The Concept Of Public Health Health And Social Care Essay

The challenges outlined in this definition are the chief duty of wellness attention professionals, particularly public wellness specializers who receive developing from Schools of Public Health ( SOPH ) . SOPH is a term used to depict a section in an establishment of higher acquisition concerned chiefly with proviso of postgraduate Public Health tutoring, chiefly in the signifier of a Masters grade in Public Health ( MPH ) . ( 3 )
1.1 Backgrounds:
Globally, there have been important alterations in public wellness, with monolithic betterments in developed states, while stagnancy and even diminution has been observed in the wellness position of developing and under-developed states. In states like the United Kingdom, the class of wellness attention during the 19th and 20th centuries focused on proviso of drinkable H2O and bettering sanitation, and clean air. These purposes have mostly been achieved to a sensible criterion, but unhappily, the state of affairs is far from what is desired in most underdeveloped states. ( 4 ) The current tendency is typified by the “ reverse attention jurisprudence ” , where comparatively few schools of public wellness exist in parts with the greatest public wellness challenges and an extra figure exist in the developed universe, where focal point has shifted to face new epidemics of sick wellness ensuing from, for case drug maltreatment, fleshiness and smoke. The key to turn toing these wellness issues, both in development and developed states, lies with the preparation of competent public wellness specializer ; this undertaking lies chiefly with SOPH. ( 3 )

With the apparent importance of public wellness, the preparation of public wellness professionals plays an indispensable function in undertaking these jobs, as it lays the foundation for the hereafter of this sector. Selection is an built-in portion of any preparation programme and its importance can non be overemphasized. It can be described as the first one of the most of import stairss in the bringing of effectual population based wellness attention in this context.
The class constructions of most MPH programmes were traditionally centred on capable countries such as ; epidemiology, wellness policy, wellness publicity, wellness direction, environmental wellness, human biological science and wellness economic sciences. ( 5-7 ) Presently nevertheless, the range has been expanded to include topics affecting statistical analysis and the usage of computing machine programmes ; the ability to entree, manage and work with information ; the ability to show and circulate information in an effectual mode ; interview and communicating accomplishments ; sensitiveness to wellness inequalities and societal accomplishments. ( 7 )
Most SOPH in the United Kingdom are organized around the subjects of capacity edifice, multidisciplinary, balanced instruction and research. Information is dissipated in traditional category room scene, either as full-time 12 month programmes, or as portion clip 24-60 months programmes. ( 8 ) Certain SOPH have adopted more advanced agencies of instruction bringing, choosing for electronic agencies for proviso of distance acquisition.
1.2 SCHOOLS OF PUBLIC HEALTH: HISTORICAL PERSPECTIVES
Institutions of larning concerned with educating pupils in the rules of public wellness started emerging in the early portion of the 20th century. The first of its sort was formed in 1916, when the Rockefeller foundation funded the gift of John Hopkins University in the United States. This establishment differed in its proficient attack to public wellness contrasting with the more societal and environmental attack adopted by Charles Edward Winslow at Yale University. ( 3 )
In line with the Rockefeller foundation ‘s aims of developing the scientific discipline of public wellness, it went in front to fund the constitution of legion SOPH within the United States and internationally. Its first international legacy was in the UK, where in 1922, it sponsored the formation of the public wellness section in the London school of Hygiene and Tropical Medicine ( LSHTM ) . However, shortly after the Second World War, the Rockefeller foundation shifted its focal point to other precedences. Despite this, there was still an addition in the figure of SOPH, with the World Health Organization join forcesing with National authoritiess specifically to develop and educate public wellness professionals from 1948. These attempts have seen the constitution of about 357 SOPH in 54 states as at 2006. ( 3 )
1.3 SCHOOLS OF PUBLIC HEALTH IN THE UNITED KINGDOM:
An cyberspace based hunt of the universities in the UK offering different signifiers of public wellness at station alumnus degree revealed about 70 eight of such establishments. However, there are differences in the quality and focal point of public wellness research offered by these establishments. These differences were highlighted after the 2008 Research Assessment Exercise ( RAE ) , which identified the figure of research active staff and conducted a peer appraisal of the quality of research within different universities. ( 9 )
Another important difference in UK SOPH is the appellation between programmes offering a Masters in public Health ( MPH ) and an MSc in public wellness as differentiated by establishments established before and after 1992. Evans ( 2009 ) identified ‘pre-1992 ‘ universities as establishments that offer intensive classs and are staffed by internationally recognized research workers and have programmes normally labelled as ‘Masters in Public wellness ‘ ( MPH ) . The ‘post-1992 ‘ universities are largely former engineering schools that run largely parttime classs and frequently have less internationally celebrated staff labelling their programme as ‘MSc in Public Health ‘ . MPH programme are by and large considered superior to most MSc Public wellness programmes for these grounds. However the full clip MSc public wellness programme the London School of Hygiene and Tropical medical specialty ( LSTHM ) is internationally celebrated and stands as an exclusion to the facts stated above. ( 3 )
