The diploma thesis deals with health literacy of employees. Health literacy throughout the Czech Republic is very low. The diploma thesis has one goal: To map the health literacy of the employees. I chose three hypotheses in my research. Hypothesis 1: The expected health literacy of the staff of the selected teams is inadequate. Hypothesis 2: Women show higher levels of health literacy than men. Hypothesis 3: The level of health literacy depends on the level of education. The thesis is divided into the theoretical and practical part. The theoretical part defines the concept of health literacy, methods of development of health literacy, health promotion and prevention, including determinants of health and health of the population of the Czech Republic. Part of the work is also devoted to the work environment, risk factors and occupational medical care. The practical part was processed using the quantitative survey method using questionnaires. The data needed for the analysis were obtain from respondents from selected collectives who were informed about the anonymity of the questionnaire survey. The obtained data was processed in MS Excel and SPSS. The results of my work disproved all three hypotheses. Respondents in the research group are health literate, health literacy among the sexes is the same and health literacy is not dependent on the level of education. Work results can serve as a good source of information for the general public or employees and company employers.

The elderly population is among the fastest growing populations in the United States. Finding and consuming medications safely and effectively are challenging endeavors for this population. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a widely consumed class of medications among the elderly population, with 70% of individuals consuming over-the-counter (OTC) NSAIDs once a week and 34% using them daily. The purpose of this quantitative study was to determine whether (a) patients are aware of the risks associated with the consumption of NSAIDs, and (b) there are differences in awareness based upon specific demographic characteristics and levels of patient-physician communication. The health belief model (HBM) was used to interpret the results. The HBM is a social cognition framework that takes into account different perceptions, namely, perceived susceptibility of acquiring a health condition, perceived severity of the condition and its consequences, perceived barriers to engaging in the recommended behavior, perceived benefits of engaging in the recommended behavior, and perceived costs of engaging in the recommended behavior. Multiple linear regression was used to analyze the data. The results, which were based upon a cross-sectional survey of 124 participants, showed that the participants' awareness of adverse events associated with NSAIDs use was not associated with sociodemographic variables, rates of consumption, or patient-physician communication. The findings will give the key stakeholders more insight into the issue of preventable adverse events that might lead to the establishment of more safety programs and informatics structural systems to monitor the consumption of OTC NSAIDs and improve lines of communication to protect the elderly population.

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-01-28T14:55:02Z No. of bitstreams: 1 arquivototal.pdf: 1500764 bytes, checksum: f68db277b1f574de6c241629ac53514d (MD5) / Made available in DSpace on 2016-01-28T14:55:03Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1500764 bytes, checksum: f68db277b1f574de6c241629ac53514d (MD5) Previous issue date: 2015-04-14 / Health Promotion is considered an important strategy for overcoming the development of purely curative and individual actions aimed at health, which are characteristic of the biomedical model. The same proposes the development of care, preventive and promotional health. However, this proposal reflects numerous obstacles, among them stands out the conceptual aspect, which was being shaped over the years from the development of understanding of the concept of health. Based on the scope of health promotion, the School Health Program was created in 2007, the same propose to the articulation of the Family Health Strategy with the school and it is proposed to integrate and link the two sectors with actions that aim to improve the quality of life of students in basic education schools. Thus, the present study was to identify the program inconsistencies from the design of health promotion that it incorporates in confront the understanding that the World Health Organization has about the same which is based on seven principles, which are: holism, intersectionality, empowerment, social participation, equity, multi-strategy actions and sustainability. This is a bibliographic and documentary research. Data collection occurred in the period from January to June 2014. Initially a literature review was conducted through a prior reading of titles and abstracts of articles, dissertations and theses contained in the scientific material to be defined. The collection was conducted with the Scielo databases ; Bireme ; Lilacs ; Medline and Cochrane Library , and the descriptors were used: health promotion; school health ; School Health Program ; Health strategy and school health . 