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Evidence What evidence was identified in the review and what was the quality of the evidence? Strengths Quality Evidence on health communication campaign evaluation for communicable diseases was identified and included: • systematic and exploratory reviews [138-143]; • European examples; and • a variety of individual study designs order rumalaya liniment 60 ml with mastercard spasms everywhere. Broad principles of campaign design generic 60 ml rumalaya liniment free shipping muscle relaxant otc cvs, implementation and evaluation have been developed and are available to public health professionals and researchers [144-147] buy rumalaya liniment 60 ml amex spasms crossword clue. Weaknesses Communication effects • The review highlighted inconsistency in the indicators used to evaluate health communication campaigns generic 60 ml rumalaya liniment visa muscle relaxant japan. Application What has been applied into practice in the area of campaign evaluation for the prevention and control of communicable diseases? Strengths European A wide range of examples of evaluation studies of health communication campaigns for prevention and control of communicable diseases in Europe have been developed and implemented. Others included: chlamydia, hepatitis C, food safety and diphtheria [140-143, 148-187]. Targeting including hard-to-reach populations • The identified European examples mainly targeted healthcare workers, the general public, and young adults. Targeting including hard-to-reach populations Only two examples explicitly stated that it targeted hard-to-reach groups [166, 185]. Health communication campaign evaluation with regard to the prevention and control of communicable diseases in Europe. Weaknesses • Blurred definitions, dispersed across various disciplines and an overlap between risk and crisis/emergency communication. Models & theories Were there any models, theories or frameworks identified in the review? Four theoretical models of risk communication [188]: • Risk perception model • Mental noise • Negative dominance • Trust determination. In addition, there are social constructionist approaches – emphasising social and cultural factors [189, 190]. Weaknesses • Few integrative risk communication theoretical frameworks that bridge diverse disciplinary traditions [191]. Tools Did the review identify any tools that facilitate step by step practical application? Weaknesses • Resources focus on crisis rather than strategic pre-crisis communication. Evidence What evidence was identified in the review and what is the quality of the evidence? Strengths Four review papers assist in bringing together the key guidance documents which have informed much of risk communication policy and application over the past two decades: • Jardine et al. Quality • A number of the same best practices elements of effective risk communication were identified in all of the first three review papers. Weaknesses Quality • The majority of the guidance documents were focused on emergency crisis situations and are of varying depth and quality. Weakness Communication effects • The review does not report any reference to assessment of public engagement in matters of risk. Behavioural and other changes There is a lack of evidence-informed evaluations of risk communication on communicable diseases in the literature [220]. Application What has been applied into practice in the area of risk communication for the prevention and control of communicable diseases? European Practical application of risk communication studies were mostly identified from Europe and North America, with some also from south-east Asia. Focus The greatest number of identified studies were found on the topics of: risk communication theories, guidelines and risk perceptions. Weaknesses • Focus is on emergency and outbreak situations rather than strategic risk communication. Targeting including hard-to-reach populations Studies show that during communicable disease outbreaks, minority populations are found to be disproportionally affected [217-219], however the review identified a paucity of studies addressing hard- to-reach groups. A literature review on effective risk communication for the prevention and control of communicable diseases in Europe. The references cited in this matrix table and upcoming tables are listed in Appendix 3. Strengths There are a range of communication theories that are applicable to the concept of pro-immunisation communication [233-238]. Weaknesses The review concluded that few interventions explicitly considered underlying conceptual assumptions of pro-immunisation communication. Models & theories Were there any models, theories or frameworks identified in the review? Weaknesses • Absence of explicitly stated theoretical underpinning in most interventions captured by the review. Tools Did the review identify any tools that facilitate step by step practical application? Strengths • A very wide range of mass communication and personalised promotional communication tools applied and evaluated across a diverse range of channels, materials and dissemination methods and agents were identified in the review [for example see 244-245, 256]. Weaknesses Many interventions combined tools but reported evaluations did not isolate and measure contribution of individual elements. Strengths The review included thirty three studies of promotional communication interventions