Morbidity due to noncommunicable diseases (NCDs) has become a worldwide epidemic. As a result, the United Nations (2015) Sustainable Developmental Goals (SDGs) included goal (3.4) that aims to reduce the premature mortality from NCDs by one third. All countries, regardless of income, are required to develop strategies and achieve a reduction in the burden of NCDs. This study, conducted in the Sultanate of Oman, aimed to explore individuals' knowledge, perceptions, actions and intentions to modify their lifestyle to reduce their risk of stroke. The Health Belief Model (HBM) was used as the underpinning theoretical framework to provide a broader conceptual understanding of the Omani sociocultural and structural influences on individuals' lifestyles. A convergent mixed methods design within a realist social constructionism methodology was used. Both quantitative (344 questionnaires) and qualitative (10 interviews) data were integrated using a narrative weaving approach. The study results confirm that both agency and structure influenced the adoption of healthy behaviours in Oman. The study indicates that the study participants are likely to engage in health-related behaviours when they perceived the benefit of such a course of actions in term of it reducing their risk of stroke. The study found that in the Omani setting, individual factors such as fear, family experience and physical sickness, the psychological status of chronic conditions and a cost-benefit analysis of the behaviour influence the individuals' decisions to practise a healthy lifestyle. The major finding in the study showed that perceptions of risk vary among individuals who share the same culture and religion, particularly individual perception of religious belief was found to influence their susceptibility to stroke risk. In addition, the study identified some sociocultural and structural factors that influenced the individuals' decisions to engage in a healthy lifestyle. This study presents an extended HBM to incorporate the role of individual religious beliefs as an individual factor. The study suggests that health improvement plans are needed in Oman to develop both individual- and community- level interventions to achieve the target of SDGs for NCDs.

Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability and Readiness Assessment survey. Correlation and multiple linear regression tests were used to determine the strength and direction of any relationship between the independent variable of leadership practices (annual work planning, therapeutic committees, and supportive supervision), and the dependent variable of NCD readiness (county readiness score). The results indicated a statistically significant relationship between therapeutic committee (p = .002) and supportive supervision practices (p = .023) and NCD readiness. Leadership practices also had a statistically significant predictive relationship with NCD readiness (p = .009). This study may be significant to county health leaders in relation to their efforts to ensure proximal access to quality NCD services in Kenya. The results of this study may help to promote the development of capacity-building programs targeting health leadership and prioritization of actions to ensure access to NCD prevention and treatment services at the county level in Kenya.

Darbo tikslas. Įvertinti slaugytojų riziką susirgti lėtinėmis ligomis ir šių ligų pirminės profilaktikos vykdomas priemones. Darbo uždaviniai. 1. Įvertinti slaugytojų profilaktinių sveikatos patikrinimų organizacinius aspektus. 2. Ištirti slaugytojų nuomonę apie sveikatą stiprinančios darbo aplinkos sudarymą. 3. Ištirti slaugytojų žinias apie lėtinių ligų rizikos veiksnius ir jų dažnį. 4. Palyginti slaugytojų, dalyvavusių ir nedalyvavusių profilaktiniuose patikrinimuose informuotumą apie lėtinių ligų rizikos veiksnius ir kontrolę. 5. Įvertinti slaugytojų profilaktinio sveikatos patikrinimo apimtis ir jų metu pateiktas rekomendacijas. Tyrimo metodika. Tyrimas vykdytas vienoje Lietuvos ligoninėje. Tyrimo dalyviai - bendrosios praktikos slaugytojos. Tyrimo būdas - vienmomentinė anoniminė apklausa ir įstaigos dokumentų analizė. Iš viso pateikta 200 anketų, sugrąžinta – 164 anketos, atsako dažnis 82 proc. Statistinei analizei atlikti buvo naudojamos SPSS 17.0 for Windows bei MS Excel programos. Rezultatai. Slaugytojų profilaktinių sveikatos patikrinimų kokybė nepatenkinama: atliekami ne visi teisės aktuose nurodyti būtini tyrimai, slaugytojos nekonsultuojamos gydytojų specialistų, nors 92,0 proc. darbe susiduria su kenksmingais darbo aplinkos veiksniais, nėra vertinami LNL rizikos veiksniai. Ketvirtadalis slaugytojų pristato medicinos pažymas nesitikrinusios sveikatos. Daugiau nei pusei slaugytojų darbovietėje nėra sudarytos sąlygos stiprinti sveikatą. Dauguma dalyvautų... [toliau žr. visą tekstą] / Aim of the study. To assess NCD risk for the nurses and the primary prevention measures of these diseases. Objectives. 1. To evaluate the organizational aspects of nurses‘ health check-up. 2. To examine the opinion of nurses about health enhancing worksite environment. 3. To assess the nurses‘ awareness about NCD‘ risk factors and their prevalence. 