The Jamkhed Comprehensive Rural Health Project and the Alma-Ata Vision of Primary Health Care.

The Jamkhed Comprehensive Rural Health Project (Jamkhed CRHP) was established in central India in 1970. The Jamkhed CRHP approach, developed by Rajanikant and Mabelle Arole, was instrumental in influencing the concepts and principles embedded in the 1978 Declaration of Alma-Ata. The Jamkhed CRHP pioneered provision of services close to people's homes, use of health teams (including community workers), community engagement, integration of services, and promotion of equity, all key elements of the declaration. The extraordinary contributions that the Jamkhed CRHP has made as it approaches its 50th anniversary need to be recognized as the world celebrates the 40th anniversary of the International Conference on Primary Health Care and the writing of the declaration. We describe the early influence of the Jamkhed CRHP on the declaration as well as the work at Jamkhed, its notable influence in improving the health of the people it has served and continues to serve, the remarkable contributions it has made to training people from around India and the world, and its remarkable influences on programs and policies in India and beyond.

Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review.

INTRODUCTION: The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. METHODS AND ANALYSIS: Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of 'Health of the Nation Outcome Scales' or 'HoNOS' will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. ETHICS AND DISSEMINATION: Ethics approval is not required as no primary data will be collected. Outcomes will be disseminated to stakeholders via reports, journal articles and presentations at meetings and conferences. PROSPERO REGISTRATION NUMBER: CRD42017057871.

Advances in Residential Design Related to the Influence of Geomagnetism.

Since the origin of the Modern Movement, there has been a basic commitment to improving housing conditions and the well-being of occupants, especially given the prediction that 2/3 of humanity will reside in cities by 2050. Moreover, a compact model of the city with tall buildings and urban densification at this scale will be generated. Continuous constructive and technological advances have developed solid foundations on safety, energy efficiency, habitability, and sustainability in housing design. However, studies on improving the quality of life in these areas continue to be a challenge for architects and engineers. This paper seeks to contribute health-related information to the study of residential design, specifically the influence of the geomagnetic field on its occupants. After compiling information on the effects of geomagnetic fields from different medical studies over 23 years, a case study of a 16-story high-rise building is presented, with the goal of proposing architectural design recommendations for long-term occupation in the same place. The purpose of the present work is three-fold: first, to characterize the geomagnetic field variability of buildings; second, to identify the causes and possible related mechanisms; and third, to define architectural criteria on the arrangement of uses and constructive elements for housing.

A Global Perspective on Drinking-Water and Sanitation Classification: An Evaluation of Census Content.

Following the recent expiry of the United Nations' 2015 Millennium Development Goals (MDGs), new international development agenda covering 2030 water, sanitation and hygiene (WASH) targets have been proposed, which imply new demands on data sources for monitoring relevant progress. This study evaluates drinking-water and sanitation classification systems from national census questionnaire content, based upon the most recent international policy changes, to examine national population census's ability to capture drinking-water and sanitation availability, safety, accessibility, and sustainability. In total, 247 censuses from 83 low income and lower-middle income countries were assessed using a scoring system, intended to assess harmonised water supply and sanitation classification systems for each census relative to the typology needed to monitor the proposed post-2015 indicators of WASH targets. The results signal a lack of international harmonisation and standardisation in census categorisation systems, especially concerning safety, accessibility, and sustainability of services in current census content. This suggests further refinements and harmonisation of future census content may be necessary to reflect ambitions for post-2015 monitoring.

Selected findings from the cross-site evaluation of the Federal Healthy Start Program.

Initiated in 1991, the Federal Healthy Start Program includes 105 community-based projects in 39 states, the District of Columbia and Puerto Rico. Healthy Start projects work collaboratively with stakeholders to ensure participants' continuity of care during pregnancy through 2 years postpartum. This evaluation of Healthy Start projects examined relationships between implementation of nine core service and system program components and improvements in birth and project outcomes. Program components and outcomes were examined using data from a 2010 Healthy Start project director (PD) survey (N = 104 projects) and 2009 performance measure data from the Maternal and Child Health Bureau Discretionary Grant Information System (N = 98 projects). We explored bivariate relationships between the nine core program components and (a) intermediate and long-term project outcomes and (b) birth outcomes. We assessed independent associations of implementation of all core program components with birth outcomes, adjusting for project characteristics and activities. In 2010, 57 projects implemented all nine core program components: 104 implemented all five core service components and 69 implemented all four core systems components. Implementation of all core program components was significantly associated with several PD-reported intermediate and long-term project outcomes, but was not associated with singleton low birth weight or infant mortality among participants' infants. This evaluation revealed a mixed set of relationships between Healthy Start projects' implementation of the core program components and achievement of project outcomes. Although the findings demonstrated a positive impact of Healthy Start projects on birth outcomes, only a few associations were statistically significant.

Vision 2020 measures University of New Mexico's success by health of its state.

The University of New Mexico Health Sciences Center (UNMHSC) adopted a new Vision to work with community partners to help New Mexico make more progress in health and health equity than any other state by 2020. UNMHSC recognized it would be more successful in meeting communities' health priorities if it better aligned its own educational, research, and clinical missions with their needs. National measures that compare states on the basis of health determinants and outcomes were adopted in 2013 as part of Vision 2020 target measures for gauging progress toward improved health and health care in New Mexico. The Vision focused the institution's resources on strengthening community capacity and responding to community priorities via pipeline education, workforce development programs, community-driven and community-focused research, and community-based clinical service innovations, such as telehealth and "health extension." Initiatives with the greatest impact often cut across institutional silos in colleges, departments, and programs, yielding measurable community health benefits. Community leaders also facilitated collaboration by enlisting University of New Mexico educational and clinical resources to better respond to their local priorities. Early progress in New Mexico's health outcomes measures and state health ranking is a promising sign of movement toward Vision 2020.

The post-millennium development goals agenda: include 'end to all wars' as a public health goal!

The process of identifying global post-millennium development goals (post-MDGs) has begun in earnest. Consensus is emerging in certain areas (e.g. eliminating poverty) and conflicts and violence are recognized as key factors that retard human development. However, current discussions focus on tackling intra-state conflicts and individual-based violence and hardly mention eliminating wars as a goal. Wars create public health catastrophes. They kill, maim, displace and affect millions. Inter-state wars fuel intra-state conflicts and violence. The peace agenda should not be the monopoly of the UN Security Council, and the current consensus-building process setting the post-MDG agenda is a rallying point for the global community. The human rights approach will not suffice to eliminate wars, because few are fought to protect human rights. The development agenda should therefore commit to eliminating all wars by 2030. Targets to reduce tensions and discourage wars should be included. We should act now.

City leadership for health and well-being: back to the future.

The new European Health Policy Framework and Strategy: Health 2020 of the World Health Organization, draws upon the experience and insights of five phases, spanning 25 years, of the WHO European Healthy Cities Network (WHO-EHCN). Applying the 2020 health lens to Healthy Cities, equity in health and human-centered sustainable development are core values and cities have a profound influence on the wider determinants of health in the European population. "Making it Happen" relies on four action elements applied and tested by municipalities and their formal and informal partners: political commitment, vision and strategy, institutional change, and networking. In turn, the renewed commitment by member states of the WHO Regional Committee to work with all spheres and tiers of government is a new dawn for city governance, encouraging cities to redouble their investment in health and health equity in all policies, even in a period of austerity. For phase VI, the WHO-EHCN is being positioned as a strategic vehicle for implementing Health 2020 at the local level. Healthy Cities' leadership is more relevant than ever.