10 Possible Reasons Public Health Communication Strategies on Behaviour Change May be Failing: An introduction to the 2-6-10 Slot Model.© « drnyashamboti

From the abstract of a Paper to be presented at the International Association of Media and Communication Researchers, Durban, 2012, University of KwaZulu-Natal

By Nyasha Mboti

University of KwaZulu Natal

Abstract

Every year many millions of dollars are spent on programmes and strategies to motivate ‘at-risk’ populations to ‘change’ their ‘behaviour’. At issue in this paper is the efficacy of such programmes and strategies. The “2-6-10 slot model” is a simple algorithm I have built to explain some of the seemingly obvious failures of Public Health interventions in Africa targeted at so-called ‘Behaviour Change’, specifically in the domain of HIV and AIDS campaigns. The model is draws on unanswered questions about ‘Behaviour Change’ programmes and strategies and is meant to be a critical commentary on the strategic assumptions of such programmes. In building the model, I argue that the notion of ‘Behaviour Change’ is too vague, sometimes to the point of uselessness. As such, the model asks the questions that public health opinion leaders seldom or never ask. The 2-6-10 slot model focuses on the interventions targeted at so-called ‘multi-partnerism’ and the efforts to motivate people to ‘stick to one partner’. It uses ‘slots’ to describe, characterise and reflect on the gaps that conventional Public Health strategies have failed to explain or fill. The model suggests the adoption of more evidence-based modelling of Public Health strategies as opposed to ones that are largely assumption-led. The 2-6-10 slot model is so-called because it comprises of diagrams, or empty slots, that begin at 2 and increase to 6, 10 and so on. The increase in slots represents the increase in failure of a respective public health intervention.

Related articles

• Public health experts condemn plans (mirror.co.uk)
• Collaboration Of Public And Private Health Partners Is Essential For Health Improvement (medicalnewstoday.com)
• Public Health Investments Pay Off (hcfama.org)
• Healthy People? Not Quite Yet – From “The Public’s Health” Blog (jflahiff.wordpress.com)

Ten Facts about Mobile Broadband

Great summary by Darrell M. West, Vice President and Director, Governance Studies at the Brookings Institution.

Here’s just one of the facts… (others topics  include  their outnumbering of personal computers next year, increase in overall use by Americans, job creation, reshaping of education, political engagement, public safety, and disparity reduction)

 

7. Mobile Helps Patients and Health Care Providers

Health care today is dominated by physicians, hospitals, the pharmaceutical industry, insurance companies, and government agencies. Patients seek to navigate their health care by moving across a variety of providers, ordering prescription drugs from pharmacies, and seeking reimbursement from either public or private insurance plans. They spend hours connecting the dots and working out the best health care for themselves and their families.

Imagine a different system where, with the aid of the Internet, electronic medical records, and smartphones, the patient is in charge.[xviii] People monitor their own weight, blood pressure, pulse, and sugar levels, and send test results via remote devices to health care providers. Patients store their medical records online and have access regardless of where they are in the United States or around the world. They get personalized feedback via e-mail and reminders when they gain weight, have an uptick on their cholesterol levels, don’t take their medicine, or have high blood pressure. Social networking sites provide discussion forums and the benefit of collective experience from other people suffering similar problems. Patients take responsibility for their routine health care and rely on physicians and hospitals for more serious medical conditions.

This system is not a futuristic vision, but is within our grasp. It would cut costs by reducing professional responsibility for routine tasks and record-keeping, while also making it possible for patients to receive higher quality care and be more satisfied with the end-result. The technologies for this kind of system transformation currently are available through cell phones, mobile broadband, remote monitoring devices, video conferencing, and the Internet.

Smartphones offer advanced features such as mobile e-mail, web browsing, and wireless communications. The sophistication of these devices has spawned a variety of new medical applications that help doctors and patients stay in touch and monitor health care needs.

For example, there is a mobile application that allows physicians to get test results on their mobile device. They can look at blood pressure records over time, see an electro-cardiogram, or monitor a fetal heart rate. AirStrip Technologies markets an application that makes it possible for obstetricians remotely to monitor the heart rates of fetuses and expecting mothers. This allows them to detect conditions that are placing either at risk.

