What factors determins the effectiveness of public health interventions Discuss with reference to at least two contrasting examples. - Free Essay Example

Sample details Pages: 8 Words: 2368 Downloads: 8 Date added: 2017/06/26 Category Medicine Essay Type Analytical essay Did you like this example? Introduction The health of the whole population is a very important issue. Conditions which are likely to affect the whole population or large sections of the population are considered to be public health issues and are the subject of specific healthcare promotions and interventions. These can take a range of forms; those aimed at raising awareness of symptoms or lifestyle factors that are implicated in developing a particular condition; management of health conditions to improve quality of life and/or longevity or recognition of symptoms to obtain early treatment. Don’t waste time! Our writers will create an original "What factors determins the effectiveness of public health interventions? Discuss with reference to at least two contrasting examples." essay for you Create order Public health interventions are developed to address identified public health issues (National Institute for Health and Care Excellence, 2015). Once these are put in place, it is important to be able to assess the impact of the interventions and their effectiveness in respect of the present situation and also to increase the knowledge base for development of further interventions in the future (Brownson, et al., 2010). This essay will consider the ways in which the effectiveness of public health interventions can be determined. Discussion One of the main factors that needs to be considered in public health interventions is cost-effectiveness (The Kings Fund, 2014). The NHS has increasing demands on its services and so, when developing new interventions or reviewing those already in place, cost effectiveness is one of the most important issues. A further aspect of the effectiveness of public health interventions is the extent to which they have demonstrably achieved the aims set for the intervention (Scutchfield Keck, 2003). These two areas will now be considered in greater detail. There is a finite budget available to the NHS to provide healthcare and this has to be utilised in the most efficient way. The economic constraints that have been in place for some time have created an even greater need for financial efficiency. One way that this can be achieved is through reducing the numbers of people who are suffering from conditions which are considered to be avoidable. Conditions such as diabetes and obesity for e xample, are considered to be largely avoidable by people changing lifestyle habits to improve their health. Thus a range of public health interventions have been directed to focus on these types of issues in order to prevent people from becoming ill as this would represent a substantial saving in costs of treatment for subsequent illnesses. It would also provide benefit to the public in that people would lead longer, healthier lives. However, preventative interventions present difficulties in measuring their effectiveness. A reduction in the numbers of people developing diabetes, for instance, may be attributable to a public health intervention or it may be the result of one or more other factors. The individuals measured may not have developed the condition anyway and so it cannot be proven that the intervention itself was solely responsible for them remaining well. As it can be difficult to accurately measure effectiveness of outcomes, the cost-effectiveness is also difficult to a ssess. Historically, preventative healthcare promotion has been a problematic area due to the difficulties in establishing effectiveness and this made obtaining funding for such activities particularly challenging. However, the increasing demand for services has meant that there has been a shift in perspective and a greater focus on prevention. Thus, the means of evaluating public health interventions in this area has become important. Although the financial implications cannot be the sole driver for health promotion, financial issues are of necessity a major factor as there are obligations on the NHS to produce evidence that their funding has been properly and effectively spent. The effectiveness of health promotions from the perspective of health improvement of the population should be the primary motivation of interventions rather than cost. In order to improve public health, there are a range of options for interventions. The impact of health interventions was described by Fr ieden, (2010) as being in the formof a five-tier pyramid with the bottom tier being the most effective as it reaches the largest sector of the population and has the greatest potential to improve the social/economic determinants of health. The higher tiers of the pyramid relate to areas where the individual is helped to make healthy choices. Topics that are within the bottom tier of the pyramid include the improvements in health brought about by changing lifestyle habits such as smoking. Wide-scale promotions and interventions have been in place for many years and this has reduced the numbers of people