bluuebunny/crossref_metadata_2025 huggingface dataset:
Behavior Change in Diabetes Education
Authors: Peyrot Mark
Published: April 2008

PURPOSE

The purpose of this paper is to explore how diabetes education produces change in self-care behavior.

METHODS

Published research on diabetes education relevant to behavior change was examined and a framework was formulated for the study of behavior change.

RESULTS

Research indicates that education improves patient selfmanagement, which in turn improves glycemic control and health status. Yet, there is relatively little information on what types of education produce what particular benefits for which types of patients. Moreover, we do not know the benefits of various forms of education (for selected groups) relative to their costs. Empirical studies of how education produces behavior change are few, but much preliminary work has been done to identify potential behavioral determinants that can be targeted by interventions. Theoretical models of behavior change have been advanced (eg, stages of change) but they have yet to be rigorously tested.

CONCLUSIONS

Initial answers to the research questions can be generated by conducting more sophisticated analyses of the type of data already being collected. However, obtaining complete answers to some of these questions will require more extensive data collection, including large-scale studies of multiple interventions in multiple patient groups.
Outcomes of and for Diabetes Education Research
Authors: Glasgow Russell E.
Published: April 2008

PURPOSE

The purpose of this paper is to review outcome measures used to evaluate diabetes self-management education and make recommendations for future research.

METHODS

Three perspectives were used: (1) the frequency with which different measures were collected prior to 1990 was compared with a sample of the 1997 to 1999 literature, (2) a multilevel pyramid model of psychosocial-environmental factors was used to evaluate the level of outcomes assessed, and (3) the RE-AIM evaluation framework was used to assess the public health impact of studies reported in the literature.

RESULTS

Knowledge and HbA1c measures are often collected to the exclusion of other, possibly more appropriate outcomes. Research has focused almost exclusively on individual or family level outcomes and paid little attention to effects at systems levels, such as neighborhoods, communities, or healthcare systems. More recent studies have been evaluating the reach of interventions, but more practice-oriented research needs to be conducted with representative patients, providers, and settings.

CONCLUSIONS

Much has been learned about the efficacy of diabetes selfmanagement and about measurement issues. Future research should now focus on effectiveness and generalization issues.
Out of the Frying Pan, into the Fire? Post-Soviet Regime Changes in Comparative Perspective
Authors: Gel'Man Vladimir
Published: April 2008

Why do some countries become democracies, while others move from one nondemocratic regime to another? Post-communist transformations in the countries of the former Soviet Union could be viewed as a “natural experiment” in regime change: the politics of post-Soviet states demonstrate a great diversity. In this article, I present a partial theory of post-Soviet regime change and attempt to explain the outcomes of elite conflicts in post-Soviet states and their consequences for regime change. The account of political transformations in Russia, Ukraine, and Belarus will outline certain common features and peculiarities of regime change in each case and provide several implications for comparative studies of regime change.
The Doctrine of Pre-emptive Strike: Application and Implications During the Administration of President George W. Bush
Authors: Gupta Sanjay
Published: April 2008

During the Iraq war, the Bush administration justified its preemptive military strike against Iraq on grounds of national security. The strike, carried out under the administration's National Security Strategy, asserts the right of the USA to take unilateral military action against rogue states and terrorist organizations so as to prevent or mitigate a presumed attack by such nations or organizations against the United States. However, the administration's action has been widely criticized as not being in conformity with international law, customary law, and UN Security Council resolutions. The doctrine's implications are serious as it may encourage other states, such as India, to take unilateral action against their adversaries. The failure of the UN to prevent US aggression against Iraq has also given rise to the suggestion that the UN is redundant in such circumstances, a view seen by US and Indian foreign policy ideologues as a favorable development.
Expectations of Benefit in Early-Phase Clinical Trials: Implications for Assessing the Adequacy of Informed Consent
Authors: Weinfurt Kevin P. , Seils Damon M. , Tzeng Janice P. , Compton Kate L. , Sulmasy Daniel P. , Astrow Alan B. , Solarino Nicholas A. , Schulman Kevin A. , Meropol Neal J.
Published: April 2008

