Background: Several selected population-based studies have emphasized the significance of resting heart rate as an independent cardiovascular risk factor. However, there are no data available for using resting heart rate as a cardiovascular risk predictor in contemporary primary care. Thus, the aim of our analysis was to examine the clinical value of the measurement of resting heart rate in a large, unselected population-based cohort of primary care subjects under the conditions of contemporary primary prevention. Design: Prospective, population-based cohort study. Methods: We examined a subgroup of 5320 unselected primary care subjects free of coronary artery disease from the nationwide, longitudinal Diabetes Cardiovascular Risk Evaluation Targets and Essential Data for Commitment of Treatment (DETECT) cohort study, which was conducted from 2003 to 2008. Results: During the follow-up time of 5 years, 258 events were reported. Elevated resting heart rate was not associated with an increased risk for cardiovascular events (HR = 0.75, p = 0.394), cardiovascular mortality (HR = 0.71, p = 0.616) or major cardiovascular events (HR = 0.77, p = 0.376). By cross-sectional analysis, elevated heart rate clustered with markers of the metabolic syndrome, like increased blood pressure (systolic: OR = 5.54, p < 0.0001; diastolic: OR = 3.82, p < 0.0001), elevated fasting plasma glucose levels (OR = 8.84, p < 0.0001), hypertriglyceridaemia (OR = 22.16, p = 0.001), and obesity (body mass index OR = 0.89, p < 0.0001). Assessment of resting heart rate in clinical practice had minimal and non-significant additional prognostic value compared to established cardiovascular risk factors as judged by C statistics (C = 0.001, p = 0.979). Conclusion: The measurement of resting heart rate in the daily routine of primary care does not provide incremental prognostic information for cardiovascular risk stratification.

No description available.

Background Sweden has experienced a unique epidemic of celiac disease (CD) in children younger than 2 years of age. The epidemic was partly explained by changes over time in infant feeding and indicated a multifactorial aetiology. In CD, a strict lifelong gluten-free diet (GFD) is crucial for health but noncompliance is often reported among adolescents. Knowledge is limited regarding their own perspectives and experiences of managing the disease and adhering to GFD. Objectives To analyse the incidence of CD in epidemic and post epidemic birth cohorts, and explore and understand how adolescents with CD perceive and manage their everyday lives in relation to the GFD. Methods A population-based incidence register of CD in children covering the entire nation from 1998 to 2003, and part of the country back to 1973. ESPGHAN diagnostic criteria for CD and NUTS classification of regions were used. Incidence rates for each year of diagnosis, age group, gender and region, and cumulative incidence by age for each birth cohort were calculated. Ten focus groups were conducted with 47 CD adolescents aged 15-18 years. Transcribed interviews were analysed to illustrate and explain adolescents’ own perspectives concerning life with a GFD, and to search for recurrent stigma-related themes across the groups. Results A considerable gap in the cumulative incidence of CD at comparable ages was demonstrated between birth cohorts of the epidemic and post-epidemic periods. The gap persisted during pre-school years, although it decreased somewhat with age. During the final years of follow-up there was again a gradual increase in incidence rate among children younger than 2 years of age. The childhood populations in ‘West Sweden’ and ‘Småland and the islands’ had a significantly higher incidence rate compared to ‘North Middle Sweden’ and ‘Stockholm’. CD adolescents described an awareness of being different from others produced by meal appearance and the poor availability of gluten-free (GF) food. Eating in public had the effect of making an invisible condition visible and thereby creating a context for felt or enacted stigma. Maintaining invisibility avoided the negative consequences of stigma. The probability of compliance with the GFD was compromised by insufficient knowledge of significant others, problems with the availability and sensory acceptance of GF food, insufficient social support and their perceived dietary deviance. Three different approaches to the GFD emerged: compliers, occasional non-compliers, and non-compliers. Conclusions The difference in CD risk between birth cohorts at comparable ages may suggest an opportunity for primary prevention. Based on post-epidemic incidence trends, the Swedish epidemic might not have been as unique as previously thought, even though its magnitude was striking. The regional variation in CD risk supports multifactorial aetiology. Continued efforts are warranted to define factors besides gluten exposure that modulate CD risk. CD adolescents experience various dilemmas related to the GFD. It can produce stigma experiences in adolescence, and dietary compliance (or lack of) can be understood in terms of dealing with GFD concealment and disclosure. The increase in CD prevalence over time and unmet needs in young celiacs require resources to attain adequate levels of dietetic provision, regulated subsidies for covering additional costs for GF food, evidence-based practice, and increased general CD awareness for optimum clinical outcomes.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Graduation theses will research the actual attitudes towards problems of drugs, drug dependences and the antidrug preventive programs at schools of teachers {--} the school metodist of primary prevention and teachers of whom the primary prevention is not special part of their work.

