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Dementia Prevention and the General Practitioners' role: a qualitative interview studyJones, Danielle K., Drewery, Rachael, Windle, Karen, Humphrey, S., Fonseca de Paiva, Andreia 10 July 2023 (has links)
Yes / General Practitioners (GPs) play an increasingly important role in proactively preventing dementia. 40% of dementia cases could be prevented or delayed by targeting 12 modifiable risk factors throughout life. However, little is known about how GPs perceive their role in dementia prevention and associated barriers.
Aims: To explore the role of GPs in dementia prevention.
Design and Setting: A qualitative study among UK GPs.
Method: Semi-structured online interviews with 11 UK GPs exploring their views regarding their role in dementia prevention. Data were analysed using thematic analysis.
Results: GPs reported that they never explicitly discuss dementia risk with patients, even when patients are presenting with risk factors, but acknowledge that dementia prevention should be part of their role. They advocate for adopting a whole team approach to primary care preventative practice, using long-term condition/medication reviews or NHS health checks as a platform to enable dementia risk communication targeting already at-risk individuals. Barriers included a lack of time, an absence of knowledge and education about the modifiable dementia risk factors, as well as a reluctance to use dementia as a term within the appointment for fear of causing health anxiety. Brain health was perceived as offering a more encouraging discursive tool for primary care practitioners, supporting communication and behaviour change.
Conclusion: There needs to be whole systems shift towards prioritising brain health and supporting primary care professionals in their preventative role. Education is key to underpinning this role in dementia prevention. / The University of Bradford, SURE funding scheme (reference: DA512)
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Behavioral Responses and Risk Detection in Sexual Encounters: A Study on the Effects of Social Anxiety and a Brief InterventionSchry, Amie R. 25 September 2013 (has links)
Sexual victimization among college women is a common problem. This two-part study sought to examine social interaction anxiety as a risk factor of sexual victimization and to examine the feasibility, acceptability, and preliminary efficacy of a computer-based risk reduction program. A total of 1095 undergraduate females completed an online survey to assess social anxiety as a risk factor (study part I), a subsample of whom (n = 136, including 51 above the clinical cutoff on a social anxiety measure and 85 below the cutoff) completed the subsequent in-lab study (study part II). During study part II, participants were randomly assigned to either receive a computer-based risk reduction program or an educational program on campus resources (control condition), and their predicted use of resistance techniques was assessed both before and after their assigned program. Participants also responded to an audio recording of a sexual assault vignette to assess risk detection. After controlling for past victimization and depression, social interaction anxiety was not related to predicted use of assertive resistance techniques or to risk detection. However, social anxiety positively predicted use of passive resistance techniques at the lowest level of unwanted sexual advances (i.e., breast fondling) in a series of three escalating sexual advances (i.e., breast fondling, genital fondling, and rape threat). No participants dropped out of the study, and ratings on a questionnaire assessing acceptability of the risk reduction program were positive. Program condition predicted change scores for predicted use of assertive resistance at a low level of unwanted sexual advances (i.e., breast fondling) such that the control group decreased in predicted use of assertive resistance significantly more than the risk reduction program group. Additionally, the risk reduction program group had significantly better risk detection compared to the control group. Therefore, support for the feasibility, acceptability, and preliminary efficacy of the risk reduction program was found. The finding that the control group decreased significantly more than the risk reduction program group in assertive resistance between the two story administrations is important because assertive resistance techniques tend to be the most effective in reducing risk of completed sexual victimization. Therefore, it is important that risk reduction programs encourage women to use assertive resistance. Clinical implications and suggestions for future research are discussed. / Ph. D.
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'Some of my patients only come to renew their prescriptions. They are not interested in any additional advice or support'. Physicians' perceptions on their roles in cardiovascular diseases risk reduction and management in FijiKumar, N., Mohammadnezhad, Masoud, Narayan, R. 01 March 2023 (has links)
Yes / Primary health care (PHC) physicians' perceptions are vital to understand as they are the first-line health care providers in cardiovascular diseases (CVD) risk assessment and management. This study aims to explore PHC physicians' perceptions on their roles and their perceptions on management and risk reduction approaches on CVD risk reduction and management in Fiji.
