Chronic diseases are among the leading causes of death globally, and as much as 80% of these deaths are reported to be preventable with proper diet and lifestyle. Although extensive research has demonstrated that the increased consumption of fruits and vegetables offers protective health effects from many chronic illnesses, populations in both developed and developing nations consistently fall short of the recommended intake of 5 or more servings a day. This study investigated the effects of daily consumption of Green Smoothies for 4 consecutive weeks on blood pressure and health-related quality of life. Green Smoothies are a blended drink consisting of fruit, leafy greens and water. The study was a randomized controlled trial with a final sample of 29 volunteer participants. Data were collected at baseline and post-intervention and included anthropometric and physiologic measures, as well as a nutrition survey. The treatment group demonstrated trends toward improvements in waist circumference (p = 0.026), waist-to-hip ratio (p = 0.05), and symptoms of burden linked to diet (p = 0.04), small intestine (p = 0.04), large intestine (p = 0.05), and mineral needs (p = 0.04). Despite the lack of statistically significant reductions in blood pressure, the trend toward improvements in waist circumference and waist-to-hip ratio are considered to be useful and informative of health risk. Thus, the results of this study provide preliminary support for the consumption of Green Smoothies as a possible primary prevention effort for chronic conditions. It may also help to reduce health risks or even reverse the effects of chronic conditions.

La presente tesis se basa en el análisis y evaluación legal, operativa y financiera para la creación e implementación de una empresa comercializadora de concentrado de aceite de cannabis (con contenido CBD y THC) orientado al uso medicinal, sobre todo para el tratamiento de enfermedades neurodegenerativas (Alzheimer, Parkinson, esclerosis múltiple), ansiedad, autismo, epilepsia, también a su vez se utiliza para el tratamiento de enfermedades inflamatorias crónicas, como lo es la enfermedad de Chron existe evidencia de la eficacia en el tratamiento de náuseas y vómitos asociados a la quimioterapia de cáncer, además está documentado el uso en el tratamiento de anorexia y pérdida de peso de pacientes con VIH, considerando los estudios de mercado a realizar y los planes y estrategias que en la presente tesis se mostrarán. Actualmente este rubro no está del todo explotado, esto debido a que, en el Perú, el proceso para otorgar licencias para venta e investigaciones de esta planta y productos a base de ésta es lenta, pese a esto, el Perú, tiene una de las regulaciones más avanzadas para el Cannabis en América Latina, y es un mercado prioritario para las grandes multinacionales. Para lograr el objetivo, se ha realizado un análisis del entorno nacional, para determinar las principales características del mercado objetivo que vienen a ser las personas con patologías tratables con cannabinoides en el Perú. Luego de determinar lo antes mencionado, y los factores que determinarían la preferencia por nuestro producto, se realizará el estudio financiero y la viabilidad del negocio. / This thesis is based on the legal, operational and financial analysis and evaluation, for the creation and implementation of a trading company for cannabis oil concentrate (with CBD and THC content) oriented to medicinal use, especially for the treatment of neurodegenerative diseases (Alzheimer, Parkinson, multiple sclerosis), anxiety, autism, epilepsy, it also used for the treatment of chronic inflammatory diseases, such as Chron’s disease, there is evidence of efficacy in the treatment of nausea and vomiting associated with cancer chemotherapy. In addition, the use in the treatment of anorexia and weight loss in patients with HIV is documented, considering the market studies to be carried out and the plans and strategies that will be show in this thesis. Currently this item is not fully, this because, in Peru, the process to grant licenses for sale and research of this plant and products based on it is slow, despite this, Peru has one of the most advanced regulations for Cannabis in Latin America, and it is a priority market for large multinationals. To achieve the objective, and analysis of the national environment has been carried out, to determine the main characteristics of the target market that people with cannabinoid – treatable pathologies in Peru. After determining the aforementioned, and the factors that would determine the preference for our product, the financial study and viability of the business. / Trabajo de investigación

No description available.

