Home Hospital and Health Education: legal documentation analysis pre COVID / Hospital a Domicilio y Educación para la Salud: análisis legislativo pre COVID

Introduction: Hospital from home (HH) is a valid and stable alternative to the conventional hospital admission. Although it has been used since early XX century only recently was implemented in Portugal, on the public sector. Health literacy is a sine qua non condition to exercise of citizenship and informed consenting.Method:document analysis based on a review process of public legal documents from the last 5 years related with the implementation of HH and the development and role that health literacy plays on the process on HH. A discourse analysis was undertaken after documents gathering.Results:a total of 27 documents were recovered from the Portuguese public legal database (Diário da República Portuguesa). From those, a total of 3 versed HH. Discourse analysis presented the lack of emphasis on health literacy on the documents and, thus, on the legal fundamentals of implementation of HH units.Conclusions:Health literacy is a key element to included individuals on their health seeking behaviors and to manage their own health balance. Thus, to accept a different kind of hospital admission (when conditions are met) individuals should be provided with fundamental tools to overcome and develop their health literacy and to have an informed decision and consenting. Health literacy and health education are the core of HH units and, therefore, should be present on the discourse that establishes the units implementation on a legal basis. (AU)

Introducción: La Hospitalización Domiciliaria es una alternativa válida y competente al internamiento clásico. No obstante, a pesar de contar con una existencia desde el siglo XX, solo recientemente fue una opción concreta para los pacientes del Serviço Nacional de Saúde. La educación para la salud y la alfabetización en salud son criterios fundamentales para un ejercicio de ciudadanía plena y acceso a cuidados de salud.Método:Estudio de análisis documental basada en una revisión de los documentos legales (leys) de los últimos cinco años (2015-2020) y relacionado con la hospitalización domiciliaria y alfabetización en salud y educación para la salud. Al final se realizó un análisis discursivo de los documentos elegidos.Resultados:Un total de 27 documentos resultaron de la búsqueda en el website del Diário da República Portuguesa Online. Dentro de este, 3 eran del Ministério da Saúde y su alcance era la Hospitalización Domiciliaria. El análisis discursivo demostró que no hay énfasis en el soporte legal para la Hospitalización Domiciliaria y sus unidades sobre la educación para la salud o alfabetización en salud.Conclusiones:La educación para la salud y la alfabetización en salud son promotores de comportamientos saludables y el conocimiento puede servir para manejar enfermedades crónicas. La Hospitalización Domiciliaria maneja, mayoritariamente, enfermos con condiciones crónicas en fase aguda. La Hospitalización Domiciliaria es un contexto importante para desarrollar procesos de educación para la salud y promoción de la alfabetización en salud. Es fundamental que la documentación que regula el funcionamiento de la Hospitalización Domiciliaria tenga suporte para intervenciones para la promoción de la alfabetización y educación para la salud. (AU)

Decolonizing Global Health Education: Rethinking Institutional Partnerships and Approaches.

Global health often entails partnerships between institutions in low- and middle-income countries (LMICs) that were previously colonized and high-income countries (HICs) that were colonizers. Little attention has been paid to the legacy of former colonial relationships and the influence they have on global health initiatives. There have been recent calls for the decolonization of global health education and the reexamination of assumptions and practices under pinning global health partnerships. Medicine's role in colonialism cannot be ignored and requires critical review. There is a growing awareness of how knowledge generated in HICs defines practices and informs thinking to the detriment of knowledge systems in LMICs. Additionally, research partnerships often benefit the better-resourced partner. In this article, the authors offer a brief analysis of the intersections between colonialism, medicine, and global health education and explore the lingering impact of colonialist legacies on current global health programs and partnerships. They describe how "decolonized" perspectives have not gained sufficient traction and how inequitable power dynamics and neocolonialist assumptions continue to dominate. They discuss 5 approaches, and highlight resources, that challenge colonial paradigms in the global health arena. Furthermore, they argue for the inclusion of more transfor mative learning approaches to promote change in attitudes and practice. They call for critical reflection and concomitant action to shift colonial paradigms toward more equitable partnerships in global education.

Philippines Case Study: Government Policies on Nutrition Education.