Background. Participants in early-phase clinical trials have reported high expectations of benefit from their participation. There is concern that participants misunderstand the trials to which they have consented, which is based on assumptions about what patients mean when responding to questions about likelihood of benefit. Methods. Participants were 27 women and 18 men in early-phase oncology trials at 2 academic medical centers in the United States. To determine whether expectations of benefit differ depending on how patients are queried, the authors randomly assigned participants to 1 of 3 interviews corresponding to 3 questions about likelihood of benefit: frequency type, belief type, and vague. In semistructured interviews, participants were queried about how they understood and answered the question. Participants then answered and discussed 1 of the other questions. Results. Expectations of benefit in response to the belief-type question were significantly greater than expectations in response to the frequency-type and vague questions (P=0:02 ). The most common justifications involved positive attitude (n=27 [60%]) and references to physical health (n=23 [51%]). References to positive attitude were most common among participants with higher (> 70%) expectations (n = 11 [85%]) and least common among those with lower ( < 50 %) expectations (n = 3 [27%]). Conclusions. The wording of questions about likelihood of benefit shapes the expectations that patients express. Patients who express high expectations may not do so to communicate understanding but rather to register optimism. Ongoing research will clarify the meaning of high expectations and examine methods for assessing understanding.
The Role of Value for Money in Public Insurance Coverage Decisions for Drugs in Australia: A Retrospective Analysis 1994-2004
Authors: Harris Anthony H. , Hill Suzanne R. , Chin Geoffrey , Li Jing Jing , Walkom Emily
Published: April 2008

Objective . To analyze the relative influence of factors in decisions for public insurance coverage of new drugs in Australia. Data Sources . Evidence presented at meetings of the Australian Pharmaceutical Benefits Advisory Committee (PBAC) that makes recommendations on coverage of drugs under Pharmaceutical Benefits Scheme. Study Selection . All major submissions to the PBAC between February 1994 and December 2004 (n = 858) if one of the outcomes measured was life year gained (n= 138) or quality-adjusted life years (QALYs) gained (n= 116). Results . Clinical significance, cost-effectiveness, cost to government, and severity of disease were significant influences on decisions. Compared to the average submission, clinical significance increased the probability of recommending coverage by 0.21 (95% confidence interval [CI] 0.02 to 0.40), whereas a drug in a life-threatening condition had an increased probability of being recommended for coverage of 0.38 (0.06 to 0.69). An increase in $A10,000 from a mean incremental cost per QALY of $A46,400 reduced the probability of listing by 0.06 (95% CI 0.04 to 0.1). Conclusions . The PBAC provides an example of the long-term stability and coherence of evidence-based coverage and pricing decisions for drugs that weighs up the evidence on clinical effectiveness, clinical need, and value for money. There is no evidence of a fixed public threshold value of life years or QALYs, but willingness to pay is clearly related to the characteristics of the clinical condition, perceived confidence in the evidence of effectiveness and its relevance, as well as total cost to government.
Sexual Offenders in Preventive Detention
Authors: Habermeyer Elmar , Passow Daniel , Puhlmann Peter , Vohs Knut , Herpertz Sabine
Published: April 2008

In the last decade, preventive detention—especially that relating to sexual offenders— has gained relevance for the German legal system. However, data are lacking concerning the inmates and the modus operandi of the psychiatric experts. Court orders and psychiatric statements of 114 offenders with orders of preventive detention were examined, 57 of whom were incarcerated because of sexual offences. Sexual offenders mostly show antisocial personality traits or even disorders, with a history of poly-trophic delinquency. In only four cases, the diagnosis of a sexual disorder was given. The analysis showed a high rate of psychiatric expert testimonies' lacking basic information, with incomplete assessment of sexual history. None of the experts used standardized prognostic instruments, meaning that most of the risk factors included in the Sexual Violence Risk—20 and the Static-99 were not considered. Further work needs to be done to improve the quality of psychiatric statements concerning sexual offenders.
Community Violence Victimization and Depressed Mood
Authors: Haden Sara C. , Scarpa Angela
Published: April 2008

The objectives of the current study were to (a) determine how lifetime community violence (CV) victimization, coping behavior, social support (SS), and depressed mood are related in young adults, and (b) assess whether the relationship between CV victimization and depressive reactions is moderated by perceived SS and coping style. Five hundred fifty college students (160 men, 355 women) completed questionnaires measuring lifetime experiences with violence, current depressed mood, perceptions of SS from family and friends, and general coping styles. Results of a series of hierarchical regressions indicated a positive relationship between frequency of CV victimization and depressed mood. Low levels of perceived SS and problem-focused coping and high levels of disengagement coping were associated with increased depression scores overall, but there was an interaction effect such that high disengagement coping strengthened the relationship between CV and depressed mood. Moreover, when controlling for the effect of posttraumatic stress, high-perceived friend support and low disengagement coping served as protective factors for depressed mood. These results were particularly strong in individuals whose last CV experience occurred within the previous 2 years. Findings suggest that perceptions of support and ability to actively cope with stressors are very important in the adjustment to CV victimization.
Anger Disturbances Among Perpetrators of Intimate Partner Violence
Authors: Eckhardt Christopher I. , Samper Rita E. , Murphy Christopher M.
Published: April 2008