for immunisation [239-250, 256-277]. The evidence pool provides evidence for a range of promotional communication practices that can improve knowledge of, attitudes towards, and uptake of immunisation [244-246, 256, 263-264, 266]. Quality • Fifteen of the thirty three evaluation studies captured in the review were rated as high-quality studies [244-245, 248-250, 259, 261-263, 265-267, 272-274] • Seven high-quality studies reported convincing evidence of positive effect [244-246, 256, 263-264, 266] Weaknesses Quality Limited conclusions can be drawn from the review on most effective practice. This is due to the heterogeneity of interventions and evaluation methods, and the small number of studies assessed as high quality and reporting convincing evidence of positive effect. Behavioural and other changes None of the studies included in the review provided data on the impact of promotional communication on health status of the target audience(s). Application What has been applied into practice in the area of national immunisation schedule promotional communication? Strengths Focus Of the thirty three studies included in the review, 22 reported on interventions to promote influenza immunisation [239,244-250, 257, 259, 261, 262-271], and 11 reported on interventions to promote immunisations for other vaccine-preventable diseases [240-243, 258, 260, 272-276]. Targeting including hard-to-reach populations The majority of studies included in the review targeted healthcare workers [239, 244 -250, 256-260, 262, 264, 267] and/or patient risk groups such as the elderly [244-245, 250, 259, 261, 263, 265-266, 268-269, 273]. Weaknesses Focus Limited evaluations of promotional communication for childhood vaccine-preventable diseases were captured in the review [240, 258, 260, 272-276]. Target Limited evidence on interventions targeting parents and young people [240-243, 258, 260, 272-276]. Targeting including hard-to-reach populations No evidence identified on vaccine promotions for hard-to-reach groups. The reference numbering system used in this table does not stem from the completed review, published in the technical report series as: Cairns G, MacDonald L, Angus K, Walker L, Cairns-Haylor T, Bowdler T.
It is clearly imperative for leaders buy cheap rumalaya liniment 60 ml on line spasms in legs, governments and organisations to be mindful of the impact of future health communication and campaigns on minority and disadvantaged groups and implement strategies designed to reduce health inequalities order 60 ml rumalaya liniment with visa spasms spinal cord injury. Participants in the online consultation recognised the importance of health professionals as not just a priority audience for health communication but also as having an intermediary role in communicating health messages to the public including potentially those in disadvantaged and /or hard-to-reach groups [3] 60 ml rumalaya liniment free shipping muscle relaxant bruxism. Stakeholders perceived that campaigns for communicable diseases were limited in their objectives and methods 60 ml rumalaya liniment amex quadricep spasms. A more strategic approach, it was suggested, would involve more strategic objectives focussing on disease eradication. Strategic planning would also result in more efficient and effective intervention and evaluation development. For example, a multitude of interventions to increase the uptake of immunisations have been implemented across Europe and yet the sample sizes in most are too small to allow for conclusions to be drawn [10]. Therefore, an accessible database of completed interventions and a commitment to build on prior knowledge and experience would result in the development and expansion of an evidence base. Strategic development could also include multi-centred trials using comparable methods and measures, coordinated across countries, resulting in larger sample sizes and data amenable to meta-analysis. Such leadership was also seen as providing coordination during a crisis and supporting countries with data, surveillance, risk assessment, and communication messages. Knowledge development The expansion of the knowledge base that supports evidence-informed policymaking at all levels, fosters the development of new research and innovative solutions to problems and establishes fruitful partnerships between research centres and academic institutions. A limited evidence base for health communication exists although with a paucity relating to health communication for communicable diseases within the European context. Although there is a degree of conceptual clarity about many of the important concepts in health communication, the level of knowledge is underdeveloped in other areas. Nine evidence reviews were undertaken for the Translating Health Communication Project and these found that while there was a degree of conceptual agreement evolving about the concepts of health literacy [4], health advocacy [5], the promotion of immunisation uptake [10] and behaviour change [11], there was a more limited consensus and/or understanding about the concepts relating to social marketing [6], health information seeking [7], risk communication [9], campaign evaluations [8], and trust and reputation management [12]. It was noted that in respect of risk communications, some of the lack of conceptual clarity may be attributed to the diversity of disciplines and theoretical models which should be integrated across the