Government policies at the national and local levels are central to the promotion, protection, and implementation of sound food and nutrition concepts in the Philippines. According to the 2015 national nutrition survey, persistent malnutrition problems, such as protein-energy malnutrition and micronutrient deficiencies (anemia, vitamin A deficiency, and iodine-deficiency disorders), continue to afflict a major proportion of Filipinos. In the Philippines, nutrition education and promotion date back as early as 1900 with the conduct of educational campaigns directed towards the prevention and control of epidemic diseases and to the care and feeding of young infants. This presentation begins with an overview of the Philippine Government, nutritional status of children, the Philippine Plan of Action for Nutrition, then devotes substantial attention to nutrition program for school children, and examines other potential legislative actions that may have an impact on the community and industry. While various nutrition education initiatives, addressing malnutrition problems among Filipinos, resulted in an improvement in some of the conditions, much is still to be done to achieve zero malnutrition for the Philippines. Eliminating hunger and malnutrition is technically feasible. The challenge lies in generating the requisite political will, developing realistic policies, and taking concerted actions nationally and internationally.

Health and Food and Nutritional Security Policies: challenges in controlling childhood obesity. / Políticas de Saúde e de Segurança Alimentar e Nutricional: desafios para o controle da obesidade infantil.

The study analyzed the initiatives of prevention and control of childhood obesity, especially those of Adequate and Healthy Food Promotion (PAAS) which have been part of the policies of the Brazilian federal government for the last 15 years. All documents that feature PAAS initiatives in the food and nutrition security, as well as public health policy fields, were evaluated according to the following criteria: (1) the approach to PAAS initiatives; (2) the aspects of obesitythat they intend to affect and (3) potential interest disputes. The main PAAS initiatives identified are intended to encourage: food and nutrition education; agroecological production systems; family agriculture; food accessibility; healthy environments and regulatory measures. These initiatives alter different aspects of childhood obesityand highlight different conceptions about the problem and affect different interests. We highlight the disputes between the interests of the processed foods and agribusiness corporations, and the governmental and corporate sectors guided by PAAS objectives. Measures aimed at regulating purchases and publicizing unhealthy products for children, are those that best express the interests involved.

O estudo analisou as ações de prevenção e controle da obesidade infantil, especialmente as de Promoção da Alimentação Adequada e Saudável (PAAS), que integram Políticas do governo federal brasileiro nos últimos 15 anos. Foram analisados todos os documentos que apresentam ações de PAAS no âmbito das políticas de saúde e segurança alimentar e nutricional a partir das seguintes dimensões: (1) a abordagem das ações de PAAS; (2) os condicionantes da obesidade que pretendem afetar e (3) as potenciais disputas de interesses. As principais ações de PAAS identificadas visam fomentar: a educação alimentar e nutricional; os sistemas produtivos de base agroecológica; a agricultura familiar; a acessibilidade alimentar; os ambientes saudáveis e as ações regulatórias. Essas ações interferem em diferentes condicionantes da obesidade infantil, apresentam distintas concepções sobre o problema e afetam distintos interesses. Destacam-se as disputas entre os interesses das corporações comerciais de alimentos processados e do agronegócio e os setores governamentais e societários norteados pelos objetivos de PAAS. As ações voltadas para a regulamentação das compras e espaços públicos, além da publicidade de produtos não saudáveis para crianças, são as que melhor expressam os interesses em disputa.

Políticas de Saúde e de Segurança Alimentar e Nutricional: desafios para o controle da obesidade infantil / Health and Food and Nutritional Security Policies: challenges in controlling childhood obesity

Resumo O estudo analisou as ações de prevenção e controle da obesidade infantil, especialmente as de Promoção da Alimentação Adequada e Saudável (PAAS), que integram Políticas do governo federal brasileiro nos últimos 15 anos. Foram analisados todos os documentos que apresentam ações de PAAS no âmbito das políticas de saúde e segurança alimentar e nutricional a partir das seguintes dimensões: (1) a abordagem das ações de PAAS; (2) os condicionantes da obesidade que pretendem afetar e (3) as potenciais disputas de interesses. As principais ações de PAAS identificadas visam fomentar: a educação alimentar e nutricional; os sistemas produtivos de base agroecológica; a agricultura familiar; a acessibilidade alimentar; os ambientes saudáveis e as ações regulatórias. Essas ações interferem em diferentes condicionantes da obesidade infantil, apresentam distintas concepções sobre o problema e afetam distintos interesses. Destacam-se as disputas entre os interesses das corporações comerciais de alimentos processados e do agronegócio e os setores governamentais e societários norteados pelos objetivos de PAAS. As ações voltadas para a regulamentação das compras e espaços públicos, além da publicidade de produtos não saudáveis para crianças, são as que melhor expressam os interesses em disputa.