who already smoke together with encouraging people not to begin smoking. As a result, the risk factors of health issues such as heart conditions has been reduced. Whilst this may not completely prevent some people from developing such conditions in terms of public health, which takes the wider perspective, a higher proportion of people will be at a lower risk. Thus, the effectiveness of interventions in this case can be measured by the proportion of the population who currently smoke, who have given up smoking and who have started smoking by comparison to previous years records (Durkin, et al., 2012). The numbers of people coming forward for help through smoking cessation provisions offered by their GPs can also be measured, together with the effectiveness of the those interventions in helping people to achieve their goal to stop smoking. The longstanding interventions to reduce the numbers of people with HIV/AIDS also fell within the same category of public health interventions (as just described in respect of smoking) once it was clear that it was a potential risk to a large section of the population. In this instance, there was a large amount of public health promotional activity when the issue was first known in the 1980s but this has largely subsided currently with few if any national high profile promotions/interventions (Bertozzi, et al., 2006). Howeve r, the risk has not been eradicated and there has been an increase in older people developing the condition (AVERT, 2015). This may be due to them not considering they are at risk or they may not have been targeted by the original campaigns which had a greater focus on the homosexual communities, needle using drug addicts and sexually active, younger adults. Married couples were not then considered to be the primary target audience for such campaigns. This demonstrates that there is a need for on-going interventions, particularly in terms of public awareness, to ensure that there is a consistent and improving impact (AVERT, 2015). Unless a health risk has been eradicated, there is likely to be a need for continuing interventions to maintain public knowledge levels. The way in which HIV/AIDS and smoking are directed at the wider population are examples of Friedens bottom sections of the pyramid. When interventions are applied in the top levels of Friedens pyramid they address indi viduals more directly, rather than the whole population (2010). Thus, it could be argued that such interventions would overall, have a greater impact as any public changes need to involve each individual changing. Unless each person is reached by the intervention and perceives that it is a valuable change for them, publicly directly interventions will have reduced effectiveness. National interventions will of necessity be broadly based and they will, therefore, not reach all those people to whom it is aimed as they may feel that it does not apply to them. Thus, the use of interventions that are more specifically targeted to individuals can take into account their socio-economic status and other factors to make the interventions more easily seen to be applicable to them (Frieden, 2010 ). A different view of public health interventions considers the situation for people with terminal or long term conditions. Many of the interventions focus heavily on the medical model and do not ta ke into account the impact on the patient or how they would prefer to be cared for. The medical view of what constitutes good health may be considered to be a more laboratory based, theoretical view that does not necessarily reflect the lived experience of individuals (Higgs, et al., 2005). Physical incapacity may not impact badly on an individual who has found ways to live a fulfilling life whilst someone who is considered fit and well may not consider that they have good quality of life (Asadi-Lari, et al., 2004). Therefore, the impact of interventions on the public also needs to be considered. A medically effective intervention may be unpleasant or difficult for the patient to endure and thus, viewed as being less effective. Furthermore, if the intervention is too unpleasant the patient may fail to comply and thus, also not obtain the level of effectiveness that the medical model would suggest it should (Asadi-Lari, et al., 2004). One area of public health that has proved to b e somewhat controversial in recent years is that of immunisation. The possible links between the MMR vaccine and autism, for instance, has impacted heavily on the numbers of people having their children immunised (BMJ, 2013). Vaccination is an important branch of public health and relies upon sufficient people being immunised against diseases so that should isolated cases occur the disease will not spread. Many parents today will be unaware of the health implications of illnesses such as German measles and mumps as vaccination has made cases rare. The rarity of the cases has also led to the incorrect belief that these illnesses have been eradicated. Therefore, in this instance the effectiveness of the intervention has been varied by the influence of the media reports or adverse outcomes. The fear that was generated has been difficult to overcome and this