disciplines [9]. The research also identified knowledge gaps with regard to determining credible sources of information and even defining the term ‘evidence’. For example, the majority of participants in the stakeholder survey felt that messages were developed from an evidence base; however few identified actual sources of evidence used to inform activities [1]. A wide variety of interventions are called ‘health communication campaigns’ and the evaluations of such interventions include: systematic and exploratory reviews, experimental and randomised, non-randomised, time series, multiple method, longitudinal, before-after, cross-sectional, content analysis, and cost-effectiveness. Behavioural or social theories are considered an important tool in the design, planning and evaluation of effective behaviour change interventions and programmes. A systematic review of the evidence for the effectiveness of interventions that use theories and models of behaviour change towards the prevention and control of communicable diseases [11] identified 61 evaluations of interventions for the prevention/control of communicable diseases that used a theory or model. However, the included studies did not report sufficient detail on communication-based indicators of change to draw any inferences or conclusions on outcomes and the review highlighted a need for further research in this area with a consistency that would allow for meta-analyses. These key steps in health communication campaigns are consistently agreed to comprise: setting goals and objectives; identifying target audiences; identifying barriers; developing and testing key messages; producing materials and tools; reaching the target audience and; assessing campaign effectiveness [8]. Likewise, the research identified a significant amount of useful tools often in the form of toolkits, templates or guidelines. The Overview of health communication campaigns developed by the Centre for Health Promotion at the University of Toronto provides a hands-on 12-step process for developing health communication campaigns [24]. It also provides health communicators with steps for communication over five phases of an emergency situation caused by an outbreak or a threatened outbreak of a communicable disease. Comprehensive knowledge exists in the form of toolkits and guides to developing, implementing and evaluating health communication activities. Resources such as these could usefully inform the development of a strategy for health communication activities for communicable diseases and provide a template for the development of initiatives. Likewise, there are extensive and comprehensive guidance and templates on, for example, online health communication produced by the U. Properly collated, these would contribute to a valuable database for the further development of health communications for communicable diseases. There is an overall lack of high-quality campaign evaluation studies in the area of prevention, and control of communicable diseases in Europe despite a consensus in the literature that effective evaluation is an important prerequisite for success [8]. Evaluation of such campaigns is complex and should incorporate complex programme objectives and interconnecting causal pathways [30, 31]. Further research is particularly needed in these areas, including clarification of what is being evaluated and the use of guiding principles for evaluation; the development of the theoretical underpinnings of the concept and methodological rigour; exploration of any unintended campaign effects and campaign cost effectiveness; and the promotion of detailed reporting of methodologies used [8]. The evidence base for health communication for non-communicable diseases is perceived in some instances to be more developed than that for communicable diseases [4, 5]. Specific instances of this include the evidence base in health advocacy and the work in progress on behavioural determinant mapping in non-communicable diseases [2, 5]. The European knowledge base may be usefully developed with reference to those in other jurisdictions and in relation to other disease groups. These evidence bases may provide a useful resource for the further development of a knowledge base for health communication for communicable diseases. The opportunity exists to explore the transferability of the expertise, capacity, information and best practice developed with regard to non-communicable diseases to communicable diseases. Interestingly, it was suggested during the stakeholders consultation that the distinction between communicable and non-communicable diseases was not a useful one as many non-communicable diseases are caused by infectious agents [2]. The need for more, systematic evaluation was repeatedly identified during this research project in relation to formative, process, impact, outcome and cost-effectiveness evaluation [4, 5, 8]. Evaluations can identify the significant and appropriate expectations of an initiative, the most effective strategies, and may support the development of best practices [32], serving to keep an initiative on track or, alternatively, indicate when it is advisable to adjust or adapt the advocacy strategies. The importance of an inclusive approach to meaningful evaluation [33] was also highlighted [5] in order to identify whether the intended beneficiaries of the advocacy intervention perceived a benefit from the initiative [32]. An initiative which