Work by Prgomet and colleagues has found that mobile handhelds have positive impacts on hospital physician work practices and patient care.  When equipped with such devices, researchers discovered benefits in terms of “rapid response, error prevention, and data management and accessibility”.[xix]  These benefits were especially profound in emergency room settings where time is of the essence in treating patients.

Mobile devices offer help for developing nations.  A majority of sub-Saharan Africa residents are served by cellphones with texting capabilities.  A non-profit organization called Medic Mobile seeks to use text messaging in that part of the world to track epidemics and help disaster relief personnel find those in need.[xx]

These applications make doctors more efficient because they don’t have to be in the physical presence of a patient to judge his or her condition. Digital technology allows people to overcome the limitations of geography in health care and access information at a distance. This makes it possible for patients to get a second opinion by sending that person relevant medical tests. If a personal conference is required, doctors can use video conferencing to speak to patients located in another locale.

Related Resources

• Get Mobilized! An introduction to mobile resources and tools in health sciences libraries (Medical Library Association)

  Archived 2011 online class including “lecture notes”, resources, class discussions, and related slides/videos

• Health Apps (in Health and Medical News and Resources selected by Janice Flahiff)
  a short list of information and tracking apps derived from the above Get Mobilized class

Related articles

• From DIY Diagnostic Tests to Mobile Health Competitions (scienceroll.com)
• mHealth: Seemingly Stuck in Neutral (chilmarkresearch.com)
• mHealth Moving Fast, Raising Hope, And Questions (jflahiff.wordpress.com)
• Mobile health: Hallelujah or bah humbug? (finance.fortune.cnn.com)
• mHealth Summit 2011 – Videos Available (imianews.wordpress.com)
• mHealth Moving Fast, Raising Hope, And Questions (egmnblog.wordpress.com)
• Sensei, Inc. Presenting at mHealth Summit (prweb.com)
• Zeo Sleep Monitor CEO at the 2011 mHealth Summit (medgadget.com)

15 new conservation concerns

 

Image via Wikipedia

From the 12 December 2011 Eureka News Alert

A review carried out by a group of international specialists has identified several emerging issues that are likely to damage biodiversity in the coming years.

The review was conducted by 22 specialists from 20 institutions, including the University of Cambridge and the European Centre for Environment and Human Health, and aims to provide a ‘critical list’ of issues that need investigating in the near future.

The analysis focused on changes in climate, technology and human behaviour, with particular attention on the way developments in these areas could impact on the conservation of biodiversity. The authors hope that by identifying these issues, which are often at the very edge of our current understanding, researchers and policy-makers can be given early warning of what tomorrow’s problems are likely to be – allowing them to take appropriate preventative action now.

A total of 15 issues have been highlighted by the review, each focusing on a specific development. One of the issues is the potentially damaging impact of pharmaceuticals that are released into the environment after human use. As populations age and our use of drugs increases, these chemicals are beginning to affect fish, birds and other organisms, but the larger scale impact on our ecosystems is mostly unknown. Another area identified by the study highlights the increasing use of nuclear batteries and the safe disposal of their waste. These novel power sources could provide electricity to remote and deprived communities but the implications for the environment are yet to be determined….

….

This review has highlighted a number of issues that are likely to be of great importance throughout the 21st century. From the warming of the deep sea to placing hydro-electric turbines in rivers, it is clear that our potential to damage the natural environment will continue to be a crucial area in which we should conduct research. By identifying these issues at an early stage we hope to gain an understanding that can drive changes in policy and behaviour, ultimately helping to preserve biodiversity and increase the adoption of sustainable ways of living.”

 

Related articles

• Is green certification good for biodiversity? (forbes.com)
• Get ready for ecosystem collapse in the years ahead [Environment] (io9.com)
• Protecting the Himalayas (thehindu.com)
• Creatures found and lost before scientists can record them (smh.com.au)
• Are Western Conservation Efforts Causing Famine In Africa? (indiancountrytodaymedianetwork.com)
• Ongoing global biodiversity loss unstoppable with protected areas alone: Study (eurekalert.org)

Growing US violent extremism by the numbers: UMD database

[Author’s note…on a hopeful note…. a number of researchers have concluded that violence overall has decreased within the human race over the past millenia. Am currently reading Steven Pinker’s book The Better Angels of Our Nature: Why Violence has Declined.]