35 articles and eight dissertations were obtained . This step was followed by desk research. As a result was obtained that: can not identify specifically that health promotion is adopted as nuclear center of the program; there is the definition of a concept of health promotion, before there is a mix of concepts that can be seen from the recommended actions; the structural difficulties faced by the FHS compromise its operation; predominates the trend of personal guilt is individual as your reality, is the professional regarding the commitment to the success of the proposed actions; do not see the incorporation of the seven principles defined by the WHO; the preponderance given to the health sector to conduct the proposed actions indicates serious weakness; the actions that stand out are the healing and promotion actions are confused with prevention. Therefore, identifies the importance of commitment to the critical evaluation of the program and the involvement of many other sectors of the political sphere and the active participation of individuals to the development of actions that are consistent with the broader concept of health and can focus the social determinants. / A Promoção da Saúde é considerada uma importante estratégia para a superação do desenvolvimento de ações meramente curativas e individuais direcionadas à saúde, pois propõe o desenvolvimento de ações assistenciais, preventivas e promocionais à saúde. Entretanto, essa proposta reflete inúmeros empecilhos, dentre eles destaca-se o aspecto conceitual, que foi sendo moldado ao longo dos anos a partir da evolução da compreensão acerca do conceito de saúde. Tomando por base o escopo da promoção da saúde, o Programa Saúde na Escola (PSE) foi criado no ano de 2007. O programa operacioanaliza-se a partir da articulação da Estratégia Saúde da Família com a escola. O presente estudo foi realizado com o objetivo de identificar as inconsistências do PSE a partir da concepção de promoção à saúde que incorpora, tendo como contraponto o entendimento que a Organização Mundial da Saúde tem sobre a temática, que se alicerça em sete princípios, quais sejam: concepção holística, intersetorialidade, empoderamento, participação social, eqüidade, ações multi-estratégicas e sustentabilidade. Trata-se de uma pesquisa bibliográfica e documental. A coleta dos dados ocorreu no período compreendido entre janeiro a junho de 2014. Inicialmente foi realizado um levantamento bibliográfico através de uma leitura prévia dos títulos e resumos dos artigos, dissertações e teses constantes no material científico a ser delimitado. A coleta foi realizada junto às bases de dados do Scielo; Bireme; Lilacs; Medline e Biblioteca Cochrane, e foram utilizados os descritores: promoção da saúde; saúde na escola; Programa Saúde na Escola; Estratégia Saúde da Família e saúde escolar. Foram obtidos 35 artigos e 8 dissertações. Esta etapa foi seguida pela pesquisa documental. Nessa etapa foram utilizados os Documentos referentes ao PSE e à Estratégia Saúde da família. Por fim, o tratamento dos conteúdos selecionados se deu a partir da análise dos resultados obtidos, no qual foi realizada a apresentação dos achados da pesquisa tendo em vista os objetivos estabelecidos. Como resultados obteve-se que: não foi possível identificar concretamente que a promoção da saúde seja adotada como centro nuclear do Programa; não há a delimitação de uma concepção de promoção da saúde, antes há uma mescla de concepções que podem ser observadas a partir das ações preconizadas; as dificuldades estruturais enfrentadas pela ESF comprometem seu funcionamento; predomina-se a tendência da culpabilização pessoal seja do indivíduo quanto a sua realidade, seja do profissional referente ao compromisso com o sucesso das ações propostas; não visualiza-se a incorporação dos sete princípios delimitados pela OMS; a preponderância dada ao setor saúde para a condução das ações propostas indica séria fragilidade; as ações que se destacam são as curativas e as ações de promoção são confundidas com as de prevenção. Diante disso, identifica-se a importância do compromisso com a avaliação crítica do programa e do envolvimento de diversos setores, da esfera política e da participação ativa dos indivíduos para o desenvolvimento de ações que sejam condizentes com o conceito ampliado de saúde e que possam incidir sobre determinantes sociais.