This is a qualitative study conducted in the Suva Medical area among 7 health centers from 1 August to 31 September, 2021. Purposive sampling was used to recruit physicians who worked in the Suva medical area as PHC physicians with at least 6 months' experience in the Special Outpatients Department clinics. In-depth interview were conducted using a semi-structured questionnaire over the telephone and recorded on a tablet device application. The interview content was then transcribed, and thematic analysis was done.
This study included 25 PHC physicians. From the thematic analysis, 2 major themes emerged with 6 subthemes. Theme 1 was CVD management skills with 3 subthemes including education, experience and trainings, beliefs and attitudes of physicians, self-confidence and effectiveness in CVD risk reduction and management. Theme 2 was roles and expectations with 3 subthemes including perceptions of effective treatment, perceptions of physicians' roles and perceptions of patients' expectations. Physicians generally see their role as central and imperative. They perceive to be important and leading toward combating CVDs.
Physicians' perceptions on their commitment to prevention and management of CVDs through their skills and knowledge, beliefs and motivation should be acknowledged. It is recommended that the physicians are updated on the current evidence-based medicine. Limitations include results that may not be the reflection of the entire physician and multidisciplinary community and the difficulties in face-to-face interviews due to the coronavirus diseases of 2019 pandemic.
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Forecasting Heat-Related Ambulance Transportations to Assess Adaptation Policies for Climate Change Response / 日本における気候変動に伴う熱中症救急搬送者数の予測及び適応策の評価Fujimoto, Marie 25 March 2024 (has links)
京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第25208号 / 社医博第135号 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 山本 洋介, 教授 石見 拓, 教授 大鶴 繁 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM
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Double Trouble : An analysis of the UNDRR’s inclusion of vulnerable groups in dual crises following natural hazards and COVID-19Nordling, Louise January 2020 (has links)
In 2020, the world and foremost vulnerable groups are facing “new” challenges. Dual crises of coexisting hazards like natural hazards occurring amid the COVID-19 pandemic has become more than a prediction. Hence, this thesis is a case study of dual crises and of how organisations and actors act upon those crises. With the aim to examine how the United Nations Office for Disaster Risk Reduction (UNDRR) includes vulnerable groups in disaster risk reduction related matters amid the COVID-19 pandemic, a qualitative text analysis has been performed on the selection of five of UNDRR’s publications. Developed from the Sendai Framework for Disaster Risk Reduction’s four ‘Priorities for Action’ guidelines, four analytical questions were asked to the material. The findings suggest that UNDRR does include vulnerable groups by mainly addressing the lack of resilience among vulnerable groups. However, a lack of concrete suggestions on how to strengthen vulnerable groups resilience and effective responses in the long term was noted. Due to the short time frame in which COVID-19 has existed, the research on vulnerable groups in dual crises of various hazards are still scarce, but nevertheless very much needed as to develop responses adapted towards both biological hazard and natural hazard impacts.
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Gender-Responsive Disaster Risk Reduction : Challenges and Solutions in UNDRR PolicymakingMatikainen, Tilda January 2023 (has links)
This paper brings insight into the international regime on Disaster Risk Reduction and its responsiveness to gendered dimensions. More specifically, it investigates the translation from theoretical prescriptions to policy practices in the internationally operating United Nations Office for DRR (UNDRR). The aim of this paper is to study to what extent the central challenges and solutions in making DRR gender-responsive, as defined by scientific literature, are brought up in UNDRR policymaking. The extent to which they were mentioned in each unit of analysis (33 UNDRR publications) is systematically documented and all quotes are listed and used as a qualitative complementary element. Results show that there are substantially more mentions of solutions than challenges. Further, while some aspects such as women’s exclusion from decision-making and promoting their leadership receive substantial attention throughout the publications, the homogenization of women and men’s exclusion do not. In conclusion, the UNDRR has, to a varying extent, integrated the central challenges and solutions into gender-responsive DRR policymaking. In identifying these gaps, the study offers practical recommendations. It also provides a theoretical framework and a descriptive foundation of trends and patterns for future research.
