Social Prescribing is a mechanism by which primary care team members can refer patients to community groups to improve their health and well-being. It integrates health, social care, and community, allowing patients to actively improve their health and well-being by participating in community initiatives and activities. These activities have traditionally been part of community life in European countries, and the benefits need to be consistently recognized.

INTRODUCTION:The prevalence of disabilities in the general population is not neglectable and gaps in providing quality health service persist between people with and without disabilities. Though life expectancy of persons with disability is increasing, there is an excess of preventable morbidity and mortality. The person with disability has needs and expectations and should be partners in the process of prevention, treatment and follow-up of their health status. According to research, the medical care for the patient with disability does not meet the standards derived from the evidence. Patient safety is a core domain in the quality of care and that is true for the care of persons with disability. Communication, stigma, lack of knowledge, skills and training, are major inhibitors of the provision of high-quality care for the people with disabilities and are considered to be factors responsible for the high incidence of adverse and medical errors in this group of patients. Approaching these topics with critical attention is needed across the span of medical care from the community to the hospital and from prevention to the more complex and sophisticated care offered to the patient with disability.

Hepatitis C virus (HCV), was called ‘non-A, non-B hepatitis’ before it was identified in 1989. Since its identification, HCV has been found in most parts of the world, mostly through studies of volunteer blood donors. Low prevalence rates were found in Northern Europe (0.07%–0.5%), while high prevalence rates were found in the Middle East (0.5%–1.5%), with the highest rate (14.4%) found in Egypt (1). Studies of risk groups have shown serologic evidence of HCV infection in 80%–90% of intravenous drug users or abusers, 60%–70% in hemophiliacs, 30% in alcoholics, 20% in organ transplant recipients, 5%–10% in hemodialysis patients, 5% in homosexuals, 1.2% in merchant seamen and 0%–1.5% in hospitals (personnel and hospitalized patients) (1). HCV is transmitted by transfusion, percutaneous routes, vertical or perinatal transmission, tatooing and, in a lesser degree, through sexual contact. HCV, just as the hepatitis B virus (HBV), is the major cause of acute and chronic liver disease, and chronic infection with these viruses often leads to chronic liver disease and failure (2). In 2012, there were an estimated 21,870 cases of acute HCV infections reported in the US. Furthermore, 75%–85% of people who become infected with HCV develop chronic infection; it is estimated that there are 3.2 million persons with chronic HCV infection in the US (3). Most people are not even aware that they are infected, because they do not look or feel sick.

Sometimes, it is difficult for parents to accept or understand that the pediatrician or family physician is not prepared to prescribe antibiotics for their sick child or adolescent. The reluctance may be due to the fact that doctors cannot treat everything with antibiotics; furthermore using them without a good reason creteas resistance. Public health experts have warned us over the past decade that inappropriate antibiotic use contributes to development of antibiotic resistance on both the individual and country levels (1). The Centers for Disease Control and Prevention (CDC) examined trends in pediatric antibiotic prescribing in physician offices for the period 1993–1994 to 2007–2008 (1). They found that antibiotic prescribing rates for persons aged up to 14 years who had visited physician offices decreased by 24% from 300 antibiotic courses per 1000 office visits in 1993–1994 to 229 antibiotic courses per 1000 office visits in 2007–2008. Among the five acute respiratory infections (ARIs) examined, antibiotic prescribing rates decreased by 26% for pharyngitis and by 19% for nonspecific upper respiratory infection (common cold); prescribing rates for otitis media, bronchitis, and sinusitis did not change significantly. Although the overall antibiotic prescribing rate decreased, it is still high, but nevertheless physician prescribing behaviors have changed over the study period (1). Antibiotics influence the overall bacterial flora and result in the selection of resistant types of bacteria. This increases the proportion of resistant bacteria and the risk of developing and disseminating resistant pathogenic bacteria. Some pathogenic bacteria have become so resistant to antibiotics that the available antibiotics are barely adequate to treat those who acquire the resulting infections. In addition, few new antibiotics are expected to become available in the near future (2). Many countries have initiated guidelines for physician prescription of antibiotics for systemic use. For example, Denmark initiated several guidelines (2) as listed below. – Antibiotic treatment must be expected to prevent severe or life-threatening events or to considerably reduce the period of illness. – Clinical and diagnostic testing must be carried out such that they can at least determine that bacteria are the likely cause of illness. – The selected antibiotic must be as narrow a spectrum as possible and influence the normal bacterial flora as little as possible, in accordance with the general and local guidelines for the use of antibiotics. – If the initial treatment is not successful, the choice of antibiotic must be reassessed and perhaps changed based on microbiological testing. – The treatment must be as brief as possible and be in accordance with the evidence available in the field. – The diagnosis that results in the prescription must be specifically outlined in the prescription system, including those stated in the prescription and in the medical records.

