Journal of the Royal Society of Health最新文献

This study considers aspects of the experiences of a group of people attending a sexual health clinic and receiving the diagnosis of a sexually transmitted infection (STI). The study was conducted in the form of action research using a qualitative approach. Participants consisted of eight attenders at a sexual health clinic who had been diagnosed with a sexually transmitted infection. Counselling skills and techniques were used throughout semi-structured interviews to explore participants' feelings about these issues. Thematic analysis was used to generate themes of importance to the participants. Some people who had been to a sexual health clinic and received a diagnosis of a sexually transmitted infection were found to experience feelings of anxiety, stigma and isolation. This study is of value to all those working in the field of sexual health with an interest in understanding the issues that are important to the client group.

In 1992, at the Rio Earth Summit, many governments, including our own, committed themselves to developing local strategies for sustainable development in the form of Local Agenda 21. Sustainable development is discussed, as is the philosophy and practice of health promotion and environmental health. Common approaches are identified and the links in relation to key areas of activities, strategies, values and principles are outlined. Finally, recommendations are made and conclusions drawn in relation to the overlap between environmental health action, Agenda 21 strategies and health promotion practice.

Obesity can no longer be viewed as merely a cosmetic or social problem, but must be acknowledged as a serious disease, responsible for the premature death and morbidity of millions and for significant expenditure of limited healthcare resources. In addition, there are significant costs to the individual with regard to social status and quality of life. It has been argued that obesity is one of the most important preventable causes of ill health in the UK today. This is especially important when one considers that the incidence of obesity is actually rising, with 13% of men and 16% of women in the UK in 1997 being obese. To begin treating such a disease it is essential to raise awareness of this problem, not only from the associated morbidity and mortality risks that have been well documented, but the socio-economic and psychological costs. This paper reviews the literature available globally, giving some measure of the magnitude of the associated burden of illness.

The epidemiological evidence linking smoking with insulin resistance is considerable. This evidence is even more convincing because there is a dose response relationship between smoking and the risk of non-insulin dependent diabetes (NIDDM). Similarly, there is a time-dependent decrease in risk of NIDDM for those who quit smoking. Insulin resistance (in the form of impaired glucose tolerance, IGT) may precede the development of NIDDM. There is a biochemical basis for the smoking-IGT/NIDDM relationship. Smoking increases the risk of developing diabetic complications like nephropathy, neuropathy and retinopathy Smoking is also an independent risk factor for myocardial infarction and all-cause mortality in NIDDM. Smokers are both insulin resistant and lipid intolerant. Smoking cessation increases circulating high density lipoprotein (HDL) and reduces low density lipoprotein (LDL) levels, despite weight gain. Those providing advice or treatment to improve cardiovascular risk factors should be aware of these smoking-related harmful effects. This is especially true if IGT is underdiagnosed despite the fact that this condition increases the risk of vascular events. Explaining that smoking increases the chance of developing diabetes as well as raising 'blood fat' levels may convince more smokers to quit.