 

 

 

 

 

 

 

 

 

From the UMD news release at Eureka Alerts

COLLEGE PARK, Md. – Over the past decade, attacks and plots by homegrown terrorists in the United States have increased, the work of extremists from across the political spectrum – roughly 40 percent of it by so-called ‘lone wolf,’ non-aligned actors – says an analysis by the National Consortium for the Study of Terrorism and Responses to Terrorism (START) based at the University of Maryland.

The statistics underscore the threat addressed in a White House plan released Thursday: Strategic Implementation Plan for Empowering Local Partners to Prevent Violent Extremism in the United States – a blueprint for “building community resilience against violent extremism.”

“There have been more than 200 terrorist attacks in the United States since 9/11, but what has really increased is the total number of foiled terrorist plots,” says UMD researcher and START director Gary LaFree, who has developed the largest and most comprehensive unclassified terrorism database in the world with funding from the U.S. Department of Homeland Security.

“Our researchers have tracked over 100 foiled plots in the past decade,” LaFree adds. “Most of these would be classified as homegrown terrorism.”

The new White House plan follows up on a strategy first laid out last August, and discussed at UMD by Secretary of Homeland Security Janet Napolitano in October.

“The facts make it clear – homegrown, violent extremism is not just a problem for other countries,” LaFree explains. “The administration plan confronts this reality by providing a strategy that draws heavily on local communities as the key to prevention.”

Click here for the rest of the news release (including a fact sheet)

From the UMD consortium’s about page

The National Consortium for the Study of Terrorism and Responses to Terrorism—better known as START – is a university-based research center committed to the scientific study of the causes and human consequences of terrorism in the United States and around the world.

Based at the University of Maryland, START supports research efforts of leading social scientists at more than 50 academic and research institutions, each of whom is conducting original investigations into fundamental questions about terrorism, including:

• Under what conditions does an individual or a group turn to terrorism to pursue its goals? What is the nature of the radicalization process?

• What attack patterns have different terrorists demonstrated during the past forty years? How has terrorist behavior evolved? And, what does this indicate about likely future terrorist activity?

• What impact does terrorism and the threat of terrorism have on communities, and how can societies enhance their resilience to minimize the potential impacts of future attacks?

Related articles

• Growing US violent extremism by the numbers: UMD database (physorg.com)
• Is The Government Omitting Anti-Abortion Violence From Its Main Terrorism Database? (huffingtonpost.com)
• Counterterrorism Czar Resists Muslim Labels, As Critics Say Right-Wing Threat Looms Larger (huffingtonpost.com)
• Beyond Guantánamo, a web of prisons (thehindu.com)
• Federal prisons hold scores linked to terrorism (sfgate.com)
• Assessing the Impact of 9/11 (mpoverello.wordpress.com)
• US believers favor international action on climate change, nuclear risk: UMD poll (eurekalert.org)
• Far right domestic terrorism on par with foreign threat, experts say (cnn.com)

Chronic Pain in Children and Adolescents Becoming More Common

 

Schematic Examples of CNS Structural Changes in chronic pain.jpg http://commons.wikimedia.org/wiki/File:Schematic_Examples_of_CNS_Structural_Changes_in_chronic_pain.jpg Borsook D, Moulton EA, Schmidt KF, Becerra LR.

 

 

From the 9 December 2011 Medical News Today article

Children who suffer from persistent or recurring chronic pain may miss school, withdraw from social activities, and are at risk of developing internalizing symptoms such as anxiety, in response to their pain. In the first comprehensive review of chronic pain in children and adolescents in 20 years, a group of researchers found that more children now are suffering from chronic pain and that girls suffer more frequently from chronic pain than boys.

