nÃo hà / A sexualidade à definida como um aspecto central do ser humano presente ao longo da existÃncia dos indivÃduos. Vivenciar a sexualidade em sua plenitude à um direito de todos, entretanto, percebem-se as distinÃÃes impostas pela sociedade Ãs mulheres com deficiÃncia. Numa sociedade na qual se valoriza o belo, o perfeito, destoar deste estereÃtipo pode levar à estigmatizaÃÃo. Desta forma, na perspectiva de valorizar aÃÃes com vistas a promover a sexualidade destas pessoas, decidiu-se elaborar esta pesquisa. Teve-se como objetivo geral intermediar o empoderamento de mulheres com deficiÃncia adquirida para que vivenciem a sexualidade de forma saudÃvel. Trata-se de um estudo de intervenÃÃo com abordagem qualitativa, realizado nos meses de junho a outubro de 2010. Os sujeitos foram seis mulheres com deficiÃncia adquirida, integrantes da AssociaÃÃo dos Deficientes do Compartimento da Borborema (ASDECB) em Campina Grande-PB. No desenvolvimento da pesquisa considerou-se a ResoluÃÃo 196/96 inerente à pesquisa envolvendo seres humanos. Como instrumentos para coleta de dados, utilizou-se um roteiro de entrevista, gravaÃÃes em MP3, observaÃÃes e registro no diÃrio de campo. Como mÃtodo e tÃcnica de investigaÃÃo, o grupo focal. Promoveram-se dez sessÃes de grupos focais, e os dados foram analisados e categorizados à luz da anÃlise de temÃtica, tendo como referencial teÃrico a promoÃÃo da saÃde na perspectiva do empoderamento. Emergiram da anÃlise dos dados trÃs categorias: ConcepÃÃes, PromoÃÃo da Sexualidade e Empoderamento, e suas respectivas subcategorias. Como resultados, as mulheres mostraram-se desempoderadas quanto ao exercÃcio das suas sexualidades; a famÃlia desfavoreceu, em sua maioria, a construÃÃo de uma sexualidade saudÃvel, no grupo estudado; os profissionais de saÃde revelaram-se despreparados ao lidar com aspectos da sexualidade; os desafios mais citados pelas mulheres foram vencer o preconceito e o medo de ser abusada sexualmente. Conforme se conclui, embora o empoderamento seja algo processual e inesgotÃvel, pode ser construÃdo mediante aÃÃes de promoÃÃo de saÃde que despertem nos sujeitos um senso crÃtico e reflexivo, viabilizando, portanto, a construÃÃo de uma sexualidade saudÃvel e empoderada. / Sexuality is defined as a central feature of human beings which is part of their whole existence. Everybody has the right to explore its sexuality, however, there are difficulties imposed to disabled women. We live in a society which emphasizes the beauty and perfection, so that those who are not framed to this stereotype become stigmatized. Hence, this thesis aims to investigate and promote the sexuality of disabled women. Its main objective is to intermediate the disabled women empowerment so that they can explore their sexuality more pleasantly. We did our study using qualitative analysis, in a group of six disabled women, from June to October of 2010. The group investigated is part of the Campina Grande Disabled Association (ASDECB), located in Campina Grande â PB, Brazil. During this research we took into account the Brazilian Resolution 196/96 which focuses on research involving human beings. The data gathering process involved questionnaires; interviews; audio recording; and observations registered in a logbook. Focal group methodology was used during ten sessions. After that, data were analyzed and categorized through thematic analysis, using as a theoretical reference the health promotion in the empowerment perspective. We obtained three categories: conception, sexuality promotion and empowerment, and their subcategories respectively. As a result, women proved to be disempowered as to the exercise of their sexuality; the family, in majority, did not contribute to a healthy sexuality and also the health professionals shown not able to deal with sexuality aspects; the main challenges mentioned by the women were to overcome the prejudice and the fear to be sexually abused. As a conclusion, we point out that although the empowerment be a long term process, it can be built through actions on health promotion that seek for criticism and reflection of people involved, so that a pleasant, healthy and empowerment sexuality may be achieved.