has resulted in a loss of faith in the process. This then results in reduced effectiveness of the intervention. However, it can pr ove very difficult to restore public support following situation such as this that have continued for a long time. The impact can be measured in both the numbers of people coming forward to have their children immunised and in the numbers of cases of the various illnesses that occur each year. The current statistics, however, do suggest that the levels of immunisation with MMR has now been restored to an appropriate level (NHS, 2013). The provision of the flu vaccine is another instance where public health interventions may have varying effectiveness. The actual effectiveness of a good vaccine is not considered to be 100% when the correct formula has been provided. In 2014, however, the vaccine was not for the actual strain of flu that occurred and so there was little protection provided (Public Health England, 2015). As a result, it is likely that there will be a downturn in the numbers of people who will come forward to receive the flu vaccination this year as the value may be perceived to be doubtful. This also demonstrates the need to provide the public with correct information so that they are aware of the potential effectiveness of the intervention. So in the case of flu, if the vaccine has a 60% chance of preventing the illness this should perhaps be specifically stated. There may be a level at which the majority of people feel that it is not worth having the vaccination. If, hypothetically, an effectiveness of less than 30% was considered by the majority of people to be so low that it was not worth having the vaccination, there could be few people immunised and a major epidemic could follow. Therefore, it is important that the information provided is correct and that the intervention itself is seen to be of sufficient value to the individual to warrant them making that choice to take advantage of what is offered (NHS, 2015). Conclusion This essay has asserted that the effectiveness of public health interventions can be viewed from two main perspectives: the cost effectiveness of the provision and the impact on the target audience. Whilst there are considerable pressures in the NHS financially, this should not be the primary consideration in respect of public health. The aim of public health interventions is to improve the health and well-being of the population as a whole and uses a wide range of methods to achieve this. Some provisions are aimed at the whole population and others are designed for the individual or smaller target groups. For these to be effective, they need to reach the target audience and have meaning for them so that they will be encouraged to take the required action. Continuous changes in the provision may also be needed to ensure that long term issues remain in the public awareness. Bibliography Asadi-Lari, M., Tamburini, M. Gray, D., 2004. Patients needs, satisfaction, and health related quality of life: Towards a comprehensive model. Health and Quality of Life Outcomes , 2(32). AVERT, 2015. HIV/AIDS Statistics 2012. [Online] Available at: https://www.avert.org/hiv-aids-uk.htm [Accessed 28 September 2015]. Bertozzi, S.; Padian, N.S.; Wegbreit, J.; DeMaria, L.M.; Feldman, B.; Gayle, H.; Gold, J.; Grant, R.; Isbell, M.T., 2006. Disease Control Priorities in Developing Countries. New York: World Bank. BMJ, 2013. Measles in the UK: a test of public health competency in a crisis. BMJ, 346(f2793). Brownson, R.C.; Baker, E.A.; Leet, T.L.; Gillespie, K.N.; True, W.R., 2010. Evidence-Based Public Health. Oxford: Oxford University Press. Durkin, S., Brennan, E. Wakefield, M., 2012. Mass media campaigns to promote smoking cessation among adults: an integrative review. Tobacco Control, Volume 21, pp. 127-138. Frieden, T. R., 2010 . A Framework for Public Health Ac tion: The Health Impact Pyramid. American Journal of Public Health, 100(4), p. 590à ¢Ã¢â€š ¬Ã¢â‚¬Å"595. Higgs, J., Jones, M., Loftus, S. Christensen, N., 2005. Clinical Reasoning in the Health Professions. New York: Elsevier Health Sciences. National Institute for Health and Care Excellence, 2015. Methods for the development of NICE public health guidance (third edition). [Online] Available at: https://www.nice.org.uk/article/pmg4/chapter/1%20introduction [Accessed 28 September 2015]. NHS, 2013. NHS Immunisation Statistics, London: NHS. NHS, 2015. Flu Plan Winter 2015/16. [Online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/418038/Flu_Plan_Winter_2015_to_2016.pdf [Accessed 28 September 2015]. Public Health England, 2015. Flu vaccine shows low effectiveness against the main circulating strain seen so far this season. [Online] Available at: https://www.gov.uk/government/news/flu-vaccine-shows-low-effectiveness-against-the-ma in-circulating-strain-seen-so-far-this-season [Accessed 28 September 2015]. Scutchfield, F. Keck, C., 2003. Principles of Public Health Practice. Clifton Park: Delmar Learning. The Kings Fund, 2014. Making the case for public health interventions. [Online] Available at: https://www.kingsfund.org.uk/audio-video/public-health-spending-roi?gclid=CM_ExbKomcgCFcZuGwodE44Lkg [Accessed 28 September 2015].