OPINION article Front. Public Health, 24 October 2014Sec.Children and Health https://doi.org/10.3389/fpubh.2014.00208

Cardiovascular disease is the cause of about 800,000 deaths reported each year in the United States with an annual cost estimated at close to 500 billion dollars (1). Risk factors for cardiovascular disease can be hypertension, high cholesterol levels, and smoking. Public health efforts are therefore focused on preventing these risk factors. The Centers for Disease Control and Prevention in Atlanta, GA, analyzed data from the National Health and Nutrition Examination Survey on uncontrolled hypertension, uncontrolled high levels of low-density lipoprotein cholesterol, and current smoking and found that 49.7% of American adults aged ≥ 20 years (an estimated 107.3 million persons) had at least one of the three risk factors. Smoking is a common addiction among adolescents and young adults (2, 3). In almost 90% of adults, it is reported that the first use of tobacco was during adolescence. Although the use of tobacco has declined over the last decades, it remains one of the major health and social challenges, and its use is still very common – among high school students almost one third of females and one half of males report using more than one tobacco product in the last 30 days. In the United States, almost 400,000 young people become regular smokers every year (2, 3). Smoking has well-known health hazards. It is associated with lung cancer, oral cancer, stroke, heart disease, emphysema, and other shortand long-term breathing problems. These troubling facts are very well known to adults and adolescents. There is also an association tobacco use and other dangerous behaviors (e.g., use of other substances such as alcohol and marijuana and high risk sexual behavior). Cognitive and mental problems including anxiety, depression, and attention deficit/ hyperactivity disorder are also associated with smoking (4). The above mentioned facts do not prevent millions from starting to smoke every year around the world. In fact, smoking is practiced by every nation and appears to take place in every society, regardless of race, color, or social status. Some adolescents begin smoking because of false notions about positive effects of smoking (e.g., lower appetite resulting in weight loss and stress reduction). The truth is that smoking is associated with undesirable cosmetic and social effects including yellow teeth, bad smell, bad breath, and lower sporting achievements. There are social and environmental factors and trends that may increase smoking prevalence in adolescence. The history of tobacco use shows that males were always more likely to smoke compared with females (2, 3). Advertisements encouraging people to smoke are still very common around the world in newspapers, commercial breaks on television, and street posters, and are generally successful in increasing sales and use. The appearance of people smoking in movies and television shows may increase smoking rates, and family members and friends who smoke appear to have a similar effect. Witnessing family members, the young, and the adults smoking together even when obvious medical problems have already compromised the health and physical abilities of the older generations is sad (5). Smoking is more common among adolescents of low socioeconomic and educational status, while regular physical activity may be a preventive factor. Smoking is addictive. Nicotine, a major ingredient in the tobacco, is highly addictive. Stopping this hazardous habit is therefore hard to do. Many products that contain nicotine and other substances were developed over the years and may help in quitting. However, avoiding cigarettes is still much more effective.