Over the last two decennaries, there have been important additions in the figure of postgraduate public wellness classs, particularly in new universities. These classs normally have a wider focal point reflecting the more societal facets of public wellness coupled with an admittance of pupils with multidisciplinary backgrounds. It was n’t until 1992 that the LSTHM opened its public wellness grade to pupils with first grades other than medical specialty. It took a twosome of more old ages until the Faculty of Public wellness admitted non-medical alumnuss into its preparation programme in the twelvemonth 2000. ( 10 )
One major challenge of SOPH in the UK has been the issue of equilibrating research with learning. Schools that have really low RAE ranking will more likely lose support. Besides, the focal point on research is driven by the desire for equal reviewed publications as a step of the grade of academic success. This tendency has resulted in the prioritization of research over learning for most establishments of public wellness. However, there has been a nexus between the National Health Service and some SOPH, where the MPH class forms the first twelvemonth of public wellness specializer preparation programme which runs for 5 old ages. This agreement it has been argued will likely assist equilibrate research and instruction. ( 3,6 )
1.4 THE PROCESS OF SELECTION:
The United Kingdom is home to some of the most reputable acquisition establishments in the universe and as such attracts a diverse group of persons every twelvemonth, who come in hunt of quality cognition. The standards used for pupil choice into a Masters Degree programme in Public Health in has important deduction on future quality of the public wellness sector in the UK, and so the universe sing the big inflow of foreign pupils seeking quality instruction in public wellness. ( 11 )
Student choice is normally based chiefly on academic background/achievements. However, in recent old ages, the standard has been widened to include other factors like single attitudes, involvements, and personal features desired ends and work experience. Selection policies based on the traditional academic ability are fast melting out for a figure of grounds. One ground is the deficiency of grounds demoing a correlativity between old academic public presentation and subsequent success in wellness professional courses/practice. ( 12 ) The purpose of any choice procedure is to choose persons who best tantrum certain defined standards. Therefore an indispensable portion of this procedure is the definition of one or more standard by which appliers can be judged. This measure is highly of import, as SOPH are expected to take and develop future public wellness practicians who will be equipped with the needed accomplishments expected to turn to the challenges of this demanding profession. ( 11 )
Until late in the United Kingdom, developing under the Faculty of Public wellness was unfastened to merely medical practician and as a consequence, handiness of infinites on medically oriented public wellness programmes for non-medical appliers were limited. However, in 2000, the module rank was opened to non-medical alumnuss. Despite this alteration, there has been a diminution in module rank. However, these happenings has prompted inquiries about the accomplishments required to be competent public wellness practicians and if it was necessary to hold a medical grade before analyzing public wellness. ( 13 )
1.5 Rationale:
The thought for this undertaking was conceived by Dr Tom Marshall ( 14 ) after it was observed that admittances into the University of Birmingham ‘s MPH classs had increased significantly following the debut of an on-line choice test, as a pre-requisite for entry in March 2009. ( 15 ) Additionally, inquiries generated following a meeting of 12 MPH/MSc programme managers in September 2009 to discourse affairs of common involvement, besides inspired this undertaking.
2. LITERATURE REVIEW:
This literature reappraisal seeks to place similar work done on the choice standards for pupils meaning to analyze for a Masters grade in Public Health. It will try to place what the current cognition on pupil choice in the UK is, place countries that have already been researched and highlight what aspects may necessitate farther research.
2.1 SEARCH STRATEGY:
The writer conducted a hunt for articles written in English linguistic communication on the pupil choice standards for postgraduate public wellness instruction. Databases included in the hunt included MEDLINE, ERIC and ISI WEB OF SCIENCE. The electronic footings used entirely or in combination for the hunt included “ Masterss, ” “ PUBLIC HEALTH, ” “ MPH, ” “ MSc, ” “ POSTGRADUATE, ” “ SELECTION, ” and “ CRITERIA ” . Search footings combinations were modified utilizing AND/OR and database specific wildcards ( e.g. $ or? ) . The initial hunt provided really limited relevant informations on the topic being researched. Therefore, the undermentioned hunt footings were included ; “ Undergraduate, ” and “ MEDICAL SCHOOL. ”
2.2 MPH AND UNDERGRADUATE MEDICAL Training:
The Rockefeller Foundation ‘s 1916 one-year study noted that the first SOPH was established to supply a sound footing of scientific cognition for the systematic publicity of populace and personal hygiene and besides set up a well defined calling as an attractive force for trefoils interested in the field of public wellness instead than the clinical pattern of medical specialty. These original aims still play a important function in finding who gets selected to analyze for an MPH.
