Demand for the development of health services that are responsive to the views of users has led to a growing interest in the measurement of patient satisfaction. Initial reluctance to seek the views of users of mental health services focused on a debate about whether or not mentally disordered patients were able to make 'valid' comments about their treatment. More recently the development of questionnaires that claim to 'reliably measure' the views of patients have coincided with a greater acceptance of the role that such studies can play. However, it is argued that the use of these quantitative and often simplistic methods underestimate the dissatisfaction of many patients. Further exploration of the differing expectations of users and providers of services and a degree of willingness in both parties to change is required if services are to be developed that better meet the needs of patients.
"The goal of improving public health involves the use of different tools, with the law being one way to influence the activities of institutions and individuals. Of the regulatory mechanisms afforded by law to achieve this end, criminal law remains a perennial mechanism to delimit the scope of individual and group conduct. Utilising criminal law may promote or hinder public health goals, and its use raises a number of complex questions that merit exploration. This examination of the interface between criminal law and public health brings together international experts from a variety of disciplines, including law, criminology, public health, philosophy and health policy, in order to examine the theoretical and practical implications of using criminal law to improve public health"--
Involuntary migration is a crucially important global challenge from an economic, social, and public health perspective. The number of displaced people reached an unprecedented level in 2015, at a total of 60 million worldwide, with more than 1 million crossing into Europe in the past year alone. Migrants and refugees are often perceived to carry a higher load of infectious diseases, despite no systematic association. We propose three important contributions that the global health community can make to help address infectious disease risks and global health inequalities worldwide, with a particular focus on the refugee crisis in Europe. First, policy decisions should be based on a sound evidence base regarding health risks and burdens to health systems, rather than prejudice or unfounded fears. Second, for incoming refugees, we must focus on building inclusive, cost-effective health services to promote collective health security. Finally, alongside protracted conflicts, widening of health and socioeconomic inequalities between high-income and lower-income countries should be acknowledged as major drivers for the global refugee crisis, and fully considered in planning long-term solutions.
ABSTRACTBackground Campylobacteriosis is a major public health concern. Despite evidence that climate factors influence the spatio-temporal patterns of the infections; their impact is not fully described and understood.
ObjectivesTo examine methods for determining the impact of rainfall and temperature on Campylobacter cases in England and Wales.
MethodsReported cases for England and Wales were linked to local temperature and rainfall at laboratory postcode locations in the 30 days before the specimen date. Descriptive, statistical and spatial methods included a novel Comparative Conditional Incidence (CCI), wavelet analysis, hierarchical clustering, generalized additive model (GAM) and generalized structural time series model (GEST).ResultsThe Campylobacter increase in late spring was linked to temperature two weeks prior, with an increase in CCI of 0.175 cases per 100,000 per week for weeks 17 to 24; the relationship was non-linear and changed through the year. GEST with penalized varying temperature coefficient found 33% of the seasonal change was attributable to temperature, while with a fixed temperature coefficient found 8%. Wavelet analysis showed a strong annual cycle, with harmonics at six and four months and no simple association with temperature or rainfall. Geographic clustering showed three clusters with geographic similarities, representing metropolitan, rural, and other areas.
ConclusionsOur analyses provide more robust and convincing associations than simple regression analysis. The association with temperature is likely to be indirect and the primary driver remains to be determined. Local-temporal linkage of weather parameters and cases is important in improving the resolution of climate associations with infectious diseases and provides methods which can improve disease predictions. Further examination of data from a wider geographic area and longer time series should improve the understanding of the epidemiology and drivers of human Campylobacter infections.