Sex is a natural means of reproduction, but by far it is not practised solely for that purpose. In recent years there has been a large release of morality and today we would hardly find a young person with a belief that sex serves for reproduction only. Sexual life is no longer taboo and therefore it is necessary to speak also about the adverse phenomena that accompany it. There is unwanted pregnancy and the spread of sexually transmitted diseases. Sexually transmitted diseases present a serious global problem that does not fudge even our society. Young people represent the largest risk group in terms of infection who go through various relationsship selecting a permanent partner. The primary prevention is the most important way how to fight against sexually transmitted diseases, and it is important particularly for those who have not begun yet to live sexually. For this reason it is often implemented in the form of prevention programs in school facilities. The current situation of sexually transmitted diseases in the Czech Republic was charted in the theoretical part of this work. The goal of the practical part of this work was to obtain an overview of the effectiveness of prevention programs in the primary prevention of sexually transmitted diseases among students of Health and Social Studies University of South Bohemia. There were defined four hypotheses for this purpose. The first hypothesis: Young people get more information about the dangers of sexually transmitted diseases from the media and from their peers than from schools and parents. The second hypothesis: Experience with random sex has a quarter of respondents. The third hypothesis was formulated as follows: Women have more knowledge about sexually transmitted diseases than men. The fourth hypothesis: Women observe the principles of safe sex more than men. The quantitative research, questioning method and questionnaire technique were used to collect empirical data. The questionnaire was anonymous and had electronic form. The research sample consisted of full-time bachelor programs students of Health and Social Studies University of South Bohemia, who belong by their age structure into the most vulnerable group of infection of sexually transmitted diseases. Respondents. The research was attended by 531 respondents. The first, third and fourth hypothesis were not confirmed on the based of a statistical test. The third hypothesis was confirmed statistically. The descriptive statistics shows that young adults do not have sufficient knowledge about sexually transmitted diseases and have no fear of the disease, which is also reflected in their behavior. The prevention programs for primary prevention of sexually transmitted diseases in the Czech Republic are not quite sufficient, according to the achieved results and in my opinion, and we can not talk about their proven effectiveness. It can be said they provide at least some awareness of the risks associated with sexual intercourse. In my opinion, it is necessary to establish the precise form of the curriculum and to incorporate sex education into the framework of the educational plan as a separate subject in school facilities as basic and secondary. It is necessary to involve parents into the process of primary prevention by increasing their awareness and to pass the acquired information. It is also necessary to promote a form of barrier contraception and introduce general preventive programs in the fight against sexually transmitted diseases.

Approaches to nourishment and eating habits are formed from early childhood under the influence of family lifestyle, gradually together with the influence of school and society where a child grows. Healthy lifestyle should systematically address all children during the whole school attendance, adequately to their age and needs. Comprehensive link between theoretical and practical influencing of pupils in subjects Human and Health and Education to Health with the possibility of link to school canteen. Then we will be on the good way to cooperation of all the involved parents, healthcare staff, teachers and school canteens leading to the common goal, which is GOOD HEALTH. The aim of the thesis was to assess the role of a children nurse in school environment, namely in school catering. The research tried to analyse catering standards for pupils of primary schools and to find the experience and satisfaction with school catering among parents and to map approaches of children of lower and higher level of primary school to school canteen meals. Quantitative and qualitative research was applied to the thesis. Data collection was performed by means of questionnaires for parents and children from the 3rd to 9th grades and focus group among children of the 1st and 2nd grades of primary school in Jindřichův Hradec. The questionnaires were processed and statistically evaluated by SPSS programme. We applied Parkinson's chi-squared test, a paired sample t-test for graph and table outputs. The focus group was performed in classrooms and in the canteen during break and during lunch at presence of a teacher and the vice headmistress. The research sample consisted of parents of children attending primary school in Jindřichův Hradec and pupils of the 1st to 9th classes of the same school. School catering, which is a frequent topic among professionals as well as the wide public in the whole Czech Republic and the results of our research are obviously an exception. Analysis of catering standards has shown that parents can only partially participate in preparation of menus, as they partially participate in financing of school lunches. From observation of 1st and 2nd class children we have found that children of this age are affected by the social environment they are in during the day. We have found that nearly all the children are satisfied with their meals. Pupils of 3rd to 9th classes formed another group. They commented and assessed canteen meals, where our sample differed from the other researches within the whole Republic. Satisfaction with canteen meals did not substantially differ with age as we expected. The research into satisfaction with school meals among parents has shown that parents of elementary school children are more satisfied that those of the higher level children, so the satisfaction among parents differs between the lower and higher primary levels. The research points out the connection of educational and healthcare systems, that there would be a place for a children nurse in this community, who operated in the school healthcare service before privatization of primary healthcare and still successfully operates there in many countries. It is necessary for community nurses to implement, lead and coordinate the care and for their care to be perceived as legitimate and essential in all spheres. The research results were requested by the vice headmistress of the school in Jindřichův Hradec in advance for possible correction of school catering and they might be also presented at seminars or conferences focused on nutrition and healthy lifestyle of children.