Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions.The findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities.

Cardiovascular disease is a major cause of death in most Westernised countries. The prevalence of obesity, type 2 diabetes mellitus and cancers is rapidly increasing. Older people with elevated blood lipids, obesity and DNA damage are at high risk of developing these diseases. There is a plethora of research to support the claim that a healthy diet and increased physical activity can reduce the risk of increased body fatness, diabetes and generally improve health. However, most interventions require intensive one to one advice. The aim of this study was to measure the effect of a group approach to advising on changes in lifestyle with particular attention to foods high in fibre. The study spanned a period of 12 weeks with a follow up session at 52 weeks to ascertain sustainability. The study: This study was a 12 week longitudinal intervention study with a follow up after 52 weeks. Measurements of anthropometry (skin folds, girths, weight and height), blood pressure, body fat by bio impedance and fasting blood (lipids, glucose and insulin) were made at weeks 0, 3, 6, 9,1 2 and 52. The participants were asked to complete a food frequency questionnaire and a physical activity questionnaire at each of the 6 measuring sessions and to provide an indication of what the goals that they had set and if they had accomplished them after 9,12 and 52 weeks. Between measurements at weeks 0 and 3 the volunteers were left to follow their usual food and activity pattern. Then as a group they were given a diet and exercise talk and provided with written material and pedometers to increase motivation. After measurement at week 6 they were randomly divided into two groups. The first group (A) were prescribed and provided with kiwifruit at a dose of 100g/30 kg body weight for three weeks while the second group (B) continued with the changes in diet and physical activity. Following measurement at week 9 group A abstained from kiwifruit while Group B added the kiwifruit to their diet and the measurements repeated. After 52 weeks, with only emails as ongoing communication, they were remeasured. Results For this multicultural, relatively middle aged group of 53 staff (28 women, 25 men) of mean age 46 years, measurable and statistically significant metabolic gains were made in the lipid profile over 12 weeks. Total cholesterol, LDL cholesterol, triglycerides and the ratio of total cholesterol to HDL all decreased and HDL increased significantly. Total cholesterol decreased from 5.6(±1.1) mean (±SD) mmol/L at baseline to 5.3(±1.1) mmol/L at week 12 (p<0.001); LDL cholesterol decreased from 3.5(±0.97) mmol/L at baseline to 3.3(±0.94) mmol/L at week 12 (p<0.001); and total cholesterol to HDL ratio decreased from 4.0(±1.1) to 3.7(±0.9) (p<0.001). In the 36 who were measured at 52- week follow- up these changes persisted. With the other outcome measures glucose showed a statistically but not biologically significant decrease over the 12 week period and body composition, blood pressure and insulin showed no significant change. The kiwifruit crossover had no apparent affect on the measures of any of the measurements reported. The participants reported that they increased fruit and vegetable and oily fish consumption and increased physical activity. These increases took place over the initial 12 week period and were maintained over 52 weeks. Conclusion: This study has shown that changes in diet and physical activity can favourably influence blood biochemistry even without accompanying changes in percentage body fat and weight. Furthermore, small, manageable lifestyle changes can result in biochemical changes persisting over 52 weeks.

This study explores how young people conceptualise addiction to smoking and, also the relationship between young people's addiction beliefs and intentions to smoke cigarettes. Addiction to smoking is a major health problem, not just for adults, but also for young smokers, up to 60% of whom are dependent on nicotine. However, anti-smoking prevention efforts targeted at young people generally emphasise ill-health effects and little attention is paid to addiction education which is generally considered relevant only to adult smoking and cessation efforts. Perhaps as a consequence, young people appear to have many misconceptions and unrealistic ideas about addiction, and these may possibly have influenced initial decisions to take up smoking. For example, between 50% and 60% of young smokers believe that it would be easy or very easy to stop smoking altogether if and when they choose to and the majority of daily smokers mistakenly believe that they will not be smoking for more than five years. For these young smokers, becoming addicted is often an unforeseen consequence and most are surprised to find that they cannot give up smoking as easily as they thought. The majority of addicted smokers regret ever taking up smoking but nevertheless continue to smoke cigarettes for perhaps 30 to 40 years because they find it very difficult to stop. This backdrop provides the impetus for the present study.