Em busca da compreensÃo da experiÃncia espiritual no contexto do acolhimento da pessoa em uso abusivo drogas e sua famÃlia, parti de uma atuacÃo no seio da EstratÃgia de SaÃde da FamÃlia-ESF, operando com a prevenÃÃo e promoÃÃo da saÃde. Elegi a perspectiva qualitativa, mediante a pesquisa-aÃÃo (BARBIER, 2007) e analisei a articulaÃÃo da dimensÃo espiritual junto aos recursos da clÃnica ampliada, no contexto do acolhimento à pessoa em uso abusivo de drogas e sua famÃlia. Para contemplar os objetivos desta pesquisa instituà o acolhimento ampliado, segundo conceituei, como um acolhimento que se estende por todo o bairro, focalizando as possibilidades de produÃÃo de saber dos grupos sociais do territÃrio (VALLA, 1998; FREIRE, 1967, 1992, 2003, 2005), visando ao fortalecimento das redes sociais de apoio terapÃutico formais e informais. Vinculei os acervos espirituais da nossa cultura (doutrina EspÃrita, como filosofia, ciÃncia e religiÃo) e da cultura da populaÃÃo ― Ãs formas de oraÃÃo nas diversas matrizes de compreensÃo da fà (VASCONCELOS, 1999, 2001, 2006, 2009, 2010). Analisei as falas dos sujeitos e suas famÃlias, complexificando o olhar do Acolhimento feito na ESF, encontrando a espiritualidade vista sobretudo como produÃÃo de sentido para a vida (KARDEC, 1804-1869, 1858, 2003, 2008; AMUI, 2011; PUTTINI, 2008, 2009), buscada nas instÃncias sociais do Grupo Acolhida, nas visitas domiciliares e no Grupo de PercepÃÃo Juvenil, que fundei na Escola Gabriel Cavalcante para aÃÃo de prevenÃÃo ao uso abusivo de drogas na interface com a promoÃÃo da saÃde mediada pela arte. Sempre buscando a perspectiva do sujeito em uso abusivo de drogas, na promoÃÃo de uma escuta qualificada, constatei a necessidade permanente de produÃao de sentido existencial e espiritual para as experiÃncias, a ser produzido pelos sujeitos no contexto do que nomeio de experiÃncia guiada (conduzida por educador junto a um grupo). Compreendi a necessidade de uma formaÃÃo continuada tomada como leitura da prÃtica, de carÃter interdisciplinar aos profissionais da unidade de saÃde e capaz de nutrir-se da prÃpria prÃxis social instaurada pela ESF no territÃrio, alimentando tambÃm os equipamentos sociais de saÃde do poder pÃblico e da comunidade. TambÃm à resultado desta pesquisa constatar a potÃncia da dimensÃo espiritual, atravÃs da fluidoterapia, como racionalidade em saÃde (ERBERELI, 2013), com o uso da tÃcnica de imposiÃÃo de mÃos (passe espÃrita), que se alia à oraÃÃo no concerto dos recursos da clÃnica ampliada, no contexto do acolhimento vivido na ESF. Sublinho ainda o valor de um trabalho com espiritualidade tomada como promoÃÃo de uma experiÃncia de si (DELORY-MOMBERGER, 2008; WARSCHAUER, 2001), que se alinha a elaboraÃÃes de projetos de vida, aspecto vital, sobretudo para as populacÃes juvenis em estado de pauperizaÃÃo. Ainda, aponto a necessidade de conceituar o sujeito das prÃticas de saÃde como sujeito biopsicossocial e espiritual / In search of understanding spiritual experience in the context of the host of the person in drug abusing and his family, I have started from the performance in the core of the Health Family Strategy (ESF), working with prevention and health promotion. I have chosen a qualitative perspective through action-research (Barbier, 2007) and I have analyzed the articulation of the spiritual dimension related to the expended clinic resources in the context of the person host in drug abusive use and family. To contemplate the objectives I came to realize expanded host according to the host which is extended to the neighborhood, focusing on the possibilities of knowledge production of the social groups in the territory (Valla, 1998; Freire 1967, 1992, 2003, 2005), aiming at social networks strengthen of formal and informal therapeutic support. I have linked the spiritual knowledge of our culture (Spiritist Doctrine as religion, philosophy and science) and from the population culture â to the praying ways in the several matrixes of faith understanding (VASCONCELOS, 1999, 2001, 2006, 2009, 2010). I have analyzed the speech of the individuals and their families complexifying the look of the host carried out in ESF, it was found the spirituality seen above all as meaning production for life (Kardec, 1804-1869, 1858, 2003, 2008; Amui 2011; PUTTINI, 