The educational course of study of sections of preventative medical specialty of most medical schools is really similar to that of many SOPH ( 16,17 ) and as a consequence the MPH programme was antecedently unfastened merely to alumnuss of medical schools as it was deemed indispensable to posses a medical grade before analyzing postgraduate public wellness.
The turning demand for more health care professionals has seen the incorporation of the MPH course of study into the undergraduate medical preparation strategy. In the United States, a few of such programmes exist including classs at Yale, Tulane and John Hopkins. These medical schools run coincident programmes with next schools of public wellness, such that on graduation, pupils possess both an MD and an MPH.
Undoubtedly, there is a strong convergence in the choice of undergraduate medical pupils and postgraduate pupils of the MPH programme. Due to the deficiency of literature on the choice standards for graduate student MPH, the writer decided to reexamine the literature on undergraduate medical pupil choice standards in the United Kingdom.
2.3 SELECTION CRITERIA FOR UNDERGRADUATE MEDICAL STUDENTS IN THE UK:
The standards used for choice of undergraduate medical pupils are mostly vague being more of an administrative exercising to fit the figure of appliers to the available infinites on the class utilizing a movable Markss threshold. The consequences are that the greater the figure of appliers that twelvemonth, the higher the threshold grade used for admittance. ( 18 )
However, most medical schools strive to guarantee that the few available places available for medical pupil admittance are unfastened to pupils who will do the best physicians. With the current consciousness that non-academic personal qualities are basically as of import in the pattern of medical specialty as academic ability, many medical schools require appliers to set about entry trials that step other qualities and features in add-on to academic ability. ( 12,19 )
One of such trial is the personal qualities assessment trial ( PQA ) , which is designed to measure verbal, numerical, and spacial logical thinking. It contains a personality stock list and besides has an ethical logical thinking paper. The PQA has added value alongside the A – degrees leting for an nonsubjective appraisal of non-cognitive features of draw a bead oning medical pupils. ( 19 )
Many surveies have been done to measure the qualities of medical pupil which will do them good physicians in the hereafter. ( 19-21 ) A 20 twelvemonth prospective cohort survey was carried out to find whether A- degree classs and intelligence abilities of medical pupils could be used to foretell physician ‘s callings. The survey was carried out on 511 medical pupils who entered West-minister medical school between 1975 and 1982 with follow up to 2002. The result steps assessed were the clip taken to make different calling classs, postgraduate makings obtained, figure of research publications, and steps of emphasis and burnout related to A- degree classs and intelligence at entry to clinical school. The consequences of the survey showed that an A-level class which has peculiar widespread application in UK pupil choice has long-run prognostic value for undergraduate and postgraduate callings. ( 21 )
Parry J et al carried out a reappraisal of the admittance procedure of five medical classs in UK universities. The aims of the survey were to depict the current methods used by medical schools to place prospective medical pupils for admittance to the five twelvemonth grade class. The reappraisal was carried out on a sum of 20 two universities utilizing documental analysis and interviews with admittance coachs. Their findings revealed that there was a common standard for medical pupil admittance, based on academic ability, coupled with a suited personality consisting motive for medical specialty, leading accomplishments, teamwork abilities and extracurricular involvement. The reappraisal concluded that despite the common implicit in standards for medical pupil admittances, universities differed in their application of their demands for pupil choice. ( 22 )
Brown and Lilford in their paper titled “ choosing medical pupils ” noted that it cost about ?200,000 lbs to develop each medical pupil in the United Kingdom. However, the deductions, fiscal and otherwise of taking the incorrect pupil to develop in the first case are far greater. Three wide attributes that a suited pupil should hold include ; appropriate cognitive ability, diligence and humanity. However, the current choice tools can merely test suitably for cognitive ability. Most medical schools have introduced aptitude trial based largely on cognitive undertakings. There is grounds to demo that the trial correlative well with presymptomatic scrutiny consequences, but have non been a dependable forecaster of clinical public presentation. They besides questioned the truth of psychological as a forecaster of diligence observing the trouble in finding the appropriate mixture of traits that is most prognostic of persevering service and personal patterned advance. They besides noted that although short medical pupil interviews were effectual enlisting tools, they had low prognostic value. ( 23 ) Another survey noted that while most medical schools may wish to choose future physicians with both cognitive and non-cognitive trial, using the usage of interviews was noted to be labour intensive and clip consuming. ( 19 ) Trial of cognitive ability seemed to be the most valid method with the highest predictive.