The aim of this thesis is to demonstrate the importance of walking to public health. The first part is characterized by epidemiological research. First, a typology for the measurement of walking is developed. A systematic review is conducted of observational studies to determine the health benefits of walking in its own right. Studies consistently confirm that 30 minutes walking on most days of the week is sufficient to reduce the risk of cardiovascular diseases and non-communicable disease risk. Then, a series of epidemiological analyses describes the prevalence and correlates of walking, using multiple health and non-health surveillance data sets. Surveillance data indicate that the prevalence of walking at the above recommended levels is low across all domains. Between 1991 and 2001 an increase in walking occurred, and was the main contributor to reductions in leisure time physical inactivity; however, the proportion of the population who achieved the recommended amount of physical activity by walking did not change in leisure and transport domains. The next part of the thesis is characterized by health promotion research examining the impact of three population-based approaches to increasing walking among Australian adults. The first was an evaluation of a conversion of rail to trail, as an environmental change intervention; the second was a mass media campaign promoting walking to work, and the third was a targeted print media walking program. Providing environmental supports with minimal promotion had no effect on walking. A nation-wide mass media campaign promoting walking to work increased walking and other moderate intensity physical activity, but process evaluation indicated other promotional efforts contributed as well. The targeted print media randomised trial had the greatest effect on walking, but the increases were not greater than spontaneous change in the control. Increases in total physical activity were achieved only when the intervention was supplemented by the use of a pedometer. The expectation that broader approaches to the promotion of walking will bring about changes at the population level, were not corroborated by these case studies. There is a need for enhancement of walking-specific interventions to influence total PA at the population levels.

The study set out to determine the influenza vaccination rate and to identify factors important in the process of vaccination acceptance decision making for a group of the well elderly in the A.C.T. Prediction of vaccination acceptance was compared using three measures: stated behavioural intention, report of past vaccination acceptance and a multiattribute utility decision model. In this study no one method of prediction was obviously better than another. The most important findings of this study included the marked variations in vaccination rates based on type of residence of the group members. Of the 15 variables of the decision model, factors related to the infection of influenza and possible complications of influenza were seen as the most important factors by both acceptors and nonacceptors of the vaccine in making the decision to have the injection. These findings can be incorporated into an area vital for nursing intervention, the planning of nursing programmes of health promotion and health maintence for the well elderly population.

Thesis (M.S.) -- Mississippi State University. Department of Agricultural and Biological Engineering. / Title from title screen. Includes bibliographical references.

