Background: Primary care may be a key setting for suicide prevention as many patients visit their General Practitioner (GP) in the weeks leading up to their death. Comparatively little is known about GPs’ perspectives on risk assessment, treatment adherence, management of and interactions with suicidal patients prior to the patient’s suicide and the services available in primary care for suicide prevention. Aim: This study aimed to explore primary care data on a clinical sample of individuals who died by suicide and were in recent contact with mental health services in order to: investigate the frequency and nature of general practice consultations; examine risk assessment, treatment adherence and management in primary and secondary care; gain GPs’ views on patient non-adherence to treatment and service availability for the management of suicidal patients. Method: A mixed-methods study design including data from the National Confidential Inquiry on 336 patients who died by suicide, data from 286 patient coroner files, primary care medical notes on 291 patients and 198 semi-structured face–to-face interviews with GPs across the North West of England. We collected data on GPs' views on the treatment and management of patients in the year prior to suicide, suicide prevention generally and local mental health service provision. Quantitative data were analysed using SPSS. Interviews were transcribed verbatim and analysed using a thematic approach. Results: Overall, 91% of individuals consulted their GP on at least one occasion in the year before suicide. GPs reported concerns about their patient’s safety in 27% of cases, but only 16% of them thought that the suicide could have been prevented. The overall agreement in the rating of risk between primary and specialist care was poor (overall kappa = 0.127; p = 0.10). Non-adherence was reported for 43% of patients. The main reasons for non-adherence were lack of insight, reported side effects and multiple psychiatric diagnoses. We obtained qualitative data from GPs on their interpretations of suicide attempts or self-harm, professional isolation and GP responsibilities when managing suicidal patients. Limitations: Our findings may not be generalisable to people who died by suicide and were not under the care of specialist services. GPs recruited for the study may have had different views from GPs who have never experienced a patient suicide. Our findings may not be representative of the rest of the UK although many of the issues identified are likely to apply across services. Conclusion: Suicide prevention in primary care is challenging. Possible strategies for future suicide prevention in general practice include: increasing GP awareness of suicide-related issues and improving training and risk assessment skills; increasing awareness in primary care about why patients may not want treatments offered by focusing on each individual’s situational context; removing barriers to accessing therapies and treatments; and, better liaison and collaboration between services to improve patient outcomes.

This theses focuses on how the criminology prevention in the frame of primary school curriculum in Czech republic is organized and what importance do the primary school teachers in Prague attache to it. In the practical part, the theses addresses criminology knowledge, with special focus on bullying at school, Labour and Social Welfare Departement's stratégy on criminology prevention, it's implementation in school subject such as Citizenship Education and Human and it's World (throught comparative analyses of textbooks content), and criminology prevention in workshops of Policy and providers of primary prevention programs (throught comparative analyses of program contents). It also samples some uccessfull criminology prevention programs abroad. In theoretical part, the theses focuses on evaluation qvantitative datas of an exploring coil, which investigated what importance do the primary school teachers in Prague attache to criminology prevention in primary school curicullum and how they evaluate it's organization. As conclusion , some recommendations are mentioned for criminology prevention enhancement within primary school curriculum framework and proposals for further research within issue.

