BACKGROUND & AIMS: :The Management Academy for Public Health is a team-based training program jointly offered by the School of Public Health and the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill. This 9-month program teaches public health managers how to better manage people, information, and finances. Participants learn how to work in teams with community partners, and how to think and behave as social entrepreneurs. To practice and blend their new skills, teams develop a business plan that addresses a local public health issue. This article describes the program and explains the findings of the process evaluation, which has examined how best to structure and deploy a team-based method to create more effective, more entrepreneurial public health managers. Findings indicate that recruitment and retention are strong, program elements are relevant to learners' needs, and learners are satisfied with and value the program. Several specific benefits of the program model are identified, as well as several elements that support business plan success and skills' application on the job. On the basis of these findings, four success factors critical for developing similar programs are identified.

背景与目标： : 公共卫生管理学院是由公共卫生学院和北卡罗来纳大学教堂山分校的Kenan-Flagler商学院联合提供的基于团队的培训计划。这个为期9个月的计划教公共卫生经理如何更好地管理人员，信息和财务。参与者将学习如何与社区合作伙伴一起团队合作，以及如何作为社会企业家进行思考和行为。为了实践和融合他们的新技能，团队制定了解决当地公共卫生问题的商业计划。本文介绍了该计划并解释了过程评估的结果，该评估研究了如何最好地构建和部署基于团队的方法，以创建更有效，更具企业家精神的公共卫生经理。研究结果表明，招聘和保留能力很强，课程要素与学习者的需求相关，并且学习者对课程感到满意并重视。确定了计划模型的几个特定好处，以及支持业务计划成功和技能在工作中的应用的几个要素。根据这些发现，确定了开发类似计划的四个成功因素。

BACKGROUND & AIMS: BACKGROUND:Telephone surveys have been used widely in public health research internationally and are being increasingly used in Ireland and the U.K. METHODS:This study compared three telephone surveys conducted on the island of Ireland from 2000 to 2004, examining study methodology, outcome measures and the per unit cost of each completed survey. We critically examined these population-based surveys which all explored health related attitudes and behaviours. RESULTS:Over the period from 2000 to 2005 the percentage of calls which succeeded in contacting an eligible member of the public fell, from 52.9% to 31.8%. There was a drop in response rates to the surveys (once contact was established) from 58.6% to 17.7%. Costs per completed interview rose from 4.48 euro to 15.65 euro. Respondents were prepared to spend 10-15 minutes being surveyed, but longer surveys yielded poorer completion rates. Respondents were willing to discuss issues of a sensitive nature. Interviews after 9 pm were less successful, with complaints about the lateness of the call. Randomisation from electronic residential telephone directory databases excluded all ex-directory numbers and thus was not as representative of the general population as number generation by the hundred-bank method. However the directory database was more efficient in excluding business and fax numbers. CONCLUSION:Researchers should take cognisance of under-representativeness of land-line telephone surveys, of the increasing difficulties in contacting the public and of mounting personnel costs. We conclude that telephone surveying now requires additional strategies such as a multimode approach, or incentivisation, to be a useful, cost-effective means of acquiring data on public health matters in Ireland and the U.K.

背景与目标：

BACKGROUND & AIMS: AIMS:To assess the relationship between ambulance attendances, emergency department (ED) presentations and hospital admissions for acute alcohol intoxication and the timing of public holidays, sporting and social events. DESIGN:Time-series analysis was used to explore trends in intoxication in the context of major events. SETTING:Population of Melbourne, Victoria, Australia between 2000 and 2009. PARTICIPANTS:All patients attended by ambulance, presenting to hospital EDs, or admitted to hospital who were classified as acutely alcohol intoxicated. MEASUREMENT:Analysis of daily numbers of presentations for acute alcohol intoxication associated with major events were undertaken, including lead and lag effects. Analyses controlled for day of week and month of year to address temporal and seasonal variations. FINDINGS:Alcohol intoxication presentations were significantly elevated the day before all public holidays, with intoxication cases on the day of public holidays only higher on New Year's Day (ambulance 6.57, 95% confidence intervals (CI): 3.4-9.74; ED 3.34, 95% CI: 1.28-5.4) and ANZAC Day (ambulance 3.71, 95% CI: 0.68-6.75). The Australian Football League (AFL) Grand Final (ED 2.37, 95% CI: 0.55-4.19), Commonwealth Games (ED 2.45, 95% CI: 0.6-4.3) and Melbourne Cup Day (ambulance 6.14, 95% CI: 2.42-9.85) represented the sporting events with significant elevations in acute intoxication requiring medical attention. The last working day before Christmas was the only social event where a significant increase in acute intoxication occurred (ambulance 8.98, 95% CI: 6.8-11.15). CONCLUSIONS:Acute alcohol intoxication cases requiring ambulance, emergency department and hospital in-patient treatment increase substantially on the day preceding public holidays and other major social events.