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A abordagem de temáticas como o fenômeno das drogas nas escolas auxilia no processo interativo entre professores, alunos, diretores, familiares e comunidade, numa dinâmica onde todos se mobilizam para o desenvolvimento integral dos indivíduos, numa perspectiva de que o ensino começa na escola e continua na vida em sociedade. Tem-se como objeto: a reconstrução sócio-imaginária do consumo de álcool para docentes do ensino fundamental e sua influência na implementação de práticas pedagógicas junto aos alunos. E como objetivos: 1) Identificar as estratégias pedagógicas desenvolvidas pelos professores do ensino fundamental na abordagem sobre o álcool junto aos adolescentes; 2) Analisar as atitudes, crenças, valores e práticas dos professores do ensino fundamental em relação ao álcool; 3) Discutir as repercussões das atitudes, crenças, valores e práticas dos professores sobre álcool na interlocução com os alunos e na implementação das estratégias supra-referidas. Trata-se de estudo descritivo com abordagem qualitativa. O cenário foi uma escola municipal do Rio de Janeiro. Os sujeitos foram 26 professores, que responderam a um formulário de identificação e um roteiro de entrevista semi-estruturada. Os dados de identificação foram analisados estatisticamente, por meio de quadros e tabelas e o depoimento através da análise de conteúdo temática. Os resultados apontam para uma equipe docente do sexo feminino, com mais de 40 anos de idade, que trabalham em mais de um turno de trabalho e que diz fazer uso social de bebidas alcoólicas. Da análise de conteúdo emergiram 5 categorias: A incorporação dos Parâmetros Curriculares e as estratégias pedagógicas utilizadas pelos docentes; Sentimentos e vivências dos docentes frente ao álcool e ao alcoolista; Abordagens sobre álcool pelos docentes e as estratégias pedagógicas desenvolvidas em sala de aula; Concepção dos docentes sobre álcool; Comportamento e interação dos alunos sobre álcool na visão dos professores. A síntese da discussão aponta para a reconstrução social e imaginária acerca do álcool; as atitudes positivas, negativas ou neutras frente ao álcool; e a prática pessoal e docente sobre o consumo de álcool. Conclui-se que há carência de formação e capacitação do corpo técnico-pedagógico da escola para abordar questões sobre o álcool, fazendo-se necessário criar programas preventivos e educativos sobre drogas para atender as atuais demandas da realidade vivenciada pelos alunos. Portanto, é essencial a participação do enfermeiro nesse processo de transformação da escola, da capacitação dos profissionais e de execução de ações de promoção da saúde e de prevenção dos riscos para o uso de álcool por adolescentes. / The thematic approach to the phenomenon of drugs in schools helps in the interactive process between teachers, students, directors, family and community in a dynamic process where everyone is mobilized to the integral development of individuals, in a view that education starts at school and continues in society. This research aims: the social imaginary reconstruction of alcohol consumption for elementary school teachers and their influence on the implementation of educational practices with students, and the objectives: 1) Identify the teaching strategies developed by elementary school teachers in the approach to alcohol with teens, 2) Analyzing the attitudes, beliefs, values and practices of elementary school teachers in relation to alcohol, 3) Discuss the impact of attitudes, beliefs, values and practices of teachers on alcohol in the interaction with the students and the implementation of the strategies mentioned above. This is a descriptive study with a qualitative approach. The setting was a public school in Rio de Janeiro. The subjects were 26 teachers who answered to a form of identification and a roadmap semi-structured. The identification data were statistically analyzed by the meaning of charts, tables and the testimony by thematic content analysis. The results point to a teaching staff were female, with more than 40 years of age who work in more than one school and usually drink socially. Content analysis emerged 5 categories: The incorporation of Curricular and Pedagogical strategies used by teachers; Feelings and experiences of teachers towards alcohol and alcoholics; Approaches to alcohol by teachers and teaching strategies developed in the classroom; The conception of teachers on alcohol; The behavior and interaction of students about alcohol in the view of teachers. The synthesis of the discussion points to the social imaginary reconstruction about alcohol; positive, negative, or neutral attitudes towards alcohol; the personal and teaching practices of alcohol consumption. The conclusion is that there is a lack of training and qualification of the team-teaching method to address questions about alcohol, making it necessary to create programs and education prevents about drugs to meet the current demands of the reality experienced by the students. Therefore, it is essential the participation of nurses in the process of transforming the school, the training of professionals and implementation of actions for health promotion and risk prevention for alcohol use by adolescents.