OBJETIVO: Avaliar o efeito de sessões educativas no peso, modelo e modo de transportar mochila escolar. MÉTODO: Estudo com 99 crianças, de 7 a 11 anos cursando ensino fundamental em escola particular de São Paulo. Na avaliação foi medido peso do sujeito (kg) e da mochila (kg), tipo e modo de transporte por filmagem pré e pós intervenção. Como medida de intervenção, os sujeitos foram submetidos à sessão educativa que consistiu em orientações sobre coluna vertebral e vivência prática de posturas corretas. Pais e professores também foram orientados. Os sujeitos receberam reforço por 3 meses. RESULTADOS: Os dados foram analisados utilizando testes estatísticos de Igualdade de duas proporções e Wilcoxon, o nível de significância adotado foi de 0,05 (5%). O tipo de mochila modificou para modelo duas alças (p=0,046), modo de transporte para ombro bilateral (p=0,047). O peso absoluto das mochilas diminuiu 2,66kg (p<0,001) e o peso relativo diminuiu 7% (p<0,001). Na adequação por categoria, o número de sujeitos do grupo adequado e aceitável aumentou, e houve redução do inadequado (p<0,001). CONCLUSÃO: As sessões educativas modificaram peso, tipo e modo de transporte das mochilas entre os escolares. / OBJECTIVE: Evaluate the effect of educational sessions in weight, model and mode of school backpack transport. METHOD: Study of a series of cases with 99 children from seven to ten years of age in a private elementary school in São Paulo. Measured in the evaluation was the weight of the subject (Kg) and backpack (Kg) and type and mode of transport for filming pre and post intervention. They were submitted to an educational session that consisted of orientations on spine and practical use of correct posture; parents and teachers were also guided. The subjects received reinforcement for 3 months. To analyze the final data, it was used two-proportion equality statistic tests and Wilcoxon. The significance level used on the tests was 0,05 (5%). RESULTS: Backpack type modified for model two straps (p = 0.046), mode of transport for bilateral shoulder (p = 0.047). Absolute weight of the backpacks diminished 2.66Kg (p <0.001) and relative weight diminished 7% (p <0.001). In adaptation per category, the number of subjects of the appropriate and acceptable groups increased while having a reduction in the inadequate group (p <0,001). CONCLUSION: Educational sessions modified weight, type and mode of transport of the backpacks among the schoolchildren.

The following final thesis "Risky behaviour of lower and upper secondary school students on social networks and its prevention" introduces the topic of primary prevention of cyberbullying and security on social networks with regards to their current use by lower and upper secondary school students. Another aim of the thesis is to ascertain which forms of risky social behaviour the target groups currently encounter on social networks and to find out the ways in which these social networks are used (the most commonly used applications, the frequency of their use etc.). The thesis doesn't focus solely on social networks, it also addresses the subject matter of critical thinking since one of the problematic aspects of using social networks by young people is the fact that they use multiple sources of information without further verification. Following the results of the research, short-term activities of primary prevention for both target groups are proposed. They aim to encourage the development of critical thinking and media studies. The proposed activities can be further incorporated into long-term prevention programmes. They include recommendations for teacher lesson planning and self-study tips. The content of the activities is based on the study of both theoretical and methodological...

The Diploma thesis is focused on experience with the realization of the prevention on primary schools. The aim of my thesis was to find out, if the schools engage in prevention activity and how the realization and efficacy looks like. The thesis consists of two parts. The first part is theoretical and the second is research. In the first chapter of the theoretical part I dealt with risk behaviour, I briefly described its particular forms. In the second chapter of the theoretical part I focused on the content of the word prevention, primary prevention in curricular documents and scholar primary prevention. In the second section of the thesis, which is the practical part, I have collected information and opinions of different subjects on realization preventive programs at school. I compared the results of the research of two grammar schools. The first type of the collection of data was questionnaire research qualitative research. The date we have gained provided us the information about the opinions of the efficacy of preventive programs from the point of view of the pupils. The second type of collected data was an interview with the Methodist of the prevention. This information show us a different point of view on risk behaviour, its prevention and efficacy of the realization primary prevention activity.