IntroductionInfluenza is an infectious disease of birds and mammals caused by RNA viruses of the family orthomyxoviridae. Influenza will cause chills, fever, runny nose, sore throat, muscle pains, headache, coughing, weakness/fatigue and general discomfort.Influenza spreads around the world in seasonal epidemics, resulting in about three to five million yearly cases of severe illness and about 250,000 to 500,000 yearly deaths. Three influenza pandemics occurred in the last century, each caused by the appearance of a new strain of the virus in humans, which killed tens of millions of people.New influenza strains emerge when an existing flu virus spreads to humans from another animal species or when an existing human strain picks up new genes from a virus that usually infects birds or pigs. The last major pandemic was in 2009, when a novel flu strain evolved that combined genes from human, pig, and bird flu A (H1N1). Yearly vaccination is the first and important step in protecting against flu. Flu vaccination can reduce illness, physician visits, missed work, as well as prevent flu-related hospitalizations, complications like pneumonia and deaths.Pediatric mortalityIn the United States influenza-associated pediatric mortality has been a nationally notifiable condition since October 2004. In a recent report (1) from CDC (Centers for Disease Control and Prevention) in Atlanta, Georgia, pediatric death from influence during the period from September 1, 2010, through August 31, 2011 is reported.There were 115 cases from 33 states. Nearly half of the deaths (46%) occurred in children aged less than five years. Of the children who died, 49% had no known Advisory Committee on Immunization Practices (ACIP) defined high-risk medical conditions with 35% who died at home or in the Emergency Department. Of the 74 children aged over 6 months for whom vaccination data were available, 17 (23%) had been fully vaccinated. ACIP recommends that all children aged over 6 months receive vaccination against influenza annually.Of the 115 cases, 72 (63%) occurred in males with the majority of cases in non-Hispanic white children (52%), followed by non-Hispanic black (18%) and Hispanic (15%) children. The highest numbers of deaths occurred in late January and early February 2011. The median age of patients was 6 years, and 53 cases (46%) were in children aged under five years. Seventy-one (62%) of these cases were associated with influenza A virus infection: 30 (26%) 2009 influenza A (H1N1), 21 (18%) influenza A (H3N2), and 20 (18%) influenza A viruses for which the subtype was not determined. The remaining 44 (38%) cases were associated with influenza B virus infections (1).Nearly half of the children who died (49%) had no known ACIP-defined high-risk medical conditions, 57 (50%) children were reported with medical conditions recognized by ACIP that placed them at increased risk for influenza-related complications, and the medical history of two children was unknown (2%). Of the 57 children with at least one ACIPdefined high-risk condition, 31 (54%) had a neurologic disorder, 17 (30%) had pulmonary disease, 14 (25%) had a chromosomal abnormality or genetic disorder, 11 (19%) had congenital heart disease or other cardiac disease, and 11 (19%) had asthma or reactive airway disease. Obesity was reported in two (4%) of the 57 children. …

Introduction: While there has been impressive progress in creating and improving community healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done. Methods: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical considerations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and delivery systems, and the areas of needed focus in their development are reviewed to set a starting point for more and greater work going forward. Conclusion: Today, we celebrate longer life spans of people with IDD, increased attention to the benefits of healthcare that is responsive to their needs, and the development of important healthcare delivery systems that are customized to their needs. We also know that the growing body of research on health status offers incentive to continue developing healthcare structures for people with IDD by training healthcare providers about the needs of people with IDD, by establishing systems of care that integrate acute healthcare with long-term services and support, by developing IDD medicine as a specialty, and by building health promotion and wellness resources to provide people with IDD a set of preventative health supports.

Obesity is an important risk factor for many chronic diseases, such as cardiovascular disease, diabetes, and cancer. Children who are overweight are at an even greater risk of developing such diseases because of their extended exposure to the harmful effects of excessive weight, and there is often an accelerated onset of chronic disease within this population. In addition, children who are overweight are more likely to suffer from impaired physical, psychological, and social development.