Household food security status in rural areas is a significant issue facing caregivers as positive health outcomes depend on appropriate access to healthy foods necessary to lead an active life. Access and affordability of healthy foods are two mediating factors of household food security that may be improved to ultimately increase rates of food security and overall health status among rural, low income populations. The purpose of the study was to examine the factors of access and affordability of nutritionally adequate food sources in one rural community in relation to food security status through the perspective of its caregivers. In general, populations suffering from low rates of food security report lower access to healthy foods and the inability to afford healthy foods. The study utilized a primarily qualitative approach; however, thirty-one participants were initially categorized by levels of food security by the US Household Food Security Survey Core Module as a quantitative measure. Twelve participants who were classified as food insecure and were caregivers to children under the age of 18 responded to an in-depth interview focusing on the factors of access and affordability. Twenty-six (84%) of the thirty-one food pantry clients who completed the initial survey were classified as food insecure. Open-ended interviews of participant perceptions of access and affordability to health foods in relation to food security revealed several major themes titled transportation and physical ability challenges, key issues in store choice, cost barriers in food shopping, strategies to maximize food dollars, and factors involved in food choice. The results of this study, while they must be interpreted with caution, suggested there were multiple systems interacting that mediated the problem of food insecurity in this rural area through the perception of low income caregivers. The data can be used to improve health promotion programs and inform public health policies that can have a positive impact on overall health in rural areas.

The purpose of the present study was to examine the relationship between mindfulness and its link to sexual satisfaction and relationship satisfaction. Data were collected from 809 individuals (18.8% bisexual, 60.7% straight, 19.2% gay/lesbian) in romantic relationships. Participants completed an online survey to measure mindfulness (five facets: observing of experience, describing with words, acting with awareness, non judging of inner experience, non reactivity to inner experience), sexual satisfaction, and relationship satisfaction. Results from two multivariate analyses (predicting sexual satisfaction and relationship satisfaction) revealed that relationship satisfaction is significantly predicted by three of the five facets of mindfulness – acting with awareness, describing with words, and non judging of inner experience. Sexual satisfaction was significantly predicted by the non judging of inner experience facet of mindfulness. Non judging of inner experience was the only facet that significantly predicted both relationship and sexual satisfaction. These findings indicate that when individuals are able to take a non-evaluative stance towards their sensations, cognitions, and emotions, they are more likely to be satisfied. Future research and clinical intervention for improving satisfaction may benefit from focusing on mindfulness related to the non judging of inner experience. Implications for clinical practice and future research will be discussed.

The National Health Planning and Resources Development Act. Public Law 93-641, the last major step in the regulation of the health care system, created a network of health system agencies and state level health planning agencies. Subsequent legislation, the Health Planning and Resources Development Amendment 1929, Public Law 96-79, amended 1974 Law and changed the role and function of health systems agencies to include more regulatory activities. By 1981, the activities of Health System Agencies were being curtained by the action of the Reagan administration. The Health promotion/wellness movement which seeks to improve health has been developing as a compliment to medical medicine for several years. Previous research has determined that health systems agencies were active in health promotion and identified several planning and implementation activities related to this involvement. This is a survey of health systems agencies to determine their efforts in healthy promotions. Resources allocated to these activities, and opinions of the director relevant to agency involvement in health promotion. All active healthy system agencies listed in the 1980. Directory of Health System Agencies (DHSH) were surveyed by a mailed questionnaire. Reponses were receive from 112 agencies (57%) and the respondents were found to be representative of the population. The results revealed health systems agencies to be involved in health promotion. More than 90 percent of the responders listed some type of health promotion activity in their Healthy System Plans for the 1979-1980 planning year. Approximately half of the responders reported some community activity in health promotion. The majority of executive directors saw health systems agencies as being only moderately effective in controlling health care costs: considered healthy promotion as a viable means of controlling health care cost: and believed that modifications of individual life-styles had the greatest potential for improving health status. The survey revealed that Healthy System Agencies did not restrict the wellness/health promotion activities to traditional health facilities, but were defining health broadly and working with a variety of agencies to develop services.