brings about a change of policy or legislation will be of little real value if those for whom the change was intended to benefit do not know that this change has come about or if they are unable to access the legal services to vindicate their rights [33]. Recent developments have strengthened the knowledge base for health advocacy evaluations, and strong recommendations exist about the importance of the use of a theory of change during the development of campaigns and initiatives to make explicit the intended relationship between actions and outcomes [5]. The emerging knowledge and resource base might be profitably utilised in the wider development of evaluation of health communication interventions for the prevention and control of communicable diseases in the future. A number of issues were highlighted as priorities, including developing an evidence base for the use of new and social media channels, profiling and targeting audiences, and retrospective evaluation on the use of health communication in recent crises in order to inform proactive planning for future crisis events. Evaluation is particularly underdeveloped in the broader context of health communication, and scant in relation to health communication for the prevention and control of communicable diseases. Integral to the development of more formal evaluation is progress in identifying the indicators of success for health communication activities. Promisingly, the evidence base is increasing and, for example, there are a number of guides and toolkits about theory-based evaluation of health advocacy interventions that can guide further advances in this sphere [34, 35]. A platform to support the development and sharing of evidence, tools, experiences and outcomes would greatly facilitate the development of the field of health communication. Interventions and activities can be accessed from such a database and tailored to suit the needs of the topic, country and target group. Such an approach would also strengthen the consistency of health communication for prevention and control of communicable diseases in Europe.
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Influenza is not “stomach flu” order rumalaya liniment 60 ml mastercard muscle relaxant cyclobenzaprine dosage, a term used by some to (Flu) describe illnesses causing vomiting or diarrhea discount 60 ml rumalaya liniment overnight delivery kidney spasms causes. If you think your child Symptoms has the Flu: Your child may have chills cheap 60 ml rumalaya liniment with mastercard muscle relaxant quiz, body aches buy rumalaya liniment 60 ml mastercard spasms in abdomen, fever, and Thell your childcare headache. Your child may also have a cough, runny or provider or call the stuffy nose, and sore throat. If your child has been infected, it may take 1 to 4 days (usually 2 days) for symptoms to start. Childcare and School: Yes, until the fever is Spread gone for at least 24 hours and the child is - By coughing and sneezing. Call your Healthcare Provider ♦ If anyone in your home has a high fever and/or coughs a lot. This includes door knobs, refrigerator handle, water faucets, and cupboard handles. Measles (also called rubeola, red measles, or hard measles) is a highly contagious virus and is a serious illness that may be prevented by vaccination. Currently, measles most often occurs in susceptible persons (those who have never had measles or measles vaccine) who are traveling into and out of the United States. A red blotchy rash appears 3 to 5 days after the start of symptoms, usually beginning on the face (hairline), spreading down the trunk and down the arms and legs. About one child in every 1000 who gets measles will develop encephalitis (inflammation of the brain). The virus can sometimes float in the air and infect others for approximately two hours after a person with measles leaves a room. Also by handling or touching contaminated objects and then touching your eyes, nose, and/or mouth. The time from exposure to when the rash starts is usually 14 days, or 3 to 5 days after the start of symptoms. Exclude unvaccinated children and staff, who are not vaccinated within 72 hours of exposure, for at least 2 weeks after the onset of rash in the last person who developed measles. If measles is suspected, a blood test for measles antibody should be done 3 to 5 days after rash begins. Persons who have been exposed to measles should contact their healthcare provider if they develop cold-like symptoms with a fever and/or rash. Encourage parents/guardians to notify the childcare provider or school when their child is vaccinated so their records can be updated. This should be strongly considered for contacts younger than one year of age, pregnant women who have never had measles or measles vaccine, or persons with a weakened immune system. Encourage parents/guardians keep their child home if they develop symptoms of measles. Wash hands thoroughly with soap and warm running water after touching secretions from the nose or mouth. If you think your child Symptoms has Measles: Your child may have a high fever, watery eyes, a runny nose, and a cough. It usually begins on the face (in the hairline) and then spreads down so it may eventually cover the Need to stay home? Childcare and School: If your child has been infected, it may take 7 to 18 days for symptoms to start, generally 8 to 12 days. A child with measles should not attend any Contagious Period activities