Abstract The study analyzed the initiatives of prevention and control of childhood obesity, especially those of Adequate and Healthy Food Promotion (PAAS) which have been part of the policies of the Brazilian federal government for the last 15 years. All documents that feature PAAS initiatives in the food and nutrition security, as well as public health policy fields, were evaluated according to the following criteria: (1) the approach to PAAS initiatives; (2) the aspects of obesitythat they intend to affect and (3) potential interest disputes. The main PAAS initiatives identified are intended to encourage: food and nutrition education; agroecological production systems; family agriculture; food accessibility; healthy environments and regulatory measures. These initiatives alter different aspects of childhood obesityand highlight different conceptions about the problem and affect different interests. We highlight the disputes between the interests of the processed foods and agribusiness corporations, and the governmental and corporate sectors guided by PAAS objectives. Measures aimed at regulating purchases and publicizing unhealthy products for children, are those that best express the interests involved.

[Health Education in the Spanish Education Laws: comparative analysis between LOE and LOMCE]. / La Educación para la Salud en las leyes de Educación españolas: comparativa entre la LOE y la LOMCE.

OBJECTIVE: The current Organic Law for the Improvement of Educational Quality (LOMCE) incorporates substantial changes from the previous law, especially a new curricular configuration with a higher prevalence of optionality, which may affect the development of health competencies by students. The objective was to evaluate the treatment of Health Education (HE) in the last two educative Spanish laws, based on the amount and varia- bility of Health related terms that they incorporate. METHODS: A comparative quantitative analysis was performed based on the presence of 281 terms related to eight areas of Health Education in both laws and for the two compulsory education stages (Primary and Secondary). Differences in the number of terms between laws was tested using an independence test. The effect of law, health area and educational level was tested using a logistic regression, and differences among curricular itineraries was assessed using a Wilcoxon test. RESULTS: LOE included 156 terms versus 153 in LOMCE. The educational level and health area affected the presence of terms (p-value < 0.001). The difference in the number of terms studied by a student depending on the curricular itinerary is 28% in Primary and ESO in LOMCE, compared to 0% and 7% in LOE. CONCLUSIONS: No significant differences have been found between laws in the number of terms, nor in the treatment of the health areas between laws. However, the increase in optional subjects in LOMCE allows a considerable asymmetry in the training of young people depending on their curricular itinerary.

OBJETIVO: La actual Ley Orgánica para la Mejora de la Calidad Educativa (LOMCE) incorpora cambios sustanciales con respecto a la ley anterior, especialmente una nueva configuración del currículum con mayor optatividad, que puede afectar al desarrollo de las competencias de Salud por parte del alumnado. El objetivo fue evaluar el tratamiento de la Educación para la Salud (EpS) en las dos últimas leyes educativas españolas, en base a la variabilidad y cantidad de términos relacionados con Salud que recogen. METODOS: Se realizó un análisis cuantitativo comparativo basado en la presencia de 281 términos relativos a ocho ámbitos de la EpS en ambas leyes y para las dos etapas de educación obligatorias (Primaria y Secundaria). Las diferencias en el número de términos entre leyes se comprobaron con un test de independencia. El efecto de la ley, el ámbito de salud y el nivel educativo se testó con una regresión logística, y las diferencias entre configuraciones curriculares con un test de Wilcoxon. RESULTADOS: La LOE recogió 156 términos frente a 153 en la LOMCE. El nivel educativo y el ámbito de salud influyeron en la presencia de términos (p-valor < 0,001). La diferencia en la cantidad de términos cursados por un alumno dependiendo del itinerario curricular fue del 28 % en Primaria y ESO en la LOMCE frente al 0 % y del 7 % en la LOE. CONCLUSIONES: No se han encontrado diferencias significativas entre leyes en el número de términos, ni en el peso de los diferentes ámbitos. Sin embargo, el aumento de optatividad en la LOMCE, introduce una asimetría considerable en la formación de los jóvenes dependiendo de su itinerario curricular.