2008, 2009),it was sought in the social instances of Grupo Acolhida, in the home visits and in the Grupo de PercepÃÃo Juvenil that I have founded in the Gabriel Cavalcante School for prevention action of drug abusive use in the interface with health promotion mediated by art. Always searching the perspective of the person in drug abusive use in the promotion of a qualified listening I have confirmed the permanent need of meaning production in the existential and spiritual field to the experiences to be produced by the individuals in the context of what we name guided experience (carried out by educator in a group). I have understood the need of a permanent formation taken as practical reading of an interdisciplinary nature to the health unit professionals which is capable of nurturing of the very social praxis established by ESF in the territory also feeding the social and health equipment belonging to community and Public Power. It is also result of this study is finding the potential of the spiritual dimension of fluid therapy with rationality in health (ERBERELI, 2013) using the technique of laying on hands (spiritist pass), which is allied with the prayer in the resource field of the extended clinic, in the context of host who is lived in the ESF. I emphasize the labor value with spirituality taken as a promotion of an experience of oneself. (Delory-Momberger, 2008; Warschauer, 2001), which aligns to the elaborations of life projects, vital aspect, especially for juvenile populations with impoverishment. Still, I point out the need to conceptualize the subject of health practices as biopsychosocial and spiritual subject.

INTRODUÇÃO: A atividade física (AF) é reconhecida como uma boa alternativa de prevenção de doenças e promoção do bem-estar físico, mental e social das populações. Não obstante esse consenso, os programas de AF para idosos têm dificuldades para encontrar métodos que sejam capazes de proporcionar, simultaneamente, eficácia nos efeitos desejados e permanência dos participantes. OBJETIVO: comparar a aquisição, a retenção e a permanência dos efeitos biopsicossociais de dois modelos de intervenção de AF para idosas em Moçambique. MÉTODO: um grupo de 69 mulheres idosas com idade igual ou superior a 60 anos participaram do estudo, tendo sido criteriosamente selecionadas e aleatoriamente distribuídas para dois grupos: Formal (prática de atividades físicas formais) e Lúdico (prática de atividades lúdicas). A intervenção foi realizada em duas fases e as aulas tiveram frequência de 3 vezes por semana em dias alternados (segundas, quartas e sextas feiras), sessões diárias de uma hora de duração e orientadas por monitores credenciados. Na primeira fase (Fase 1) que durou 12 semanas, o Grupo Formal (n=35) realizou sessões de 20 minutos de trabalho aeróbio em cicloergômetro com intensidade de esforço controlada de 65 à 85% da frequência cardíaca máxima (FCmáx.), mais 8 exercícios de resistência muscular com 15 repetições máximas (RM) enquanto o Grupo Lúdico (n=34) realizou atividades físicas de caráter lúdico compostas por jogos, atividades recreativas ativas incluindo danças tradicionais. Na segunda fase (Fase 2) que durou 8 semanas, cada grupo foi subdividido em dois subgrupos que combinados resultaram na formação de 4 subgrupos: Formal (n=18/14); Lúdico (n=17/15); Formal + Lúdico (ForLuD; n=17/14) e Lúdico + Formal (LudFor; n=17/16). Um dos subgrupos continuou a realizar o mesmo tipo de atividade da fase 1 (retenção), enquanto o outro realizou AF que antes não tinha realizado (permanência). Antes do início da intervenção e no final de cada fase as participantes foram submetidas aos mesmos testes (pré; pós1 e pós2) que incluía: (1) antropometria (peso, altura, perímetro da cintura e porcentagem da gordura por bioimpedância); (2) fatores de risco de doença cardiovascular (pressão arterial sistólica e diastólica; glicemia; colesterol, lipoproteína de alta densidade e triglicerídeos); (3) teste de aptidão física de Rikli e Jones (1999) (sentar e levantar; rosca; sentar e alcançar; agilidade e caminhada); (4) nível da atividade física habitual (acelerômetro por 7 dias) e (5) variáveis psicossociais (autoeficácia; autopercepção do desempenho; autoestima, autoimagem e motivação intrínseca). Os dados foram analisados no