In the present study, the authors clustered a pretreatment sample of 190 perpetrators of intimate partner violence (IPV) mandated to attend group counseling based on State–Trait Anger Expression Inventory scores and examined whether these profiles were associated with differential outcomes 1 year postadjudication. Cluster analysis revealed 3 groups: (a) high anger–expressive (HA-E, n = 56), (b) moderate anger–inexpressive (MA-IE; n = 13), and (c) low anger (LA; n = 118). HA-E men perpetrated more IPV, reported experiencing and witnessing more abuse during childhood, scored higher on psychopathology measures, and reported more substance problems. HA-E and MA-IE males had higher program attrition and rearrest rates; MA-IE males were more likely to be arrested for assault-related offenses. Thus, although the majority of partner-abusive men do not present with anger-related disturbances, the presence of anger problems may be a marker for an array of traits that may complicate the treatment process.
Correlates of In-Law Conflict and Intimate Partner Violence Against Chinese Pregnant Women in Hong Kong
Authors: Chan Ko Ling , Tiwari Agnes , Fong Daniel Y. T. , Leung Wing Cheong , Brownridge Douglas A. , Ho Pak Chung
Published: April 2008

This study examines correlates of in-law conflict with intimate partner violence (IPV) against pregnant women in a cohort of Chinese pregnant women who visited antenatal clinics in Hong Kong. This was a territory-wide, cross-sectional study of 3,245 pregnant women recruited from seven hospitals in Hong Kong. Participants were invited to complete the Chinese Abuse Assessment Screen and a demographic questionnaire. About 9% of the pregnant women reported having been abused by their partners in the preceding year. In-law conflict was the characteristic most significantly associated with preceding-year abuse against pregnant women, after controlling for covariates. Findings underscore the need to obtain information on in-law conflict as a risk factor for IPV. In-law conflict should be included in the assessment of risk for IPV. For the prevention of IPV, family-based intervention is needed to work with victims as well as in-laws.
Impact of Emergency Department Intimate Partner Violence Intervention
Authors: Kendall Jayne , Pelucio Maria Tereza , Casaletto Jennifer , Thompson Karen Parker , Barnes Sherry , Pettit Erin , Aldrich Mae
Published: April 2008

The objective of the study is to assess the impact of emergency department (ED) intimate partner violence (IPV) counseling and resource referrals on patient-perceived safety and safety planning. ED patients with risk factors were offered consultation with trained IPV advocacy counselors who completed safety assessments, provided resource referrals, and helped patients develop safety plans. Patients were contacted after ED intervention to assess progress and further assist in IPV counseling. Over 96% of patients perceived an increase in their safety after the intervention, and approximately 50% had completed a portion of their safety plan. Legal assistance and/or law enforcement were considered the most beneficial resource referrals. Although follow-up was limited, this study appears to demonstrate that an ED IPV intervention program may be useful in helping IPV victims achieve safer living environments and access local resources.
Disability Trends in Hong Kong Community-Dwelling Chinese Older Adults
Authors: Chou Kee-Lee , Leung Joe C. B.
Published: April 2008

Objective: This article examines the trends of disability in six activities of daily living (ADLs) among Hong Kong community-dwelling older adults during the period from 1996 to 2004 by using three independent cross-sectional surveys of representative samples. Method: Logistic regression was performed to assess the association between the year of survey and the presence of any ADL limitation with a wide range of covariates. Results: We found that older adults in 2004 were more likely to report ADL disability than their counterparts in 1996, and the results would remain valid after considering the prevalence of ADL disability in nursing home residents. In addition, we found that age, education, the use of proxy, and the presence of six medical conditions were significantly related to ADL limitation. Discussion: In general, public health efforts to prevent ADL limitation should be supported to reduce the demand for long-term care services in the coming decades.
Charters, declarations, world conferences: practical significance for health promotion practitioners `on the ground'
Authors: Mittelmark Maurice B.
Published: April 2008

This text was commissioned and has been slightly adapted from the Preface to: Scriven, A. (ed) (2005) Health Promoting Practice: The Contribution of Nurses and Allied Health Professions. Palgrave, London. It has also been published on-line in the Reviews of Heatlh Promotion and Education Online (www.rhpeo.org) under the series entitiled Ottawa 1986- Vancouver 2007: should the Ottawa Charter be revisited?
Cartas, declaraciones, conferencias mundiales: importancia práctica para los profesionales de la promoción de la salud “sobre el terreno”
Authors: Mittelmark Maurice B.
Published: April 2008