4. To compare the awareness of NCD‘s risk factors, their control among nurses participants and non-participants of health check-up. 5. Toevaluate the coverage of nurses‘ health check-up and the given recommendations. Methods. The study was provided in one Lithuanian hospital. Nurses were the participants of the study.Cross- sectional anonymous survey was carried out and the documentary analysis was performed. 200 questionaires were delivered, 164 - returned, response rate - 82 %. The SPSS 17.0 for Windows and MS Excel programmes were used for statistical anlysis of data. Results. The quality of nurses health check-up is unsatisfactory: not all investigations are carried out which are enumerated in the existing legal documents, nurses are not consulted by physicians specialists, despite the fact, that 92.0 % of them have contact with harmful environmental factors, the NCD risk factors are not detected. The quarter of nurses present the health certificates without health check-up. More than half of the nurses don’t have conditions for health promotion. Majority of nurses express willingness to participate in such health... [to full text]

Introdução: O excesso de peso em adultos jovens está associado ao desenvolvimento de doenças crônicas não transmissíveis (DCNT) e à diminuição da qualidade de vida e ao aumento da mortalidade precoce. A transição da adolescência para a fase adulta é o período de maior risco para a incidência da obesidade. Objetivo: Estimar o efeito o índice de massa corpora (IMC) aos 20 anos sobre a incidência de DCNT em adultos brasileiros com idade entre 30 a 49 anos. Métodos: Foram selecionados 12.079 indivíduos de 30 a 49 anos da Pesquisa Nacional de Saúde (PNS), realizada no ano de 2013. O modelo adotado para determinação das DCNT foi aquele proposto pela Organização Mundial de Saúde. A incidência das DCNT (hipertensão, doenças cardiovasculares, diabetes e câncer, entre outras), informada pela data do diagnóstico, foi modelada como função do IMC aos 20 anos. Os indivíduos sem a doença até o presente foram considerados como censura. As estimativas de sobrevida foram calculadas com o método de Kaplan-Meier (KM) para cada uma das doenças, estratificada por sexo e ajustada por escolaridade. A análise dos fatores de risco para as doenças foi feita utilizando-se o modelo de riscos proporcionais de Cox. Resultados: Nas curvas de sobrevida KM, indivíduos com IMC >=25kg/m² apresentaram incidência mais elevada e precoce de DCNT, principalmente hipertensão, diabetes e depressão. A idade mediana para incidência do diabetes em obesos foi de 47 anos para homens e 48 anos para mulheres. A incidência da hipertensão arterial foi 4,2 por mil com sobrevida mediana de 48 e 44 anos em mulheres com excesso de peso e obesidade, respectivamente. Dentre os fatores de risco associados as DCNT, o tabagismo em idade precoce foi associado à incidência de depressão. Conclusão: O excesso de peso em adultos jovens aumenta a incidência precoce de DCNT, com efeitos negativos na qualidade de vida, lazer e produtividade, além de aumentar a demanda por serviços de saúde. Torna-se necessário que a intervenção para redução dessas doenças seja direcionada para o período da infância e adolescência com ações que promovam a redução da exposição desses indivíduos à alimentação de má qualidade e incentivo a prática de atividade, não uso do tabaco e consumo moderado de álcool. / Introduction: Overweight in young adults is associated with the development of chronic noncommunicable diseases (NCDs) and decreased quality of life and increased early mortality. The transition from adolescence to adulthood is the period of greatest risk for the incidence of obesity. Objective: To estimate the effect of the corpora mass index (BMI) at age 20 on the incidence of NCDs in Brazilian adults aged 30-49 years. Methods: We selected 12 079 individuals 30-49 years of the National Health Research (PNS) held in 2013. The model adopted for determining the NCD was that proposed by the World Health Organization The incidence of NCDs (hypertension, diseases. cardiovascular, diabetes and cancer, among others), informed by the date of diagnosis, and modeled as a function of BMI at age 20. Individuals without the disease to date have been considered as censorship. Survival estimates calculated with the Kaplan-Meier (KM) for each of the diseases, stratified by gender and adjusted for schooling. The analysis of risk factors for the disease made using the model of Cox proportional hazards. Results: In the survival curves KM, individuals with BMI> = 25 kg / m² presented higher and early incidence of NCDs, particularly hypertension, diabetes and depression. The median age for incidence of diabetes in obese was 47 years for men and 48 years for women. The incidence of hypertension was 4.2 per thousand with a median survival of 48 and 44 years in women with excess weight and obesity respectively. Among the risk factors associated with the NCD, smoking at an early age was associated with the incidence of depression. Conclusion: Being overweight in young adults increases the early incidence of NCDs, with negative effects on quality of life, leisure and productivity, and increase the demand for health services. It is necessary that the intervention to reduce these diseases directed to the period of childhood and adolescence with actions that promote a reduction in exposure of these individuals to the poor quality of food and encouraging the practice of activity, no tobacco use and moderate consumption alcohol.