A recent article proposed a comprehensive theoretical account for the choice of medical pupils based on informed ego choice, academic accomplishment, general cognitive ability ( GCA ) and facets of personality and interpersonal accomplishments. They used informations ( n=1000 ) from existent choice processs to show how their proposed theoretical account can be applied to increase the opportunities of doing accurate and defendable pupil choice. ( 24 )
2.4 SELECTION PROCESS FOR MPH ADMISSION IN OTHER COUNTRIES
The choice of pupils into the MPH programme in the United States follows a different format than what applies in the UK. In the US, all SOPH and public wellness plans are accredited by the nationally recognized Council on Education for Public Health ( CEPH ) . Students meaning to use for a graduate student grade in public wellness direct their application through the Schools of Public Health Application Service ( SOPHAS ) . SOPHAS so completes the application to different schools, on behalf of single pupils. Before pupils can subject their application to SOPHAS, they must sit for an entryway scrutiny. Most schools accept the Graduate Record Exam ( GRE ) , although demands may change for some schools. ( 25 )
It is clear from a reappraisal of the literature that the implicit in rules of pupil choice procedure is geared towards placing persons who are most suited to the entry demands which are designed to choose campaigners that are most likely to win in the class. It besides aims to forestall the credence of campaigners that will most likely constitute a hazard to the profession.
2.5 AIMS AND OBJECTIVES
This undertaking aims to measure how pupils are selected for admittance into a Master ‘s programme by assorted schools of public wellness the United Kingdom.
Specific aims will include:
To measure the differences in MPH pupil choice procedure used by different Universities.
To find the coveted qualities of a suited MPH pupil.
To determine if entry demands differ for first twelvemonth public wellness trainees when compared to other pupils
To determine if entry demands differ for campaigners with or without medical preparation
To analyze the differences in entry demand for place and international pupils
To increase our apprehension of why pupils chose certain MPH courses/universities
3. Methodology:
3.1 STUDY DESIGN:
This is an exploratory survey which will affect a qualitative appraisal of MPH class manager ‘s sentiments, followed by a cross-sectional survey of MPH pupil ‘s sentiments.
3.1 STUDY Setting:
The survey will be carried out in different universities in the United Kingdom which offer a postgraduate public wellness grade class.
3.2 STUDY POPULATION:
UK universities
MPH class managers
Miles per hour pupils
3.3 STUDY TOOLS:
A information extraction signifier used to study university web sites
A semi structured telephone recorded interview with MPH class managers.
A structured questionnaire for MPH pupils
3.4 Sampling:
This will get down with an initial study of web sites of all UK universities offering public wellness at postgraduate degree. Universities offering full clip or portion clip MPH/MSc Public Health and/or wellness publicity and classs under alternate names like Global Health will be selected for inclusion in the survey. Exclusion from the survey will be made on Public wellness classs offered at PHD or MPhil degree and Public wellness classs with rubrics such as Public Health Nutrition, Public Health Practice and Public Health policy.
Based on the information collated from the website study, universities will be stratified into groups based on the undermentioned features:
SOPH affiliated with medical schools
SOPH affiliated with schools of nursing/other allied schools of wellness.
Sophomore with long distance preparation programmes
SOPH with Health Promotion as a strong component
SOPH Involved with Public wellness trainees
Subsequently, a graded random trying technique will be used to choose participant universities from each group. If an establishment has more than one of the features used for stratification, it will be included in a group with the least figure of universities. The current mark is aimed at choosing 20 universities for the telephone interview stage of the undertaking.
3.4.1 UNIVERSITY SELECTION PROCESS:
After informations extraction is complete, each university will be assigned a alone designation ( ID ) figure in the Microsoft Access database. Based on the features outlined above, universities will be stratified into different groups. Each group will so be exported into a separate Microsoft Excel dispersed sheet, with the alone ID figure arranged in columns. Subsequently, each column will be indiscriminately sorted utilizing the random generator tool for Excel. ( 26 ) The university at the top of the list from each group will be chosen for the interview procedure. The selected university will be excluded from the list, and the procedure repeated ( choosing and excepting the university at the top of the randomly sorted list each clip ) , until the coveted figure of participants has been reached. If there if any trouble contacting or obtaining consent from a chosen university, the procedure will be repeated to choose a replacing.