SPSS.20 com 95% de intervalo de confiança e obedeceu aos pressupostos da normalidade de dados (ANOVA mista) e não normalidade (Mann-Whitney, Wilcoxon e Qui quadrado). RESULTADOS: As participantes apresentaram elevada prevalência de risco de saúde no início do estudo, quadro que permaneceu até o final da intervenção. Na fase de aquisição ambos os grupos melhoraram a capacidade cardiorrespiratória e aumentaram o nível de confiança em continuar a participar do programa. Na retenção e na permanência todos os subgrupos diminuíram a porcentagem de gordura corporal e melhoraram a agilidade. Não houve diferença estatisticamente significante na comparação intergrupos (na aquisição) e intersubgrupos (na retenção e na permanência). CONCLUSÃO: Os dois modelos de intervenção foram similares nos efeitos biopsicossociais da AF, o que permite sugerir que o modelo lúdico é uma alternativa real e viável de programa de intervenção para idosas moçambicanas, consideradas as condições culturais, sociais e econômicas do país / INTRODUCTION: Physical activity (PA) is recognized as a good alternative to prevent disease and to promote populations physical, mental and social well being. Beside this agreement, PA programs for the elderly have faced difficulties to find methods that can congregate the efficacy of the effects and the permanence of people on the program. OBJECTIVE: the aim of this study was to compare the acquisition, retention and permanence of biopsychosocial effects of two types of PA program for Mozambican older women. METHOD: 69 older women (>=60 years old) were randomlly distributed to two groups: FAG (formal activity group) and LAG (ludic activity group). The intervention program was carried out in two phases with 3 practice sessions (one hour of duration) per week (Mondays, Wednesdays and Fridays), and were oriented by credited trainers. The first phase of the study lasted 12 weeks and the participants of FAG (n=35) practiced 20 min of aerobic work on the treadmill with standard intensity control procedure (65 to 85% HR max) followed by 8 muscular endurance exercises with 15 maxim repetitions (RM). On the other hand participants of LAG (n=34) practiced games, dance and recreational activities. On the second phase, the study had 8 weeks of practice, and both groups were further divided into 2 sub-groups whose combination resulted in 4 sub-groups: Formal activity (FFAG; n=18/14); Ludic activity (LLAG; n=17/15); Formal+Ludic activity (FLAG; n=17/14) and Ludic+Formal activity (LFAG; n=17/16). Two of the sub-groups continued to practice the same activity of the first phase and another two sub-groups changed to the activities practiced by the other group in the first phase. The participants were submitted to the anthropometry test batteries (weight, height, west and body fat) and risk factor of cardiovascular disease test (systolic blood press and diastolic blood press; glycemic; cholesterol; high-density lipoprotein and triglycerides). Additionally they were submitted to fitness test (chair stand; arm curl; chair sit-and-reach; 8-foot up-and-go and 6-minute walk), physical activity level test (by accelerometer for seven consecutive days) and psychosocial factors test (self-efficacy; self-perception skill, self-esteem; self-image and intrinsic motivation). The data were analyzed by SPSS.20 with 95% of confidence interval. When normality criterion was achieved parametric test was used (mixed ANOVA) and nonparametric tests (Mann-Whitney, Wilcoxon and X square tests) were used when normality criterion was not achieved. RESULTS: the participants showed high level of health risk factor from the beginning to the end of the intervention. In the acquisition all groups improved the cardiorespiratory fitness and the level of the confidence to continue on the PA program. In the retention and permanence, all sub-groups reduced the level of body fat and improved agility. Inter-group comparisons reveled no statistical difference between groups (acquisition) and sub-groups (retention and permanence). CONCLUSION: The two types of PA program were similar in acquisition, retention and permanence of the biopsychosocial effects. Thus, it can be suggested that the ludic model of PA program is a real and viable alternative program for Mozambican older women, especially taking into account the cultural, social and economic conditions of the country