…

Their findings indicate that most types of pain are more prevalent in girls than in boys, but the factors that influence this gender difference are not entirely clear. Pain prevalence rates tend to increase with age. Psychosocial variables impacting pain prevalence included anxiety, depression, low self-esteem, and low socioeconomic status. Headache was found to be the most common studied pain type in youth, with an estimated prevalence rate of 23%. Other types of pain, ie, abdominal pain, back pain, musculoskeletal pain, and pain combinations, were less frequently studied than headache, and prevalence rates were variable because of differences in reporting. However, the overall results indicated that these pain types are highly prevalent in children and adolescents, with median prevalence rates ranging from 11% to 38%. “These rates are of great concern, but what is even more concerning is that research suggests that the prevalence rates of childhood pain have increased over the last several decades,” stated Dr. King.

Researchers also found that many studies did not meet quality criteria and there was great variability in prevalence rates across studies due to time periods over which pain was reported……

Related articles

• Chronic pain in children and adolescents becoming more common (scienceblog.com)
• Chronic pain in children and adolescents becoming more common (eurekalert.org)
• Chronic pain in children and adolescents becoming more common (medicalxpress.com)
• When Children Live With Chronic Pain (everydayhealth.com)
• Know Your Risk for Chronic Pain (everydayhealth.com)
• Physical Therapy for Pain Management (everydayhealth.com)
• Opioids May Be Overused for Chronic Stomach Pain (cherished79.wordpress.com)
• Remote-controlled medical device helps alleviate chronic pain ()

Missed Opportunity To Transform Global HIV/AIDS Fight Reported By Tropical Disease Experts

 

English: Estimated HIV prevalence among young adults (15-49) by country. http://commons.wikimedia.org/wiki/File:Map-of-HIV-Prevalance-in-Africa.png

 

From the 12 December 2011 Medical News Today article 

Global HIV/AIDS prevention and treatment efforts are missing a major opportunity to significantly improve health conditions in poor countries by simply adding low-cost care for the many other chronic and disabling diseases routinely afflicting and often killing these same patients, according to a panel of disease experts who spoke at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH).

“People want better health; they do not understand why we silo diseases,” said Judd Walson, a global health and infectious disease expert at the University of Washington. “If you die from malaria, you don’t care that your HIV was treated. Communities want us to leverage the resources we have to treat and prevent disease as effectively as possible.”

Walson and his colleagues on the panel noted that many victims of HIV/AIDS also typically suffer from one or more of about 17 neglected, but burdensome, tropical diseases often called “diseases of poverty” because they prey on the “bottom billion” – the world’s poorest people. They include ailments such as trachoma, schistosomiasis, lymphatic filariasis, leishmaniasis, Chagas disease and onchocerciasis, all of which are either insect-borne disease, bacterial infections, or caused by parasitic worms.

Despite the illness and deaths attributable to these diseases, proposed US funding for fighting them was only about $155 million in 2011, or about 3 percent of the $5.6 billion invested in HIV/AIDS efforts. Moreover, the programs often exist in isolation from one another with, for example, many programs restricting support only to antiretroviral drugs to treat AIDS.

Yet tropical disease experts note that in places like sub-Saharan Africa, where neglected diseases affect 1.4 billion people, co-infections with HIV are common. And they see mounting evidence that dealing with multiple diseases at the same time and in the same place is more cost-effective and clinically beneficial.

Walson pointed to a program in Western Kenya that focused on a community suspected of having high levels of HIV but whose remote location made it hard to reach to conduct testing. The program promised access to free bed nets and water filters to those residents who came in for a test. In just six days, some 10,000 residents turned out for the free nets and filters. The result: 1181 people were found to be HIV positive and referred to care while thousands of people gained new tools for preventing malaria and water-borne diseases. …….

Related articles

• Tropical disease experts report missed opportunity to transform global HIV/AIDS fight (eurekalert.org)
• Tropical disease experts report missed opportunity to transform global HIV/AIDS fight (medicalxpress.com)
• World AIDS Day: American Indians Join the Fight ‘Getting to Zero’ New HIV Infections (indiancountrytodaymedianetwork.com)
• Doctors Without Borders Pays Tribute to the People Fighting HIV/AIDS in Africa and Launches “Positive Generation: Voices for an AIDS-Free Future” (prweb.com)
• Women&AIDS&World: Globally, HIV/AIDS is the leading cause of death among women of reproductive age (one365.org)
• World AIDS Day 2011 Theme: ACT AWARE (VIDEOS) (blippitt.com)