3.4.2 INTERVIEW OF COURSE DIRECTORS:
After stratification and random choice of universities, class managers from chosen SOPH will be contacted via electronic mail, and their consent sought for engagement in a semi-structured telephone recorded interview. Questions asked during the interviews will be structured to run into the declared aims of the undertaking. All interviews will be audio recorded with the consent of the respondents. Each telephone interview is anticipated to last between 30 to 45 proceedingss. Notes will be taken during the interview to supplement the sound taped conversations.
3.4.3 MPH STUDENT QUESTIONNAIRES:
Structured questionnaires with be distributed to MPH pupils from two universities affiliated with medical schools, in add-on to the University of Birmingham SOPH, to measure the pupils sentiments on their pick of MPH programmes. The universities will be chosen from those already selected for interview of the class manager. Questionnaires will be distributed via electronic mail to pupils in selected universities.
3.5 JUSTIFICATION OF APPROACH
The survey will be executed by blending method, utilizing both qualitative and quantitative attacks. Qualitative methods are suited to for this undertaking as it provides the model for understanding the contexts of societal experience and enhances our capacity for societal account and generalisation. ( 27 ) It besides allows for the incorporation of professional positions, in this survey, those of different MPH class managers. Furthermore, this research method centres strongly on inductive logical thinking when construing informations and normally consequences in findings that were wholly unexpected. ( 28 ) Telephone interviews have been mostly neglected as a qualitative tool by many research workers who prefer face to confront interview. They argue that the deficiency of ocular cues, loss of non verbal informations and trouble set uping rapport brand s telephone interviews less attractive as a information aggregation method. However, it is easier for sensitive information to be disclosed as respondents feel more relaxed. There is besides no grounds demoing that telephone interviews produce lower quality informations than face to confront interviews. ( 29 ) This method is besides rather utile for this undertaking as it is easier to schedule and cheaper, sing the geographical distribution of participant SOPH.
Quantitative methods will be used to supplement qualitative methods in this survey, since it has been argued that the logic of qualitative thought can be extended with qualitative methods. ( 27 )
3.6 Analytic Method:
This will be done utilizing a combination of qualitative and quantitative techniques.
Data analyses will get down instantly after informations extraction from surveyed university websites. This will be done utilizing basic descriptive statistics and comparative analyses where necessary. The semi-structured telephone interviews will be reviewed and reported in a structured format foregrounding repeating subjects which will be coded and analysed utilizing a thematic model.
Structured pupil questionnaires will be analysed utilizing basic descriptive statistics, rank correlativity and thematic analysis.
Statistical bundles which will help in informations managing and analysis include Microsoft Access, Microsoft Excel and NVivo.
3.7 Anticipated Problem:
The most hard facet of this undertaking is the country of informations aggregation. The study of university web sites has been really disputing so far with tonss of trouble originating from screening out of import information from different university web sites.
The writer anticipates that another major jobs associated with informations aggregation will be acquiring consent from MPH class managers for telephone interviews, sing their highly busy agenda. There is besides the issue of holding adequate clip to roll up, collate and adequately analyse informations generated for this undertaking.
The job with the usage of pupil questionnaires is the issue of non-responders ( response rate possibly every bit low as 20 % ) . This could be addressed by utilizing on-line study tools e.g. study monkey and directing reminders to non-responders.
Data analysis will necessitate some expertness in operating package bundles like Access, Excel an Nvivo. The writer has registered for and attended classs on these package bundles organized by the University of Birmingham IT-services section.
3.8 ESTIMATED PROJECT TIMETABLE:
The university web site study has reached an advanced phase and will be completed before the terminal of March 2010. Stratification of universities based on the standards outlined above has commenced and will be complete at about the same clip website informations extraction is completed. Subsequent choice of participant universities will be done in April 2010. It is expected that consent from take parting class managers will be received before the terminal of the April, and telephone interviews can be scheduled for May 2010. Data analysis will get down at the same time with the interviews and is expected to run through the month of June 2010.
Design of pupil ‘s questionnaires is about complete. Its construction will be refined in April 2010 and distributed by the terminal of the month. Responses should be received during the moth of May 2010. Analysis of pupil questionnaires should get down in June 2010.
Compilation of consequences and treatments will be done in July 2010 in readying for concluding entry in August 2010.