Magister Public Health - MPH (Public Health) / The prevalence of diabetes in Africa has been on the increase. A prevalence of 1%- 10% has been reported by different authors in different regions in Nigeria. The International Diabetes Federation estimates that 1.9% of Nigerians are diabetic and most of them have complications at the time of diagnosis. Laboratory measurement of Glycosylated hemoglobin (HbA1c) is the method of choice for monitoring glycaemic control but due to its cost and limited availability, most developing countries use fasting plasma glucose (FPG) measurement (which is less reliable) to assess glycaemic control. Most diabetic patients in Nigeria have poor glycaemic control and several factors have been implicated especially socio-economic, behavioral and treatment-related factors. Understanding the reasons for poor glycaemic control is essential in order to reduce the rate of diabetes complications.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-09-05T19:02:18Z No. of bitstreams: 1 AnaKarinePires.pdf: 6619893 bytes, checksum: e0c44f5cd4047f60fbc4ecee3f696f4f (MD5) / Made available in DSpace on 2017-09-05T19:02:18Z (GMT). No. of bitstreams: 1 AnaKarinePires.pdf: 6619893 bytes, checksum: e0c44f5cd4047f60fbc4ecee3f696f4f (MD5) Previous issue date: 2013-12-10 / The objective of the research was to identify the environmental perception of the users physical activity program of the Municipal Health Secretariat (SEMUS) of São Luís - MA investigating the factors that contribute positively and/or negatively to the performance of activities in green areas and/or enclosed spaces. Evaluated as well, the level of user satisfaction and physical education teachers who work in the program. The quantitative and qualitative research was taking place in the first stage, literature and analysis of the National Health Promotion (PNPS) addressing their guidelines, operationalization and its effects on the development of the Municipal Policy fighting the Chronic Noncommunicable Diseases (NCDs) São Luís - MA. The data on hypertension and diabetes were collected on Registration and Monitoring System for Hypertensive Diabetics - HIPERDIA in the period 2005-2011. In the second stage, the data were obtained from semi-structured interviews applied to users and Physical Education teachers working in the program. We used the theory of Social Representation focusing on qualitative and quantitative research through technical analysis of the subject discourse, from the interviews. The program "São Luís in Moviment" was created in 2008, is organized in 04 centers: Park Bom Menino; Coroado-Sacavém; COHAB and Vinhais, serving on average 200 registered users, aged between 16 and 70. As a general conclusion it is emphasized that the users' perception regarding physical exercise is positive, because the regularity of activities in the field provides benefits physiological, psychological and social aspects of the respondents. When comparing the two groups of users that perform activities in areas with green spaces and closed the first group evaluated more positively than the second. However, users who perform in closed stressed the factor of "security" as a determinant to prefer these spaces. We conclude that although the PNPS determine the adoption of a preventive policy against the advancement of NCDs, the research showed that lack of proper structuring, both in the green areas as in enclosed place where the program activities compromise the achievement of the goals established evident that preventive actions are not priorities of local public administrations. The data HIPERDIA revel that during the evaluation period was the growth of the diseases reported, especially hypertension among women. Alongside it was observed that there was a reduction in vegetation cover capital of Maranhão affect even more the availability of green areas for the practice of physical activities, the population in general and users of the program. Thus, it is suggested the expansion and/or maintenance of green areas, open spaces in the capital of Maranhão in conditions of minimal infrastructure needed to encourage sports activities and leisure in general, in addition to expanding the program by creating other hubs in different neighborhoods. / O objetivo da pesquisa foi identificar a percepção ambiental dos usuários do programa de atividade física da Secretaria Municipal de Saúde (SEMUS) de São Luís - MA investigando os fatores que contribuem positiva e/ou negativamente para a realização das atividades em áreas verdes e/ou espaços fechados. Avaliou-se assim, o nível de satisfação dos usuários e professores de Educação Física que atuam no programa. A pesquisa foi qualiquantitativa