Este trabalho descreve e analisa as práticas relativas à promoção da saúde da criança, a partir das representações sociais de profissionais e de mães. A pesquisa de campo foi realizada em dois serviços locais de saúde, situados na Grande São Paulo. Foram analisadas 48 entrevistas utilizando-se técnicas quali-quantitativas, para reconstruir os contextos sócio-familiar, institucional e político nos quais as representações se constituíram e adquiriram sentido. São discutidas as relações estabelecidas entre práticas e representações, resultando daí a caracterização de posições institucionais em função das representações dos profissionais. Isto, por sua vez possibilita a delimitação de uma \"geografia\" das relações entre equipes de trabalho; e ainda compreensão da dinâmica de relações estabelecida entre os saberes profissionais e destes com a população. A pesquisa apresenta dados sobre o exercício da violência simbólica nas práticas dos profissionais no cotidiano do seu trabalho. Por outro lado, aponta diferentes perfis de incorporação desse tipo de relação de por parte da população. Não se revela, conseqüentemente, aqui um simples caso de hegemonia do conhecimento científico, mas também a legitimação de um saber \"naif\". Apresenta como conclusão que tratar a saúde da criança enquanto objeto de estudo, não se esgota na análise das práticas dirigidas ao processo saúde-doença, mas exige novas definições paradigmáticas que efetivem o conceito de \"promoção da saúde\". Considera a explicitação das representações sociais dos agentes que interagem em dado processo de trabalho como elemento decisivo para a constituição, de um modelo assistencial que responda, no cotidiano dos serviços e das comunidades, às demandas da população segundo sua percepção da realidade; e ainda, que aponte necessidades específicas em função do saber técnico. Algumas premissas para a constituição de um novo modelo assistencial para a Promoção da Saúde da Criança são destacadas no capítulo final. / This research describes and analizes the child care services rendered to promote health as seen through the social representations of mothers and professionals. The field research was carried out in two health centers, located in the Great Sao Paulo area. Forty eight interviews were analized using both qualitative and quantitative techniques to reconstruct the social, political, institutional and family contexts in which these representations acquired their meanings. The discussion focuses on the relationships established between pracices and social representations and the outcome of which is the characterization of positions within each institution as a function of the professional representations. This in its turn opens the possibility of, not only maping out the relationships between work teams, but also understanding the dynamics established among the different realms of professional knowledge and of these with the public. The research traces signs of exertion of simbolic violence through the daily professional work routines. It shows, on the other hand, the different absortion profiles adopted by the community in response to this type of power relationship. The analysis of data reveals that this is not just a case of hegemony of scientific and technological knowledge over common sense, but it is actually also a case of legitimation of \"naive\" knowledge. As a conclusion it is pointed out that, when Infant Health is considered as an object of systematic investigation, the analysis of the routines involved in the health / desease process does not exhaust the subject under enquiry; but it is also required that new paradigmatic definitions be adopted to implement the concept of \"health prmotion\". The clarification of the social representations held by the interacting agents within a given labor process is considered decisive for the development of a welfare model which is apt to respond to the requests of the community, to take into account its perception of reality and yet to point out the specific needs in function of technical knowledge. Some assumptions for a new welfare model designed to establish a Child Health Promotion Programare stated and presented in the last chapter.