The prevalence of obesity has doubled over the past 25 years in the United States, particularly in North Carolina. Obesity is influenced by biological, social, and environmental factors; its prevalence has been found to be higher among African American women and other racial ethnic minorities. Guided by the social ecological model, the purpose of this cross sectional study was to examine the relationship of the psycho-social, psycho-behavioral factors, and body mass index levels (BMI) in African American women living in North Carolina versus their Hispanic American and European American counterparts. A logistic regression model using secondary data from the Behavioral Risk Factor Surveillance System revealed a significant association in income levels, house hold size, dietary intake, physical activity, and increased BMI levels in African American women. African American women were significantly more likely to be obese (r = 0.93 p > 0.05) compared to European American and Hispanic American women. The association of each variable to BMI assessed for African American women was as follows: income (r = 0.46, p = 0.001), dietary intake (r = 0.-17, p = 0.04), household size (r = 0.57, p = 0.001), physical activity (r = -0.16, p = 0.05), depression (r = 0.37, p = 0.001), and alcohol consumption (r = 0.39, p = 0.001). A culturally sensitive weight loss model addressing the psycho-behavioral and psychosocial risk factors that negatively influence BMI and subsequently obesity is warranted for African American women living in North Carolina to promote social change and decrease the incidence of obesity in this ethnic group.

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2015-05-04T14:07:11Z No. of bitstreams: 1 Patricia Matias Pinheiro.pdf: 11031479 bytes, checksum: 12ef13948d06971c93de048c5ef818a7 (MD5) / Made available in DSpace on 2015-05-04T14:07:12Z (GMT). No. of bitstreams: 1 Patricia Matias Pinheiro.pdf: 11031479 bytes, checksum: 12ef13948d06971c93de048c5ef818a7 (MD5) Previous issue date: 2012-08-30 / Objective:Intervention evaluation strategies of Health Education for students in a municipal school in Santos. The themes chosen were sexual health, nutrition and dengue. Methodology:This is an intervention study. The study included a group of 20 fifth year students, a group of 13 sixth year students, a group of 22 eighth year students, and a group of 17 ninth year students. One of the themes outlined in the objective was chosen for each group. The theme of sexual health was divided into STD's/HIV, and teenage pregnancy with methods of contraception. The study was conducted in workshops and lectures and the evaluation was made by applying two questionnaires. The first with demographic data and the second theme-specific issues. These questionnaires were applied before and after the interventions to evaluate knowledge gain, and were measured by the McNemar statistical test. The level of significance considered was 0.05. Results: During the sexual health educational sessions, the results were significant after the interventions with respect to the number of STDs knows (p<0.05), breast feeding (p<0.05) as a means of transmission (p<0.05), knowledge of fertile periods (p<0.05), and the vaginal ring (p<0.05) and adhesives (p<0.05) as a contraceptive method. With regard to dengue, only the knowledge that people can get dengue four times showed a significant trend (p<0.07). With respect to nutritional health, there was a slight improvement of consumption patterns, however, only the consumption of red meat at lunch showed a difference (p<0.05). Conclusions:The workshops proved to be especially effective, as this was where a greater change in knowledge was found, yet continuity and systematization of educational activities is still needed. It is hoped that these teenagers will in turn pass on this information, contributing to an improvement in health indices. / Objetivo: Avaliar estratégias de intervenção de Educação em Saúde para estudantes em uma escola municipal de Santos. Os temas escolhidos foram saúde sexual, saúde nutricional e dengue. Metodologia: Trata-se de um estudo de intervenção. Participaram do estudo uma turma de 50 ano, com 20 alunos, uma turma de 60 ano com 13 alunos, uma de 80 ano com 22 alunos e uma do 90 ano com 17 alunos. Para cada turma desta foi escolhido um dos temas. O assunto saúde sexual foi dividida em DST-HIV e gravidez na adolescência com métodos contraceptivos. Foram realizadas oficinas e palestras educativas. A avaliação se deu pela aplicação de dois questionários. O primeiro continha dados sócio-demográficos e o segundo questões específicas de cada tema. Esse, foi aplicado antes e após às intervenções, para se avaliar o ganho de conhecimento, mensurado por meio do teste estatístico McNemar e o nível de significância considerado foi de 0,05. Resultados: Nas ações educativas de saúde sexual, os resultados se mostraram significantes, após as intervenções, no número de DST conhecidas (p<0,05), no aleitamento materno (p<0,05) como forma de transmissão, no conhecimento do período fértil (p<0.05) e do anel vaginal (p<0,05) e adesivos (p<0,05) como métodos contraceptivos. Com relação à dengue, apenas o conhecimento de que se pode pegar dengue quatro vezes apresentou uma tendência à significância (p<0,07). Com relação à saúde nutricional, houve melhora discreta do padrão alimentar, contudo apenas o consumo de carne vermelha no almoço mostrou diferença (p<0,05). Conclusões: As oficinas se mostraram efetivas, principalmente, onde foi verificado maior mudança de conhecimento, contudo necessitando de continuidade e sistematização dessas ações educativas. Espera-se que esses adolescentes tornem-se multiplicadores dessas informações, contribuindo para uma melhora dos índices de saúde.