Este articulo ha sido redactado por Maurice B. Mittelmark a petición de la UIPES y ha sido ligeramente adaptado del Prefacio: Scriven, A. (ed) (2005) Health Promoting Practice: The Contribution of Nurses and Allied Health Professions. Palgrave, London. También ha sido publicado en la revista interactiva de la UIPES, Reviews of Heatlh Promotion and Education Online (www.rhpeo.org) en la serie titulada Ottawa 1986 - Vancouver 2007: revisar la Carta de Ottawa ¿una necesidad?
Pragmatic health promotion in a globalised world: reflections on Bangkok from the next generation
Authors: Corbin J. Hope
Published: April 2008

This commentary was commissioned from J. Hope Corbin by the IUHPE in order to share her personal experience as a rapporteur and particpant in the 6th WHO Global Conference on Health Promotion held in Bangkok, Thailand, in August 2005. Her contribution serves as an example of how the IUHPE is committed to continue supporting a dialogue on the Bangkok Charter and its implementation through its electronic journal the Reviews of Health Promotion & Education Online which has provided a forum for IUHPE members to share their thoughts and views in the series: From Ottawa 1986 to Vancouver 2007, Should the Ottawa Charter be revisited? This series will be prolonged all the way up to the IUHPE's next world conference in Vancouver where the issues taken up by the various declarations of global WHO conferences, notably the Ottawa one in 1986, will be at the core of its programme (see http://www.iuhpeconference.org/). We are thus looking forward to a strong ongoing debate until then, and all IUHPE members are invited to submit their own paper on this subject for consideration and posting on RHP&EO (www.rhpeo.org)!
Una promoción de la salud pragmática en un mundo globalizado: reflexiones de la generación joven en torno a Bangkok
Authors: Corbin J.H.
Published: April 2008

Este comentario ha sido redactado por petición de la UIPES a J. Hope Corbin con el fin de compartir su experiencia personal como relatora y participante de la VI Conferencia mundial de Promoción de la Salud celebrada en Bangkok, Tailandia, en Agosto de 2005. Su contribución sirve como ejemplo de cómo la UIPES se compromete a un continuo apoyo del dialogo sobre la Carta de Bangkok y su implementación a través de la revista electrónica Reviews for Health Promotion and Education On-line (RHP&EO) que proporciona un foro de discusión a los miembros de la UIPES para compartir sus ideas en la serie titulada: De Ottawa 1986 a Vancouver 2007, Deberíamos revisar la Carta de Ottawa? Esta serie continuará hasta la próxima Conferencia mundial de la UIPES en Vancouver donde se retomarán las diversas declaraciones que han resultado de las conferencias de la OMS, en especial la Carta de Ottawa de 1986 (véase http://www.iuhpeconference.org). Esperamos que este debate continúe hasta Vancouver e invitamos a todos los miembros de la UIPES a presentar sus opiniones para su consideración a ser publicadas en RHP&EO.
What do we know about promoting mental health through schools?
Authors: Weare Katherine , Markham Wolfgang
Published: April 2008

There is a growing evidence base on what schools need to do to promote mental health effectively. There is strong evidence that they need first and foremost to use a whole school approach. This shapes the social contexts which promote mental health and which provide a backdrop of measures to prevent mental health disorders. In this context the targeting of those with particular needs and the work of the specialist services can be much more effective. Schools need to use positive models of mental health, which emphasise well being and competence not just illness- this will help overcome problems of stigma and denial and promote the idea of mental health as 'everyone's business'. The most effective programmes in schools which address mental health have the following characteristics:

• They provide a backdrop of universal provision to promote the mental health of all and then target those with special needs effectively.

• They are multi-dimensional and coherent.

• They create supportive climates that promote warmth, empathy, positive expectations and clear boundaries.

• They tackle mental health problems early when they first manifest themselves and then take a long term, developmental approach which does not expect immediate answers.

• They identify and target vulnerable and at risk groups and help people to acquire the skills and competences that underlie mental health.

• They involve end users and their families in ways that encourage a feeling of ownership and participation, and provide effective training for those who run the programmes, including helping them to promote their own mental health.

Using these starting points, we need to develop a rigorous evidence-based approach on this issue. We also require the facilitation of the dissemination of such research findings while encouraging new and innovative approaches.
Successful strategies and lessons learned from development of large-scale partnerships of national non-gowernmental organisations
Authors: Potts-Datema William , Smith Becky J. , Taras Howard , Lewallen Theresa C. , Bogden James F. , Murray Sharon
Published: April 2008

National governments worldwide work to improve education and health outcomes for children and youth and influence their behaviours. Also heavily engaged are national non-governmental organisations (NGOs) in the voluntary and non-profit sector. While individual agencies and non-profit organisations are often concerned with specific issues of interest related to their charge, constituency or membership, they often develop allegiances with like-minded groups to accomplish broader goals.

