Studies have found substantial differences in health-related behavior and health care usage between educational groups, which may explain part of the well-documented educational gradient in health. The allocative efficiency hypothesis offers a behavioral explanation for these reported differences. According to this theory, the educated possess more health knowledge and information, allowing them to make better health choices. We perform a mediation analysis to study this mechanism using original survey data from the Philippines, a lower-middle-income country. As an extension of previous empirical research, we construct a comprehensive index that captures different dimensions of health knowledge. Using generalized propensity scores, we find strong support for the allocative efficiency argument. Schooling is significantly associated with health knowledge levels, which explain up to 69% of the education effect on health lifestyle. This corresponds to twice the mediation strength of economic resources, suggesting an important role of this factor in explaining education effects on health decisions.

Master of Public Health - MPH / A matched case-control study was carried out to identify the factors associated with the nutritional status of children in Livingstone district, Zambia. A trained field researcher collected data on demographic, feeding practices and socio-economic factors in matched groups of underweight children and normal weight children from the mothers/caregivers of the children. Interviews, using a structured pre-tested questionnaire, were used to obtain the data. All children aged from six to fifty-nine months admitted at Livingstone General Hospital during the months of October to December, 2003 with a weight for age below –2SD from the median of the reference population formed the underweight children (cases). The total was 47 children. The cases were then matched according to sex and age to 47 normal weight children attending the under five clinic at Livingstone General Hospital during the same months, with a weight for age above –2SD from the median of the reference population (controls). The final sample was 94 children. Weights were recorded using the same scale in the outpatient’s department prior to admission and during the under five clinic session. Interviews then took place in a separate room after the clinic nurse had attended them. A separate visit was then made to the homes of the children on a different day. Odds ratios and 95% confidence intervals were used to measure strengths of associations. Results revealed that the basic causes of underweight were the poor economic state of the country, unfavorable policies and insufficient government support in the areas of health, education, agriculture, housing and employment. Underlying causes were inadequate access to food, inadequate care of children, poor access to health services and unhealthy living environments, while immediate causes were poor food intake and disease. Low educational and literacy levels of the mothers/caregivers, unemployment and lack of sufficient finances to access basic necessities such as food, housing and health contributed to underweight. / South Africa

A survey was performed to compare basic health education knowledge between sophomore students at Utah State University and sophomore students at the University of Utah . This was performed through the use of a questionnaire consisting of 40 questions covering the following eight areas of prominence in health education: 1. Alcohol and tobacco 2. Community health and communicable disease 3. Consumer health 4. Drugs and narcotics 5. Food fads and medical quackery 6. Mental health 7. Personal health 8. Sex education This questionnaire was administered through the mail to 250 randomly selected students at the two universities. When responses were received they were scored and keypunched on IBM-5080 cards . The cards were then processed through the IBM-350 Model 44 computer using Analysis of Variance and the Quest Program. Computation of student "T 11 scores verified that students at the University of Utah were superior in health knowledge at the .05 level of significance based on the one tailed test. The University of Utah last year required a basic health education class of all freshmen . At Utah State University such a class is not required or even offered. The f act that University of Utah students were superior verified that positive learning of health education did increase through specific instruction.

No description available.