realizando-se na primeira etapa, levantamento bibliográfico e análise da Política Nacional de Promoção da Saúde (PNPS) abordando suas diretrizes, operacionalização e seus reflexos no desenvolvimento da Política Municipal de combate as Doenças Crônicas Não Transmissíveis (DCNT) em São Luís - MA. Os dados sobre hipertensão arterial e diabetes foram coletados no Sistema de Cadastramento e Acompanhamento de Hipertensos e Diabéticos - HIPERDIA, no período de 2005-2011. Na segunda etapa, os dados levantados foram obtidos a partir de entrevistas semiestruturadas aplicadas aos usuários e professores de Educação Física atuantes no programa. Utilizou-se a teoria da Representação Social com foco na pesquisa qualiquantitativa por meio da técnica de Análise do Discurso do Sujeito, a partir das entrevistas realizadas. O programa “São Luís em Movimento” foi criado em 2008, está organizado em 04 polos: Parque do Bom Menino; Coroado-Sacavém; COHAB e Vinhas, atendendo em média 200 usuários cadastrados, na faixa etária entre 16 e 70 anos. Como conclusão geral destaca-se que a percepção dos usuários quanto à prática do exercício físico é positiva, pois a regularidade das atividades proporciona benefícios no campo fisiológico, psicológico e social dos entrevistados. Quando comparados os dois grupos de usuários que realizam as atividades em áreas com espaços verdes e fechados, o primeiro grupo avaliou mais positivamente que o segundo. Entretanto, usuários que realizam em espaços fechados destacaram o fator “segurança” como determinante para preferirem esses espaços. Conclui-se ainda que, apesar da PNPS determinar a adoção de uma política preventiva frente ao avanço das DCNT, a pesquisa evidenciou que ausência de estruturação adequada, tanto nas áreas verdes quanto nos espaços fechados onde acontecem as atividades do programa compromete o cumprimento das metas estabelecidas evidenciado que ações preventivas ainda não são prioridades das gestões públicas locais. Os dados do HIPERDIA revelaram que no período avaliado houve o crescimento dos agravos notificados, sobretudo hipertensão arterial entre as mulheres. Paralelamente observouse que houve redução na cobertura vegetal da capital maranhense comprometendo mais ainda a disponibilidade de áreas verdes para a prática das atividades físicas, da população em geral, e usuários do programa. Dessa forma, sugere-se a ampliação e/ou manutenção das áreas verdes, espaços livres na capital maranhense em condições de infraestrutura mínima necessária para estimular as práticas desportivas e lazer em geral, além da ampliação do programa através da criação de outros polos em diferentes bairros da cidade.

<p>Livsstilsrelaterade sjukdomar är ett växande globalt problem, och fysisk inaktivitet är en av de största riskfaktorerna. En av sjuksköterskans uppgifter är att motivera till hälsosammare levnadsvanor. En hälsofrämjande metod är fysisk aktivitet på recept, FaR®, som används i flera länder, men vars effekt även har ifrågasatts. Syftet med studien var att undersöka värdet av FaR® och vilka faktorer som påverkar det värdet. En granskning av 12 vetenskapliga artiklar genomfördes. Resultaten visade att FaR® medförde positiva förändringar hos deltagarna, men förändringarna påverkades av följsamheten. Förskrivningsfrekvensen varierade starkt, och det var framförallt läkare som skrev ut recept. En liten del av dem som låg i riskzonen för livsstilsrelaterade sjukdomar fick ett recept. FaR® bör användas till dem som är motiverade till förändring. Det behövs mer forskning om den påverkan FaR® har på dem som inte är följsamma och om kunskaperna och attityderna hos den hälso- och sjukvårdspersonalen som har förskrivningsrätt.</p>

Livsstilsrelaterade sjukdomar är ett växande globalt problem, och fysisk inaktivitet är en av de största riskfaktorerna. En av sjuksköterskans uppgifter är att motivera till hälsosammare levnadsvanor. En hälsofrämjande metod är fysisk aktivitet på recept, FaR®, som används i flera länder, men vars effekt även har ifrågasatts. Syftet med studien var att undersöka värdet av FaR® och vilka faktorer som påverkar det värdet. En granskning av 12 vetenskapliga artiklar genomfördes. Resultaten visade att FaR® medförde positiva förändringar hos deltagarna, men förändringarna påverkades av följsamheten. Förskrivningsfrekvensen varierade starkt, och det var framförallt läkare som skrev ut recept. En liten del av dem som låg i riskzonen för livsstilsrelaterade sjukdomar fick ett recept. FaR® bör användas till dem som är motiverade till förändring. Det behövs mer forskning om den påverkan FaR® har på dem som inte är följsamma och om kunskaperna och attityderna hos den hälso- och sjukvårdspersonalen som har förskrivningsrätt.