during this time From 4 days before to 4 days after the rash starts. Call your Healthcare Provider If a case of measles occurs If anyone in your home: in your childcare or school, ♦ was exposed to measles and has not had measles or public health will inform measles vaccine in the past. Prevention All children by the age of 15 months must be vaccinated against measles or have an exemption for childcare enrollment. An additional dose or an exemption is required for kindergarten or two doses by eighth grade enrollment. When a single case of measles is identified, exemptions in childcare centers or schools will not be allowed. Meningitis - fever, vomiting, headache, stiff neck, extreme sleepiness, confusion, irritability, and lack of appetite; sometimes a rash. Each situation must be looked at individually to determine appropriate control measures to implement. Most children may return after the child has been on appropriate antibiotics for at least 24 hours and is well enough to participate in routine activities. The childcare provider or school may choose to exclude exposed staff and attendees until preventive treatment has been started, if there is concern that they will not follow through with recommended preventive treatment otherwise. Exposed persons should contact a healthcare provider at the first signs of meningococcal disease. Clean and disinfect other items or surfaces that come in contact with secretions from the nose or mouth. The vaccines are highly effective at preventing four of the strains of bacteria that cause meningococcal meningitis. However, the vaccine takes some time to take effect and is not considered a substitute for antibiotics following a high risk exposure. If you think your child has Symptoms Meningococcal Disease: Your child may have chills, a headache, fever, and stiff Thell your childcare neck. If your child is infected, it may take 1 to 10 days for Childcare and School: symptoms to start. The child - By direct contact with secretions of the nose and should also be healthy throat. This may happen by kissing, sharing food, enough for routine beverages, toothbrushes, or silverware. Call your Healthcare Provider If anyone in your home: ♦ has symptoms of the illness. Prevention The local or state health department will help to determine who has been exposed and will need to take preventive antibiotics. When staph is present on or in the body without causing illness, this is called colonization. When bacteria are resistant to an antibiotic it means that particular antibiotic will not kill the bacteria. These infections commonly occur at sites of visible skin trauma, such as cuts and abrasions, and areas of the body covered by hair (e. A long delay may occur between colonization with staph and the onset of infection. Activities: Children with draining sores should not participate in any activities where skin-to-skin contact is likely to occur until their sores are healed. Childcare/school personnel should notify parents/guardians when possible skin infections are detected. Wash hands thoroughly with soap and warm running water after touching secretions from the nose, tracheostomies, gastrostomies, or skin drainage of an infected or colonized person. When bacteria are antibiotic resistant it means that an antibiotic will not kill the bacteria.
To gain noticeable health benefits order 60 ml rumalaya liniment overnight delivery muscle relaxant alcoholism, only 30 minutes of moderate physical activity such as walking buy rumalaya liniment 60 ml online spasms knee, and only over the course of most days of the week buy rumalaya liniment 60 ml muscle relaxant tincture, is enough purchase 60 ml rumalaya liniment with amex muscle relaxant with ibuprofen. For greater cardiovascular benefits you need to perform moderate to high-intensity aerobic exercise three to five times a week, for 30 to 40 minutes, in addition to warm-up and cool-down activities. Muscular fitness consists of strength (what a muscle produces in one effort) and endurance (the ability to perform repeated muscle contractions in quick succession over a period of time). You can also use exercise bands of broad elastic or exercise tubes in various sizes, which are really handy when your shipboard space is so limited as to prohibit bringing bulkier equipment. The principle of elastic band exercises is that as you stretch the elastic during the exercise, it provides continuously increasing resistance. Women should start with a pair of two- or three- pound weights or elastic equivalents, men with five- or ten- pound weights. Most equipment comes with an illustrated set of instructions that shows you recommended exercises. Perform moderate intensity resistance workouts twice a week lasting at least fifteen minutes per session (not counting your warm-up and cool-down). Do up to 10 separate exercises that train each of the major muscle groups; start with one set then progress to two sets of 8-12 repetitions each until the point of muscle fatigue. Many trainers recommend alternating upper body strength training days with lower body strength training days. A simple upper body strength training session could consist of the bench/chest flys for the pectorals, lateral raises for the deltoids, upright rows for the trapezius, triceps extensions, curls for the biceps, and push-ups. The next day, a simple lower body strength training session could consist of squats for the buttocks, heel raises and dips for calf