SBM recommends policy support to reduce smoking disparities for sexual and gender minorities.

The Society of Behavioral Medicine supports the inclusion of gender and sexual minorities in all local, state, and national tobacco prevention and control activities. These activities include surveillance of tobacco use and cessation activities, targeted outreach and awareness campaigns, increasing access to culturally appropriate tobacco use dependence treatments, and restricting disproportionate marketing to lesbian, gay, bisexual, and transgender communities by the tobacco industry, especially for mentholated tobacco products.

La Educación para la Salud en las leyes de Educación españolas: comparativa entre la LOE y la LOMCE / Education for health in Spanish education laws: comparative between the LOE and the LOMCE

Fundamentos: La actual Ley Orgánica para la Mejora de la Calidad Educativa (LOMCE) incorpora cambios sustanciales con respecto a la ley anterior, especialmente una nueva configuración del currículum con mayor optatividad, que puede afectar al desarrollo de las competencias de Salud por parte del alumnado. El objetivo fue evaluar el tratamiento de la Educación para la Salud (EpS) en las dos últimas leyes educativas españolas, en base a la variabilidad y cantidad de términos relacionados con Salud que recogen. Métodos: Se realizó un análisis cuantitativo comparativo basado en la presencia de 281 términos relativos a ocho ámbitos de la EpS en ambas leyes y para las dos etapas de educación obligatorias (Primaria y Secundaria). Las diferencias en el número de términos entre leyes se comprobaron con un test de independencia. El efecto de la ley, el ámbito de salud y el nivel educativo se testó con una regresión logística, y las diferencias entre configuraciones curriculares con un test de Wilcoxon. Resultados: La LOE recogió 156 términos frente a 153 en la LOMCE. El nivel educativo y el ámbito de salud influyeron en la presencia de términos (p-valor < 0,001). La diferencia en la cantidad de términos cursados por un alumno dependiendo del itinerario curricular fue del 28 % en Primaria y ESO en la LOMCE frente al 0 % y del 7 % en la LOE. Conclusiones: No se han encontrado diferencias significativas entre leyes en el número de términos, ni en el peso de los diferentes ámbitos. Sin embargo, el aumento de optatividad en la LOMCE, introduce una asimetría considerable en la formación de los jóvenes dependiendo de su itinerario curricular

Background: The current Organic Law for the Improvement of Educational Quality (LOMCE) incorporates substantial changes from the previous law, in particular a new curricular configuration with a higher prevalence of optionality, which may affect the development of health competencies by students. The objective was to address health education in the last two years, according to the amount and variability of Health related terms. Methods: A comparative quantitative analysis was performed based on the presence of 281 terms related to eight areas of Health Education in both laws and for the two compulsory education stages (Primary and Secondary). Results: Overall, no significant differences were found in the number of terms, or in the treatment of the health areas between laws. However, the increase in optional subjects in the LOMCE increases differences in training in Health Education. The difference in the number of terms studied by a student depending on the curricular itinerary is 28% in Primary and ESO in the LOMCE, compared to 0% and 7% in the LOE. Conclusions: The LOMCE does not represent an improvement in Health Education in terms of the number of health terms, and allows considerable asymmetry in the training of young people depending on their curricular itinerary. The results suggest that it would be necessary to reinforce the contents of Health Education in compulsory subjects

A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework.

OBJECTIVE: To offer an overview of sport-related concussion (SRC) prevention and education strategies in the context of the socioecological framework (SEF). Athletic trainers (ATs) will understand the many factors that interact to influence SRC prevention and the implications of these interactions for effective SRC education. BACKGROUND: Concussion is a complex injury that is challenging to identify and manage, particularly when athletes fail to disclose symptoms to their health care providers. Education is 1 strategy for increasing disclosure. However, limited information addresses how ATs can integrate the many factors that may influence the effectiveness of SRC education into their specific settings. Public health models provide an example through the SEF, which highlights the interplay among various levels of society and sport that can facilitate SRC prevention strategies, including education. DESCRIPTION: For ATs to develop appropriate SRC prevention strategies, a framework for application is needed. A growing body of information concerning SRC prevention indicates that knowledge alone is insufficient to change concussion-related behaviors. The SEF allows this information to be considered at levels such as policy and societal, community, interpersonal (relationships), and intrapersonal (athlete). The use of such a framework will facilitate more comprehensive SRC prevention efforts that can be applied in all athletic training practice settings. Clinical Applications: Athletic trainers can use this information as they plan SRC prevention strategies in their specific settings. This approach will aid in addressing the layers of complexity that exist when developing a concussion-management policy and plan.

