No abstract

Issue addressed: The Healthy Island concept has given rise to many health promotion initiatives throughout the Pacific, including the use of 'settings' to reorient environmental health (EH) practice. The apparent success of such approaches has seen a major shift in the practice of EH practitioners, yet formal evaluation of either the process or outcomes is rarely undertaken.Methods: This paper examines the issue of community participation in one such settings project through the development, distribution, and analysis of a questionnaire distributed to 200 residents in the Makoi district of Fiji. The questionnaire explored processes and outcomes related to the implementation of a Healthy Islands settings project in the Makoi community and assessed whether a core stated goal of the Makoi Healthy Island project, namely community-wide participation, had been met. Results/Conclusions:The study found that awareness of health promotion interventions was not evenly distributed across various sectors of the population and that community support structures were not being accessed by the full range of the target population. The use of the Methodist Church as a single entry point to the Makoi community in isolation from a possible range of entry points is a likely contributor in not allowing for the racial and cultural inclusion the project had aimed for. The study concludes with recommendations for entry into settings more likely to engage the full range of stakeholders and community members. So what?This study highlights that engagement in health promotion initiatives is highly reliant on access strategies. It also suggests that goals relating to evidence-based decision-making can only be met if critical evaluative strategies are embedded in health promotion project planning from the inception.

Atlanto-axial rotatory subluxation is a rare, controversial and frequently misdiagnosed condition occurring primarily in children. A single case study design was used to evaluate the effectiveness of cervical stabilisation training and correction of muscle imbalance, following reduction of this condition, in a nine-year-old boy. The study was conducted over a six-week period during which the subject maintained a daily diary to record his symptoms. The programme consisted of various muscle relaxation and lengthening techniques, endurance training of the deep cervical flexors and lower scapular stabilisers, as well as postural re-education. No treatment was directed at the articular component. The patients signs and symptoms were greatly reduced during the study period. This study supports the importance of correcting the muscle dysfunction component in cervicogenic pain sufferers.