ABSTRACT
AIM: This study analyzed the trend of gender gaps in life expectancy (GGLE) in Japan between 1947 and 2010, and explored the correlations of GGLE with gender mortality ratio and social development indices. METHODS: Using GGLE and social indices data collected from the official websites, we carried out trends analysis of GGLE by calculating segmented average growth rates for different periods. We explored the association between GGLE and all-cause mortality; and between GGLE and Human Development Index (HDI) while controlling for time trend, by computing the generalized additive models based on the software R (version 2.15). RESULTS: Japan's GGLE increased in a fluctuating fashion. Across 53 years, the average growth rates varied widely: 0.14% (1947-1956), 1.43% (1956-1974), 1.06% (1974-2004) and -0.60% (2004-2010) (overall average 0.87%). The value of GGLE peaked to 7.00 years in 2004, and then has slowly declined (6.75 years in 2010). Age-adjusted all-cause gender mortality ratio had a statistically positive association with GGLE (P<0.01), whereas HDI was found to have no such association. CONCLUSION: The increased trend of GGLE in Japan could be partly explained by increased disease-specific mortality ratios (male/female), especially those involving chronic bronchitis and emphysema, diseases of the liver, suicide and cancer. The recent decline of GGLE might imply that Japanese women have been catching up with the lifestyle of men, resulting in similar mortality patterns. This calls for gender-sensitive approaches to developing policies and programs that will help sustain healthy lifestyles to combat smoking and alcohol intake, and social support to prevent suicide.
Subject(s)
Life Expectancy/trends , Cause of Death/trends , Female , Humans , Japan/epidemiology , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Factors , Socioeconomic FactorsABSTRACT
BACKGROUND: Many countries with shortages in health personnel are introducing task shifting in primary health care. GPs' attitudes and practices strongly affect task shifting and the expansion of the roles of physician assistants (PAs). OBJECTIVE: To assess, in a German state with shortages of health personnel, the overall willingness of GPs to delegate home visit tasks to PAs and to elicit their perceptions of barriers to and benefits of such delegation and the current practice of informal delegation. METHODS: Postal self-administered anonymous survey of all practicing GPs in the rural state of Mecklenburg-Vorpommern. Main outcomes were GPs' willingness to delegate in home visit tasks to a properly trained PA, perceived barriers to and benefits of home visit delegation and current practice of informal delegation. Using multinomial logistic regression, associations were identified among outcome variables, and characteristics of the GPs and of their practices. RESULTS: Response rate was 47%. Responders (500) were comparable to all GPs in the state (1096); 48% of practitioners are willing to delegate home visits tasks to PAs. The main barrier to delegation was the related costs of PAs' training (34%), and the main benefit that it 'saves the GP's time' (67%). The 46% of practitioners who are informally delegating home visit tasks were significantly more likely be younger [odds ratio (OR) and 95% confidence interval (CI)] [OR = 0.96 (0.93-0.99)] and female [OR = 1.70 (1.12-2.58)]. CONCLUSION: The increasing proportion of women in family medicine might favor task shifting in General Practice.
Subject(s)
Attitude of Health Personnel , General Practice/organization & administration , General Practitioners/psychology , House Calls , Personnel Delegation , Physician Assistants , Practice Patterns, Physicians'/statistics & numerical data , Adult , Aged , Female , Germany , Health Care Reform , Health Care Surveys , Humans , Logistic Models , Male , Middle Aged , Primary Health Care/organization & administration , Professional Role , Rural Health Services/organization & administration , Surveys and Questionnaires , WorkforceABSTRACT
A major difficulty in a disaster is knowing where to find accurate information to help coordinate efforts in a quick and organized way. The establishment of a global information network, in place before a disaster occurs, could link all the efforts towards relief. We propose that a Global Health Unit for Disaster and Relief Coordination be set up as part of the Global Health Network, having the Internet as its backbone. This Unit would establish the links for the disaster information mosaic (AU)
Subject(s)
Disasters , Public Health , Computer Communication Networks , Telecommunications , Technology , Information Systems , Communications MediaABSTRACT
National and Global Health have dramatically improved since the end of WWII. This has been primarily the result of public health actions. Public health is information transfer. The information superhighway can markedly improve public health, but public health and prevention have been neglected. Tele medicine, but it should. We have outlined a global health network to address this. The global health network consists of 1) connectivity of all people in public health worjdwide. 2)tele-monitoring of disease, the use telecommunication for disease monitoring. 3)establishment of a global health network university, a health network through the internet, 4)connecting health related non-government organizations, 5)establishment of a global health network research server to replace biomedical journals, 6)the training of cyberdocs, individual trained in public health and networking (AU)
