Evaluation of an innovative approach to the Director of Public Health's annual report.

BACKGROUND: The aim of this study was to evaluate the process of an innovative 'presentation with discussion' approach to the Director of Public Health's (DPH) annual report for North Derbyshire Health Authority. STUDY DESIGN: Mixed methods-survey and interviews. METHODS: Survey methods were used to obtain qualitative and quantitative data. Key stakeholders were sent a postal questionnaire, individuals attending presentations could respond via a printed slip or letter, structured group discussions following presentations were recorded manually, and presenters and producers were interviewed. RESULTS: Thirty-five of 41 (85.4%) key stakeholders returned questionnaires, 18 people responded individually, discussions following 26/30 (86.7%) presentations were documented, and all eight presenters and 11 producers were interviewed. The general response was extremely positive with 25 of 35 (71%) key stakeholders, 100% of presenters and 80% of producers preferring the new format to the previous year's report. People felt that it conveyed the public health message effectively, and appreciated the opportunity to contribute to the recommendations for improving health in North Derbyshire. Many were concerned that the circulation should be wide, and key stakeholders were keen to have a printed reference document to support their work. Presenters enjoyed the process although tailoring the presentations to unfamiliar audiences proved difficult. The production team found the process more efficient and focused, although direct production costs were increased. Presenters and producers were concerned that the process for implementing recommendations for action was not fully considered. CONCLUSIONS: Most people preferred this innovative approach to the traditional annual report, and it is therefore recommended that this format should be used for future DPH annual reports. Key stakeholders still require a reference document, and presenters' briefing notes could be adapted for this purpose. Circulation of the report should be wide, and further consideration of how participants' recommendations for action are implemented is needed.

Thermal effects of prolonged treadmill exercise in the heat. 1974.

Six trained men 21-38 yrs old ran 19-29 km (1.5 to 2.5 hrs) approximately 75% of their VO2 max on a level treadmill in the heat (33.5/21.5 degrees C db/wb, wind velocity 36 m/min). Every 20 min while running they (a) drank 200 ml of 10 degrees C water, (b) drank 200 ml of water at core body temperature, or (c) sponged their faces, arms, and trunks for 2 min with a towel soaked in 10 degrees C water. In another series of experiments each subject (d) hydrated 30 min before the run by drinking 1 liter of water, (e) hydrated and performed (a) above, and (f) hydrated and performed (b) above. Rectal temperature (Tre) and body weight loss (WL) were determined every 30 min and metabolism at 45 min of running. Terminal Tre after (a) through (f) averaged 39.1, 39.3, 39.9, 39.7, 39.1, and 39.3 degrees C respectively. During a control run the corresponding mean Tre was 39.9 degrees C. In a 66.7 kg man with a body weight/surface area (BW/SA) ratio of 37.5 and running at 74% of his VO2 max, Tre rose 0.4 degrees C/1% WL with increasing WL's greater than 2.0% of his initial body weight regardless of the intervention imposed. In another subject weighing 70 kg with a BW/SA ratio of 38.8 and running at 83% of his VO2 max, Tre rose 0.49 degrees C/1% WL over the entire range of WL's.(ABSTRACT TRUNCATED AT 250 WORDS)