BACKGROUND Cardiovascular disease (CVD) is a major health problem worldwide. In South Africa, the prevalence of cardiovascular disease (CVD) is often underestimated. The prevalence of CVD is very high, especially in urban areas, where two thirds of Africans present with multiple risk factors for CVD. The surge in CVD seems largely caused by modifiable risk factors. Although several studies have been conducted on the high prevalence and burden of CVD, there is limited research investigating possible relationships between CV risk factors and CVD knowledge. In order to address the burden of CVD as a public health issue, it is necessary to determine the level of CVD knowledge to bridge the possible knowledge gap in the control and primary prevention of CVD. It is therefore important to get a clear understanding of the relationship between CV risk factors and knowledge of CVD to contribute to the development and implementation of primary prevention programmes to reduce the prevalence of CVD. The findings from the study may be useful in designing community based health promotion programmes to prevent and control CVD within primary health care settings. A clear and comprehensive understanding of how risk factors contribute to the development of the CVD may enable individuals to identify their risk factors, but also to take action to reduce their risk for developing CVD. AIM This study aimed to determine the relationship between CV risk factors and knowledge of CVD in a group of African men. METHODOLOGY This study is quantitative in nature and followed a descriptive correlational design to describe the relationship between CV risk factors and knowledge of CVD. The study included 118 African men employed at the Vaalharts Water Scheme, North-West Province, South Africa. For the purpose of the study, data was collected by means of questionnaires and individual health screening. Participants completed a general health questionnaire, as well as a Heart Disease Knowledge Questionnaire. Individual health screening included anthropometric measurements (height, weight, waist circumference and body mass index), blood pressure (BP), rapid testing of blood glucose and cholesterol. By using Pearson correlations we determined whether CVD knowledge scores relate to individual CV risk factors. RESULTS The mean CV knowledge score was 75%, with an acceptable Cronbach’s alpha of 0.64 (CA=0.64). One third of the group displayed moderate to high CV risk profiles. Participants had a mean BP of 146/92 mmHg, which falls in the hypertensive range of the European guidelines. Their fasting blood glucose levels of 5.8 ± 2.0mmol/L were higher than the normal cut-off of 5.6mmol/L. Their mean body mass index was 25.9 ± 5.9 kg/m2. Overall, we observed a lack of association between CV risk factors and CVD knowledge. Only one borderline significant association existed between triglycerides and CVD knowledge (r=0.167; p=0.071). CONCLUSIONS Despite African men having increased CV risk and a relatively good knowledge of CVD risk factors, there seems to be a disconnect between their CV risk and CVD knowledge. Furthermore, in this group of African men, this knowledge does not appear to translate to changes in their own perceived severity of risk factors. Our results suggest that a good CVD knowledge does not appear to influence changes in CV risk factor levels. / MCur, North-West University, Potchefstroom Campus, 2015

BACKGROUND Cardiovascular disease (CVD) is a major health problem worldwide. In South Africa, the prevalence of cardiovascular disease (CVD) is often underestimated. The prevalence of CVD is very high, especially in urban areas, where two thirds of Africans present with multiple risk factors for CVD. The surge in CVD seems largely caused by modifiable risk factors. Although several studies have been conducted on the high prevalence and burden of CVD, there is limited research investigating possible relationships between CV risk factors and CVD knowledge. In order to address the burden of CVD as a public health issue, it is necessary to determine the level of CVD knowledge to bridge the possible knowledge gap in the control and primary prevention of CVD. It is therefore important to get a clear understanding of the relationship between CV risk factors and knowledge of CVD to contribute to the development and implementation of primary prevention programmes to reduce the prevalence of CVD. The findings from the study may be useful in designing community based health promotion programmes to prevent and control CVD within primary health care settings. A clear and comprehensive understanding of how risk factors contribute to the development of the CVD may enable individuals to identify their risk factors, but also to take action to reduce their risk for developing CVD. AIM This study aimed to determine the relationship between CV risk factors and knowledge of CVD in a group of African men. METHODOLOGY This study is quantitative in nature and followed a descriptive correlational design to describe the relationship between CV risk factors and knowledge of CVD. The study included 118 African men employed at the Vaalharts Water Scheme, North-West Province, South Africa. For the purpose of the study, data was collected by means of questionnaires and individual health screening. Participants completed a general health questionnaire, as well as a Heart Disease Knowledge Questionnaire. Individual health screening included anthropometric measurements (height, weight, waist circumference and body mass index), blood pressure (BP), rapid testing of blood glucose and cholesterol. By using Pearson correlations we determined whether CVD knowledge scores relate to individual CV risk factors. RESULTS The mean CV knowledge score was 75%, with an acceptable Cronbach’s alpha of 0.64 (CA=0.64). One third of the group displayed moderate to high CV risk profiles. Participants had a mean BP of 146/92 mmHg, which falls in the hypertensive range of the European guidelines. Their fasting blood glucose levels of 5.8 ± 2.0mmol/L were higher than the normal cut-off of 5.6mmol/L. Their mean body mass index was 25.9 ± 5.9 kg/m2. Overall, we observed a lack of association between CV risk factors and CVD knowledge. Only one borderline significant association existed between triglycerides and CVD knowledge (r=0.167; p=0.071). CONCLUSIONS Despite African men having increased CV risk and a relatively good knowledge of CVD risk factors, there seems to be a disconnect between their CV risk and CVD knowledge. Furthermore, in this group of African men, this knowledge does not appear to translate to changes in their own perceived severity of risk factors. Our results suggest that a good CVD knowledge does not appear to influence changes in CV risk factor levels. / MCur, North-West University, Potchefstroom Campus, 2015