Background Recent studies have demonstrated a significant relationship between vitamin D and cholesterol levels. Cholesterol is important in the synthesis and metabolism of vitamin D. Additionally, foods rich in vitamin D also contain high cholesterol supplements. Given that sources of vitamin D and cholesterol are different, we hypothesized that there is a potential mean bias in true relationship between an individual’s vitamin D and cholesterol levels. The study therefore aimed to examine the relationship of serum cholesterol and vitamin D levels. Methods We utilized NHANES 2001-2006 data (n=30,954). The outcome was vitamin D deficiency defined as individuals with serum 25-hydroxyvitamin D level12 ng/ml were classified as normal. Significant differences in cholesterol levels between the two groups were determined using Chi-Square contingency test. Generalized linear models were conducted to assess the association of vitamin D deficiency with cholesterol levels adjusting for age, sex, physical activity (proxy measure for sunlight exposure) and other serum lipid levels. Results Vitamin D deficiency was significantly lower in males(5.2%) than females(7.8%)(P Conclusion Vitamin D deficiency was associated with high LDL and triglyceride levels. Study findings help establish the importance of distinguishing vitamin D and cholesterol levels as separate entities while making inferences about their relationship with chronic diseases.

Health literacy has become an important public health concern. Multistage cluster random sampling was used to select 12 450 individuals. Using the 2009 Chinese Health Literacy questionnaire, participants were divided into groups with poor or not poor health literacy status. The knowledge rates for 6 areas of health literacy were determined with the following results: science concept of health (60.0%), literacy for preventing acute infectious disease (66.8%), literacy for preventing noncommunicable chronic disease (51.9%), safety and first aid (66.8%), obtaining and making use of basic medical care (55.3%), and comprehensive health literacy (52.5%). Multiple logistic regression showed that living in a rural area, fewer individuals in a household, younger age, low education, agricultural or rural migrant occupation workers, and low family income were associated with a poor health literacy status. Our results support the use of health education and promotion interventions to improve health literacy in this high-risk population in China.