Thesis (Ph.D. (Health Sciences)) -- University of Limpopo, 2022 / Background: Cardio Vascular Diseases(CVD) are presently the main cause of high mortality rate around the world. In sub-Saharan Africa, CVDs contributes to about 13% of deaths, with 80% deaths being recorded from developing countries. Behavioural and metabolic risk factors contribute to high mortality rate related to development of CVD which self-management strategies and practices could effectively prevent. Objective: To explore and develop ―self-management strategies‖ to prevent the development of CVD among patients living with chronic conditions at Ga Molepo Area clinics in the Limpopo Province, South Africa. Methods: “A mixed method exploratory sequential design study was conducted in four primary health care settings in a rural setting.‖ A semi structured one-on-one interviews were conducted with 43 patients selected by non-probability homogenous purposive sampling for a qualitative strand. Qualitative findings that was obtained with thematic ―Tesch‘s open coding data analysis method guided the quantitative strand‖. A simple random sampling was used to sample 347 respondents for the quantitative strand.Descriptive statistics and chi-square were applied to analyze data from the quantitative strand. ``Results: The qualitative results revealed that there is different self management strategies used by patients living with hypertension and Diabetes Mellitus as risk factors of CVDs. The self-management strategies include engaging in physical activity, eating a healthy balanced diet, drinking a lot of water and adhering to treatment. The quantitative revealed majority of participants(74%) perform mild exercises with 26% performing moderate exercis.On the other hand 7% are having stress and depression and while 7% are smoking.`` Conclusions:The findings indicated that by adopting self-management strategies could be an effective way of preventing the development of CVD which complicates to hypertension and diabetic mellitus .Therefore are encouraged to adhere to strategies adhere to treat,healthy diet and perform mild exercises Recommendations Hence, the government needs to appoint CHW permanently to strengthen the guidelines on the prevention of CVD and also the risk factors that put the communities at risk of developing CVD. Communities need to adhere to preventative strategies ti order prevent CVD. / SPICES Project - (Scaling -up Packages of Interventions for CVD prevention in Europe and sub-Saharan)

Text in Afrikaans / Summaries in English and Afrikaans / This research sets guidelines for parents of chronically ill children. The guidelines are aimed at equipping the parents to cope more efficiently with the chronic illness and to support other family members in doing so. The nature of chronic illness and its effect on the sick child, his education, the parents and siblings have been researched in the literature study. Chronic illness affects family members in different ways. The· illness affects the sick child's physical, emotional, cognitive, moral and psychosocial development. The parent's total existence and the education of their child are also affected. The illness influences the emotional, cognitive, moral and psychosocial development of siblings. The effect of chronic illness on family members gives rise to certain needs concerned with coping with the illness. Parents as the caretakers of the family and educators of the child are mainly responsible, to assist family members to deal with the illness and its consequences. An empirical study was carried out, involving 102 parents of chronically ill children. This study confirmed that the chronic illness impedes the education process and complicates the adequate development and maturation of specifically the sick child. The effect that chronic illness has on other family members was also confirmed. The empirical study proved that parents need assistance to cope with the illness. They need assistance for themselves as well as assistance in helping other family members to cope. Based on this literature study and the results of the empirical research, guidelines were developed for the parents of the chronically ill child. These guidelines empower the parents in their support roles. It enables them to deal with the needs of the family thereby enabling family members to cope more efficiently with the illness. Several guidelines have been given regarding how to cope with the matters concerned with educational, physical, emotional, cognitive, moral and psychosocial consequences of the illness. Parents should streamline these guidelines to suit the needs of every unique child and the rest of his family. / Hierdie navorsing stel riglyne vir ouers van 'n cluoniese siek kind. Die riglyne is daarop gemik om die ouers te bemagtig om cluoniese siekte beter te kan hanteer en ander gesinslede te steun in hulle hantering van die siekte. Die aard van cluoniese siekte en die effek daarvan op die siek kind, sy opvoeding, die ouers en sibbe is in die literatuurstudie nagevors. Cluoniese siekte raak elke gesinslid op verskeie wyses. Die siek kind se liggaamlike, emosionele, kognitiewe, morele en psigososiale ontwikkeling word deur die siekte beYnvloed. Ouers se totale bestaan en hulle opvoeding van die kind word deur die siekte geraak. Die siekte beYnvloed sibbe se emosionele, kognitiewe, morele en psigososiale ontwikkeling. Die effek van chroniese siekte op elke gesinslid laat behoeftes, wat met die hantering van die siekte verband hou, by elkeen ontstaan. Ouers as versorgers van die gesin en opvoeders van die kind is grootliks verantwoordelik om die siek kind en ander gesinslede te help om die siekte en die gevolge daarvan te hanteer. 