Syftet med denna studie var att skapa förståelse för hur man kan motivera individer med utländsk bakgrund till att sluta använda tobak. Studien undersökte vilka uppfattningar dessa individer kan ha om tobaksrelaterade hälsorisker och vilka anledningarna kan vara till att dessa individer röker. Metoden som användes är av kvalitativ ansats, som är induktiv och tolkande. Datainsamling skedde med hjälp av systematiska litteraturöversikter som analyserades med hjälp av en metaetnografi. Resultatet visar att individer med utländsk bakgrund underskattar tobaksrelaterade hälsorisker och har en positiv inställning till tobak. Familjeutmaningar, stress, ångest, nöje och lycka är de ledande motiven för tobaksbruk bland dessa individer. Brist på kunskap om tobaksrelaterade hälsorisker leder till mindre motivation till att sluta röka. Slutsatsen av denna studie påvisar att för att kunna motivera individer med utländsk bakgrund till att sluta röka är det viktigt att utveckla insatser för att öka deras kunskaper om tobakens hälsorisker.

Introdução: Diante do acelerado aumento da obesidade infantil e da ciência de que suas consequências perduram ao longo da vida, na grande maioria dos casos, fica evidente, a necessidade de prevenção precoce do excesso de peso na infância para reduzir esse importante problema de saúde pública. A promoção da alimentação adequada e saudável e a promoção da saúde estão intensamente relacionadas, por isso, tratar crianças com excesso de peso implica considerá-las em seus contextos familiares e sociais com um olhar além da gordura corporal, mas de respeito às suas histórias, sentimentos, conflitos, valores, crenças e saberes. Objetivo - Descrever, interpretar e compreender as vivências familiares relativas ao aconselhamento nutricional para crianças com obesidade. Métodos - Pesquisa qualitativa, de caráter exploratório, com produção dos dados por meio de grupos focais. Os sujeitos participantes foram os familiares de crianças que realizam acompanhamento nutricional devido ao diagnóstico de obesidade na Policlínica Centro de São Bernardo do Campo. A amostragem foi constituída através do critério de saturação quando nos dados produzidos não emergiram novos temas que contribuíssem para a reflexão teórica. Foi utilizada análise de conteúdo para analisar os dados produzidos. Resultados - Foram realizados 12 grupos focais que compuseram uma amostra total de 13 participantes, entre eles, mães, avó e tia. As categorias que emergiram dos dados abarcaram as memórias alimentares da infância dos familiares; a imagem corporal das crianças percebidas pelos familiares e pelas próprias crianças, segundo as percepções dos familiares; a dimensão afetiva do comportamento alimentar; as manifestações infantis sobre o aconselhamento nutricional, segundo os familiares; às experiências familiares após o aconselhamento nutricional; as redes de apoio social reconhecidas, e os comportamentos alimentares familiares, tanto em ambiente doméstico, quanto no lazer. Conclusão - O alimento demonstrou ter funções que vão além do suprimento das necessidades biológicas por agregarem significados culturais, comportamentais e afetivos a partir dos quais os indivíduos se relacionam. As vivências e trajetória de vida de cada uma dessas famílias são únicas e fundamentam a forma como as situações são experienciadas individualmente por elas e impactam diretamente em suas atitudes e comportamentos. A comida e o comer se mostraram ligadas a história, as memórias e a dimensão afetiva que compõe cada uma dessas pessoas. / Introduction - Faced with the accelerated increase in childhood obesity and the knowledge that its consequences lasts throughout life in the vast majority of cases, it is evident, the need for early prevention of overweight in childhood to reduce this important public health problem. The promotion of the adequate and healthy food, and the promotion of health are intensely related, therefore, treating overweight children involves considering them in their family and social contexts with a look beyond body fat, but that respects their stories, feelings, conflicts, values, beliefs and knowledges. Objective - To describe, interpret and understand family experiences related to nutritional counseling for obese children. Methods - Qualitative exploratory research, with the production of data through focus groups. The subjects of this research were the relatives of children who undergo nutritional monitoring due to the diagnosis of obesity in the Downtown Polyclinic of São Bernardo do Campo. The sampling was constituted through the saturation criterion when, in the data produced, no new themes emerged that contributed to the theoretical reflection. Content analysis was used to analyze the produced data. Results - Twelve focus groups comprised a total sample of 13 participants, including mothers, grandmother and aunt. The categories that emerged from the data encompassed the family members´s childhood memories around food; the body image of the children perceived by the relatives and by the children themselves, according to the perceptions of the relatives; the affective dimension of eating behavior; infant manifestations on nutritional counseling, according to the relatives; family experiences after nutritional counseling; the recognized social support networks, and family eating behaviors, both in the domestic and leisure settings. Conclusion - The food has demonstrated characteristics that go beyond the supply of biological needs, since it adds cultural, behavioral and affective meanings from which individuals relate themselves. The experiences and life trajectory of each family are unique and base the way in which the situations are experienced individually by them and directly impact on their attitudes and behaviors. Food and eating were linked to the history, memories and affective dimension that compose each of these people.