Community perspectives on the use of regulation and law for obesity prevention in children: A citizens' jury.

INTRODUCTION: Childhood obesity is a significant challenge for public health internationally. Regulatory and fiscal measures propagated by governments offer a potentially effective response to this issue. Fearing public criticism, governments are often reluctant to use such measures. In this study we asked a descriptively representative and informed group of Australians their views on the use of legislation and fiscal measures by governments to address childhood obesity. METHODS: A citizens' jury, held in South Australia in April 2015, was asked to consider the question: What laws, if any, should we have in Australia to address childhood obesity? RESULTS: The jury agreed that prevention of obesity was complex requiring multifaceted government intervention. Recommendations fell into the areas of health promotion and education (n=4), regulation of food marketing (n=3), taxation/subsidies (n=2) and a parliamentary enquiry. School-based nutrition education and health promotion and mandatory front-of-pack interpretive labelling of food and drink were ranked 1 and 2 with taxation of high fat, high sugar food and drink third. CONCLUSION: The recommendations were similar to findings from other citizens' juries held in Australia suggesting that the reticence of decision makers in Australia, and potentially elsewhere, to use legislative and fiscal measures to address childhood obesity is misguided. Supporting relevant informed public discussion could facilitate a politically acceptable legislative approach.

The impact of child restraint legislation on the incidence of severe paediatric injury in Chile.

BACKGROUND: The objective of this study is to determine the association between Chile's 2005 child restraint legislation (CRL) and the incidence of severe paediatric motor vehicle-related injury. METHODS: We analysed motor vehicle injury data from Chile's Road Safety Commission from 2000 to 2012 to determine the association between Chile's 2005 CRL and severe paediatric injury. Using Poisson time-series models we assessed the effect of the law on two outcome variables: (1) severely injured children per vehicle fleet; and (2) severely injured children per population. RESULTS: Chile's 2005 CRL is significantly associated with a 24% reduction in severely injured children per vehicle, and 19% reduction in severely injured children per population in the 1st year of its enactment. In 2007 this law is also significantly associated with a 17% decrease in severely injured children per vehicle, and with an 11% decrease in severely injured children per population. However, this legislation had a short-term effect since no reductions in severely injured children per vehicle were observed after 2009 and no reductions for severely injured children per population were registered after 2008. CONCLUSIONS: This is the first study to examine the association between CRL and severe paediatric injury in a Latin-American country. This study suggests that Chile's CRL was only effective in the short term. To support this type of reforms in the long term, other measures such as police enforcement, public information campaigns and involvement of public health professionals in educating parents about the benefits of using child restraints should be considered.

Changes in Legal Aspects of Public Education about Drugs and Their Importance.

Requirements for education on proper use of drugs were included in the junior high school educational guideline in 2012 incorporating pharmaceutical education in the obligatory school curriculum. This move is closely related to the country's new OTC drug marketing system. The amendment of the Pharmaceutical Affairs Law (PAL) in 2013 highlighted the public's own role in "promoting proper use of drugs and other related products and making greater efforts to acquire knowledge and improve understanding of their effective and safe use". Furthermore, the Law to Amend the PAL and Pharmacists Law enforced in 2014 allowed all OTC drugs to be sold online under appropriate rules. Deregulation of online sale of OTC drugs is expected further to promote self-medication for minor illnesses and require stricter measures to ensure people's safety through their proper use. These legal amendments in recent years have made people's education about proper use of drugs one of the top priorities Japan should pursue at state level. Since 2000, the author has been offering education on drugs to early primary school children as part of their healthcare education program. In the future, dedicated education on drugs will be necessary for people of all ages including not only school children but also their guardians and elderly citizens as well.