<p>Kat är en buske vars blad tuggas och saliven som bildas sväljs, för att uppnå stimulans. Den växer i Yemen, Etiopien och Kenya och smugglas till Sverige från Storbritannien via flyg samt bil. Kat-användandet är utbrett bland somalier i västvärlden och har medfört både hälsomässiga och socioekonomiska konsekvenser. För att förstå hur somalier i Sverige har anpassat sina uppfattningar gällande kat-bruk är syftet i denna uppsats att beskriva varierande uppfattningar om användande av kat hos några somaliska män och kvinnor boende i Sverige. Information samlades och analyserades utifrån en fenomenografisk studie design. Data samlades genom intervjuer.</p><p> </p><p>Resultatet visar att kat-tuggande uppfattas både som en föda och som en drog. Största skälet till att kat brukas uppfattas som att den skapar gemenskap och sysselsättning. Den kat som används i Sverige smugglas vilket uppfattas problematiskt för somalier. Som implikation ska</p><p>hälsofrämjande arbete genomföras utifrån det ekologiska perspektivet. Hälsofrämjande aktiviteter ska riktas på både individ- och familjnivå genom att ge information om kat, skapa sysselsättning samt stödja familjen. På samhälls- och organisations/policynivå är det viktigt</p><p>att öka samarbetet mellan de somaliska föreningar och myndigheten samt att problemet kring kat sätts på agendan och diskuteras på nationell- och internationellnivå.</p><p> </p> / <p>Kat is a plant whose leaves are chewed to produce juice and to be swallowed for its stimulating effect. Kat plant grows in Yemen, Ethiopia and Kenya. It is smuggled from Great Britain to Sweden by plane or car. The use of kat is widely spread among Somalis in western countries. This has led to both health and socioeconomic consequences for the users and their families. In order to understand Somalis’ attitudes regarding kat - the aim of this study was to describe variations of perceptions of the use of kat among Somalian men and women living in Sweden. A phenomenographic design was used to collect and analyze data. Data collected through interviews.</p><p> </p><p>The findings show that chewing kat is perceived both as food and as a drug. The biggest reason for chewing kat is to create a feeling of belonging to a social group and to create activity. Kat being chewed in Sweden is smuggled here, which creates problems for Somalis.</p><p>As an implication of this study health promotion activities, based on the theory of the ecological system, should focus on individual and family level for example by supporting and giving information to families on the issues of kat. Health promoting activities should also focus on community and organization/policy level to increase the cooperation between the</p><p>Somali society and the public authority. Finally, the problem regarding kat should be on the agenda to be discussed both on national and international level.</p> / Har redan gått upp med min uppsats. Vill bara att den blir tillgänglig för de som vill läsa.

<p><strong>Background:</strong> The past three decades have seen a growth in health promotion research and practice, stimulated by the epidemiologic transition of the leading causes of death from infectious to chronic diseases. An estimated 50% of mortality from the 10 leading causes of death is due to behaviour, which suggests individuals can make important contributions to their own health by adopting some health-related behaviours and avoiding others. Motivational interviewing (MI) has emerged as a brief counselling approach for behavioural modification that builds on a patient empowerment perspective by supporting self-esteem and self-efficacy. MI has become increasingly popular in a variety of health care settings as well as non-health care settings.</p><p><strong>Aims:</strong> The overall aim of this thesis is to contribute to improved understanding of the different factors that impact on the learning and practice of MI. The aim of study I was to identify barriers and facilitators to use MI with overweight and obese children in child welfare and school health services. The aim of study II was to identify barriers, facilitators and modifiers to use MI with pharmacy clients in community pharmacies.</p><p><strong>Methods:</strong> Participants in study I were five child welfare centre nurses from the county council and six municipally-employed school health service nurses, all from Östergötland, Sweden. Participants in study II were 15 community pharmacy pharmacists in Östergötland Sweden. Data for both studies were obtained through focus group interviews with the participants, using interview guides containing open-ended questions related to the aims of the studies. Study II also included five individual interviews. Interview data were interpreted from a phenomenological perspective.</p><p><strong>Results:</strong> In study I, important barriers were nurses’ lack of recognition that overweight and obesity among children constitutes a health problem, problem ambivalence among nurses who felt that children’s weight might be a problem although there was no immediate motivation to do anything, and parents who the nurses believed were unmotivated to deal with their children’s weight problem. Facilitators included nurses’ recognition of the advantages of MI, parents who were cooperative and aware of the health problem, and working with obese children rather than those who were overweight. In study II, pharmacists who had previously participated in education that included elements similar to MI felt this facilitated their use of MI. The opportunity to decide on appropriate clients and/or healthrelated behaviours for counselling was also an important facilitator. The pharmacists believed the physical environment of the pharmacies was favourable for MI use, but they experienced time limitations when there were many clients on the premises. They also experienced many difficulties associated with the practical application of MI, including initiating and concluding client conversations.</p><p><strong>Conclusions:</strong> Learning and practicing MI effectively is difficult for many practitioners as it requires a new way of thinking and acting. Practitioners’ use of MI is not effective unless there is recognition that there is an important health-related problem to be solved. Practitioners feel more confident using MI with clients who have health-compromising behaviours and/or risks in which the practitioners feel they have expertise. Possessing considerable MI counselling skills does not compensate for insufficient knowledge about a targeted health-related behaviour and/or risk. Feedback from clients plays an important role for the quality and quantity of practitioners’ MI use.</p>