Knowledge And Power In Doctor Faustus - 1116 Words

Knowledge and Power in The Tragical History of the Life and Death of Doctor Faustus and The Bloody Chamber Throughout literature, television and film you could name countless examples of different wordings of the aphorism ‘Knowledge is power’. This idea is popularly attributed to Francis Bacon’s Meditationes Sacrae, in which the phrase ipsa scientia potestas est, or â€Å"knowledge itself is power† appears. However, five years before this was first written, this concept was a belief of the titular character in Christopher Marlowe’s The Tragical History of the Life and Death of Doctor Faustus, with knowledge and power serving as key themes. Another text which shares these themes is Angela Carter’s collection of subversive fairy tales, The†¦show more content†¦Faustus has gained an almost unlimited knowledge of magic, and therefore the ability to do almost anything he could imagine. However, he quickly ends up performing cheap tricks for his livelihood. As Stapleton and Scott aptly summarise: â€Å"In the opening scene, the hero aims for nothing less than power over life and death. But by Act 4 he winds up fetching grapes for a pregnant woman, whose big belly shows that she has more power to create life than he does. He calls for knowledge of God’s secrets that â€Å"stretcheth as far as doth the mind of man,† but in the end he accepts a career of staging entertainment for mere popes, emperors and dukes.† (M.L. Stapleton , and Sarah K. Scott) Faustus has the knowledge to control life and death, but when asked to raise Alexander the Great and his paramour he admits that he cannot raise â€Å"the true substantial bodies of those two deceased princes, which long since are consumed to dust†, only â€Å"such spirits as can lively resemble Alexander and his paramour†. As Faustus cannot raise true-to-life people as the pregnant woman can, he must be therefore less powerful than her, even though Faustus is far more knowledgeable in necromancy than any other person. Rutter goes onto further criticise Faustus’s lack of power: â€Å"Furthermore, who is to say whether the spirits who appear genuinely look like Alexander and his paramour? Neither Faustus norShow MoreRelatedDoctor Faustus978 Words   |  4 PagesPoor Faustus believes it is he who has called upon the demon Mephistopheles and it is his tongue that orders the servant of hell, yet he could not be any more mistaken. In reality, Faustus is the one with strings attached to him and it is Lucifer, Mephistopheles, and the Evil Angel playing the role of the puppeteer. Nevertheless, Faustus remains a student to the ideology of Christianity throughout his adventures, even amongst the bleakest of hours. 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The use of facebook Free Essays

Bernard Williams Dr. cutull Method and Theory In Psychology October 8, 2013 Romantic Jealousy and Facebook usage The use ot Facebook, a popular social network, can have a significant influence in the development of romantic jealousy. Facebook jealousy can occur when someone feels threatened after vlewlng their partner Interacting online with a superior potential mate, which could possibly lead to a daily surveillance of their partner’s activity on Facebook, A person with enxlous-dttachment could be described ds having low self- esteem and a tear ot abandonment, resulting in the continuous need tor reassurance bout the status of their romantic relationship and possible signs of Infidelity. We will write a custom essay sample on The use of facebook or any similar topic only for you Order Now Individuals who have an anxious-style of attachment and frequently view their partners Facebook activity are more prone to experience feelings of romantic jealousy. Prior research has shown that anxious attachment is positively related, and avoidant attachment negatively related, to Facebook jealousy and surveillance (Marshall, Bejanyan, DICastro, ; Lee, 2012, Those with an anxious-style of attachment do not feel that they deserve a loving relationship and are scared of being alone. The researchers designed an online survey to test the prevalence of Facebook Jealousy. The study included 255 participants, 201 women and 54 men. Two tests were conducted that measured attachment style, self-esteem. perceived relationship quality, Jealousy, and their usage ot Facebook. The participant’s answers were formatted in the form of a Likert Scale. The study discovered that attachment anxiety and avoidance were strongly correlated to Facebook Jealousy and surveillance because individuals with attachment anxiety had a lack of trust in their partner (Marshall et al. , 2012, p, 17), Overall. those who were less satisfied with their elationship and had a lack ot trust tor their partners were most likely to display Facebook jealousy. Another