Two such collaborations in the United States are the focus of this discussion, the National Co-ordinating Committee on School Health and Safety (NCCSHS) and the Friends of School Health (hereafter, "the Friends"). This article reviews these two significant partnerships of public health and education NGOs and outlines successful strategies and lessons learned from the development of these large-scale partnerships.

NCCSHS is a collaboration of 64 NGOs and six U.S. government departments representing both the fields of public health and education. Nearly all major NGOs working in fields related to school health are represented, and the six primary governmental agencies all have at least some responsibility for students' health and safety. The group is the primary intersection of NGOs and the Federal government related to school health at the national level.

The Friends of School Health ("the Friends") is the primary school health advocacy coalition at the national level in the United States. Sixty-one education and public health NGOs participate. The coalition serves as a communication mechanism and venue for collaborative action on issues before the U.S. Congress and state legislatures that relate to school health. Since the coalition advocates to legislators and other decision makers, no government agencies participate.

The paper describes the strategies relating to the initial development of the collaboratives and their ongoing operation.

A common theme in development of both of these examples of large-scale partnerships is trust. Like any partnership, the ability to work and grow is dependent on the level of trust among the partners.

Both the National Coordinating Committee on School Health and Safety and the Friends of School Health work together successfully within and across their collaborations, to improve health and educational outcomes for children and youth. While both experience challenges, and neither would indicate that its work is near completion, they provide important insight into how these collaboratives can initially develop and subsequently operate productively while providing important contributions to the promotion of healthy schools, and ultimately, healthy nations.
Involving students in learning and health promotion processes - clarifying why? what? and how?
Authors: Bruun Jensen Bjarne , Simovska Venka
Published: April 2008

The concept of student participation is currently a popular notion in health promoting schools as well as in general education. However, phrases such as 'involvement', 'participation', 'co-determination' and 'influence' are frequently used without careful definition. In this article two models, developed in the context of health promoting schools in two different cultures, are presented and discussed.

The first model makes a fundamental distinction between token and genuine participation. Token participation in health promotion is characterised by focusing on prescribed knowledge, closed and convergent outcomes and targeting individuals isolated from the surrounding environment. In contrast, genuine participation stresses students' own construction of knowledge, open and divergent outcomes and targeting individuals in their context. Genuine participation is in accordance with a democratic health promoting school aiming at students' empowerment and action competence.

The second model clarifies a number of different categories of students' participation in health promotion. The different categories illustrate how the teacher in various ways can play an active role in participatory approaches as a responsible professional. The more the students are involved in health projects, the more important it will be for the teacher to provide support, insight and knowledge to facilitate the learning processes. Furthermore, the different participation categories have to be related to a number of decisions which are normally included in a school health project. The model illustrates that participation should always be viewed in relation to the context and that it makes no sense to establish a single ideal way of working with participation in a health promoting school.

The theoretical models are illuminated by concrete examples from health promoting schools. The overall conclusion is that participation is a complex term and rather than providing definitive answers, the models can be used as a framework for discussion among all stakeholders in planning, implementation, evaluation and managing projects involving student participation.

Finally, specific implications and challenges for future health promoting schools are outlined. These are as follows:

•a participatory approach does not imply that health content should be regarded as vague or superfluous;

• teachers need flexible educational models and resources to manage participatory projects in health promoting schools;

· schools have to be acknowledged as cultural systems with firmly rooted rules and routines that are often difficult to change;

• a participatory approach has to influence all aspects of a democratic health promoting school rather than solely the teaching strategies.
A framework for evaluating community-based physical activity promotion programmes in Latin America
Authors: Schmid Thomas L. , Librett John , Neiman Andrea , Pratt Michael , Salmon Art
Published: April 2008

A growing interest in promoting physical activity through multi-sectoral community- based programmes has highlighted the need for effective programme evaluation. Meeting in Rio de Janeiro, an international workgroup of behavioural, medical, public health and other scientists and practitioners endorsed the principle of careful evaluation of all programmes and in a consensus process developed the Rio de Janeiro Recommendations for Evaluation of Physical Activity Interventions". Among these recommendations and principles were that when possible, evaluation should 'built into' the programme from the beginning. The workgroup also called for adequate funding for evaluation, setting a goal of about 10% of programme resources for evaluation. The group also determined that evaluations should be developed in conjunction with and the results shared with all appropriate stakeholders in the programme; evaluations should be guided by ethical standards such as those proposed by the American Evaluation Association and should assess programme processes as well as outcomes; evaluation outcomes should be used to revise and refine ongoing programmes and guide decisions about programme continuation or expansion. It was also recognised that additional training in programme evaluation is needed and the Centers for Disease Control and Prevention's Physical Activity Evaluation Handbook could be easily adapted for use in culturally diverse communities, especially in Latin America. This paper describes a 6-step evaluation process and provides the full set of recommendations from the Rio de Janeiro Workgroup. The handbook has been translated and additional case studies from Colombia and Brazil have been added. Spanish and Portuguese language editions of the Evaluation Handbook are available from the Centers for Disease Control and Prevention, Physical Activity and Health Branch.
Advocacy for physical activity-from to influence
Authors: Shilton Trevor
Published: April 2008