O envelhecimento populacional e a mudança no perfil epidemiológico ocorridos nas últimas décadas trazem novos desafios sociais, políticos e culturais tanto no Brasil como no restante do mundo. A nova Promoção da Saúde tem influenciado o setor saúde propondo uma concepção ampla do processo saúde-doença e de seus determinantes, na articulação de saberes técnicos e populares, e na mobilização de todos os setores da sociedade para seu enfrentamento e resolução. Objetivos: Traçar um panorama da produção bibliográfica sobre Promoção da Saúde do Idoso, no Brasil. Identificar o enfoque conceitual de Promoção da Saúde e o tipo de delineamento de pesquisa dos artigos avaliados.Método: Realizou-se um estudo exploratório descritivo, por meio de levantamento bibliográfico no banco de dados LILACS, mediante descritores do vocabulário DECS. O período pesquisado foi de 1994 a 2009, no Brasil; tendo como marco histórico a promulgação da Política Nacional do Idoso. A análise dos dados foi dividida em duas seções: quanto aos periódicos e quanto aos artigos selecionados. Resultados: Foram obtidos 112 registros de publicações; sendo: 26 teses, 21 livros, 63 artigos, 1 (hum) editorial de saúde e 1 (hum) documento Pelos critérios de inclusão foram analisados 31 artigos em 23 revistas da área da saúde. As áreas dos periódicos que mais publicaram artigos sobre a temática da promoção da saúde do idoso, foram a Saúde Pública (8) e Enfermagem (8). O estudo mostrou que as publicações se concentraram nas regiões Sudeste e Sul do país. Quanto aos artigos, verificou- que a maior parte (22), foi publicada nos três anos mais recentes ao período analisado. Abordam em sua maioria a Promoção da Saúde sob o enfoque sócio-ambiental com ênfase no campo do desenvolvimento de habilidades. Conclusões: O panorama atual da literatura brasileira indica uma tendência de crescimento das publicações voltadas para a temática do envelhecimento a respeito da promoção da saúde do idoso desde 2006, nas diferentes áreas da saúde. O enfoque da Promoção da Saúde sob a perspectiva socioambiental demonstra uma preocupação dos pesquisadores quanto aos determinantes da saúde sob um olhar ampliado, para além do enfoque biomédico. A ênfase no campo do desenvolvimento de habilidades representa um aspecto preponderante na maioria dos artigos analisados o que aponta para a necessidade de uma análise critica sobre o desenvolvimento de pesquisas na área de envelhecimento e promoção da saúde no Brasil / Introduction- Population aging and epidemiological changes that have taken place in the last twenty years brought new social, political and cultural challenges in Brazil as well as in the rest of the world. The new concept of Health Promotion has influenced health field proposing a wider conception of the health-sickness process and its determinants, as well as the articulation of technical and traditional knowledge, and in the mobilization of all sectors of society in facing the issue and working out solutions. In this research we had the following objectives: to elaborate a scenery of the bibliographical production on Health Promotion for the Elderly in Brazil; to identify the conceptual focus on Health Promotion and the process by which such researches were carried out in the articles under consideration. Methodology: We carried out an exploratory descriptive study by means of the bibliographical inventory LILACS database, through DECS vocabulary descriptors. The period under consideration comprehends the years between 1994 and 2009, considering the promulgation of The National Policy for the Elderly as its historical benchmark. Data analysis was divided into two sections: first, with reference to periodicals; and second, with reference to selected articles. Results: 112 registered publications were obtained; 26 of them were theses, 21 were books, 63 were articles and 1 (one) was an editorial on health. According to the inclusion criteria, 31 articles published in 23 magazines were analyzed. Public Health and Nursing journals published the majority number of articles on the theme of health promotion for the elderly, 8 (eight) each one of them. This study showed that these publications were concentrated in the Southeast and South regions of the country. As for the articles, it was found that most of them (22) were published in the three most recent years of the period under consideration. The articles focus was mainly on the socio-environmental scope of Health Promotion with special emphasis on development of personal skills. Conclusions: The current scenery in the Brazilian literature shows a growing tendency in the number of articles engaged with the theme of aging focusing on health promotion for the elderly since 2006 in different areas of health field. The emphasis on Health Promotion under socio-environmental perspective demonstrates both, special concern from the researchers on health determinants, further than the biomedical focus. The emphasis on the field of development of personal skills represents a major aspect in most of the articles under evaluation, suggesting the need of critical analysis about the development of researches concerning Health Promotion and Aging in Brazil