背景与目标：

BACKGROUND & AIMS: :Stakeholder engagement is an emerging field with little evidence to inform best practices. Guidelines are needed to improve the quality of research on stakeholder engagement through more intentional planning, evaluation and reporting. We developed a preliminary framework for planning, evaluating and reporting stakeholder engagement, informed by published conceptual models and recommendations and then refined through our own stakeholder engagement experience. Our proposed exploratory framework highlights contexts and processes to be addressed in planning stakeholder engagement, and potential immediate, intermediate and long-term outcomes that warrant evaluation. We use this framework to illustrate both the minimum information needed for reporting stakeholder-engaged research and the comprehensive detail needed for reporting research on stakeholder engagement.

背景与目标： : 利益相关者参与是一个新兴领域，几乎没有证据为最佳实践提供信息。需要通过更有意的计划，评估和报告来提高有关利益相关者参与的研究质量的准则。我们通过已发布的概念模型和建议为规划，评估和报告利益相关者参与制定了初步框架，然后通过我们自己的利益相关者参与经验进行了完善。我们提出的探索性框架强调了在规划利益相关者参与时要解决的背景和过程，以及需要评估的潜在的近期，中期和长期结果。我们使用此框架来说明报告利益相关者参与研究所需的最低信息，以及报告利益相关者参与研究所需的全面细节。

BACKGROUND & AIMS: This paper reports on a public authority's decision to "make" or "buy" mental health services. Data come from key informant interviews with California county contract or program managers. The questionnaire measures the extent of contracting and the importance of factors that are hypothesized to affect the relative costs of contracting. The percent of contracting by programs ranges from zero to 100, averaging 41%. Sixty-two percent of rural programs perceive little or no competition for public mental health contracts, and contract significantly less than urban programs. The extent of contracting is related to economic and public organizational factors.

背景与目标： 本文报告了公共机构 “制造” 或 “购买” 精神卫生服务的决定。数据来自对加利福尼亚县合同或计划经理的关键线人采访。问卷测量了合同的程度以及假设会影响合同相对成本的因素的重要性。按项目签订合同的百分比从零到100，平均41%。60 2% 的农村计划对公共精神卫生合同的竞争很少或没有竞争，并且合同明显少于城市计划。缔约的程度与经济和公共组织因素有关。

BACKGROUND & AIMS: :Widespread interest in global health issues is a common characteristic of students and faculty in schools of public health and schools of medicine. Building on strong university-based and community-based programs in global health, the University of Washington has created a unique Department of Global Health that is housed jointly in its School of Public Health and Community Medicine and its School of Medicine. The creation of this department has generated significant enthusiasm throughout the university and the Seattle community as a new paradigm for addressing global health education, research, and service. Placing the new Department of Global Health in two university schools and finding the appropriate niche for the department among the university's many global health initiatives presented challenges, as well as opportunities. This article describes the goals of the department, the process by which it was created, and what it expects to accomplish.

背景与目标： : 对全球卫生问题的广泛关注是公共卫生学院和医学院的学生和教职员工的共同特征。华盛顿大学以强大的基于大学和社区的全球卫生计划为基础，创建了一个独特的全球卫生部门，该部门位于其公共卫生和社区医学学院及其医学院中。这个部门的创建在整个大学和西雅图社区产生了极大的热情，成为解决全球健康教育，研究和服务的新范式。将新的全球卫生部门安置在两所大学学校中，并在大学的许多全球卫生计划中找到适合该部门的利基市场，带来了挑战和机遇。本文介绍了该部门的目标，创建该部门的过程以及预期实现的目标。

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BACKGROUND & AIMS: :This study aimed to investigate the effect of patient engagement in self-monitoring with a telemonitoring device on glycemic control among patients with type 2 diabetes. We conducted a subanalysis of the telemonitoring device study in Kaiser Permanente Northern California members. We divided the telemonitoring group into 53 frequent and 54 infrequent users based on self-monitoring of blood glucose (SMBG) frequency of the first 6 weeks. The frequency of SMBG transmitted from the telemonitoring device was examined over 24 weeks. Clinic and laboratory tests were collected at baseline, 6 weeks and 6 months. There was no significant difference in baseline HbA1c level between the two groups. After 6 months, change in HbA1c was -2.4 ± 1.6% among frequent users and -1.5 ± 1.5% among infrequent users (p = 0.003). The proportion of patients achieving target HbA1C level at 6 months was significantly higher among frequent users than among infrequent users. An increased frequency of SMBG was significantly correlated with a reduction in HbA1c at 6 months. In conclusion, initial active engagement in self-monitoring with a telemonitoring device could provide incremental improvement of glycemic control over 6 months.