Made available in DSpace on 2014-12-17T15:16:17Z (GMT). No. of bitstreams: 1 HeloisaMJSB_DISSERT.pdf: 1667099 bytes, checksum: 389f0ddd379405a8f7a32916a7240c60 (MD5) Previous issue date: 2012-12-21 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult / Introdu??o: Quedas entre idosos ? um problema de sa?de p?blica, por isso faz-se necess?rio a??es preventivas, no entanto a ades?o ? o maior problema enfrentado por pesquisadores e profissionais de sa?de que trabalham com programas de preven??o de quedas. Objetivo: Averiguar as vari?veis relacionadas ao processo de ades?o a um programa de preven??o de quedas em idosos cadastrados em uma Unidade B?sica de Sa?de (UBS). M?todos: Foi realizado um estudo observacional anal?tico de corte transversal. Todos os idosos cadastrados em uma UBS e com capacidade de deambula??o independente foram convidados a participar de um programa de preven??o de quedas. Os Idosos que Aderiram ao Programa (IAP) foram avaliados na UBS; j? os Idosos que N?o Aderiram ao Programa (INAP) foram identificados e avaliados em domic?lio. A avalia??o para ambos os grupos foi realizada por meio de uma ficha de avalia??o contendo dados pessoais e cl?nicos, escalas e medidas para avaliar o estado cognitivo, equil?brio, mobilidade, medo de cair, for?a de preens?o manual. Os dados foram analisados no software SPSS 20.0. Al?m desta avalia??o, os INAP foram submetidos a uma entrevista semiestruturada, na qual foi utilizada a abordagem qualitativa embasada na figura do Discurso do Sujeito Coletivo. Resultados: Participaram deste estudo 222 idosos, 111 IAP e 111 INAP, maioria com idade entre 70 e 79 anos (48,2%), do g?nero feminino (68,5%), casados (52,3%) e n?o alfabetizados (47,7%). Consolidaram-se como fatores de prote??o ? ades?o, piores ?ndices de pr?tica de atividade f?sica (p=0,001), equil?brio (p=0,010) e cogni??o (p=0,007). A entrevista dos INAP identificou dois temas: Local para execu??o de programas de preven??o de quedas e Rela??o entre a UBS e o cuidado em sa?de do idoso , que verificaram que os idosos n?o aderiram por impossibilidade de ir ao local de interven??o; e n?o mencionaram que programas de aten??o prim?ria est?o relacionados ao cuidado em sa?de do idoso. Conclus?es: Os idosos que n?o aderiram ao programa diferem dos idosos que aderiram quanto a piores ?ndices de cogni??o, equil?brio e pr?tica de atividade f?sica, o que pressup?e maior risco de queda; e estiveram impossibilitados de participar do programa de preven??o de quedas por ser cuidador e apresentar dificuldade de deslocamento

The Czech Republic is numer one in the mortality and morbidity due to cardio-vascular diseases. It is evidence that the incidence of cardio-vascular dieseases can be influenced positively by primary prevention as to the lifestyle of the population and that the secondary prevention can improve the lifequality of patiens, diminish thein mortality and morbidity and reduce the numer of recurrences and complications. The degree work on the subjekt {\clqq}Change in the lifestyle of men after an acute myocardial infarct`` is in its general part concentrated on risk factors connected with cardio-vascular diseases, on a self-contained system of rehabilitation, on prevention (primary, secondary, tertiary) and on the welfare system in the Czech Republic. The risk factors connected with cardio-vascular diseases can be dividend into influenceable ones (nutrition, smoking, lack of physical exercise, alkohol consumption, hypertension, dyslipoproteineme, diabetes mellitus, obesity), into uncontrollable ones, (age, sex, genetic factors) and into behavioural ones, among which count psychosocial and economic factors. The mail aim of the work was to establish the extent as to the occurrence of risk factors in relation to men, who underwent an acute myocardial infarct and to determine the posibility of involving them in an active change in the lifestyle. The research proceeded in the form of questionnaires distributed at cardiological out-patients` departments in the region of Příbram.The data collection was under way from November 2009 to February 2010. The research was quantitative, the questionnaire was anonymous, in printed form, contained 29 questions and the respondents answered in writing. One thousand questionnaire were distributed, where of 231 fully completed questionnaires came back. The return rate of questionnaires were destined only for men, who underwent an acute myocardial infarct (two fundamentals identifications marks). I arrived to two hypotheses. The first was that the education of population played an important role in occurrence of cardio-vascular diseases and in awareness of influence of the lifestyle on reducing the risks connected with the development of these diseases. The second hypothesis was that the secondary prevention of risk factors connected with cardio-vascular diseases was not effetively and regorously applied to men, who underwent myocardial infarct. Both hypothese of