'n Empiriese ondersoek is uitgevoer waarby I 02 ouers van cluoniese siek kinders betrek is. Die empiriese ondersoek het bevestig dat cluoniese siekte opvoeding kan bemoeilik en toereikende ontwikkeling en volwassewording by veral die siek kind kompliseer. Chroniese siekte se effek op die ander gesinslede is ook bevestig. Die empiriese ondersoek het aangedui dat ouers behoeftes aan hulp het om die siekte te kan hanteer. Ouers se behoeftes het verband gehou met hulp aan hulself en hulp om die ander gesinslede te help om die siekte beter te hanteer. Op grond van die literatuurstudie en die resultate van die empiriese ondersoek, is riglyne vir ouers van die cluoniese siek kind geskryf. Die riglyne bemagtig ouers as steungewers deurdat hulle toenemend in staat gestel word om in die gesin se behoeftes te voorsien, sodat gesinslede die siekte beter kan hanteer. Verskeie riglyne om sake rakende die siekte te hanteer, is gegee. Daar is aan opvoedkundige, liggaamlike, emosionele, kognitiewe, morele en psigososiale aspekte aandag gegee. Die ouers behoort die riglyne te verbesonder vir elke unieke kind en sy gesin. / Psychology of Education / D.Ed.(Sielkunde Opvoedkunde)

Text in Afrikaans / Summaries in English and Afrikaans / This research sets guidelines for parents of chronically ill children. The guidelines are aimed at equipping the parents to cope more efficiently with the chronic illness and to support other family members in doing so. The nature of chronic illness and its effect on the sick child, his education, the parents and siblings have been researched in the literature study. Chronic illness affects family members in different ways. The· illness affects the sick child's physical, emotional, cognitive, moral and psychosocial development. The parent's total existence and the education of their child are also affected. The illness influences the emotional, cognitive, moral and psychosocial development of siblings. The effect of chronic illness on family members gives rise to certain needs concerned with coping with the illness. Parents as the caretakers of the family and educators of the child are mainly responsible, to assist family members to deal with the illness and its consequences. An empirical study was carried out, involving 102 parents of chronically ill children. This study confirmed that the chronic illness impedes the education process and complicates the adequate development and maturation of specifically the sick child. The effect that chronic illness has on other family members was also confirmed. The empirical study proved that parents need assistance to cope with the illness. They need assistance for themselves as well as assistance in helping other family members to cope. Based on this literature study and the results of the empirical research, guidelines were developed for the parents of the chronically ill child. These guidelines empower the parents in their support roles. It enables them to deal with the needs of the family thereby enabling family members to cope more efficiently with the illness. Several guidelines have been given regarding how to cope with the matters concerned with educational, physical, emotional, cognitive, moral and psychosocial consequences of the illness. Parents should streamline these guidelines to suit the needs of every unique child and the rest of his family. / Hierdie navorsing stel riglyne vir ouers van 'n cluoniese siek kind. Die riglyne is daarop gemik om die ouers te bemagtig om cluoniese siekte beter te kan hanteer en ander gesinslede te steun in hulle hantering van die siekte. Die aard van cluoniese siekte en die effek daarvan op die siek kind, sy opvoeding, die ouers en sibbe is in die literatuurstudie nagevors. Cluoniese siekte raak elke gesinslid op verskeie wyses. Die siek kind se liggaamlike, emosionele, kognitiewe, morele en psigososiale ontwikkeling word deur die siekte beYnvloed. Ouers se totale bestaan en hulle opvoeding van die kind word deur die siekte geraak. Die siekte beYnvloed sibbe se emosionele, kognitiewe, morele en psigososiale ontwikkeling. Die effek van chroniese siekte op elke gesinslid laat behoeftes, wat met die hantering van die siekte verband hou, by elkeen ontstaan. Ouers as versorgers van die gesin en opvoeders van die kind is grootliks verantwoordelik om die siek kind en ander gesinslede te help om die siekte en die gevolge daarvan te hanteer. 