[Show abstract][Hide abstract] ABSTRACT: Introduction
There is increasing international interest in universal, health promoting services for pregnancy and the first three years of life and the concept of proportionate universalism. Drawing on a narrative review of literature, this paper explores mechanisms by which such services might contribute to health improvement and reducing health inequalities.
Through a narrative review of empirical literature, to identify:
(1) What are the key components of health visiting practice?
(2) How are they reflected in implementing the universal service/provision envisaged in the English Health Visitor Implementation Plan (HVIP)?
The paper draws upon a scoping study and narrative review.
We used three complementary approaches to search the widely dispersed literature:
(1) broad, general search,
(2) structured search, using topic-specific search terms
(3) seminal paper search.
Our key inclusion criterion was information about health visiting practice. We included empirical papers from United Kingdom (UK) from 2004 to February 2012 and older seminal papers identified in search (3), identifying a total of 348 papers for inclusion. A thematic content analysis compared the older (up to 2003) with more recent research (2004 onwards).
The analysis revealed health visiting practice as potentially characterized by a particular ‘orientation to practice.’ This embodied the values, skills and attitudes needed to deliver universal health visiting services through salutogenesis (health creation), person-centredness (human valuing) and viewing the person in situation (human ecology). Research about health visiting actions focuses on home visiting, needs assessment and parent-health visitor relationships. The detailed description of health visitors’ skills, attitudes, values, and their application in practice, provides an explanation of how universal provision can potentially help to promote health and shift the social gradient of health inequalities.
Identification of needs across an undifferentiated, universal caseload, combined with an outreach style that enhances uptake of needed services and appropriate health or parenting information, creates opportunities for parents who may otherwise have remained unaware of, or unwilling to engage with such provision.
There is a lack of evaluative research about health visiting practice, service organization or universal health visiting as potential mechanisms for promoting health and reducing health inequalities. This paper offers a potential foundation for such research in future.
[Show abstract][Hide abstract] ABSTRACT: Cel pracy
Przegląd piśmiennictwa w celu zweryfikowania następującej hipotezy: zastosowanie leków przeciwgorączkowych u dzieci z ostrymi zakażeniami opóźnia wyzdrowienie.
Przeprowadzono przegląd systematyczny i metaanalizę piśmiennictwa w celu oceny wpływu leków przeciwgorączkowych na ustąpienie objawów klinicznych chorób infekcyjnych u dzieci. Przeszukano bazy piśmiennictwa Medline (od 1946 roku do listopada 2012 roku) i EMBASE (od 1980 roku do 1 listopada 2012 roku) w celu znalezienia badań klinicznych, w których autorzy porównali zastosowanie leków przeciwgorączkowych z niefarmakologicznymi sposobami zwalczania gorączki.
Znaleziono 6 artykułów, z których 5 włączono do metaanalizy. Trzy badania przeprowadzono u dzieci chorych na malarię, a pozostałe trzy dotyczyły ogólnych zakażeń wirusowych, zakażeń wirusowych układu oddechowego oraz ospy wietrznej. Średnia różnica w czasie ustąpienia gorączki na podstawie połączonych danych wyniosła 4,16 godziny. Czas ten był krótszy u dzieci otrzymujących leki przeciwgorączkowe w porównaniu z dziećmi, które leczono bez stosowania tych leków (95% CI -6,35 do -1,96 godziny; p = 0,0002). Wykazano niewielkie różnice znamienne statystycznie (χ2 4,84; 4 df; p = 0,3; I2 17%).
Na podstawie analizowanych badań nie potwierdzono, że zastosowanie leków przeciwgorączkowych wydłuża czas ustępowania gorączki u dzieci.
[Show abstract][Hide abstract] ABSTRACT: The UK is currently experiencing an epidemic of pertussis (whooping cough), in spite of the fact that uptake of immunisation against this disease has remained consistently high for some time. The number of cases is far higher in adults and adolescents, but there has also been a huge increase in the burden of disease among infants under 3 months, in whom the outcome is potentially far more serious. Last year, 14 infants died from the disease, prompting the Joint Committee on Vaccination and Immunisation (JCVI) to recommend vaccination for all women in the third trimester of pregnancy. This article looks at the background to the current epidemic, outlining the history of the disease; the underpinning immunological principles that have influenced attempts to control its spread to date; the current immunisation schedule; and other possible measures being considered.
British journal of nursing (Mark Allen Publishing) 10/2013; 22(18):1046-1050.
[Show abstract][Hide abstract] ABSTRACT: To undertake a concept analysis to clarify the meaning of the term 'fever' in children and to identify models of fever-related belief that may help in understanding the response of parents and professionals to fever in children.
This concept analysis was undertaken because the approach to the treatment of fever varies widely and in particular that there is often a difference between what parents want for their children, official guidelines and what professionals do in practice.
The study used a modified evolutionary method of concept analysis. The analysis was based on data from medical, nursing, popular and biological literature and used an iterative process to clarify the term.
Fever has a number of distinct uses based on its meaning and history; these include its use to indicate an illness itself, as a beneficial symptom associated with disease, and a diagnostic sign. Three models of fever-related practice emerged from the analysis, these being a phobic-fearful approach that drives routine treatment, a scientific approach that sees fever as a potentially adaptive and beneficial response and a scientific but pragmatic approach that recognises potential benefit but results in treatment anyway. These different uses, which are often not clarified, go some way to explaining the different approaches to its treatment.
When parents, clinicians, physiologists and guideline writers discuss fever, they attribute different meanings to it, which may go some way to explaining the dissonance between theory and practice. In the absence of new knowledge, the emphasis of practitioners should therefore be on their safe use.
When discussing the meaning and treatment of fever, it is important to understand what is meant in different circumstances. The models of fever-related beliefs outlined here may go some way to helping this process.
[Show abstract][Hide abstract] ABSTRACT: REVERED OR reviled, the late Margaret Thatcher transformed UK society, with opinion divided on whether it was for the better or worse. Among other things, her government devised the healthcare purchaser-provide split, enacted under her successor John Major in 1991, which heralded a new era in health service management.
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