Aim of study Person-centered medicine (PCM) with its focus on humanistic-biographical-oriented medicine and integrated, positive-salutogenic health is a central aspect in the patient-physician relationship in general practice. The objective of this analysis is to assess the prevalence and type of research project in academic institutions of general practice in Germany (Ger) and Austria (At) and the thematic priorities of the projects in the areas PCM, health promotion (HP), prevention (PRE) and conventional medicine (CM). Methods A search was conducted (September–December 2015) on the websites of 30 institutes and divisions of general medicine for their current research projects. The retrieved projects were assigned to five categories: PCM, HP, PRE, CM and others. Subsequently, we identified the targeted patient groups of the projects as well as the thematic focus in the categories PCM, HP, PRE and CM with focus on PCM and HP. Results 541 research projects were identified, 452 in Germany and 89 in Austria. Research projects were only included if they were explicitly indicated as research-oriented. Seventy projects addressed PCM aspects, 15 projects HP aspects, 32 projects PRE aspects and 396 projects CM aspects. The most frequently target groups in the categories PCM (24 of 70) and HP (7 of 15) were chronically ill patients. The most common thematic focus in PCM was communication (13 of 70) and in HP, physical activity (6 of 15). Conclusion The vast majority of research projects focused on conventional medical topics. PCM (13%) or PCM including HP (16%) in Ger and At is below the European average of 20%. From our point of view, PCM and HP need to be considered in general practice.

Icelandic children can expect to live a long and healthy life and have the right to the highest possible standard of health. Despite this, as in other Western countries, the prevalence of psychosocial complaints and long term conditions in Icelandic children is growing and they are struggling with increased levels of preventable health conditions. The purposes of this cross sectional, secondary analysis were to perform a psychometric evaluation on the instrument School-Children Health Promotion; to describe self-reported health promotion behavior of 10-12 year old Icelandic school children, and to predict novel and potentially useful patterns of health promotion behavior of 10-12 year old Icelandic school children using data mining methods. Existing data from 480 10-12 year old Icelandic school children and 911 parents were analyzed. Analysis of the instrument School-Children Health Promotion indicates that it is, in general, a valid and reliable instrument for measuring health promotion behavior of 10-12 year old Icelandic children. Five factors emerged from the 21 item instrument, which were labeled: "Positive Thinking." "Diet and Sleep Pattern," "Seek Psycho-social Support," "Coping Behavior," and "Health Habits." The results indicated that girls use more positive health promotion behavior than boys; however, differences in health promotion behavior between 5th and 6th grade students were not obvious. The results of data mining analyses, using the classifiers decision tree (J48) and logistic regression (Logistic) to predict health promotion behavior, showed better performance with the subsets of the five factors and the overall instrument than with the full dataset of 199 items. For the subsets, the logistic regression models performed better than the decision trees with AUC ranging from 0.71 to 0.80. The strongest predictors of health promotion behaviors were validation and caring in friendship, intimate disclosure between friends, and quality of life. Results of this secondary analysis indicate that friendship is of vital importance with regards to health promotion behavior. Therefore, further studies on the effect friendship has on health promotion behavior of Icelandic children in the 10-12 year old age group are clearly needed.

Hispanics now constitute the largest ethnic minority group in the U.S. As the country’s fastest growing demographic, social welfare and public health professionals should focus on ameliorating health issues affecting this population. However, Hispanics continue to experience health disparities including high rates of HIV infection. Moreover, South Florida, is home to two counties with the highest per capita incidence of HIV in the U.S. Risks for HIV are heightened in college settings where individuals may have multiple partners and inconsistent condom use. As such, Hispanic college students in a minority serving institution in Miami, FL comprise an ideal group for the implementation of targeted prevention efforts to decrease health disparities related to HIV. This dissertation evaluated the implementation of an HIV prevention effort that utilized social media based technologies to engage Hispanic college students in HIV prevention conversations and services. This dissertation (1) evaluated the effectiveness of exposure to a social media based campaign using an experimental design and (2) provided a systematic review of the campaign’s content and user interactivity. Participants were recruited from students electing to receive free HIV testing on-campus as part of a SAMHSA-funded project. Hispanic young adults (ages 18-24 years) completed baseline and follow-up assessments—reporting demographic and background characteristics as well as perceptions and incorporation of HIV preventive behaviors. Participants were randomized to social media exposure (n=30) or control (n=30) conditions. The exposure condition received three updates per week in the form of social media post updates. Follow-up assessments occurred 4 weeks after HIV testing. Mixed ANOVA and logistic regression analysis were used to examine the impact of exposure over time by comparing mean scores of baseline and follow-up responses between conditions. This dissertation examined the following outcomes: awareness of HIV testing and prevention services, confidence of using condoms, perceived benefits of using condoms, and frequency of reported protected sex acts. While analyses revealed no statistically significant differences between groups, McNemar’s test results indicated a statistically significant increase in awareness of HIV prevention services on the university campus for participants in both study conditions (p< .001). These exploratory results indicate further research is needed to determine the effectiveness of social media based strategies and how such technologies should be harnessed to achieve HIV prevention goals.

