment in Europe (DECiPHEr), a project part funded by the European Union. It had twin objectives: first, to develop and validate a vocational educational training package for policy makers and political decision takers; second, to use this opportunity to iterate a robust and user-friendly investment tool for maximizing the public health impact of 'mainstream' municipal policies, programs and investments. There were seven stages in the development process shared by an academic team from Sheffield Hallam University and partners from four cities drawn from the WHO European Healthy Cities Network. There were five iterations of the model resulting from this process. The initial focus was CVD as the biggest cause of death and disability in Europe. Our original prototype 'cost offset' model was confined to proximal determinants of CVD, utilizing modified 'Framingham' equations to estimate the impact of population level cardiovascular risk factor reduction on future demand for acute hospital admissions. The DECiPHEr iterations first extended the scope of the model to distal determinants and then focused progressively on practical interventions. Six key domains of local influence on population health were introduced into the model by the development process: education, housing, environment, public health, economy and security. Deploying a realist synthesis methodology, the model then connected distal with proximal determinants of CVD. Existing scientific evidence and cities' experiential knowledge were 'plugged-in' or 'triangulated' to elaborate the causal pathways from domain interventions to public health impacts. A key product is an enhanced version of the cost offset model, named Sheffield Health Effectiveness Framework Tool, incorporating both proximal and distal determinants in estimating the cost benefits of domain interventions. A key message is that the insights of the policy community are essential in developing and then utilising such a predictive tool
The ethics of global psychiatric genomics: multilayered challenges to integrating genomics in global mental health and disability - A Position Paper of Oxford Global Initiative in Neuropsychiatric GenEthics (NeuroGenE)
Psychiatric genomics has the potential to radically improve the prevention and early intervention of serious mental and neurodevelopmental disorders worldwide. However, little work has been done on the ethics of psychiatric genomicsâan oversight that could result in poor local uptake, reduced practical/clinical application, and ethical violations in this rapidly developing area of scientific research. As part of the Global Project of the Stanley Center for Psychiatric Research, the Global Initiative in Neuropsychiatric GenEthics (NeuroGenE) based at the University of Oxford aims to embed ethical inquiry within scientific investigation and engage with fundamental ethical questions around a psychiatric genomics approach to mental and neurodevelopmental disorder. This position paper sets out the core aims of the NeuroGenE research programme and explores the importance of a crosscutting research orientation in this field based on multidisciplinary methodologies which can ensure that efforts to translate and apply global psychiatric genomics in public policy and clinical practice are ethically grounded strategies, respectful of different cultures and contexts
A Blueprint to Evaluate One Health
One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the âNetwork for Evaluation of One Health,â an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy
Public health, research and rights : the perspectives of deliberation panels with politically and socially active disabled people
Public health research purports to provide the evidence base for policies, programmes and interventions to improve the health of a population. However, there is increasing awareness that the experiences of disabled people have played little part in informing this evidence base. This paper discusses one aspect of a study commissioned by Englandâs National Institute for Health Research (NIHR) to review the implications for public health of theories and models of disability. This part of the study focused on the development of a tool or decision aid to promote ethical inclusion of disabled people in public health randomised controlled trials (RCTs) and evaluative research. The tool was introduced at four regional âdeliberating panelsâ involving politically and socially active disabled people. In addition, we held a panel with public health professionals. The deliberation panels debated how the focus of public health was narrowing, why disability was excluded and positive and negative issues with using rights to guide research and evaluative practice. Politically active disabled people argued for a social model of human rights to guide any rights based tools or decision aids in public health and disability research
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The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
Objectives: There is scant qualitative research into the experiences of tuberculosis treatment in urban risk groups with complex health and social needs in the UK. This study aimed to describe the social context of adherence to treatment in marginalised groups attending a major tuberculosis centre in London.
Methods: Qualitative cross-sectional study using semi-structured interviews with patients receiving treatment for tuberculosis. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions.
Results: Seventeen participants, the majority were homeless and had complex medical and social needs including, drug and alcohol use or immigration problems affecting entitlement to social welfare. Participants rarely actively chose not to take their medication but described a number of social and institutional barriers to adherence and their need for practical support. Many struggled with the physical aspects of taking medication and the side effects. Participants receiving DOT reported both positive and negative experiences reflecting type of DOT provider and culture of the organisation.
Conclusions: There is a need for integrated care across drug, alcohol, HIV and homeless services in order to address complex clinical co-morbidities and social need which impact on patientsâ ability to sustain a course of treatment
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