'n Empiriese ondersoek is uitgevoer waarby I 02 ouers van cluoniese siek kinders betrek is. Die empiriese ondersoek het bevestig dat cluoniese siekte opvoeding kan bemoeilik en toereikende ontwikkeling en volwassewording by veral die siek kind kompliseer. Chroniese siekte se effek op die ander gesinslede is ook bevestig. Die empiriese ondersoek het aangedui dat ouers behoeftes aan hulp het om die siekte te kan hanteer. Ouers se behoeftes het verband gehou met hulp aan hulself en hulp om die ander gesinslede te help om die siekte beter te hanteer. Op grond van die literatuurstudie en die resultate van die empiriese ondersoek, is riglyne vir ouers van die cluoniese siek kind geskryf. Die riglyne bemagtig ouers as steungewers deurdat hulle toenemend in staat gestel word om in die gesin se behoeftes te voorsien, sodat gesinslede die siekte beter kan hanteer. Verskeie riglyne om sake rakende die siekte te hanteer, is gegee. Daar is aan opvoedkundige, liggaamlike, emosionele, kognitiewe, morele en psigososiale aspekte aandag gegee. Die ouers behoort die riglyne te verbesonder vir elke unieke kind en sy gesin. / Psychology of Education / D.Ed.(Sielkunde Opvoedkunde)

Thesis (DPhil)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: This qualitative study comprised an in-depth investigation into the subjective - the explicitly human - experience of those suffering from Myalgic Encephalomyelitis (ME). I was, firstly, concerned with the nature and meaning of the social side of illness, that is, the sufferer's encounters with doctor, family member, friend and acquaintance alike. I was, secondly, set to develop greater insight into the essentially personal experience of being ill. I was able to conclude that, even amidst the inhumane presence of utter ignorance that permeate the very experience of ME, no ME sufferer is inevitably doomed a victim. They can always make a deliberate decision to have a say in their situation, in their own experience of their circumstances. They have the power of personal choice. Recommendations are, therefore, directed at expanding the potential extent and magnitude of this dynamic power. The substantive focus of my study was enriched by a deliberate concern with the methodological implications of my own intimate involvement within the research process. I was here primarily concerned with my personal contribution to the research process as well as the influence thereof on the research relationships developed and the research strategies chosen and applied. I could not but conclude that the understanding I explicate is, as all social science theory, essentially a human construction, developed by me, in my distinctly human capacity. Recommendations are, therefore, geared to sensitise all social researchers to their own contribution to the construction of that which is eventually presented (and taken) as truthful knowl~dge. In conclusion, I am thoroughly convinced that the experience of both illness and research is fundamentally human. This "humanness" cannot and should not be denied. Instead, I advocate a more deliberate focus on the human dimension of illness and research. Without such a focus, a more comprehensive understanding of either realm will continue to linger as but an elusive ideal. / AFRIKAANSE OPSOMMING: Hierdie kwalitatiewe studie is gebaseer op 'n in-diepte ondersoek gerig op die subjektiewe - die onteenseglik menslike - ervaring van diegene wat ly aan Myaligië Enkefalomiëlitis (ME). Ek was, eerstens, geïnteresseerd in die aard en betekenis van die sosiale dimensie van siekte, dit wil sê, die lyer se ervaring van sosiale kontak met dokters, gesinslede, vriende en kennisse. Ek was, tweedens, gerig op die ontwikkeling van 'n grondige insig in die uiters persoonlike ervaring van siek-wees. Ek het tot die gevolgtrekking gekom dat, selfs te midde van die onmenslike teenwoordigheid van blatante onkunde wat die ganse ervaring van ME kenmerk, geen ME lyer noodwendig tot 'n slagoffer-status gedoem is nie. Hulle kan altyd 'n doelbewuste besluit neem om 'n sê te hê in hul eie situasie, in hul eie ervaring van hul omstandighede. Hulle het die mag van persoonlike keuse. Aanbevelings is dus daarop gerig om die potentiële trefwydte en impak van hierdie dinamiese mag uit te brei. Die substantiewe dimensie van my studie is verryk deur 'n doelbewuste fokus op die metodologiese implikasies van my eie intieme betrokkenheid in die navorsingsproses. Ek was hoofsaaklik gemoeid met my persoonlike bydrae tot die navorsingsproses en die invloed daarvan op die ontwikkel van navorsingsverhoudings en die toepassing van gekose navorsingstrategieë. Hierdie fokus het gelei tot die besef dat die beskrywing wat ek aanbied, soos inderdaad alle sosiale teorie, essensieël 'n menslike konstruksie is, soos ontwikkel deur my, in my uitdruklik menslike kapasiteit. Aanbevelings is dus daarop gerig om alle sosiale navorsers te sensitiseer ten opsigte van hul eie bydrae tot die konstruksie van dit wat uiteindelik voorgestel (en geag) word as die waarheidsgetroue kennis. In slotsom, is ek oortuig dat die ervaring van beide siekte en navorsing fundamenteel menslik is. Hierdie "mensheid" kan en behoort nie ontken te word nie. Inteendeel, ek bepleit 'n doelbewuste fokus op die menslike dimensie van siekte en navorsing. Sonder só 'n fokus sal 'n meer diepgaande begrip van iedere area bloot 'n onbereikbare ideaal bly.