背景与目标： : 这项研究旨在研究患者参与远程监控设备对2型糖尿病患者血糖控制的影响。我们对北加州Kaiser Permanente成员的远程监控设备研究进行了亚分析。根据前6周的自我血糖监测 (SMBG) 频率，我们将远程监护组分为53个频繁用户和54个不频繁用户。在24周内检查了从远程监控设备传输的SMBG的频率。在基线，6周和6个月收集临床和实验室检查。两组患者基线HbA1c水平差异无统计学意义。6个月后，频繁用户的HbA1c变化为-2.4   ±   1.6%，不频繁用户的HbA1c变化为-1.5   ±   1.5% (p   =   0.003)。在6个月达到目标HbA1C水平的患者比例在频繁使用者中显著高于不频繁使用者。6个月时，SMBG频率的增加与HbA1c的降低显着相关。总之，使用远程监控设备进行自我监控的初始主动参与可以在6个月内逐步改善血糖控制。

BACKGROUND & AIMS: BACKGROUND:Road traffic injuries contribute substantially to the disease burden in India. This paper describes the road safety issues discussed by members of the Indian Parliament, and highlights the gaps that need to be addressed to make road safety visible as a public health problem to policy-makers in India. METHODS:All questions asked to and information provided by the Ministry of Road Transport and Highways, and questions relating to accident asked to the Ministry of Health and Family Welfare of the Government of India were reviewed for the two Houses of the Indian Parliament for the years 2002 to 2004. RESULTS:Of the 1529 questions asked to the Ministry of Road Transport and Highways, only 140 (9.1%) were related to road safety, whereas 1076 (70.5%), 181 (11.8%), 51 (3.3%) and 81 (5.3%) were related to other aspects of the national highways, state roads, vehicles and other issues, respectively. Data on the magnitude of road crashes dealt only with the number of crashes and fatalities and not with the age, sex and type of road users affected by road traffic injuries. The parliamentarians were informed that human error was the main cause of road crashes in India; however, the robustness of this information is questionable. Strategies to prevent road crashes focused mainly on training of drivers with little attention to other factors that cause road crashes. The discussion on legislations also focused on drivers, ignoring other road users. Ten of the 4741 questions (0.2%) asked to Ministry of Health and Family Welfare were related to accident, the majority of which were about the setting up of trauma care services. CONCLUSION:An appropriate policy and intervention response by policy-makers is not possible with data that are presented in a manner that do not highlight the true nature of the problem, and are neither comprehensive nor robust. Majority of the proposed road safety interventions by the Ministry of Road Transport and Highways are based on the traditional view of human error as a major cause of road crashes highlighting the lack of a scientific public health approach towards prevention of road crashes. It would be useful to build the technical capacity of the Ministry of Road Transport and Highways in road safety to use the available data more effectively, and to facilitate generation of further relevant data about the magnitude, underlying causes and impact of road traffic injuries, for policy-makers to better understand the critical issues for planning effective road safety policies and interventions to reduce the high burden of mortality and morbidity due to road crashes in India.

背景与目标：

BACKGROUND & AIMS: :In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000-2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004-2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20-50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.

背景与目标： : 在一项对芬兰公共部门雇员的前瞻性队列研究中，作者研究了工作场所社会资本与抑郁症之间的关联。数据来自33,577名员工，他们最近没有抗抑郁药治疗史，并且在2000-2002年的基线时没有医生诊断的抑郁症病史。通过两个指标来衡量他们的抑郁症风险: 记录到2005年12月31日之前的抗抑郁药购买量，以及2004-2005年医生在随访调查中诊断出的新发抑郁症的自我报告。使用多水平logistic回归分析来探讨自我报告和综合水平的工作场所社会资本是否可以预测随访时的抑郁指标。自我报告社会资本低的员工的抗抑郁治疗和医生诊断的抑郁症的几率比报告社会资本高的员工高20-50%。这些关联没有按性别，年龄，婚姻状况，社会经济地位，工作地点，吸烟，饮酒，体育锻炼和体重指数来解释。社会资本与自我报告的抑郁症之间的关联减弱，但在进一步调整基线心理困扰 (未诊断的精神卫生问题的代表) 后仍然显着。总水平的社会资本与随后的萧条无关。

BACKGROUND & AIMS: OBJECTIVES:To describe the US public health nutrition workforce and its future social, biological and fiscal challenges. DESIGN:Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors. SETTING:The United States. SUBJECTS:Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services. RESULTS:The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81.7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18.2 % speaking Spanish as a second language. CONCLUSIONS:The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce's capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.