Memorial apresentado à Faculdade de Ciencias Farmacêuticas, Campus de Araraquara - UNESP, como parte das exigências do Concurso para obtenção do título de Livre-Docente no conjunto de disciplinas 'Atenção Farmacêuticas', 'Introdução ao Planejamento de Fármacos', e de 'Desenvolvimernto de Fármacos' do Departamento de Fármacos e Medicamentos. / Resumo: Não disponível / Abstract: Not available

Physical activity is now a key strategy for preventing or minimising numerous chronic diseases. Worksites are an ideal location to promote regular physical activity. For workers, a large portion of waking hours is spent at work where numerous opportunities exist to accumulate physical activity. Consequently, the aims of this thesis were to: 1) systematically review worksite physical activity literature, especially in the New Zealand context; 2) identify the contribution of worksite activity to total activity levels, and the correlates contributing to physical activity levels for professional occupations; and 3) objectively measure physical activity changes with point of decision prompt visibility in professional worksites. Accordingly the thesis incorporated one systematic review and two separate studies.Effect sizes calculated in an analysis of previous worksite physical activity health promotion studies show inconclusive evidence for increased employee retention and job satisfaction, and no evidence of reduced absenteeism or productivity increases. A major criticism of worksite research is that many unvalidated and unreliable designs are used, limiting study efficacy. Research initiatives need to identify the determinants of physical activity for different occupations, ethnicities, and gender in New Zealand worksites.Study 1 (N=56) consisted of participants wearing two pedometers over a three-day block, and subsequently completing a Three-Day Physical Activity Recall (3DPAR). A moderate, positive Spearman correlation (r=0.28) existed between the METs (3DPAR) and total pedometer values. Contributions of (mean + SD)worksite (14 283 +4761), non-work (12 516 +4 172), and total (26 798 +8 933) pedometer values were analysed. The sample was divided into tertiles according to total step counts. The high activity group (HAG) achieved more physical activity outside the workday (56%) when compared to the lowest activity group (LAG) (29%). Physical activity correlates were identified using binary logistic regression and simple correlation analyses. Relationships between physical activity and active transport, manual work, sport and exercise, and individual exercise were shown.Study 2 evaluated the National Heart Foundation (NHF) point of decision prompts for increasing physical activity levels in professional worksites. Forty-six participants (27 men and 19 women) wore two pedometers for three days, over four occasions to monitor changes in physical activity. The study was a crossover design with Worksite 1 receiving the treatment for three weeks, followed by a six-week wash out period, then a three-week control. Worksite 2 was given the control prior to the treatment period. Results indicate that the NHF point of decision prompts were ineffective at increasing objectively measured work and total physical activity levels, showing trivial positive (0.04) to moderate negative Cohen effect sizes (-0.79). When point of decision prompts were visible in the worksites overall mean step counts decreased. On the basis of these findings, the NHF's point of decision prompts had no effect, or were potentially detrimental to physical activity.Nevertheless, both studies were limited by some traditional worksite design problems, including low participation and sample contamination. However, by incorporating an objective measure of physical activity (pedometers) and a robust study design, these findings are the first objective measures of worksite physical activity, and the effects of point of decision prompts in a confined sample.