Background: Nearly half of the US population is overweight or obese, carrying with them a higher risk for morbidity and mortality and rising healthcare costs. Rural women are disproportionately affected, with higher rates of obesity, obesity-related chronic diseases, and poorer health outcomes (Befort, Nazir, & Perri, 2012; Penney, Rainham, Dummer & Kirk, 2014). There may be several factors. In general, rural health systems are more isolated, with a lack of healthcare resources including quality providers, technology, and public health services (IOM, 2009). Purpose: The purpose of this quality improvement project was to assess how obesity is managed in women residing in one rural community - Ritzville, Washington. Methods and Aims: Charts of all women ≥ 18 years of age receiving care at Hometown Family Medicine clinic (HTFM) were queried for a diagnosis of obesity. The prevalence of obesity in this group was calculated. Of those identified as obese, thirty charts were selected at random and reviewed. The following was determined: 1) Prevalence of chronic disease in adult women who receive care at HTFM; and 2) The management of obesity at HTFM compared with current evidence-based guidelines. This was followed by a community assessment to determine the resources available for the prevention and treatment of obesity in Ritzville, WA. Results: The prevalence of obesity (36.9%) and chronic diseases (hypertension, diabetes type 2, dyslipidemia, and heart disease) in the population studied were found to be significantly higher than both state and national averages. Due to a lack of basic resources, (access to weight loss specialties, exercise facilities, healthy foods, etc.) management of obesity in Ritzville, WA may be challenging. Findings from this study helped to inform resource allocation and identified opportunities to improve the management of obesity based on current practice guidelines. Primary health care may be the only opportunity to promote healthy behaviors and improve health outcomes in this vulnerable population. Action needs to be taken or the burden of obesity will continue to rise.

Bakgrund: Efter akut kranskärlssjukdom är det viktigt att förändra sin livsstil då det har stor betydelse för framtidsutsikten för dessa patienter. Trots detta så förändrar inte alla patienter sina livsstilsvanor, eller klarar av att bibehålla de nyligen förändrade vanorna.   Syfte: Syftet var att studera vad som påverkar genomförandet av livsstilsförändringar hos personer i efterförloppet av akut kranskärlssjukdom.   Metod: Litteraturstudie med ett systematiskt tillvägagångssätt. Datainsamling genomfördes i databaserna CINAHL, PsycINFO, PubMed, Swemed+ och UniSearch. Efter datainsamling och kvalitetsgranskning inkluderades 15 artiklar varav nio kvalitativa artiklar och sex kvantitativa artiklar. För bearbetning av data utfördes en analys där fyra huvudkategorier identifierades.   Resultat: De fyra huvudkategorierna som identifierades var: Den enskilde individen, Kunskap, Inre faktorer och Yttre faktorer. Dessa områden kunde både främja och/eller hämma genomförandet av livsstilsförändring i efterförloppet av akut kranskärlssjukdom.    Konklusion: Sjuksköterskan bör vara medveten om den multifaktoriella process som livsstilsförändring innebär för patienten. Patientens behov kan tillgodoses genom tydlig information om sjukdomen men även andra aspekter såsom livsstilsförändring och hantering av förändring. Patienten behöver stöd från sjukvården, likasinnade och närstående för att kunna förändra sin livsstil.

The thesis is focused on the lifestyle of people with elevated cholesterol level. Fundamental terms, which are basic for the topic, are explained. The latest findings stated in professional literature on lifestyle, health, diseases, health promotion and health prevention are presented. The most recent statistical results are mentioned The first section of the thesis is focused on the issue in general, i.e. on lifestyle, the definition of health and its determinants, nutrition and stress. A large section is devoted to determinants of health that significantly affect human health. These are healthcare, genetics, environmental impacts. Therefore, the great importance of our lifestyle, which may be influenced by smoking, stress, physical activity, drug use, alcohol consumption and diet, is demonstrated. A large part of our activities can be positively influenced by ourselves. The determinants and their effects on human body are mentioned. The main focus is put on diseases associated with elevated cholesterol levels, where cardiovascular disease stands first. Another aspect makes a positive side and this is healthy lifestyle. Healthy lifestyle and practices how to positively influence our health are characterized. A specific decalogue, giving certain constrains, is outlined. And also the irreplaceable role of prevention and health promotion, which is one of activities of the public health protection authorities, is mentioned. The projects of the World Health Organization also contribute to the population health promotion. The project Health 21 is also mentioned in this thesis. The objective of this study was to analyze the results of cholesterol tests in the framework of a screening program in the South Bohemian Region carried out over the period of three years. A sub-objective was to determine the lifestyle changes in clients with the decrease in blood cholesterol levels. The main hypothesis is ? there is a rising trend in elevated cholesterol levels in the blood In the practical section the results obtained from the qualitative research focused on the lifestyle of people with elevated cholesterol levels are presented. The issues concerning their lifestyle such as physical activity, stress, smoking, dietary habits, fluid intake and sleep are investigated. The questionnaire survey and the subsequent analysis of the data obtained have shown that these persons have a more responsible approach to their lifestyle. They admit that the results of the tests focused on cholesterol levels positively affect their lifestyle. The majority of respondents positively affect their lifestyle according to theoretical recommendations. Comprehensive investigation has proved that the overall lifestyle is comparable to the general population.