Este trabalho promove um estudo em informática em saúde no qual se analisam laudos de radiologia torácica através de métodos de processamento estatístico de linguagem natural com o intuito de subsidiar a interoperabilidade entre sistemas de saúde. Foram utilizados 2000 laudos de radiologia do tórax para a extração de conhecimento identificando-se as palavras, n-gramas e frases que os compõem. Foi calculado o índice de Zipf e verificou-se que poucas palavras compõem a maioria dos laudos e que a maioria das palavras não tem representatividade estatística A partir dos termos identificados foi realizada a tradução e a comparação da existência desses em um vocabulário médico padronizado com terminologia internacional, o SNOMEDCT. Os termos que tinham uma relação completa e direta com os termos traduzidos foram incorporados nos termos de referência juntamente com a classe à qual o termo pertence e seu identificador. Foram selecionados outros 200 laudos de radiologia de tórax para realizar o experimento de rotulação dos termos em relação à referência. A eficiência obtida neste estágio, que é o percentual de rotulação dos laudos, foi de 45,55%. A partir de então foram incorporados aos termos de referência, sob a classe de conceito de ligação, artigos, preposições e pronomes. É importante ressaltar que esses termos não adicionam conhecimento de saúde ao texto. A eficiência obtida foi de 73,23%, aumentando significativamente a eficiência obtida anteriormente. Finalizamos o trabalho com algumas formas de aplicação dos laudos rotulados para a interoperabilidade de sistemas, utilizando para isto ontologias, o HL7 CDA (Clinical Documents Architecture) e o modelo de arquétipos da Fundação OpenEHR. / This work promotes a study in health informatics technology which analyses reports of chest X-ray through statistical natural language processing methods for the purpose of supporting the interoperability between health systems. Two thousand radiology reports were used for the extraction of knowledge by identifying the words, n-grams and phrases of reports. Zipfs constant was studied and it was determined that few words make up the majority of the reports and that most of the words do not have statistical significance. The translation and comparison with exisiting standardized medical vocabulary with international terminology, called SNOMED-CT, was done based on the terms identified. The terms that had a complete and direct correlation with the translated terms were incorporated into the reference terms along with its class and the word identifier. Another 200 reports of chest x-rays were selected to perform the terms tagging experiment of with respect to the reference. The efficiency obtained, which is the percentage of labeling of the reports, was 45.55%. Subsequentely, articles, prepositions and pronouns were incorporated into the terms of reference under the linkage concept of class. It is important to note that these terms do not carry health knowledge to the text. Thus, the efficiency ratio was 73.23%, significantly increasing the efficiency obtained previously. The study was concluded with some forms of application of the reports tagged for system interoperability, using different ontologies, the HL7 CDA (Clinical Documents Architecture) and the archetypes at OpenEHR Fondation.