This diploma thesis deals with nutrition as the primary prevention for seniors and the influence of way of housing on their eating behavior. With regard to ways of living, they are seniors living in their own household together with a partner, and seniors who live on their own. The aims that are set for this thesis are: mapping eating habits in observed seniros; finding how aware seniors are of nutrition including nutrition recommendations and finding what influence living with a partner or independent living has on eating behavior in observed seniors. To reach the aims a qualitative research method was used. Data colletion was done via semistructured interviews with healthy seniors living in the town of Kaplice. The obtained data was subsequently coded and categorized. I consider the finding of insufficient consumption of fruit, vegetables, milk including dairy products, and an unnecessary intake of candies and sweetened beverages in seniors to be a significant finding. Seniors usually get correct information about nutrition including nutrition recommendations, however, there are certain shortcomings in information about the recommended amounts of fruit and vegetable consumption or foods containing Vitamin D. In connection to the housing issues, a significant influence of independent living on seniors´ tendency to ignore themselves. With regard to the observed shortcomings in both nutrition as well as respondents´ awareness I would recommend an increase in senior education. An information leaflet, which I created and which is also a part of the appendix of this thesis, may serve as a tool.

Made available in DSpace on 2014-06-11T19:25:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-12-09Bitstream added on 2014-06-13T20:32:37Z : No. of bitstreams: 1 freitas_fl_me_mar.pdf: 707800 bytes, checksum: e0dd7ed9cb2d8ae5f16f653e1ef879f0 (MD5) / O tabagismo define-se como uma doença epidêmica, pediátrica, crônica e contagiosa, relacionando-se a uma das maiores causas mundiais de morbi-mortalidade. O contexto escolar apresenta-se como principal local para o desenvolvimento de medidas preventivas de caráter primário, tendo como alvo a população pré-adolescente. O treino de habilidades sociais pertinentes à exposição tabágica, bem como o uso da instrução verbal na aquisição de conhecimentos relativos aos malefícios do cigarro parecem indicar fatores de proteção à iniciação ao tabagismo. Esta dissertação caracteriza pré-adolescentes da 5ª série de duas escolas públicas e seus familiares quanto aos conhecimentos prévios sobre tabagismo, perfil sócio-econômico e história tabagística, e avalia, por meio de delineamento de pesquisa quase-experimental, a eficiência de uma intervenção educativa de prevenção primária ao tabagismo nas escolas participantes, sendo uma caracterizada como grupo Experimental (n=27) e a outra, grupo Controle (n=34). Foram realizadas avaliações com os pré-adolescentes distribuídos por sexo, antes e após a intervenção por meio de um Instrumento de Avaliação de Conhecimento e pela medida de auto-relato do Inventário Multimídia de Habilidades Sociais para Crianças (IMHSC-Del-Prette). A intervenção educativa constituiu-se de 8 sessões, com duas horas de duração cada, às quais ocorreram com freqüência de duas vezes por semana. As sessões foram intercaladas quanto ao conteúdo abordado, sendo as sessões ímpares de caráter informativo (utilização da técnica da instrução verbal) e, as pares, de caráter vivencial (realização do treino de desempenhos sociais adequados para lidar com exposição tabágica). Os resultados obtidos indicam diferença estatisticamente significativa entre os grupos Controle e Experimental nas fases... / Smoking is defined as an epidemic, pediatric, chronic and contagious disease, relating to one of the major worldwide causes of morbi-mortality. The school context is presented as the main place for the development of preventive measures that are primary, targeting the preadolescent population. The social skills training relevant to tobacco exposure and the use of verbal instruction in the acquisition of knowledge concerning the harm caused by cigarette seem to prevent smoking initiation. This dissertation characterize preadolescents in the 5th grade of two public schools and their families as to previous knowledge about smoking, social-economic profile and smoking history, and evaluates, through design of quasi-experimental research, the efficiency of an educational intervention for primary prevention of smoking among the participating schools, being characterized as Experimental group (n = 27) and the other, Control group (n = 34). Evaluations were conducted with preadolescents distributed by sex, before and after an intervention through a Knowledge Assessment Instrument and through the self-report measure of Multimedia Social Skills Inventory for Children (MUSSIC – Del-Prette). The educational intervention consisted of 8 sessions, with the duration of two hours each, which occurred twice a week. The sessions were interspersed according to the discussed subject, the odd sessions had an informative character (using the verbal instruction technique) and, the even ones, living character (realization of social performance training appropriate to dealing with smoking exposure). The results show a statistically significant difference between the Experimental and Control groups in pre and pos-intervention stages of the Knowledge Assessment measures, but did not show significant difference between these groups in the self-report of social behavior frequency of MUSSIC in the different studied... (Complete abstract click electronic access below)