Introduction Self-rated health (SRH) is a widely used indicator of health service utilisation and reflects self-perceived objective health condition. Poorer non-comparative SRH was shown to be related to higher inpatient and outpatient utilisation in Western and elderly populations. Little is known about how healthcare utilisation relates to SRH in non-Western settings, such as Hong Kong and in adult populations. The association of age- and time- comparative SRH with healthcare utilisation is also unclear. This study aimed to assess the association of three types of SRH (non-, age- and time- comparative SRH) with inpatient and outpatient utilisation in Hong Kong‟s general populaion. Methods Data were derived from 2011 Thematic Household Survey (THS), covering 23,892 non-institutional residents aged 20 and above. The study adopts Andersen‟s Behavioral Model of Health Service Use for the analytical framework. Healthcare utilisation was measured by inpatient use during the past year and outpatient use (including General Outpatient Clinic (GOPC) and Specialist Outpatient Clinic (SOPC)) during the past month, in terms of ever-use and the amount of use (bed-days and number of outpatient visits). SRH was measured with a 5-point Likert Scale: non-comparative SRH from “Excellent” to “Poor”; age- and time- comparative from “much worse” to “much better”. Logistic regression and zero-truncated negative binomial/ Poisson regression were applied to examine the association of SRH and chronic diseases with healthcare utilisation in the public and private sector separately as per the Andersen behavioral model. Results “Fair/ poor” non-comparative SRH was associated with higher inpatient and outpatient utilisation. The association was not significant for hospital bed-days. Similarly, age-comparative SRH was associated with inpatient (except private bed-days) and outpatient utilisation (except the number of SOPC visits). “Worse/ much worse” time-comparative SRH was associated with higher healthcare utilisation, but the relationship was less clear for private hospitalisation. The presence of cancer, cardiovascular diseases, diabetes, lower respiratory diseases, and musculoskeletal diseases were associated with higher healthcare utilisation, with stronger association observed for ever-use than the amount of use. The relationships between musculoskeletal diseases and inpatient utilisation, between cardiovascular diseases and diabetes and the number of private outpatient visits, and between lower respiratory diseases and GOPC utillisation were not significant. Conclusions The present study suggests SRH to be a useful health indicator of health service utilisation. All three SRH measures were associated with health service utilisation and no marked differences were observed between different measures. Poorer SRH were strongly related to higher public inpatient utilisation, with stronger association observed for ever hospitalisation than bed-days. Poorer SRH measures were also related to higher outpatient uilisation in both sectors during the past month. All the selected chronic conditions were related to increased healthcare use. The associations were less clear for hospital bed-days and the private sector. Future studies should focus on the predictive validity of SRH on future healthcare utilisation. / published_or_final_version / Public Health / Master / Master of Philosophy

<p style="text-align: justify / " class="Default">In developing economies and specifically Sub-Saharan Africa physical inactivity has been identified as a risk factor along with tobacco use, poor nutrition and poor diet as this has increasingly formed part of today&rsquo / s lifestyle. Physical activity declines with age this decline is more marked during the adolescent period. The aim of this study was to determine the prevalence of physical inactivity and factors associated with it among adolescents in <st1:place><st1:city>Nairobi</st1:city>, <st1:country-region>Kenya</st1:country-region></st1:place>. The overall aim of the study is to determine the factors influencing their levels of physical activity in relation to their socio-economic characteristics. <o:p></o:p></p>