Lietuvoje PSP reforma yra vykdoma jau beveik dvidešimt metų.Labai svarbu įvertinti jos privalumus ir trūkumus, iškylančias problemas. 1994 ir 2004 metais atlikti tyrimai, kuriuos lyginant stebėti teigiami ir neigiami šeimos gydytojų veiklos pokyčiai ir netolygumai, susiję su gydytojų kvalifikacine kilme (persikvalifikavę pediatrai, terapeutai, šeimos gydytojai po rezidentūros), darbovietės steigėju (privatus ar valstybinis PSPC), urbanizacija (apskrities centras, miestas, mestelis ar kaimas), vykdoma veikla.Vertintas paslaugų prieinamumas, išaiškintos šeimos gydytojų veiklos problemos. Išryškėjo poreikis kitiems tyrimams, gautiems rezultatams patikslinti, atsakyti į naujai iškilusius klausimus. Todėl, siekiant įvertinti tolimesnius šeimos gydytojų veiklos kitimus per penkiolikąreformos metų, 2010 metais atliktas naujas tyrimas, papildytas ir pataisytas atsižvelgus į buvusių tyrimų trūkumus ir naujai iškilusias aktualijas.Šio šeimos gydytojų veiklos tyrimo užibrėžti uždaviniai: 1. Nustatyti ir palyginti šeimos gydytojų darbo krūvio ir veiklos apimčių pokyčius per 15 PSP reformos metų. 2. Įvertinti šeimos gydytojo normoje numatytų ir praktikoje atliekamų procedūrų dažnius. 3. Ištirti šeimos gydytojų nuomonės apie jų atliekamą darbą ir jo organizacinius aspektus pokyčius vykstant PSP reformai. 4. Išanalizuoti pacientų požiūrį į savo sveikatą, jos stiprinimą ir šeimos gydytojo vaidmenį kontroliuojant LNL rizikos veiksnius. / In Lithuania PHC reform has been carried out for nearly twenty years. It is very important to assess its benefits and shortcomings, and to acknowledge emerging problems. Research was conducted in 1994 and 2004. Researchers compared positive and negative changes and differences in family physicians’ practices in relation to physicians training (retrained pediatricians, internists and residency trained family physicians), type of PHCC (private or public), urbanization (region center, town, small town or village) and provided services. They evaluated access to services and revealed problems in family physicians’ work. The need for additional research emerged in order to further explore the results and to answer newly posed questions. For that reason new survey was conducted in 2010 with the purpose to assess further changes in family physicians practice over last 15 years of health care reform. It was changed and developed according to shortcomings of previous research and newly emerged questions. The objectives of this research were: 1. To identify and compare the changes in family physicians’ workload and services during fifteen years of primary health care reform. 2. To assess the use of the procedures named in family physicians’ norm in practice. 3. To investigate the changes of family physicians’ opinion about their work and its organizational aspects during PHC reform. 4. To analyze the patients’ attitude towards their health, its strengthening and family physicians’ role... [to full text]

Material and methods Characteristics of study population The entire adult population (patients 16 years or older) of two PHC doctors practices in Kaunas were invited to participate in study. Approval from the Kaunas University of Medicine Ethics Committee was obtained and participants signed a written informed consent prior to examination. Patients from one practice were intervention community, patients from another practice - control community. In intervention community 1219 patients 16 years or older participated in first survey (506 men and 713 women, response rate 87.1%), in control community – 1068 patients (439 men and 629 women, response rate 87.1%). Intervention, oriented to improve control of risk factors of NCD, was integrated into the PHC team daily practice during one year in intervention community. Control community was receiving usual PHC. After one year (in 2000) all participants of first survey were invited to participate in second survey. Each survey followed the same methods. In intervention community 1069 patients (506 men and 713 women, response rate 87.7%) participated in second survey, in control community - 940 patients (439 men and 629 women, response rate 88.0%). There was no difference between communities concerning age and sex distribution of participants (table 2.1.1). Table 2.1.1 Distribution of respondents by age and sex in intervention and control communities Age,years Intervention community Control community Men women total men women... [to full text]