study aimed to figure out whether an Increased usage of Facebook had an effect on romantic jealousy. The researcher hypothesized that the amount of time spent on Facebook would significantly add to the amount of Facebook Jealousy, In addition to other variables that were described in the jealousy literature (Muise, Christofides, Desmairais, 2009). To evaluate their thesis. Muise. Christofldes. and Desmarals created a questionnaire with 27 Items measured on a 7- polnt Likert scale. The topics included jealousy, perceived amount of trust within their relationship, self- esteem, uncertainty, and level of commitment (Mulse et al. , 2009). The subjects included 308 undergraduate students (231 temale, 77 male) between the ages ot 17 and 24. It was concluded that regular Facebook usage had a strong Influence on romantic Jealousy. The researchers explained that these findings could be the result of a partner having access to new information about their partner’s social circle; therefore the partner continues to look at their significant other’s Facebook page to ocial circle were often innocent, but frequent viewing of their activity cause the other partner to become more suspicious of their intentions. The next study focused on determining whether Facebook Jealousy had a negative effect on relationship satisfaction and if trait Jealousy is positively related to social network sites (SNS) Jealousy. Continuous surveillance of behaviors is and indicator of a possessive relationship, which is a typical effect of an individual with an anxious style of attachment. The researchers built an online survey consisting of questions esigned to measure monitoring behavior, Facebook Jealousy, and self-esteem. A few items of the Facebook Jealousy scale measured actions such as the number of times they check their partner’s Facebook page or whether they â€Å"add† their partner’s friends to watch their online activity (Utz Beuekeboom, 2011). The participants were students enrolled in a course at a large Dutch University. The study found that individuals with lower self-esteem experienced higher rate of Facebook Jealousy than individuals with higher self-esteem, although there was not a significant difference in relationship satisfaction. According to I-J? et al. 201 1), individuals who were prone to trait Jealousy, monitoring behavior, had a low self-esteem, and a need for popularity, were more likely to display Facebook Jealousy. A lack of self-esteem could possibly cause a person to believe that every potential attractive mate is a threat to their relationship and happiness. Because of their own insecurities, they may feel the need to compete with those they view as competition for their mate. The following study was conducted to test the outcome of Facebook intrusion on romantic relationships. Facebook intrusion can be described as an obsessive ttachment to Facebook that causes a lack of functioning in daily lives and in romantic relationships (Elphinston Noller, 2011). The researchers aimed to further existing research by evaluating whether Facebook intrusion is linked to romantic jealousy and dissatisfaction in relationships. The participants consisted of 342 (110 men and 232 women) freshman, undergraduate psychology majors at an Australian university. They were recruited based on the university’s first-year student pool. The students received partial course credit for participating in the study. Approximately 90 to 95 percent of the articipants were Facebook users, between the ages of 18 and 25. 86. 9 percent of participants were currently dating, with the average length of 16. 44 months. The study was in the format of a quantitative self-report, consisting of several questionnaires. All of the participants took a 7-point Facebook Intrusion scale with answers ranging from strongly disagree to strongly agree, which measured amount of Facebook usage, level of romantic Jealousy, and relationship satisfaction. To measure the level of romantic Jealousy, a five-item Short-form Multidimensional Jealousy Scale was administered. A five-item questionnaire was also given to measure the level of romantic satisfaction in the participant’s current relationship (Elphinston Noller, 2011). It was found that the more an individual spent time on Facebook, they more likely they were to feel threatened by a potential mate of their partner. Also, Facebook intrusion was positively correlated with romantic Jealousy, relationship dissatisfaction, and cognitive Jealousy. A strength of the study was that multiple questionnaires were given to the participants. Findings would not be as informative if large, which welcomes many perspectives. No evidence of validity or reliability was reported. Some of the limitations included a restricted participant pool because it only included first-year psychology students