<p>Då människor befinner sig till stor del av sin vakna tid på arbetsplatsen har denna blivit en viktig arena för hälsofrämjande arbete. Studier visar hur viktigt det är för företag att ha en frisk och välmående personal. Fokus ligger då oftast på företagets behållning av hälsofrämjande arbete. Syftet med studien var därför att beskriva hur anställda upplevde hälsofrämjande arbete på sin arbetsplats. Kvalitativa intervjuer genomfördes med samtliga anställda på ett litet företag. Intervjuerna spelades in på band varefter de transkriberades och tolkades. Resultatet delades in i tre olika kategorier; <em>uppskattning från ledningen, gemenskap med arbetskollegerna </em>och<em> individuell motivation.</em> <em>Uppskattning</em> vilken de anställda upplevde genom att ledningen var lyhörd, brydde sig om och fick dem att känna sig bekräftade. <em>Gemenskap</em> till kollegor vilken kunde upplevas genom att de kände samhörighet. För vissa var det betydelsefullt medan andra inte brydde sig om det. Att som individ känna <em>motivation</em> för de hälsoförmåner som fanns på företaget visade sig vara viktigt. Det var egentligen inte de anordnade aktiviteterna som var det viktiga för informanterna, utan att få känna sig delaktig, inkluderad och sedd på arbetsplatsen. Upplever de anställda sig uppskattade inom företaget och att de har en bra sammanhållning främjar detta i sin tur individens upplevda hälsa.</p> / <p>The workplace has become an important platform for health promotion since people spend a big part of their life at work. Studies have shown how important it is for employers to have an understanding of the health and wellbeing of their staff. Yet most of the focus is still on the benefits for the employer. The aim of the study was to describe the employee’s experiences of their workplace health promotion. Qualitative interviews were implemented on all employees at a small company. All interviews were recorded, transcribed, interpreted and have been divided into three different categories; <em>The sense of value</em> that employees experienced when employers were good listeners, showed that they cared and made the employees feel important. The spirit of <em>fellowship</em> to colleagues could be experienced as very important to some and others didn´t care at all. To feel individual <em>motivation </em>for health promotion at the workplace was important. It showed that it wasn´t the actual method that was the most important part but to feel involved, included and to be seen at the workplace. The employees experience that they have a big participation in the company and that the solidarity is good which promote the individuals health experience.</p>

<p><strong>Syfte:</strong> Syftet var att undersöka ledares syn på hälsa och hälsofrämjande arbete samt hur det eventuella hälsofrämjandet arbetet såg ut på deras företag. Vidare undersöktes ur ledarens synvinkel, hur, vad och varför ledaren och företaget arbetar som de gör med hälsa på sin arbetsplats. <strong>Metod: </strong>Författarna har genom intervju frågat ledare vid fyra företag med kontorsverksamhet vad de anser om hälsa och hälsofrämjande arbete och hur företagets hälsoarbete ser ut. <strong>Resultat:</strong> Resultatet visade att ledarnas syn på hälsa och hälsofrämjande arbete påverkar hälsoarbetet på företaget. Resultatet visade även att tre av fyra företag hade ett välutvecklat hälsofrämjande arbete. <strong>Slutsats: </strong>Samtliga ledare visade intresse för hälsa och hälsofrämjande arbete om än i olika grad och ledarnas intresse har en påverkan på det hälsofrämjande arbetet.</p>