Advocacy is an evolving and underdeveloped element of public health practice. Historically, it was used to describe activities undertaken by persons on behalf of the poor, the sick or oppressed. In the seventies, led by tobacco control advocates such as Pertschuk in the United States, Gray in Australia and Daube in the United Kingdom, public health advocacy became more focused on structural and policy change. Since the Ottawa Charter (WHO, 1986), the health promotion movement has embraced a broader view of the role of advocacy. The public health community now see advocacy as social action primarily aimed at effecting changes in legislation, policy and environments that support healthy living. Advocacy is defined by the World Health Organization as a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or programme (WHO, 1995).

This paper describes a model for understanding and mobilising physical activity advocacy. It outlines a three step process:

1. Gathering and translating the most pertinent physical activity evidence. Why advocate for physical activity?

2. Developing from the evidence, a physical activity advocacy agenda and articulating a plan (or plans) of key actions that will increase population levels of physical activity. What should be advocated?

3. Implementing a mix of advocacy strategies to influence and mobilise support for the physical activity agenda. How should advocacy be implemented?
Coaliciones y redes: cómo facilitan la promoción global de la actividad física
Authors: Mahecha Matsudo Sandra , Matsudo Victor Rodrigues
Published: April 2008

Este artículo tiene como objetivo, resumir la experiencia de los programas y redes contemporáneas de promoción de la actividad física en grandes poblaciones mediante la utilización de coaliciones (parcerias). Tras describir el concepto de coaliciones, en especial en el contexto brasileño, los autores enumeran algunos de los principales elementos que dan evidencia de la efectividad en la formación de coaliciones y redes, como por ejemplo, la financiación, la membresía, el principio de inclusión o empowerment. Agita Sao Paulo, la Red de Actividad Física de las Américas -RAFA y Agita Mundo son utilizados como ejemplos. De esta forma el artículo demuestra que la experiencia de programas y redes locales y globales, que las alianzas o coaliciones y la formación de redes en todos los niveles es esencial para garantizar el éxito de la promoción de la actividad física como estrategia eficaz de la promoción de la salud pública.
Development of Healthy Cities networks in Europe
Authors: Goepel Eberhard
Published: April 2008

The Healthy Cities network in Europe was inspired by the Ottawa Charter for Health Promotion when it was launched in 1987. The networking process was initiated by the WHO Regional Office for Europe, but developed its own dynamics in different European countries during a time marked by fundamental political transformations in many of the countries of Eastern Europe. The networks then connected with the `Local Agenda 21' and the `Sustainable Cities and Towns Campaign' to create a new and broader programmatic agenda at the local level. In particular, the «Aalborg plus10 — commitments» of local governments in 2004 have the potential to inspire a new phase of participatory and sustainable policies at the level of local communities in Europe. However, the extent to which these initiatives will influence the macro-politics of the European Union towards a proclaimed “Europe of Citizens” remains to be watched carefully during the coming years. ( Promotion & Education, 2007, (2): pp 103-104)
EQUINET: Networking for equity in health in eastern and southern Africa
Authors: Loewenson Rene
Published: April 2008

This short report outlines the perspectives and motivations for the work of the Regional Network for Equity in Health in eastern and southern Africa (EQUINET). It presents key areas of work on health equity being implemented to strengthen the state and public sector in health; organised around the active participation and involvement of communities. This includes work on strengthening people's power for health, on increased fair financing; and on retaining health workers and challenging trade policies that encroach on health. Such work faces challenges that can be met through increased regional networking to exchange experience, information and expertise, particularly given the demand for learning by doingî. ( Promotion & Education, 2007, (2): pp 105-106)
Reducing social inequalities in health: public health, community health or health promotion?
Authors: Ridde Valéry
Published: April 2008