Introdução: Diante do acelerado aumento da obesidade infantil e da ciência de que suas consequências perduram ao longo da vida, na grande maioria dos casos, fica evidente, a necessidade de prevenção precoce do excesso de peso na infância para reduzir esse importante problema de saúde pública. A promoção da alimentação adequada e saudável e a promoção da saúde estão intensamente relacionadas, por isso, tratar crianças com excesso de peso implica considerá-las em seus contextos familiares e sociais com um olhar além da gordura corporal, mas de respeito às suas histórias, sentimentos, conflitos, valores, crenças e saberes. Objetivo - Descrever, interpretar e compreender as vivências familiares relativas ao aconselhamento nutricional para crianças com obesidade. Métodos - Pesquisa qualitativa, de caráter exploratório, com produção dos dados por meio de grupos focais. Os sujeitos participantes foram os familiares de crianças que realizam acompanhamento nutricional devido ao diagnóstico de obesidade na Policlínica Centro de São Bernardo do Campo. A amostragem foi constituída através do critério de saturação quando nos dados produzidos não emergiram novos temas que contribuíssem para a reflexão teórica. Foi utilizada análise de conteúdo para analisar os dados produzidos. Resultados - Foram realizados 12 grupos focais que compuseram uma amostra total de 13 participantes, entre eles, mães, avó e tia. As categorias que emergiram dos dados abarcaram as memórias alimentares da infância dos familiares; a imagem corporal das crianças percebidas pelos familiares e pelas próprias crianças, segundo as percepções dos familiares; a dimensão afetiva do comportamento alimentar; as manifestações infantis sobre o aconselhamento nutricional, segundo os familiares; às experiências familiares após o aconselhamento nutricional; as redes de apoio social reconhecidas, e os comportamentos alimentares familiares, tanto em ambiente doméstico, quanto no lazer. Conclusão - O alimento demonstrou ter funções que vão além do suprimento das necessidades biológicas por agregarem significados culturais, comportamentais e afetivos a partir dos quais os indivíduos se relacionam. As vivências e trajetória de vida de cada uma dessas famílias são únicas e fundamentam a forma como as situações são experienciadas individualmente por elas e impactam diretamente em suas atitudes e comportamentos. A comida e o comer se mostraram ligadas a história, as memórias e a dimensão afetiva que compõe cada uma dessas pessoas. / Introduction - Faced with the accelerated increase in childhood obesity and the knowledge that its consequences lasts throughout life in the vast majority of cases, it is evident, the need for early prevention of overweight in childhood to reduce this important public health problem. The promotion of the adequate and healthy food, and the promotion of health are intensely related, therefore, treating overweight children involves considering them in their family and social contexts with a look beyond body fat, but that respects their stories, feelings, conflicts, values, beliefs and knowledges. Objective - To describe, interpret and understand family experiences related to nutritional counseling for obese children. Methods - Qualitative exploratory research, with the production of data through focus groups. The subjects of this research were the relatives of children who undergo nutritional monitoring due to the diagnosis of obesity in the Downtown Polyclinic of São Bernardo do Campo. The sampling was constituted through the saturation criterion when, in the data produced, no new themes emerged that contributed to the theoretical reflection. Content analysis was used to analyze the produced data. Results - Twelve focus groups comprised a total sample of 13 participants, including mothers, grandmother and aunt. The categories that emerged from the data encompassed the family members´s childhood memories around food; the body image of the children perceived by the relatives and by the children themselves, according to the perceptions of the relatives; the affective dimension of eating behavior; infant manifestations on nutritional counseling, according to the relatives; family experiences after nutritional counseling; the recognized social support networks, and family eating behaviors, both in the domestic and leisure settings. Conclusion - The food has demonstrated characteristics that go beyond the supply of biological needs, since it adds cultural, behavioral and affective meanings from which individuals relate themselves. The experiences and life trajectory of each family are unique and base the way in which the situations are experienced individually by them and directly impact on their attitudes and behaviors. Food and eating were linked to the history, memories and affective dimension that compose each of these people.