Public health
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We live in a rapidly changing world; one where existing models for and approaches to health appear to deliver diminishing returns, whilst new public health challenges emerge. This paper outlines an integrative approach to such challenges. Integral theory suggests that key dimensions of human experience, frequently presented in opposition to each other (e.g. subjective-objective; individual-collective), need to be understood as integral to the whole. ⋯ This is illustrated in this paper by focusing on the issue of well-being, which illustrates the interconnected ways in which people in affluent societies can suffer from particular problems arising in such society and contribute to broader, global problems. The integral framework is used to show how a more integrative approach to such challenges can transcend some neglected blind-spots within public health. It is argued that public health leaders and practitioners need to apply integrative forms of thinking to their own practice in order to respond more effectively to the complexity of contemporary public health problems.
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The Scottish Public Health Observatory (ScotPHO) is a collaboration of the observatory sections/functions of several organizations. It operates within a small country, part of the UK, with devolved legislative and executive powers in health and in many areas relating to wider social determinants of health. ⋯ A key factor in ScotPHO's impact is the directness of its contact with Scottish government policy and analysis leadership. The context and organization of ScotPHO differentiates it from other PHOs in the UK and Ireland, but many of the health and information challenges faced are similar and the Association of Public Health Observatories enables experience and expertise to be shared.
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To assess the burden of road traffic injury (RTI) in primary and secondary level hospitals in Bangladesh, and its economic impact on affected families. ⋯ RTI is a major cause of hospital admission in Bangladesh, and represents an economic and social burden for the family and the nation. A national strategy and road safety programme need to be developed to reduce the hospital burden and minimize the economic and social impact.
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Comparative Study
Controlled evaluation of injury in an international Safe Community: Kashmar, Iran.
To determine the degree to which the Safe Community (SC) model is effective in reducing injuries. Although positive results have been reported for some communities in developed countries, there is no consistent relationship between being an international designated SC and subsequent changes in observed rate of injury, and no controlled studies have examined the effectiveness of the SC model in developing countries. The aim of this study was to evaluate and compare the injuries in the SC programme of Kashmar (population 149,358) with injuries in counties in Iran that have not applied the SC model. ⋯ The controlled evaluation of injury in the international SC of Kashmar showed an increase in the number and rate of injuries in Kashmar and in the 44 control counties over 3 years, but the injury-related fatality rate decreased over the same time period. A greater decrease was seen in Kashmar than in the control counties. Long-term evaluation is necessary to confirm these results.
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While the introduction of biomedicine within the Sri Lankan healthcare system has resulted in reduced reliance on traditional, complementary and alternative medicine (TCAM) over the last century in Sri Lanka, treatment modalities such as Ayurveda, Sinhala and traditional religious practices still receive considerable public support. Cancer is an increasing burden in Sri Lanka, and whilst Sri Lankans are known to use TCAM for everyday ailments, there has been no research examining the role of TCAM in the context of cancer. The aim of this study was to evaluate the prevalence and patterns of TCAM use by cancer patients. ⋯ The high use of TCAM amongst cancer patients in Sri Lanka raises numerous important issues, including those related to patient safety, potential benefit, interactions with biomedical cancer treatments, and delays in seeking biomedical cancer care. Further research is needed to explore the decision-making processes of cancer patients, including the perceived benefits/limitations of key processes in biomedical and TCAM care.