Cette recherche sur les barrières à l’accès pour les pauvres atteints de maladies chroniques en Inde a trois objectifs : 1) évaluer si les buts, les objectifs, les instruments et la population visée, tels qu'ils sont formulés dans les politiques nationales actuelles de santé en Inde, permettent de répondre aux principales barrières à l’accès pour les pauvres atteints de maladies chroniques; 2) évaluer les types de leviers et les instruments identifiés par les politiques nationales de santé en Inde pour éliminer ces barrières à l’accès; 3) et évaluer si ces politiques se sont améliorées avec le temps à l’égard de l’offre de soins à la population pour les maladies chroniques et plus spécifiquement chez les pauvres. En utilisant le Framework Approach de Ritchie et Spencer (1993), une analyse qualitative de contenu a été complétée avec des politiques nationales de santé indiennes. Pour commencer, un cadre conceptuel sur les barrières à l’accès aux soins pour les pauvres atteints de maladies chroniques en Inde a été créé à partir d’une revue de la littérature scientifique. Par la suite, les politiques ont été échantillonnées en Inde en 2009. Un cadre thématique et un index ont été générés afin de construire les outils d’analyse et codifier le contenu. Finalement, les analyses ont été effectuées en utilisant cet index, en plus de chartes, de maps, d'une grille de questions et d'études de cas. L’analyse a tété effectuée en comparant les barrières à l’accès qui avaient été originalement identifiées dans le cadre thématique avec celles identifiées par l’analyse de contenu de chaque politique. Cette recherche met en évidence que les politiques nationales de santé indiennes s’attaquent à un certain nombre de barrières à l’accès pour les pauvres, notamment en ce qui a trait à l’amélioration des services de santé dans le secteur public, l’amélioration des connaissances de la population et l’augmentation de certaines interventions sur les maladies chroniques. D’un autre côté, les barrières à l’accès reliées aux coûts du traitement des maladies chroniques, le fait que les soins de santé primaires ne soient pas abordables pour beaucoup d’individus et la capacité des gens de payer sont, parmi les barrières à l'accès identifiées dans le cadre thématique, celles qui ont reçu le moins d’attention. De plus, lorsque l’on observe le temps de formulation de chaque politique, il semble que les efforts pour augmenter les interventions et l’offre de soins pour les maladies chroniques physiques soient plus récents. De plus, les pauvres ne sont pas ciblés par les actions reliées aux maladies chroniques. Le risque de les marginaliser davantage est important avec la transition économique, démographique et épidémiologique qui transforme actuellement le pays et la demande des services de santé. / This research on the barriers to access chronic disease care for the poor in India has three objectives: 1) to assess whether the goals, objectives, instruments and targeted populations, as formulated in current national health policies in India, address the main barriers to access chronic disease care for the poor; 2) to assess the types of policy levers and instruments identified in current national health policies to address these barriers to access; 3) And to assess whether national health policies in India have improved over time with respect to ensuring chronic disease care to the population and more specifically to the poor. Using Ritchie and Spencer’s framework approach (1993), a qualitative content analysis was completed on selected Indian national health policies. To begin with, a conceptual framework on the barriers to access chronic disease care for the poor in India was generated from a review of the scientific literature. Policy documents were then sampled in India in 2009. A thematic framework and index scheme were generated to build the analysis tools and codify the content. Finally, the analysis was conducted using indexing, charts, maps, questions grids and case studies. It was achieved by comparing the barriers to access identified in the original conceptualization to those identified by the content analysis of each policy. This research highlights that a number of barriers to access for the poor in India are addressed by national health policies as they relate to upgrading services in the public sector, improving the knowledge of the population and scaling up some interventions for chronic disease care. On the other hand, barriers related to the costs of chronic disease care, the affordability of outpatient services and people’s ability to pay for them were the least addressed from the framework that was previously established. Moreover, when looking at the timeline of our sample of policies, it appears that efforts to scale up interventions for physical chronic diseases are more recent. In addition, the poor are not targeted specifically for actions related to chronic disease care. The risk of marginalizing them further is important as economic, demographic and epidemiologic transitions are transforming the country and the demand for health services.