The lifestyle of secondary school students in the town of Havlíčkův Brod. The objective of my thesis was to call attention to the current possible risks of adolescents at secondary schools who live an inappropriate lifestyle. This is primarily the risk of becoming addicted to alcohol and smoking. The consumption of alcohol and smoking is very widespread among young people in the Czech Republic. The lifestyle of adolescents is affected by numerous factors. It is important to beginning teaching children a healthy lifestyle as soon as possible. Addiction to alcohol and smoking adversely affects the human body and causes very many diseases. The thesis presents up-to-date information about the lifestyle of secondary school students in the town of Havlíčkův Brod. The age at which a child or adolescent acquires his first experience with alcohol or cigarettes has markedly decreased in the past two years. This fact, of course, disturbs a wide range of experts from ranks of pedagogues, educators, medical workers, and other experts. Czechs belong among the leading consumers of alcoholic drinks in the Word. The number of smokers among adolescents increases daily. The risk of premature death is associated with this. A lifestyle belongs among important factors that can influence not only behaviour but also a person's health.

The life style of the homeless in České Budějovice is varied, and these people do not take homelessness their own life style. The most common cause of homelessness is disagreement between parents, even if the majority passed their childhood within the properly functioning family. In most of cases, the men are single, without a partner. Over a half of the homeless people in České Budějovice are healthy, and they regard health important. The majority of them do not use health services and they do not pay the health insurance. Over a half do not get financial means by means of their own work, which means that they either draw employment benefits, material shortage benefits, or they go begging. As against this, the majority is looking for a job, do occasional work or are registered unemployed at the job centre. The unemployed in St. Paul{\crq}s House have their own meals and they keep to the regular drinking regime. People living outdoor eat of what they cadge or what they get from people in streets. In the category of those addicted it ensued that the dependence on cigarettes of the homeless is a more frequent phenomenon than on alcohol. Over a half of the homeless people in České Budějovice use the sanitary facility in St. Paul{\crq}s House. People living outdoor do their hygiene in the river, mostly. In their free time, over a half of the homeless go in for their jobs or seeking for a job. In the evening people attending St. Paul{\crq}s House watch TV, and people living outdoor drink alcohol and relax. Over a half of the homeless have a regular daily routine. Most of the homeless is not concerned in what is happening around. Over a half of the homeless people do not anything about being homeless, they are unsatisfied with their life situation, they perceive it to be wrong, serious, and therefore to be changed. As for the values, they consider health the most important value, while the least important one for them is their own housing. The primary idea of this Diploma Thesis is to make both lay and professional public acquainted, and help to increase awareness of the said problem.

A vast majority of tourism development in Guanacaste has occurred in the northern coastal region along the Pacific coast (Honey, Vargas and Durham 2010). However, recent development is beginning to move south as developers visualize big returns on early investments. As new tourism development continues to expand in the southern region of the Nicoya Peninsula, small communities are being transformed from small fishing and farming communities to communities heavily reliant on tourism. Playa Azul, a small beach town in the southern region of the Nicoya Peninsula, is one such community. This dissertation utilizes ethnographic fieldwork to examine the impacts of tourism on the daily lives of residents of Playa Azul, particularly looking at how local residents cope with perceived changes to the norms and values of the community as tourism development continues to expand in the area. The penetration of foreign capital into the community is having a transformative effect on community relations, particularly challenging community norms and values. It is my contention that as Playa Azul continues to develop as a primary tourist destination and development continues to expand, the rifts within the community between existing community members (Azuleños, foreign Ticos and lifestyle migrants) and newly arriving “business-oriented” members will continue to grow with it. I argue this has led to subtle forms of resistance among community members as they work to maintain the pura vida “vibe” of the town and the values that support a multicultural community based on humility, acceptance and mutual respect. / 2021-01-11