Background: Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the ‘Be smart against cancer’ (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. Methods: 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: “What is cancer?,” “Sun protection,” “Non smoking,” and “Physical activity, Healthy nutrition, and Limited alcohol consumption.” Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. Results: BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p < .001), as well as in increasing intentions to engage in health-promoting behavior (p < .001), independent of a student’s risk profile. Knowledge did not serve as a mediator for intention building. Conclusions: The BSAC is an effective school-based program for raising awareness of cancer, associated risk factors and intentions to engage in cancer-preventive behavior. The results indicate that the effectiveness of BSAC is independent of a student’s risk profile. Therefore, it holds considerable promise as a broadly applicable program to raise cancer awareness and promote healthy behavior intentions.

Fatores associados com falhas na cobertura da vacinação contra o sarampo na cidade de São Paulo foram estudados por meio de entrevistas com pais ou responsáveis por 122 crianças de até cinco anos. Observou-se que a população conhece a doença e identifica a vacina com a idéia de proteção, mas não cumpre o calendário de vacinação e atrasa as doses da vacina contra o sarampo. Idade, região de origem ou de residência, status familiar ou nível educacional não mostraram associação com o cumprimento do calendário obrigatório (uma dose da vacina contra o sarampo deve ser aplicada dos 9 aos 11 meses e a segunda, aos 15 meses). A televisão é o meio de comunicação que mais informa os entrevistados sobre as Campanhas Nacionais de Multivacinação e o cartão de vacinação foi identificado como uma das vias de comunicação utilizadas para informar sobre a vacinação fora das Campanhas, na rotina. No entanto, nenhum meio de comunicação identificado no estudo pôde, significativamente, promover a mudança de comportamento da indife rença para o compromisso com o cumprimento do calendário, ou seja, adesão. A única variável significativamente relacionada com o atraso na vacinação, de até 20 dias, foi o sentimento de dó de aplicar injeções nas crianças (p = 0,08). Crianças brasileiras têm de visitar o posto de saúde para receber, até cinco anos de idade, 19 vacinas, 12 até o primeiro ano. O estudo deixa claro que não há adesão ao calendário proposto para vacinação contra o sarampo, apesar de ser esta a proposição das Campanhas Nacionais de Multivacinação e da vacinação de rotina / Risk factors associated with failure to receive measles vaccine were studied in eight districts of São Paulo city, Brazil. Parents or carers of 122 children were interviewed about their perception and understanding about the disease anda about measles vaccination, a kind of knowledge that can be acquired through vaccination communication campaigns or from personal communication (from the doctors, nurses of the health care center or friends). Population description factors were also identified. Results analysis shows that neither age, region of origin or residence, marital status nor educational level were related to taking or not taking measles vaccines adequately. Most of the people remembered about having being informed about the last annual vaccination campaign by television, but no communication channel was significantly associated with vaccination status. Answers to questions about knowing the disease or not or knowing the vaccine or not, when analysed alone, did not show any association with taking measles vaccines at the time indicated by health agencies. However, the results showed that when parents felt pity for their children receiving shots, they delayed the vaccination for at least 20 days. Since families visit the health center at least seven times before children complete five years of age and since most of the children does not take the measles vaccine in the exactly recommended day, but delay or anticipate the shots, it is clear that there is no compliance to the recommended government\'s measles vaccination schedule (first dose at 9 and second at 15 months of age), although this is the message that annual communication campaigns and interpersonal communication try to pass

The thesis provides a comprehensive overview of key issues affecting practice, policy and patients, in current efforts for colorectal cancer (CRC) disease control. The global burden of CRC is expected to increase by 60% to more than 2.2 million new cases and 1.1 million deaths by 2030. CRC incidence and mortality rates vary up to 10-fold worldwide, which is thought to reflect variation in lifestyles, especially diet. Better primary prevention, and more effective early detection, in screening and surveillance, are needed to reduce the number of patients with CRC in future1. The risk factors for CRC development include genetic, behavioural, environmental and socio-economic factors. Changes to surveillance, which offer non-invasive testing and provide primary prevention interventions represent promising opportunities to improve outcomes and personalise care in those at risk of CRC. By systematic review of the literature, I highlight the gaps in comparative effectiveness analyses of post-polypectomy surveillance. Using micro-simulation methods I assess the role of non-invasive, faecal immunochemical testing in surveillance programmes, to optimise post-polypectomy surveillance programmes, and in an accompanying sub-study, I explore the value of adding an adjunct diet and lifestyle intervention. The acceptability of such revisions is exposed to patient preference evaluation by discrete choice experiment methods. These preferences are accompanied by evidence generated from the prospective evaluation of the health literacy, numeracy, sedentary behaviour levels, body mass index (BMI) and information provision about cancer risk factors, to highlight the potential opportunities for personalisation and optimisation of surveillance. Additional analysis examines the optimisation of a screening programme facing colonoscopy constraints, highlighting the attendant potential to reduce costs and save lives within current capacity.