Adolescents and Young Adults (AYAs) ages 15-39 years with cancer have received little attention in the health field, resulting in a lack of progress. The purposes of this study were to use the Tennessee Cancer Registry for all new cancer cases from 2004-2008 to determine the main types of cancer that affect AYAs in Tennessee and understand if there were any cancer types that warranted additional investigation. A total of 8,097 cancer cases were diagnosed in AYAs in Tennessee from 2004-2008. The main types were breast, melanomas, thyroid, lymphomas, and testicular, accounting for over 50% (N=4,269) of cancers in the sample. The incidence of melanoma and thyroid cancer was higher in Tennessee compared to the United States, deserving further examination. In Tennessee, females were significantly more likely to be diagnosed with melanomas (AIR 14.01, 95% CI 12.96-15.06) and thyroid cancers (AIR 13.39, CI 12.37-14.42) compared to males (AIR 8.08, CI 7.28-8.88 and AIR 3.50, CI 2.98-4.03. Regression models were used to further analyze melanoma and thyroid cancers, specifically looking at predictors of late stage diagnosis and treatment types, respectively. Individuals with government insurance were eight times (OR 8.41, CI 3.04-23.27) more likely to be diagnosed with late stage melanoma when compared with private or other types of insurance. Individuals diagnosed with regional or distant stage thyroid cancer compared to localized stage were three times (OR 3.01, CI 1.84-4.94) more likely to have a total thyroidectomy. These data suggest the need for additional cancer prevention and control efforts geared towards AYAs.

Background: The incidence of cardiovascular disease (CVD) is high in obese people. The potential effects of inadequate calcium intake on CVD are receiving increased attention. We assessed the association between several risk factors for CVD and calcium intake among obese adults. Methods: We investigated 14,856 obese subjects age 20 years or older from the National Health and Nutrition Examination Survey, 1999-2010. ANOVA and Pearson correlation analyses were used to examine if any relationships existed. Simple and multiple linear and logistic regression analyses were conducted to determine the association between risk factors for CVD and calcium intake. Results: After adjusting for energy intake and other potential confounders, systolic blood pressure, diastolic blood pressure, C-reactive protein, glycosylated hemoglobin, and albuminuria were negatively associated with calcium intake at =0.05 level in both linear and logistic regression analyses. Adjusted regression coefficients and ORs did not show a significant relationship between high-density lipoprotein (HDL) and calcium intake. Total cholesterol was negatively associated with calcium intake in continuous form, but no relationshipwas seen between total cholesterol and the calcium intake quartiles form. When comparing low quartile to high quartile, total cholesterol had a weak negative association with calcium intake at =0.1 level. Conclusion: Our study provides evidence that adequate calcium intake could decrease the risks of CVD, such as high blood pressure and high glycosylated hemoglobin, among obese adults. However, calcium intake was not associated with HDL levels. More research is needed to assess the effect of total cholesterol by calcium intake.

Childhood obesity remains prevalent among African American (AA) adolescents in low income neighborhoods with limited access to a variety of foods from stores. Guided by the ecological framework, the purpose of this study was to examine the impact of neighborhood stores on food choices, and physical activity among AA adolescents in a low income neighborhood. A quantitative research design with cross sectional primary and secondary surveys was used. Participants included 176 high school students and 42 store merchants. Data sources were the 2011 New Jersey Student Health Survey with core questions from the Youth Risk Behavior Survey and the Hmong Food Store Survey. Descriptive statistics were used to describe the sample characteristics and food store food variety and cost. Inferential statistics were used in analyzing the association between the dependent variable (grade level, age, or gender) and the independent variables, food choices and physical activity level, and to test for hypotheses. The findings revealed there were no significant associations between grade level, age, or gender and food choices, or physical activity level. Food variety reported as MyPlate food items were low for adolescents who shopped at small grocery and convenience stores as compared to those who shopped at supermarket and large grocery stores. Average cost differed by, MyPlate food groups and store type. Convenience stores had the lowest costs for fruits, grains, and protein, and highest for diary, reflecting the lack of variety in the mix of foods used to calculate costs. This study demonstrated the need for policy change at the community that will benefit disadvantaged AA adolescents in low income neighborhoods and improve access to a variety of food choices for purchase that are nutritious and affordable.