Magister Curationis - MCur / Pregnancy induced hypertension is one of the causes of maternal, fetus and neonatal morbidity and mortality. It is the condition in which a pregnant woman develops hypertension because of physiological changes that result during pregnancy and both mother and fetus can be affected. According to the World Health Organization (WHO), the first target of the third United Nations Sustainable Development Goals (SDG-3) is to reduce the maternal mortality rate (MMR) to less than 10 per 100.000 live births by 2030 (WHO, 2017). This is because globally, about 350 000 women die every year from pregnancy related causes (Hogan, Foreman, & Naghavi, 2010). According to the WHO (2015), these conditions namely post-partum hemorrhage, hypertension in pregnancy, infections, unsafe abortion and other delivery-related complications cause three quarters of all maternal deaths in the World. Hence the needs to prevent or successfully treat conditions that contribute to this scourge (WHO, 2011). The two main interventions that are used to prevent or treat hypertension in pregnancy are medication and lifestyle adjustment. However, it is important to understand the intervention that is most suited to a context and its patient and compare the effects of these interventions on management of hypertension in pregnant women as a patient outcome.

With an increase in life expectancy, the number of older people affected by cognitive decline and dementia is rising, causing major, global public health concerns. However, there is substantial variation in the rate and magnitude of cognitive decline experienced among ageing individuals. Evidence suggests that many age-associated changes in cognitive functioning can be explained by modifiable lifestyle factors such as smoking, physical activity and diet choices. The weight of the evidence supports the promotion of a healthy lifestyle as an effective strategy for healthy cognitive ageing. Many epidemiological studies have drawn causal conclusions with regard to the positive and direct benefits of lifestyle, yet few have considered the possible confounding role of prior cognitive ability in explaining the lifestyle and cognition relationship in older age. Given the potential for reverse causation, whereby better prior cognitive functioning leads to a greater uptake of healthy behaviours rather than vice versa, it is a mechanism which should be studied, but rarely is. The present thesis focuses on the possible confounding effect of prior cognitive ability on the cross-sectional relationships between lifestyle factors and cognitive ability domains in later-life. The core of the thesis is a series of independent, peer-reviewed (six first-author and one co-author) journal articles in the public domain. Data were derived from the Lothian Birth Cohort 1936 study (n = 1091), a sample of relatively healthy, community-dwelling men and women aged 70 years from Edinburgh, Scotland, for whom childhood (age 11) mental test scores are available. The lifestyle factors investigated were caffeine consumption, alcohol consumption, dietary patterns, body mass index, smoking, serum cholesterol, and physical activity. Cognitive function was assessed across five major ageing-related domains: age 70 IQ (based on the same test that was taken in childhood), general cognitive ability (g), processing speed, memory, and verbal ability. General linear models (ANCOVA) were adjusted for the following covariates: age; sex; childhood cognitive ability; and socioeconomic status (SES). Other potential covariates were additionally adjusted for as necessary. Overall, the positive and significant associations observed between ‘healthy’ lifestyle factors and better cognitive functions at age 70 were consistent with previous research; their effect size was around 1% of the variance in cognitive tests scores. However, these relationships were markedly attenuated (by on average 80%) by a higher childhood cognitive ability and adult SES; for the most part, associations were reduced to non-significance. None of the lifestyle factors were consistent predictors of performance across cognitive domains, though smoking avoidance, a physically active lifestyle, and moderate intake of alcohol, appeared to have the most potential. The key novel finding of this thesis is that, in addition to having predictive value for lifestyle choices over 60 years later, cognitive ability at age 11 accounted for the majority of the cross-sectional associations between lifestyle factors and cognitive abilities in later-life. This finding is consistent with the theory of confounding or even reverse causation. That is, individuals with higher lifetime ‘trait’ cognitive ability may be more likely to adopt a lifestyle which protects against cognitive decline. Rather than a unidirectional or indirect effect of health behaviours on cognitive function, the present findings suggest there may be a dynamic cycle involving cognition, self-management of health and ultimate cognitive outcomes.

