Sozial- und Praventivmedizin最新文献

Objectives: To document and analyze the initial steps in building a health research partnership. To enable a greater appreciation of what these processes entail and also to provide guidance in negotiating the inevitable tensions between parties with different aims and objectives.

Methods: This case study is based on participant-observation and document analysis. It employed three general analytic strategies: developing a case description, relying on theoretical propositions and thinking about rival explanations.

Results: The development of a research partnership framework entails a complex negotiation process marked by tensions: one of representing the interests of the various parties; and one establishing the basis for collaboration. Some factors can facilitate these processes: acknowledging the specific interests and organizational culture of the various organizations involved; designating a mediator to develop a climate of trust; and mitigating the inequalities among partners, in a process which requires considerable efforts over a rather long period of time.

Conclusion: The process of structuring the relations among the associated partners does not end with negotiating a partnership accord. Denying this would be tantamount to denying the political nature of a research partnership, and denying those involved any autonomy in future research projects.

Objectives: To describe the relationship of subjective health and harmful lifestyle with familial risk factors, such as low parental educational level, parental psychiatric disorder reported by their offspring, alcohol use, and divorce.

Methods: 3615 hungarian women aged 15-24 in 1998. The questionnaire addressed socio-economic factors, physical and mental health, and health damaging behaviours.

Results: Low self-rated health (OR: 2.32; Cl: 1.54-3.47; p < 0.001) or at least five health complaints (OR: 2.09; CI: 1.68-2.60; p < 0.001) were significantly more common among women with reported parental psychiatric disorder. Drug use (OR: 2.35; CI: 1.86-2.98; p < 0.001) and regular or excessive alcohol consumption (OR: 1.86; CI: 1.46-2.37) was in strongest association with parental high education.

Conclusions: Family related social problems, especially reported parental psychiatric disorders, regular alcohol consumption, and educational level, are important factors to be taken into account when planning specific interventions for young women.

Objectives: To assess inequalities in mortality from external causes by the level of education and the place of residence during the period of socio-economic transition in Lithuania.

Methods: Information on deaths, place of residence, and the level of education of persons aged 25 and older was derived from the National Database of Lithuania and censuses for 1989 (n=3537) and 2001 (n=4790).

Results: Mortality from external causes of Lithuanian urban and rural populations was strongly associated with the level of education. Educational inequalities increased throughout the period of socio-economic transition. In urban areas, mortality among the least educated population was 3.20 times higher in 1989 and 3.37 times higher in 2001, compared to those with university-level education. In rural areas the educational mortality rate ratios reached 3.47 and 4.33, respectively. The greatest educational inequalities were observed in suicide mortality, especially among males.

Conclusions: The results of this study disclosed increasing inequalities in mortality from external causes. Less educated populations, especially in rural areas, should receive particular attention in the development of strategies for the prevention of mortality from external causes.

Objectives: To develop and test a counselling programme based on the Transtheoretical Model of behavioural change, for promoting exercise in people over the age of 65.

Method: The sample (n = 448) consisted of women and men aged between 65 and 92, recruited from Swiss GPs' practices between 2000 and 2004. After a baseline measurement (T1) and an initial counselling session, they received two counselling sessions, followed by a 12-month follow-up (T2). Changes in exercise behaviour were recorded by means of stage classification and the time spent on everyday moderate-intensity activities that increase the breathing rate.

Results: At T1 there was a tendency for women to be less physically active than men. T1 to T2 the proportion of inactive people fell from 12.2% to 4.2%, and the proportion of people sufficiently active rose from 19.0 % to 31.3 %. The changes in stage were significant in both men and women. At T2 more than half of the participants in the study spent more time exercising.

Conclusions: The results indicate that, with counselling, the exercise behaviour of the elderly can be positively influenced over a 1-year period.

Objectives: To assess socioeconomic differences between towns with and without water fluoridation, and to compare dental caries levels among socioeconomic strata in fluoridated and non-fluoridated areas.

Methods: A countrywide survey of oral health performed in 2002-03 and comprising 34,550 children aged 12 years provided information about dental caries levels in 249 Brazilian towns. Socioeconomic indices, the coverage and the fluoride status of the water supply network of participating towns were also appraised. Multivariate regression models fitted the adjustment of dental caries levels and covariates to socioeconomic status and water supply. Inequalities in dental outcomes were compared in towns with and without fluoridated tap water.

Results: Better-off towns tended to present a higher coverage by the water supply network, and were more inclined to add fluoride. Fluoridated tap water was associated with an overall improved profile of caries, concurrent with an expressively larger inequality in the distribution of dental disease.

Conclusion: Suppressing inequalities in the distribution of dental caries requires an expanded access to fluoridated tap water; a strategy that can be effective to foster further reductions in caries indices.