The Journal of the Royal Society for the Promotion of Health最新文献

We report a case of fatal internal haemorrhage in an elderly man who consumed only cranberry juice for two weeks while maintaining his usual dosage of warfarin. We propose that naturally occurring compounds such as flavonoids, which are present in fruit juices, may increase the potency of warfarin by competing for the enzymes that normally inactivate warfarin. While traditionally regarded as foodstuffs, consumption of fruit juices should be considered when patients develop adverse drug reactions.

The use and regulation of homeopathy has long been the focus of debate, lacking as it does in scientific evidence of its clinical effectiveness. Claimed to be 'harmless', it is often argued that there is no reason for it not to be used in conjunction with conventional treatments, and that there is the possibility that it may be beneficial. Lizzy Hay discusses whether in fact patients are at risk from this 'harmless' treatment if their confidence stretches to using homeopathy solely as an alternative treatment when really only 'a spoonful' should be taken to help the conventional medicine go down.

Wales is developing a unique integrated system of governance to improve public health, which is diverging from some recent developments in the rest of the UK but shares many common features. There is a focus on strengthening collaborative working and co-ordination between bodies inspecting, regulating and auditing health and social care. Systems are being developed that are proportionate to the level of risk, eliminate unnecessary burdens of external review and support the improvement of services for patients, service users and carers. This is consistent with the Assembly Government's aim to improve the way that public services are delivered in Wales, including strengthening input from the public in the planning, delivery and reporting of regulation and inspection work. The test in the future will be how far we can demonstrate quantitatively and qualitatively the added value from our uniquely Welsh approach, built as it is on devolution and the aspirations for small-country governance.

Aims: Cervical cancer and breast cancer have had the first and second highest occurrence rates among women in Taiwan since 1981 and have also been two of the leading causes of cancer death. In order to more effectively promote preventive medical care programs, it is important to identify the key determinants of women's behavior regarding their decisions to engage in screenings. This study aims to identify the major factors that affect the utilization of breast and cervical cancer screening among women in Taiwan, who are covered by universal National Health Insurance.

Methods: Data were obtained from the 2001 National Health Interview Survey for the Taiwan area and targeted women between 30 and 75 years old. The sample size consisted of 5,611 individuals for Papanicolaou (Pap) tests and breast examinations by a doctor. For breast ultrasounds and mammograms, 3,875 individuals were included. The propensity among women in Taiwan to use the two types of screening services, i.e., Pap test and breast examinations, were estimated by maximum likelihood probit regressions.

Results: The findings in this study show that the likelihood of a woman receiving a Pap test or a clinical breast examination depends on a variety of factors such as age, marital status, income level, education, and health status. Women with lower socioeconomic status were found to be much less likely to undergo the freely available cancer screening services. In addition, healthy behavior, such as not smoking and engaging in exercise, had a positive effect on the uptake of screening.

Conclusions: The results of this study enable us to understand more thoroughly the characteristics of women who undergo a Pap test and breast examination, as well as the factors that influence them in Taiwan. The findings can help formulate related policies that are directed at removing the barriers to accessing medical care and targeting those at-risk groups. This analysis provides new evidence of the factors affecting the utilization of preventive care among women in a developing country, which are comparable to those of other countries, and may shed further light on the issue of promoting cancer screening and women's health.