Submitted by Ana Elisa Messetti Christofoletti (anaelisamchr@hotmail.com) on 2018-10-08T00:10:52Z No. of bitstreams: 1 DISSERTAÇAO VERSAO FINAL ANA ELISA.pdf: 4111346 bytes, checksum: 21bfa518a05d08ef1568406749e30116 (MD5) / Rejected by Ana Paula Santulo Custódio de Medeiros null (asantulo@rc.unesp.br), reason: Solicitamos que realize uma nova submissão seguindo as orientações abaixo: - Agradecimento à CAPES: citar conforme a portaria abaixo: "O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Código de Financiamento 001" PORTARIA Nº 206, DE 4 DE SETEMBRO DE 2018 Dispõe sobre obrigatoriedade de citação da CAPES O PRESIDENTE DA COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR, no uso das atribuições que lhe foram conferidas pelo art. 26 do (a) Estatuto, aprovado (a) pelo Decreto nº 8977, de 30/01/2017, e CONSIDERANDO o indicado nos Editais da CAPES, nos Termos de Compromisso de Bolsista, nos regulamentos de bolsas no exterior e de bolsas no país, no Manual de AUXPE, e no termo de adesão ao Portal de Periódicos; CONSIDERANDO o constante dos autos do processo nº 23038.013648/2018-51, resolve: Art. 1º Os trabalhos produzidos ou publicados, em qualquer mídia, que decorram de atividades financiadas, integral ou parcialmente, pela CAPES, deverão, obrigatoriamente, fazer referência ao apoio recebido. Art. 2º Para fins de identificação da fonte de financiamento fica autorizada a utilização do código 001 para todos os financiamentos recebidos. Art. 3º Deverão ser usadas as seguintes expressões, no idioma do trabalho: "O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Código de Financiamento 001 "This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001" Art. 4º Fica o pró-reitor de pós-graduação ou congênere, responsável pela divulgação e aplicação da regra dentro das Instituições de Ensino Superior que recebem apoio da CAPES. Art. 5º A falha em obedecer esta norma implicará em mudanças eventuais nos apoios da CAPES para as instituições e pesquisadores envolvidos, a partir de 2020. Art. 6º Esta Portaria entra em vigor na data de sua publicação. Agradecemos a compreensão. on 2018-10-08T12:02:18Z (GMT) / Submitted by Ana Elisa Messetti Christofoletti (anaelisamchr@hotmail.com) on 2018-10-08T14:36:06Z No. of bitstreams: 1 DISSERTAÇAO VERSAO FINAL ANA ELISA.pdf: 4110139 bytes, checksum: ae311cf67ad448294621f1e94868e43d (MD5) / Approved for entry into archive by Ana Paula Santulo Custódio de Medeiros null (asantulo@rc.unesp.br) on 2018-10-08T17:01:27Z (GMT) No. of bitstreams: 1 christofoletti_aem_me_rcla.pdf: 4110178 bytes, checksum: f82dffd1c9c6becbbc7214f58a787060 (MD5) / Made available in DSpace on 2018-10-08T17:01:28Z (GMT). No. of bitstreams: 1 christofoletti_aem_me_rcla.pdf: 4110178 bytes, checksum: f82dffd1c9c6becbbc7214f58a787060 (MD5) Previous issue date: 2018-09-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A prevalência de adolescentes brasileiros expostos ao tempo sentado, como utilizar smartphones mais de 5 horas e 51 minutos por dia, é de 65%. Assim, as intervenções para reduzir o comportamento sedentário (CS) em jovens são importantes, mas pouco se sabe sobre como reduzir o CS dos adolescentes por meio do uso de aplicativos de smartphones, o que é interessante, uma vez que essa ferramenta é usada por 87,4% dos jovens brasileiros. Mas antes de criar um aplicativo com esse propósito, é necessário verificar as variáveis associadas ao CS de determinada região e explorar as características que o aplicativo deverá possuir para futuramente ser criado. Com base nisso, o objetivo do estudo foi verificar os fatores sociodemográficos associados ao CS e explorar as características que aplicativos para smartphones devem conter para redução do CS no tempo livre a partir da visão dos adolescentes. Participaram do estudo 482 adolescentes (14,43±2,08 anos) de 3 escolas públicas e 2 particulares do ensino fundamental (anos finais) e ensino médio da cidade de Rio Claro - SP. Para a coleta de dados, os participantes responderam a um questionário de identificação, anamnese clínica e questionário para caracterizar o nível socioeconômico; o Questionário de Comportamento Sedentário, com questões adicionais relacionadas ao CS e o uso de smartphones e videogames; o Questionário de Atividade Física Habitual para Adolescentes e mensuração do peso e estatura para o cálculo de Índice de Massa Corporal (IMC) (kg/m²). A análise de dados dos questionários e medidas antropométricas foram realizadas no programa SPSS versão 22.0 e foi feita a análise descritiva dos dados, teste T de Student para comparar meninos e meninas e o teste de regressão logística para verificar associação das variáveis do estudo com o CS (p<0,05). Após à aplicação dos questionários, realizaram-se entrevistas individuais semiestruturadas com 8 participantes, com o intuito de descobrir o que deve conter em um aplicativo de smartphone para diminuir o CS de adolescentes. Para a análise da entrevista semiestruturada, foi utilizado o método de codificação simples. O CS total foi de 13,7±3,4 horas/dia e 47,5% da população apresentou mais de 14,1 horas/dia