mine proved to be right. The doctors and the learned public are doubtless well informed of the prevention and therapy as to the cardio-vascular diseases. The question is how effectively the professional information and recommendations find their way into the subconsciousness of our population. The research results show that an imaginary gap arises between recommended advices relating to the change in the lifestyle and in the positive influencing of influenceable and behaviour risk factors, the doctors give in thein routine practice. It is neccessary to create programmes of intervention in the lifestyle within the scope of a self-contained rehabilitation system. This system is applied on the occasion of spa care in the Czech Republic. The effect of the spa care is shortterm, lasts half a year to one year and there is no direkt further contact of the patient with dietary centres and with specialized physiotherapists. The recommendations concerning the change in the lifestyle should be popularized in the society as a whole in order to find their way into the wide subconsciousness of our population.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / As doenÃas sexualmente transmissÃveis (DST) sÃo consideradas risco ocupacional para as prostitutas, podendo ser prevenidas com o uso do preservativo. Faz-se necessÃria uma conscientizaÃÃo acerca da sua importÃncia mediante a EducaÃÃo em SaÃde, pois esta à a estratÃgia mais eficiente na prevenÃÃo das DST/Aids, trazendo mudanÃa de comportamentos, valores e atitudes. Diante de toda a problemÃtica que à a prostituiÃÃo e sua relaÃÃo com as DST, interessou compreender o trabalho realizado pelas prostitutas da AssociaÃÃo das Prostitutas do Cearà - APROCE no que se refere à prevenÃÃo das DST/Aids. Nesse contexto, este estudo objetivou analisar o trabalho educativo realizado pelas prostitutas da APROCE no que se refere à prevenÃÃo das DST e Aids, e verificar se essa EducaÃÃo em SaÃde estimula a reflexÃo, criticidade, mudanÃa de comportamento, ou à somente um repasse de informaÃÃes. Dessa forma, despertou-se para a relaÃÃo do objeto de estudo com a abordagem teÃrica baseada nas reflexÃes de Paulo Freire, pois âmudanÃaâ, ao lado de âconscientizaÃÃoâ, à um âtema geradorâ da prÃtica teÃrica de Paulo Freire. Trata-se de uma pesquisa qualitativa, inspirada na teoria e prÃtica de Paulo Freire e analisada segundo a Teoria CrÃtica. Os dados foram agrupados de acordo com as etapas em que foram coletados: Observando as Educadoras Sociais e Dialogando com as Educadoras Sociais. Posteriormente, dividida a segunda parte em duas categorias: o perfil e o diÃlogo com as educadoras sociais. No diÃlogo com as educadoras sociais, foram identificados seus sentimentos quanto ao trabalho realizado; as principais dificuldades; os pontos facilitadores; como percebem seus resultados; os pontos mais e menos importantes do trabalho que realizam. Conclui-se, portanto, que conscientizar-se da importÃncia da prevenÃÃo das DST e Aids, e mudar de comportamento, nÃo sÃo tarefas simples, pois vÃrios fatores interferem na vida da prostituta. As estratÃgias de EducaÃÃo em SaÃde utilizadas pela AssociaÃÃo nÃo estimulam a reflexÃo, criticidade, mudanÃa de comportamento, como se deseja e espera, mas jà deu um grande passo, pois repassa informaÃÃes e entrega freqÃentemente o preservativo para as prostitutas, e, como essa à uma aÃÃo que acontece hà alguns anos, muitas mulheres jà mudaram de comportamento. Devem ser realizados projetos, estratÃgias mais eficazes, para que conscientizaÃÃo e mudanÃa aconteÃam em um menor espaÃo de tempo. Para obtenÃÃo desse fim, foram elaboradas estratÃgias metodolÃgicas de EducaÃÃo em SaÃde na prevenÃÃo das DST/Aids para prostitutas / Sexually Transmitted Diseases (STD) are considered an occupational risk for prostitutes, and they can be prevented with the use of condom. A conscientization about its importance through health education is necessary, as it is the most efficient strategy in STD/Aids prevention, what will bring changes in behavior, values and attitudes. In face of all this problematic situation of prostitution and its relation with STD, we got interested in understanding the work carried out by the prostitutes from the Association of Prostitutes from Cearà - APROCE concerning STD/Aids prevention. In this context, this study objectified to analyze the educational work carried out by the prostitutes from APROCE concerning STD and Aids prevention, and to verify if this Health Education estimulates reflexion, criticism and behavior change, or if it is only an information provider. This way, we awakened to the relation between the object of study and the theoretical approach based on Paulo Freireâs reflexions, considering that âchangeâ, together with âconscientizationâ, is a âtheme generatorâ of Paulo Freireâs theoretical practice. It is a qualitative research inspired in Paulo Freireâs theory and practice, and analyzed according to the Critical Theory. The