Journal of the Royal Society of Health最新文献

Many studies have indicated the health status of homeless people to be typically poorer than that of the general population, with various studies indicating a high prevalence of psychiatric illness, drug or alcohol misuse and associated socio-medical problems. The Bristol Primary Healthcare Project is an agency which was established to provide a local health care service tailored to the needs of people who are homeless. The present study was carried out as part of an evaluation of the service offered locally to homeless people by General Practitioners (GPs). A postal questionnaire survey of 155 general practices within the Avon FHSA area was carried out. Both fundholding and non-fundholding practices were included, within an area including inner city, urban and rural/semi-rural locations. One hundred and seventeen completed questionnaires were returned, providing a response rate of 75%. Twenty-seven percent of practices would fully register a homeless person who seeks to register at the practice, 24% would treat as immediate and necessary and 33% would treat as a temporary resident. Four percent of fundholding practices surveyed would fully register homeless persons and 55% of inner city practices would do so. Seventy-nine percent of doctors indicated that homeless patients were more difficult to treat than other patients. The most frequent problems associated with registering homeless persons were perceived to be the associated social problems (90% of respondents agreed), the lack of medical records (88% agreed), the complex health problems (79% agreed) and the associated alcohol or substance misuse (78% agreed). The study has highlighted a need for government to consider providing incentives to GPs to register homeless people without resulting in adverse effects on their contract targets. The reluctance of some practices to register these patients varied by area and type of practice with doctors at fundholding practices being the most reluctant. There is an identified need for further health education and promotion work and initiatives exemplified by the Bristol Primary Healthcare Project for people who are homeless.

'Aromatherapy' is one of the most actively growing forms of alternative medicine combining massage together with counselling and a nice odour. Most clients suffer from some kind of stress-related disorder and aromatherapy encourages the healing process largely through relaxation and the relief of stress. Stress is also a major problem in hospitals, hospices and homes for the aged and physically or mentally-challenged. Aromatherapy is welcomed by nurses who want to be closer to their patient and doctors who can refer patients with stress-related disorders who do not respond to conventional medicines. The actual mode of action of essential oils in vivo is still far from known, although there is strong in vitro evidence that essential oils can act as an antimicrobial or antioxidant agent or have a pharmacological effect on various tissues. Studies have shown that essential oils have an effect on brainwaves and can also alter behaviour. It is possible that most of the effect of the oils is probably transmitted through the brain via the olfactory system. Used professionally and safely, aromatherapy can be of great benefit as an adjunct to conventional medicine or used simply as an alternative.

The case is presented of a 14 year old boy who developed severe anaemia at the onset of puberty caused by nutritional deficiency of vitamin B12 of about 10 years duration. The dietary intake comprised mainly chips, ice-cream, fruit and Coca-Cola--with small amounts of vitamin B12 from occasional slices of chicken meat. His denial of abnormal nutritional intake, supported by his mother, delayed confirmation of the correct diagnosis. However, the true situation was eventually confessed--and following implementation of a normal diet he rapidly improved clinically, the haemoglobin value rose to normal and he subsequently remained well.

A cross-sectional study was carried out on a sample of elderly subjects aged 65 years and above, resident in Qassim region, in central Saudi Arabia. The sample size was 266 subjects (12%). The study objective was to assess the subjects' functional activities in the form of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Wadu, the Muslim tradition of washing before the main five daily prayers was included in the ADL. The results showed that impairment of ADL, ADL and Wadu, and IADL was observed in 12.4%, 7.9% and 54.4% of subjects. Advancing age and female gender were found to be negatively, while male gender and having an occupation were found to be positively associated with functional activity.

There is extensive use of simple and inexpensive roof water collection systems in some Southeast Asian countries. The collected runoff which flows off different types of roofs is affected not only by the inherent quality of the roofing material but also by the contamination of roofs by rodents, birds, etc. Consequently, bacteriological quality levels are excessive though the collected rainwater is still used extensively for potable purposes. From samples collected in most locations, there were positive Total and Faecal Coliform counts though, in terms of physico-chemical parameters, roof water appears to be of a higher quality. Various causes have been attributed to the frequent presence of Faecal Coliform but, mostly, pollution is of animal origin as the Faecal Coliform/Faecal Streptococci ratio is less than unity. It is proposed that the collected roof water be boiled, disinfected with household bleach or be subjected to radiation from sunlight which appears to have good potential to be an effective bactericide. It is recommended that simple testing methods be developed and health education imparted to the various aspects of utilising roof water collection systems.

Pica is the compulsive eating of non-food substances over a sustained period of time. It remains an intriguing, little understood occurrence, with a potential for both positive and negative outcomes. In this review information is given on the history of the phenomenon, its prevalence among children and women, and its relation to iron and zinc deficiency. A number of examples of pica practice are reported from Africa.