While the Consortium on 'Community Health Promotion' is suggesting a definition of this new concept to qualify health practices, this article questions the relevance of introducing such a concept since no one has yet succeeded in really differentiating the three existing processes: public health, community health, and health promotion. Based on a literature review and an analysis of the range of practices, these three concepts can be distinguished in terms of their processes and their goals. Public health and community health share a common objective, to improve the health of the population. In order to achieve this objective, public health uses a technocratic process whereas community health uses a participatory one. Health promotion, on the other hand, aims to reduce social inequalities in health through an empowerment process. However, this is only a theoretical definition since, in practice, health promotion professionals tend to easily forget this objective. Three arguments should incite health promoters to become the leading voices in the fight against social inequalities in health. The first two arguments are based on the ineffectiveness of the approaches that characterize public health and community health, which focus on the health system and health education, to reduce social inequalities in health. The third argument in favour of health promotion is more political in nature because there is not sufficient evidence of its effectiveness since the work in this area is relatively recent. Those responsible for health promotion must engage in planning to reduce social inequalities in health and must ensure they have the means to assess the effectiveness of any actions taken. ( Promotion & Education, 2007, (2): pp 63-67)
Aparajita Orissa
Authors: Mukhopadhyay Alok
Published: April 2008

Following the 1999 cyclone, which devastated important areas in the state of Orissa, India, the Voluntary Health Association of India (VHAI) established Aparajita as the long-term aid and reconstruction programme. Aparajita aims at empowering the local community and building their capacity to recover from devastation and prepare for future natural disasters. The programme operates in three main areas of the state: Jagatsinghpur, Kendrapara and Puri. After an assessment study of the damage and the communities' socio-economic and health status, Aparajita focused its interventions on livelihood support, infrastructure development, capacity building, savings and credit, and health interventions. This programme has served to establish the basis of a disaster management process, which includes two main components, preparedness and relief. Given the number of natural adversities in India, there is a need to both empower the communities in the management process, as well as influence government to support and institutionalise initiatives like Aparajita. ( Promotion & Education, 2007, (2): pp 74-75)
Reorienting health services through community health promotion in Kwaio, Solomon Islands
Authors: MacLaren David , Kekeubata Esau
Published: April 2008

When ethnic minorities adhere to cultural practices which mark them as unique, structural impediments within health services can deny access and significantly add to the burden of disease. This is particularly pertinent if the development of health services is not done in partnership with all population groups in the area. This is the case at Atoifi Hospital, which structure prevents certain Kwaio people (Solomon Islands) from receiving benefits of hospital services and maintaining cultural beliefs at the same time. A Participatory Action Research process was used to collaboratively work with health service providers and community groups to review the situation, design and build a health facility with both medically and culturally appropriate policies and procedures. The Participatory Action Research process of collectively looking, thinking, planning and acting towards reorienting health services to become more culturally appropriate at Atoifi was the first time leaders, from both the community and hospital, had collectively sat together in a mutually respectful way to discuss community health promotion initiatives. The project was complete in 2006 with collaboration and dialogue between both groups proving vital to its success. Numerous indicators are present that the culturally appropriate health facility is making a difference, not only in terms of the hospital usage by all, but also for the feeling of “community ownership.” ( Promotion & Education, 2007, (2): pp 78-79)
Motuca healthy municipality project: building together a better future
Authors: Mendes Rosilda , Falvo Fabio
Published: April 2008

The Brazilian Ministry of Health in collaboration with the Municipality of Motuca and the School of Public Health at the University of São Paulo set up in 2002 the Motuca Healthy Municipality project with the aim of improving the population's health and quality of life. The project used a participatory and holistic approach, which addressed the social determinants and structural inequities, and called for strategies of community empowerment, social participation, intersectoral networking and good governance. All local and public actors from rural and urban areas were consulted and participated in the project to collect information on the living conditions and challenges to better well-being. This participatory methodology allowed in turn developing cultural and socially appropriate initiatives to improve local governance and standards of living on a long-term basis. Although there is still the challenge to maintain the momentum and reenergize the efforts, the project serves as a model for further efforts to evaluate the effectiveness of participatory intervention and research methodologies to promote health and well-being in communities. ( Promotion & Education, 2007, (2): pp 81-82)
Health promotion in Australia: twenty years on from the Ottawa Charter
Authors: Lin Vivian , Fawkes Sally
Published: April 2008

Australia has a longstanding history of promoting health through programs that reflect the principles of the Ottawa Charter and recognising the importance of social determinants of health. Health promotion programs are delivered by a wide range of organisations, in a wide range of settings and sectors for, or with, multiple groups. Since the mid-1980s aspects of infrastructure and capacity for health promotion, such as human and financial resources, have been put in place including the establishment of health promotion foundations via tobacco hypothecation. Following neo-liberal reforms in the 1990s, however, government policies have increasingly focused more narrowly on specific diseases and risk factors. Chronic disease has become the new banner under which health promotion, social determinants and efforts to address health inequalities fit. While the importance of social determinants is often recognised within and outside the health sector, health promotion practitioners are seldom at the centre of policy development. ( Promotion & Education, 2007, XIV (4): pp 203-208)
Health promotion in Brazil
Authors: Marchiori Buss Paulo , Ivo de Carvalho Antonio
Published: April 2008