Fatores associados com falhas na cobertura da vacinação contra o sarampo na cidade de São Paulo foram estudados por meio de entrevistas com pais ou responsáveis por 122 crianças de até cinco anos. Observou-se que a população conhece a doença e identifica a vacina com a idéia de proteção, mas não cumpre o calendário de vacinação e atrasa as doses da vacina contra o sarampo. Idade, região de origem ou de residência, status familiar ou nível educacional não mostraram associação com o cumprimento do calendário obrigatório (uma dose da vacina contra o sarampo deve ser aplicada dos 9 aos 11 meses e a segunda, aos 15 meses). A televisão é o meio de comunicação que mais informa os entrevistados sobre as Campanhas Nacionais de Multivacinação e o cartão de vacinação foi identificado como uma das vias de comunicação utilizadas para informar sobre a vacinação fora das Campanhas, na rotina. No entanto, nenhum meio de comunicação identificado no estudo pôde, significativamente, promover a mudança de comportamento da indife rença para o compromisso com o cumprimento do calendário, ou seja, adesão. A única variável significativamente relacionada com o atraso na vacinação, de até 20 dias, foi o sentimento de dó de aplicar injeções nas crianças (p = 0,08). Crianças brasileiras têm de visitar o posto de saúde para receber, até cinco anos de idade, 19 vacinas, 12 até o primeiro ano. O estudo deixa claro que não há adesão ao calendário proposto para vacinação contra o sarampo, apesar de ser esta a proposição das Campanhas Nacionais de Multivacinação e da vacinação de rotina / Risk factors associated with failure to receive measles vaccine were studied in eight districts of São Paulo city, Brazil. Parents or carers of 122 children were interviewed about their perception and understanding about the disease anda about measles vaccination, a kind of knowledge that can be acquired through vaccination communication campaigns or from personal communication (from the doctors, nurses of the health care center or friends). Population description factors were also identified. Results analysis shows that neither age, region of origin or residence, marital status nor educational level were related to taking or not taking measles vaccines adequately. Most of the people remembered about having being informed about the last annual vaccination campaign by television, but no communication channel was significantly associated with vaccination status. Answers to questions about knowing the disease or not or knowing the vaccine or not, when analysed alone, did not show any association with taking measles vaccines at the time indicated by health agencies. However, the results showed that when parents felt pity for their children receiving shots, they delayed the vaccination for at least 20 days. Since families visit the health center at least seven times before children complete five years of age and since most of the children does not take the measles vaccine in the exactly recommended day, but delay or anticipate the shots, it is clear that there is no compliance to the recommended government\'s measles vaccination schedule (first dose at 9 and second at 15 months of age), although this is the message that annual communication campaigns and interpersonal communication try to pass