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Mitigating the effects of recurrent drought : the case of Setlagole community, Ratlou Municipality (North West Province) / Lesego Bradley ShoromaShoroma, Lesego Bradley January 2014 (has links)
Disasters have increased in frequency and their impact has been intensely felt on
the continent. This frequently results in damage to the resources and infrastructure
on which humans rely on for survival and quality of life. When disasters strike, large
segments of the population are faced with devastating consequences, which include
food shortages, limited shelter and inadequate health services. Disasters are a result
of a complex mix of natural and other hazards, including human actions and
vulnerabilities. They consist of a combination of factors that determine the potential
for people to be exposed to particular types of hazards. The frequency and impact of
disasters in South Africa has increased significantly, the most common type of
disaster being drought.
Droughts are the result of reduced amounts of rain received over a long period of
time, but it includes delays at the beginning of the precipitation season that affects
crops that depend on the rain. For the purpose of this study, agricultural and socioeconomic
drought received attention. Agricultural drought is when the humidity in the
soil is not sufficient to assist crop production and growth in the area. Socio-economic
drought arises when economic activities aligned with other elements do not meet the
population demand. Agricultural droughts often have the latent effect of reducing
agricultural production to such an extent that the livelihoods of the communal
farmers are threatened. Drought effects often result in shrivelling crops, loss of water
resources, vegetation and a decrease in livestock forage for communal farmers.
This, in turn, leads to a decreased availability of food and the overall loss of
livelihoods. In addition, activities such as crop growing and grazing conditions for
livestock remain vulnerable, yet rural communities rely on these to generate income.
The most severe impact of droughts do not simply include the absence of food
supply for the community, but rather correlates directly with the severity and the
duration of droughts. This often increases the community’s vulnerability.
The empirical findings were concluded from focus groups interviews and semistructured
interviews as data collection for the study. The data collected from the
field was compared to the Sustainable Livelihood Framework. The analysis revealed
that drought mitigation in South Africa only exists in governmental policy documents.
Moreover, the lack of a disaster management plan for Setlagole makes it difficult to
prepare for drought. An inadequate relationship between farmers and the
government also makes it difficult to create a sense of shared vision and mission for
drought alleviation. One prominent issue that makes the effects of drought so severe
is the process of relief; it takes too long for the government to give assistance to the
farmers. This shows that mitigation measures are needed to prepare both the
farmers and the government for drought. / M Development and Management, North-West University, Potchefstroom Campus, 2015
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Mitigating the effects of recurrent drought : the case of Setlagole community, Ratlou Municipality (North West Province) / Lesego Bradley ShoromaShoroma, Lesego Bradley January 2014 (has links)
Disasters have increased in frequency and their impact has been intensely felt on
the continent. This frequently results in damage to the resources and infrastructure
on which humans rely on for survival and quality of life. When disasters strike, large
segments of the population are faced with devastating consequences, which include
food shortages, limited shelter and inadequate health services. Disasters are a result
of a complex mix of natural and other hazards, including human actions and
vulnerabilities. They consist of a combination of factors that determine the potential
for people to be exposed to particular types of hazards. The frequency and impact of
disasters in South Africa has increased significantly, the most common type of
disaster being drought.
Droughts are the result of reduced amounts of rain received over a long period of
time, but it includes delays at the beginning of the precipitation season that affects
crops that depend on the rain. For the purpose of this study, agricultural and socioeconomic
drought received attention. Agricultural drought is when the humidity in the
soil is not sufficient to assist crop production and growth in the area. Socio-economic
drought arises when economic activities aligned with other elements do not meet the
population demand. Agricultural droughts often have the latent effect of reducing
agricultural production to such an extent that the livelihoods of the communal
farmers are threatened. Drought effects often result in shrivelling crops, loss of water
resources, vegetation and a decrease in livestock forage for communal farmers.