The evolution of health promotion within the Brazilian health system is examined, including an assessment of the intersectoral and development policies that have influenced the process. Particular attention is paid to the legal characteristics of the Unified Health System. Human resources formation and research initiatives in health promotion are outlined, with a summary of the obstacles that need to be overcome in order to ensure the effective implementation of health promotion in the future. Up to the end of the 20th Century health promotion was not used as a term in the Brazilian public heath context. Health promoting activities were concentrated in the area of health education, although targeting the social determinants of health and the principle of intersectoral action were part of the rhetoric. The situation has changed during the last decade, with the publication of a national policy of health promotion, issued by the Ministry of Health and jointly implemented with the States and Municipals Health Secretaries. More recently there has been a re-emergence of the discourse on the social determinants of health and the formation of intersectoral public policies as the basis of a comprehensive health promotion. Health promotion infrastructure, particularly around human resources and financing, requires strengthening in order to ensure capacity and sustainability in health promotion practice. ( Promotion & Education, 2007, XIV (4): pp 209-213).
The present and future of Mexican health promotion
Authors: Acosta-Mendez María , Mariscal-Servitje Lorenza , Santos-Burgoa Carlos
Published: April 2008

Mexico, with a 92 percent literacy, 62 native languages and 12.7 million indigenous people, has entered a new era of macroeconomic stability. Nevertheless 40 percent of the population live below the poverty line. The burden of disease includes malnutrition, infectious diseases, reproductive health problems, as well as chronic diseases. Addressing the social determinants of health has been a priority. This can be seen in two of the most successful Mexican programs. The National Healthy Communities Program that uses a setting approach to establish a link between socioeconomic development and health levels and the Opportunities Program that has become an international model and which is a comprehensive, poverty alleviation program that uses education, fiscal measures and health education to improve population health. Both have been implemented throughout all the states in an intersectorial manner, since 1997 and 2000 respectively. Health promotion in Mexico has evolved in many positive ways during the past 20 years. Development of healthy environments and community actions are the strongest components. Evidence and evaluation, health services reorientation, and building personal skills and empowerment are the weakest. The paradox between low empowerment and high community action results in a superficial community participation that lacks a real commitment towards health. The newest Mexican health promotion policy is named National Alliance for Health and it aims to involve all members of society. Its value is to be independent of any international recommendation; its weakness is that it lacks a deep analysis of the health issues that it is supposed to solve. Consequently valid evaluations are not feasible, and without real evidence the impact of these kinds of policies will remain unknown. ( Promotion & Education, 2007, XIV (4): pp 224-227)
Thy Will Be Done?
Authors: Sandelands Lloyd
Published: April 2008

This essay is a meditation on the idea of power in contemporary writing about management. It finds power puzzling because people think about it in natural terms of forces and resistances rather than in moral terms of authority. Authority derives ultimately from the Divine, from the author of human being and all creation. To exercise power with authority is to serve the Divine in humility by serving the human person made in the Divine image. To lead is to serve. A few of the many implications of a theological concept of power for management are considered.
Single-parent family background and physical illness in adulthood: a follow-up study of the Northern Finland 1966 Birth Cohort
Authors: Sauvola Anu , Mäkikyrö Taru , Jokelainen Jari , Joukamaa Matti , Järvelin Marjo-Riitta , Isohanni Matti
Published: April 2008

The association between single-parent family background and physical illness in early adulthood was studied in a sample of an unselected, general population: the Northern Finland 1966 Birth Cohort. Between the ages of 16 and 28 years, women of single-parent family background were more commonly treated (61% versus 57%) for any physical condition in hospital wards compared with women of two-parent family background. Spontaneous abortions (odds ratio; OR=1.4, 95% CI 1.0-2.0), complications of pregnancy (OR=1.1, 95% CI 1.0-1.3), and intracranial injuries (OR=2.0, 95% CI 1.0-3.8) were more common among women with single-parent family background. They also had a clearly higher risk for induced abortions (OR=1.6, 95% CI 1.4-1.9), and a higher incidence of deliveries than did other women. The risk of hospital-treated physical illness did not differ between men of single-parent and two-parent family background. Poisonings and injuries were, however, more common reasons for hospital admission among men with single-parent family background than among other men. In conclusion, our main finding was that, among women, an association between overall hospital-treated physical illness and single-parent family background does exist. However, offspring of single-parent families are mostly in as good physical health as others.