背景与目标：

BACKGROUND & AIMS: :In 1998 the Society for Academic Emergency Medicine's (SAEM's) Board of Directors asked the SAEM Public Health and Education Task Force to develop recommendations for prevention, screening, and counseling activities to be conducted in emergency departments (EDs). The Task Force's work was divided into two phases: 1) a discussion of the rationale for preventive services in the ED, along with generation of a preliminary list of prevention activities that could be studied for ED implementation; and 2) a formal evidence-based review of topics chosen from the preliminary list, along with recommendations for ED implementation and further study. This paper represents Phase I of the project. Phase II, the formal evidence-based review and recommendations, is published separately in this issue.

背景与目标： : 1998年，学术急诊医学协会 (SAEM's) 董事会要求SAEM公共卫生和教育工作组为在急诊科 (EDs) 进行的预防，筛查和咨询活动制定建议。专责小组的工作分为两个阶段: 1) 讨论在ED中提供预防服务的理由，并生成可研究用于ED实施的预防活动的初步清单; 2) 对从初步清单中选择的主题进行正式的循证审查，以及对ED实施和进一步研究的建议。本文代表了该项目的第一阶段。第二阶段，正式的循证审查和建议，在本期单独发表。

BACKGROUND & AIMS: :The aim of this study was to assess the prevalence of dental caries in the primary dentition and associated variables in low socioeconomic preschool children enrolled in public nursery schools in Juiz de Fora, Minas Gerais, Brazil. Four public institutions were selected by geographic criteria (two in the central region and two in the peripheral region). The study population comprised 338 children (181 boys; 157 girls) aged 2-6 years old. Dental caries was recorded using the decayed, missing, and filled teeth (dmf-t) index. Among the examined children, 50.6% were caries-free. The mean dmf-t index was 2.03. It was higher in the peripheral nursery schools (p<0.01). A trend towards a difference between sexes (p = 0.06) was observed. Logistic regression analysis selected a previous child's visit to dentist (p<0.001), geographic location of the public nursery school (p<0.01), and age (p<0.01) as predictive variables for the dmf-t index. The study showed the need for an oral health program for this population, including both curative and preventive measures in order to achieve the WHO/FDI goals for the year 2000, namely 50% of children free of caries at age 5-6 years.

背景与目标： : 这项研究的目的是评估在巴西米纳斯吉拉斯州Juiz de Fora的公立托儿所就读的低社会经济学龄前儿童的主要牙列中龋齿的患病率和相关变量。根据地理标准选择了四个公共机构 (两个在中部地区，两个在外围地区)。研究人群包括2-6岁的338名儿童 (181名男孩; 157名女孩)。使用腐烂，缺失和填充的牙齿 (dmf-t) 指数记录龋齿。在接受检查的儿童中，有50.6% 人没有龋齿。平均dmf-t指数为2.03。在外围托儿所中较高 (p<0.01)。观察到性别差异的趋势 (p = 0.06)。Logistic回归分析选择了以前的儿童去看牙医 (p<0.001)，公立托儿所的地理位置 (p<0.01) 和年龄 (p<0.01) 作为dmf-t指数的预测变量。该研究表明，需要为这一人群制定口腔保健方案，包括治疗和预防措施，以实现世卫组织/外国直接投资2000年的目标，即50% 5-6岁无龋齿儿童。

BACKGROUND & AIMS: :South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

背景与目标： : 南非长期以来一直承认公共部门和私营部门之间的伙伴关系是卫生方面的政策目标，但经验仍然有限，而且文献记载很少。本文的目的是了解增加南非公私互动成功可能性的因素，并确定和讨论扩大它们的机会。财政部为管理伙伴关系制定了强有力的立法框架和许多准则和工具。对文献的审查证实，国家需要制定有效的法规，以监督质量和标准，并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系，而且还需要创新和实验。评估是所有互动的组成部分，不仅要从成功中学习，而且要确定可能导致意外后果的任何不正当激励措施。四个案例研究表明，私营营利部门已经参与了许多与当前卫生系统改革优先事项密切相关的项目。增加互动成功可能性的因素包括: 提高政府管理公私关系的能力; 选择对国家目标具有战略重要性的公私互动; 建立有效的知识基础，在何处以及为什么; 从试点转向大规模计划; 利用私人供应商的合同专业知识; 鼓励创新和学习。

BACKGROUND & AIMS: BACKGROUND:Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES:The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS:A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS:Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION:These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.

背景与目标：