This, in turn, leads to a decreased availability of food and the overall loss of
livelihoods. In addition, activities such as crop growing and grazing conditions for
livestock remain vulnerable, yet rural communities rely on these to generate income.
The most severe impact of droughts do not simply include the absence of food
supply for the community, but rather correlates directly with the severity and the
duration of droughts. This often increases the community’s vulnerability.
The empirical findings were concluded from focus groups interviews and semistructured
interviews as data collection for the study. The data collected from the
field was compared to the Sustainable Livelihood Framework. The analysis revealed
that drought mitigation in South Africa only exists in governmental policy documents.
Moreover, the lack of a disaster management plan for Setlagole makes it difficult to
prepare for drought. An inadequate relationship between farmers and the
government also makes it difficult to create a sense of shared vision and mission for
drought alleviation. One prominent issue that makes the effects of drought so severe
is the process of relief; it takes too long for the government to give assistance to the
farmers. This shows that mitigation measures are needed to prepare both the
farmers and the government for drought. / M Development and Management, North-West University, Potchefstroom Campus, 2015
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Construction, social structure and policy response in Jamaica - A hurricane hit country : / Byggteknik, samhällsuppbyggnad och politiskt gensvar på Jamaica – Ett orkandrabbat landNilsson, Josephine January 2014 (has links)
The Jamaican hurricane history goes back a long time. The country has an average ratio of getting hit or brushed every 3.84 years and it is estimated to be hit directly every 9.47 years. This underscores the relevance of this paper since it seeks to investigate the construction, social structure and policy response of Jamaica. The impressions of the author combined with the interviews and literature study resulted in the conclusion of the constructions and social structure not being the main issue, but the policy response.
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An evaluation of the implementation of the institutional capacity for disaster risk reduction (DRR) : the case of Capricorn District Municipality / Mmberegeni Mackson MunzheleleMunzhelele, Mmberegeni Mackson January 2011 (has links)
Since 1994, fundamental transformation has taken place in South Africa in terms of disaster risk management. The transformation processes have led to the promulgation of the Disaster Management Act, 2002 (Act No 57 of 2002) that was heralded as a new era for disaster risk management in South Africa. Subsequently, the publication of the National Disaster Risk Management Framework (of 2005) provides a set of clear guidelines on the implementation of the Disaster Management Act, 2002 (Act No 57 of 2002). The National Disaster Risk Management Framework underscores the significance of the integration and co-ordination of disaster risk management activities in all levels of government in South Africa. This emphasises the fact that Disaster risk management in South Africa has been established as a public sector function within each sphere of government. In its KPA1, the framework further emphasis the establishment of integrated disaster risk management structures by each sphere of government.
The disaster risk management structures, such as interdepartmental committees and a district forum have not yet been established in the Capricorn District Municipality. In cases where other structures have been established, the main challenge is the participation of all role players and the inconsistency in the representation of local municipality in those structures. Another gap is the lack of clear responsibility of disaster risk management in some of the internal key role players. This dissertation aims to evaluate the implementation of the institutional capacity for Disaster Risk Reduction in the Capricorn District Municipality. This dissertation caters for the reader within the theory of organisation. Subsequently, the disaster risk management structures were discussed, based on the requirements of both the Disaster Management Act, 2002 (Act No 57 of 2002) and a National Disaster Risk Management Framework policy document (of 2005). This dissertation made use of the one-on-one semi-structured interviews for data collection in the field of disaster risk management within the Capricorn District Municipality. As regards recommendations, this dissertation suggests a number of points that the Capricorn District Municipality needs to implement in order to fast-track the establishment of disaster risk management structures that could lead to progress in meeting the legislative mandate of Disaster Risk Reduction. / Thesis (M. Development and management)--North-West University, Potchefstroom Campus, 2011
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