Adapting developing country epidemiological assessment techniques to improve the quality of health needs assessments in developed countries

BACKGROUND: We were commissioned to carry out three health assessments in urban areas of Dublin in Ireland. We required an epidemiologically robust method that could collect data rapidly and inexpensively. We were dealing with inadequate health information systems, weak planning data and a history of inadequate recipient involvement in health service planning. These problems had also been identified by researchers carrying out health assessments in developing countries. This paper reports our experience of adapting a cluster survey model originally developed by international organisations to assess community health needs and service coverage in developing countries and applying our adapted model to three urban areas in Dublin, Ireland METHODS: We adapted the model to control for socio-economic heterogeneity, to take account of the inadequate population list, to ensure a representative sample and to account for a higher prevalence of degenerative and chronic diseases. We employed formal as well as informal communication methods and adjusted data collection times to maximise participation. RESULTS: The model we adapted had the capacity to ascertain both health needs and health care delivery needs. The community participated throughout the process and members were trained and employed as data collectors. The assessments have been used by local health boards and non-governmental agencies to plan and deliver better or additional services. CONCLUSION: We were able to carry out high quality health needs assessments in urban areas by adapting and applying a developing country health assessment method. Issues arose relating to health needs assessment as part of the planning cycle and the role of participants in the process

Inequalities in health in Ireland - hard facts.

The following are the principal findings of this report: • In 1996 unskilled manual men were twice as likely to die as higher professional men (standardised ratio 122 versus 64). • In 1996 unskilled manual men were eight times more likely to die from an accidental cause than higher professional men (standardised ratio 136 versus 17). • In 1996 you were almost four times as likely to be admitted to hospital for the first time for schizophrenia if you were in the unskilled manual category than if you were a higher professional (standardised ratio of 130 versus 35). • In the early 1990s women in the unemployed socio-economic group were over twice as likely to give birth to low birth weight babies as women in the higher professional group (standardised ratio of 140 versus 66). • Persons with socio-economic group ‘unskilled manual’ have worse health than professional groups in all years and for all the conditions which are analysed in this report. • Persons with socio-economic group ‘unknown’ have consistently worse health than those in socio-economic group ‘unskilled manual’. • The proportion of persons where socio-economic group is unknown is growing in each database. • Mortality seems to be worse in medium sized towns than in cities or in rural areas. • Data from the Perinatal Reporting System has not been published for eight years. • HIPE is of practically no use in making comment on socio-economic differences

Sketching the Moon: An Astronomical Artist's Guide /

Soon after you begin studying the sky through your small telescope or binoculars, you will probably be encouraged by others to make sketches of what you see. Sketching is a time-honored tradition in amateur astronomy and dates back to the earliest times, when telescopes were invented. Even though we have lots of new imaging technologies nowadays, including astrophotography, most observers still use sketching to keep a record of what they see, make them better observers, and in hopes of perhaps contributing something to the body of scientific knowledge about the Moon. Some even sketch because it satisfies their artistic side. The Moon presents some unique challenges to the astronomer-artist, the Moon being so fond of tricks of the light. Sketching the Moon: An Astronomical Artist’s Guide, by five of the best lunar observer-artists working today, will guide you along your way and help you to achieve really high-quality sketches. All the major types of lunar features are covered, with a variety of sketching techniques applied to each. These techniques are explained and illustrated in ways that take the mystery out of artwork, rendering it (so to speak) more accessible to those observers interested in going farther than merely illustrating their notes. So use this comprehensive and easy to follow guide to make astronomy more than science for you—make it also an art