at an Australian University. For future studies, participants that do not attend a college or university and individuals of a more broad age range should be included. A longitudinal study of the effects of Facebook intrusion would be beneficial for acquiring new information about the long term effects of Facebook on romantic relationships. The final research study aimed to explore romantic Jealousy from the attachment theory perspective. Cognitive ealousy can be described as feelings of discomfort when a partner feels a third party is a threat to their romantic relationship. According to the attachment theory, an individual’s relationship with their parent or caregiver shapes the individual’s mental needs in their adult life (Knobloch, Solomon, Cruz, 2001, p. 6). The researchers hypothesized that attachment styles that were developed during childhood, play a key role in influencing romantic Jealousy. An empirical, cross-sectional design was formulated to test their assumptions. The sample included students enrolled in a communication class at a large Mid-western University. The students received extra course credit for participating in the study. Overall, 132 students (43 men and 89 women), between the ages of 18 and 30, finished all portions of the experiment. The participant’s relationship lengths ranged from 1 to 65 months, with the average relationship length being of 12 months. 31 out of the 132 relationships were heterosexual (Knoblauch et al. , 2001). Several self-report questionnaires were given to the participants, and were completed in groups ranging from 5 to 25 people. The first questionnaire measured attachment styles, perceived Jealousy, and the level of ntimacy in their current romantic relationships. Next, the researche rs distributed Pfeiffer and Wong’s (1989) Multidimensional Jealousy Scale to measure cognitive jealousy. The answers were formatted in a 7-point Likert scale, ranging from never (1) to all the time (7). The Knobloch and Solomon’s (1999) relational uncertainty scale was given to measure the level of uncertainty in the relationship, with answers formatted on a 6-point scale. Lastly, the participants completed the Rubin’s (1970) Love Scale to measure the level of intimacy in their relationship, in addition to affiliate need, illingness to help, and exclusiveness toward their partner (Knobloch et al. , 2001). The study found that women and men did not significantly differ in their level of romantic Jealousy. It was also found that attachment anxiety was positively correlated with the relational uncertainty measures. Findings also indicated that a negative correlation between cognitive Jealousy and intimacy was present (Knobloch et al. , 2001, p. 10). Because the results found a significant positive association between cognitive Jealousy, emotional Jealousy, and anxiety over relationships, their ypothesis was proven to be correct (Knobloch et al. , 2001, p. 12). During childhood, an anxious style of attachment is formed when a child’s caregiver is often inconsistent or overly protective, resulting in the child becoming more prone to insecurity and fearfulness. Consequently, adults with an anxious-style of attachment are frequently worried about the status of their relationship. These individuals usually crave the attention of their partner, which could leady to clingy and controlling behavior. They often become Jealous or overact at the possibility of a coincides with Guerrero and Andersen’s 1998 study. Reliability was reported because the researcher’s bivariate results produced the same results as the first experiment. The strengths of the study included a very detailed explanation as to why an anxious- style of attachment is associated with romantic Jealousy. Another strength of the study was that it expanded upon previous studies on the notion that relationship uncertainty and intimacy are strongly linked to emotional and cognitive Jealousy. Some of the drawbacks of the study included the cross-sectional design. A longitudinal study would be more efficient in confirming their conclusions. Another limitation was the lack of male participants in the study. If the amount of men and women participants were more equal, the results would be more universal. The final limitation is that the study focused on the experience of Jealousy but not on the underlying factors that cause Jealousy. A better understanding about Jealousy could be achieved if information was given from the individuals about their upbringing. This study looks to expand the literature by evaluating how attachment styles that were developed during an individual’s childhood can influence romantic Jealousy on Facebook. Little research has been conducted to determine how these attachment styles are developed and their effect on Jealousy. How to cite The use of facebook, Papers