muscles, straight leg lifts for the quadriceps, inner thigh leg raises, and step-ups for the buttocks, quadriceps, hamstrings, and calves. Abdominal muscles can be strengthened using curls and curl downs (negative sit-ups). You may feel that the biggest barriers to exercising when at sea are time and space limitations. You can do this by working out at your usual intensity a few times per week and for shorter durations than your regular exercise; this is much better than not exercising at all. Try to perform flexibility exercises three to four times a week, or even daily, only and always after a thorough warm-up. Stretching should always be preceded by a brief five to ten minute warm-up, such as jogging in place or energetic walking. Gently stretching before you begin aerobic exercise is useful because it makes warmed-up muscles looser and decreases the chances of injury. A basic stretching session would consist of stretches of the neck, the shoulders, the arms, the calves, the spine, the outer thighs, the hips, the lumbar area, as well as the butterfly stretch for muscles in the groin, and a crossover stretch for the lower back. Each static stretch should be held at least ten seconds, working up to 20 to 30 seconds, and usually repeated three to four times. Keep your back aligned, your abdominal muscles contracted, buttocks tucked in, and knees aligned over the feet. When you are starting a new program, have someone else watch you to make sure your position is correct throughout your workout. These call for gradual stretching throughout a muscle’s full range of movement until you feel resistance. Wearing improper or worn-out shoes places added stress on your hips, knees, ankles, and feet, where up to 90 percent of all sports injuries occur. Aerobics instructors suffer injuries to their bodies because of the repetitive, jarring movements of some routines. Substitute the marching or gliding movements of low-impact aerobics for the jolting up-and-down motion of typical aerobics routines. Slowly jog for five minutes, even in place if need be, before your workout to gradually increase your heart rate, and core and muscle temperatures. This is particularly important in hot weather, when you can easily lose more than a quart of water in an hour. Even after you have a well-established exercise program, there will be interruptions. You may be ill, you may be in a setting where it is difficult to exercise, shipboard duties may take precedence over leisure activities, or you may sustain an injury. The general rule is that it will take as long to get back to your previous level of activity as you were out. If you cannot exercise for two weeks, gradually increase your activity over a two-week period to get back to your previous level. After your exercise program is established, make sure that it becomes a habit you want to continue for a long time. In 1980 the United States Department of Agriculture and the United States Department of Health and Human Services first issued Nutrition and Your Health: Dietary Guidelines for Americans to provide practical dietary advice based on current research. In addition, the Dietary Guidelines Advisory Committee was established to incorporate new scientific data, and to update the guidelines. The latest revision of the Dietary Guidelines for Americans provides the basis for all Federal nutrition information and education programs for healthy Americans. They are for healthy people two years of age and over, and are not for people who need special diets because of disease and conditions that interfere with normal nutrition. Generally, these guidelines can be followed for a short period of time by people with chronic diseases until more specific advice can be 6-6 obtained from a Registered Dietitian. If one occasionally eats foods that are higher in fat, sugars, or sodium, balance them during the day with other foods that are lower. These Guidelines offer tips for helping to choose foods for a healthful diet: Eat a variety of foods. The nutrients should come from a variety of foods, not from a few highly fortified foods or supplements. A varied diet is defined below by the Food Guide Pyramid with suggested numbers of servings from vegetables, fruits, grain products, dairy products and meat/meat substitutes. A "healthy" body weight depends on the percentage of body weight as fat, the location of fat deposition, and the existence of any weight-related medical problems. However, using tables with suggested weight-for-height-and-age is a popular method of estimating recommended body weight. A number of studies suggest a possible association between excess body weight and several cancers including breast, uterine, colon, gallbladder, and prostate. Of all the dietary factors thought to affect cancer, fat has been the subject of the most research. Substantial evidence suggests that excessive fat intake increases the risk of developing cancers of the breast, colon, and prostate. The National Cancer Institute and National Cholesterol Education Program recommend reducing total fat intake to 30% or less of total calorie intake. This level of fat intake can be achieved by a change in eating habits and is also an effective way to reduce total calories. Consuming more vegetables, fruits, breads, cereals, potatoes, pasta, rice, and dry beans and peas are emphasized especially for their complex carbohydrates, dietary fiber, and other components linked to good health.