de CS. As variáveis associadas ao CS foram: smartphone; computador/tablet e videogame; CS nas obrigações e televisão. O uso exacerbado do smartphone está relacionado ao sexo feminino e ao elevado tempo de CS. As principais características que um aplicativo de smartphone para diminuir e gerar pausas no CS são: envolvimento social, metas, recompensa, mensagens de incentivo, layout atrativo, envolvimento com as redes sociais, atualizações periódicas, podendo ser em formato de jogo. Os domínios do CS devem ser investigados de forma distintas, pois o presente estudo demonstrou que eles influenciam de forma distinta o CS total dos adolescentes. Assim, deve-se considerar variáveis técnicas do aplicativo e variáveis sociais dos adolescentes para a criação de aplicativos para smartphones para redução do CS no tempo livre. / The prevalence of Brazilian adolescents exposed to sitting time, such as using smartphones for more than 5 hours and 51 minutes per day, is 65%. Thus, interventions to reduce sedentary behavior (SB) in adolescents are important, but little is known about how to reduce adolescents' SB using smartphone applications, which is interesting, since this tool is used by 87.4% of the Brazilian adolescents. However, before creating an application for this purpose, it is necessary to check the variables associated with the SB of a given region and to explore the characteristics that the application must have to be created in the future. Based on this, the aim of this study was to verify the sociodemographic factors associated with SB and explore the characteristics that applications for smartphones should contain to reduce SB in leisure time from the adolescents' view. A total of 482 adolescents (14.43 ± 2.08 years) from 3 public schools and 2 private elementary schools (final years) and high school in the city of Rio Claro - SP participated to the study. For the data collection, the participants answered an identification questionnaire, clinical anamnesis and a questionnaire to characterize the socioeconomic level; the Sedentary Behavior Questionnaire, with additional questions related to SB and the use of smartphones and video games; the Normal Physical Activity Questionnaire for Adolescents and weight and height measurement for the calculation of Body Mass Index (BMI) (kg / m²). The data analysis of the questionnaires and anthropometric measurements were performed in the SPSS version 22.0 program and the descriptive analysis of the data was done. Further, it was performed Student's T test to compare boys and girls and also the logistic regression test to verify the association of the study variables with SB (p <0.05). Subsequent to the application of the questionnaires, semi-structured individual interviews with 8 participants were conducted, in order to find out what should be contained in a smartphone application to decrease adolescents’ SB. For the analysis of the semi-structured interview, the simple coding method was used. Total SB was 13.7±3.4 hours/day and 47.5% of the population presented more than 14.1 hours/day of SB. The variables associated to SB were: smartphone; computer / tablet and video game; SB in chores and television. The exacerbated use of the smartphone is related to female and to the high time of SB. It was also elucidated that the main characteristics that a smartphone application should have to decrease and generate breaks in SB are: social involvement, goals, reward, incentive messages, attractive layout, involvement with social networks, periodic updates, and it can come in a game format. SB domains should be investigated differently, as the present study has demonstrated that they have a distinct influence 10 on adolescents’ total SB. Thus, it is necessary to consider technical variables of the application and adolescents’ social variables for the creation of applications for smartphones to reduce the SB in free time. / CAPES: 001

This thesis deals with the lifestyle of policemen of Czech Republic in South Bohemia. The aim of this study is to discuss the most risky aspects the lifestyle of policemen of Czech Republic in South Bohemia. The questionnaire method and cotent analysis were used in this research. Policemen of South Bohemia, specifically jindřichohradecký and českobudějovický took part in research. Total number of respondents was 100. The theoretical part is concerning specific terms like lifestyle, funeral, exercise, nutrition, stress, relaxation and overall characteristic of policemen of Czech Republic. In the practical part the results of filled-in questionnaires were analyzed, using the method of Pearson´s chi square to test the null hypothesis. On the basis of data that we acquired, following statements can be pronounced: 67% of respondents are non-smokers; only 7% of respondents do not regullarly have breakfast; daily income of fluids is 2 l or more for 57% of respondents; stressful situations are fully handled by 66% of respondents. From those results we assume that most of policemen in South Bohemia are familiar with healthy lifestyle and that they abide to its rules.