data were grouped according to the stages they were collected: Observing Social Educators and Dialoguing with Social Educators. Later, the second part was divided in two categories: the profile and the dialogue with social educators. In the dialogue with social educators their feelings about the work done were identified, as well as the main difficulties; the facilitator points; how they perceive their results; and the most and least important points of their work. Therefore, we can conclude that being aware of the importance of STD and Aids prevention and changing behavior are not easy tasks because many factors interfere in prostitutesâ lives. The Health Education strategies used by the Association are not estimulating reflexion, criticism and behavior change as expected, but it has given a great step, as they provide information and condom to prostitutes. And, as it is an action that has happened for some years, many women have already changed behavior. More efficient strategies and projects must be carried out so that conscientization and change happen in a shorter period of time. For the obtention of this aim, Health Education methodological strategies in STD/Aids prevention for prostitutes were elaborated

OBJETIVO: Avaliar o efeito de sessões educativas no peso, modelo e modo de transportar mochila escolar. MÉTODO: Estudo com 99 crianças, de 7 a 11 anos cursando ensino fundamental em escola particular de São Paulo. Na avaliação foi medido peso do sujeito (kg) e da mochila (kg), tipo e modo de transporte por filmagem pré e pós intervenção. Como medida de intervenção, os sujeitos foram submetidos à sessão educativa que consistiu em orientações sobre coluna vertebral e vivência prática de posturas corretas. Pais e professores também foram orientados. Os sujeitos receberam reforço por 3 meses. RESULTADOS: Os dados foram analisados utilizando testes estatísticos de Igualdade de duas proporções e Wilcoxon, o nível de significância adotado foi de 0,05 (5%). O tipo de mochila modificou para modelo duas alças (p=0,046), modo de transporte para ombro bilateral (p=0,047). O peso absoluto das mochilas diminuiu 2,66kg (p<0,001) e o peso relativo diminuiu 7% (p<0,001). Na adequação por categoria, o número de sujeitos do grupo adequado e aceitável aumentou, e houve redução do inadequado (p<0,001). CONCLUSÃO: As sessões educativas modificaram peso, tipo e modo de transporte das mochilas entre os escolares. / OBJECTIVE: Evaluate the effect of educational sessions in weight, model and mode of school backpack transport. METHOD: Study of a series of cases with 99 children from seven to ten years of age in a private elementary school in São Paulo. Measured in the evaluation was the weight of the subject (Kg) and backpack (Kg) and type and mode of transport for filming pre and post intervention. They were submitted to an educational session that consisted of orientations on spine and practical use of correct posture; parents and teachers were also guided. The subjects received reinforcement for 3 months. To analyze the final data, it was used two-proportion equality statistic tests and Wilcoxon. The significance level used on the tests was 0,05 (5%). RESULTS: Backpack type modified for model two straps (p = 0.046), mode of transport for bilateral shoulder (p = 0.047). Absolute weight of the backpacks diminished 2.66Kg (p <0.001) and relative weight diminished 7% (p <0.001). In adaptation per category, the number of subjects of the appropriate and acceptable groups increased while having a reduction in the inadequate group (p <0,001). CONCLUSION: Educational sessions modified weight, type and mode of transport of the backpacks among the schoolchildren.

Aims: The DETECT study was performed to obtain representative data about the frequency, distribution, and treatment of patients with coronary artery disease (CAD) in the primary care setting in Germany. Methods and results: The DETECT study was a cross–sectional clinical– epidemiological survey of a nationally representative sample of 3795 primary care offices and 55 518 patients. Overall, 12.4% of patients were diagnosed with CAD. Stable angina pectoris and myocardial infarction were the most frequent (4.2%) subgroups, followed by status post (s/p) percutaneous coronary interventions (PCI, 3.0%) and s/p coronary bypass surgery (2.2%). Patients with CAD were prescribed AT1 receptor antagonists (in 19.4% of cases), beta blockers (57.2%), ACE inhibitors (49.9%), antiplatelet agents (52.7%), statins (43.0%), and long–term nitrates (24.5%). When comparing all CAD patients with social health care insurance to those who had private insurance, private patients had significantly higher rates of revascularisation procedures and use of preventive medications. Conclusion: Great potential remains for improving secondary prevention in primary care in Germany to reduce the risk of further coronary or vascular events, especially in patients with social health care insurance.