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1.
N C Med J ; 81(1): 5-13, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31908325

RESUMEN

BACKGROUND In 2016, the North Carolina Division of Public Health (DPH) launched the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) program to provide 5 local health departments (LHDs) with financial resources and technical assistance to address 3 aims: improve birth outcomes, reduce infant mortality, and improve health for children from birth to 5 years.METHOD: State legislation established an academic-practice partnership between NCDPH and the University of North Carolina at Chapel Hill (UNC) to provide program evaluation and implementation coaching to LHDs. ICO4MCH used a collective impact framework, principles of implementation science, and a health equity approach to implement evidence-based strategies to address the program's aims.RESULTS: A shared measurement system was developed by an evaluation stakeholders group led by the NCDPH and UNC in which LHDs reported data on a quarterly basis and the evaluators returned reports to drive improvements. Structured assessments and technical assistance provided by implementation coaches helped grantees address barriers to implementation including cultivating and sustaining a diverse community action team, addressing staff turnover, and using data to drive improvements.LIMITATIONS: It was challenging for grantees to balance community needs and build partnerships in the first year while integrating data from multiple assessments into action plans to meet the performance measures. It was necessary to streamline assessments and reduce indicators to make data more actionable.CONCLUSION: An academic-practice partnership was integral to successful implementation of the ICO4MCH program and may serve as a model for moving evidence-based maternal child health programs to practice in LHDs.


Asunto(s)
Salud del Niño , Promoción de la Salud/organización & administración , Relaciones Interinstitucionales , Salud Materna , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , North Carolina , Embarazo , Evaluación de Programas y Proyectos de Salud
3.
Enferm. clín. (Ed. impr.) ; 29(6): 376-380, nov.-dic. 2019. tab
Artículo en Español | IBECS | ID: ibc-184659

RESUMEN

Desde 1953, con la aparición de la figura de Ayudante Técnico Sanitario de Empresa, hasta 2005, con el reconocimiento de la especialidad de Enfermería del Trabajo, los cambios socioculturales y tecnológicos han determinado la evolución del trabajo, de sus procesos y condiciones, pero también han concretado los riesgos laborales a los que los trabajadores estamos expuestos, así como la forma de organizar la prevención, la seguridad y la salud laboral. La Enfermería del Trabajo se define como una especialidad enfermera que aborda los estados de salud de los individuos en su relación con el medio laboral, con el objeto de alcanzar el más alto grado de bienestar físico, mental y social de la población trabajadora, teniendo en cuenta las características individuales del trabajador, del puesto de trabajo y del entorno sociolaboral en que este se desarrolla. La Enfermería del Trabajo desarrolla sus funciones básicas a través de la vigilancia de la salud de los trabajadores, y constituye, junto con Medicina del Trabajo, la unidad básica de salud que, a su vez, forma parte de los servicios de prevención de las empresas públicas y privadas. Hoy en día existen en España unos 9.000 especialistas en Enfermería del Trabajo, un número insuficiente para garantizar la prevención de accidentes de trabajo y enfermedades profesionales, detectar precozmente enfermedad laboral, promocionar la salud a través de la modificación de estilos de vida y mejorar el bienestar de la población trabajadora española. Enfermería del Trabajo es consciente de los innumerables retos que debe afrontar en los próximos años y, para ello, recurre a competencias tan fundamentales como la docencia, la gestión y la investigación para integrarse dentro de los proyectos interdisciplinares en salud laboral que den solución a los cada vez más complejos problemas de salud y seguridad en el trabajo


From 1953, with the appearance of the Company Occupational Health Technical Assistant Specialist, until 2005, with the recognition of the specialty of Occupational Health Nursing, socio-cultural and technological changes have determined the evolution of work, its processes and conditions, but have also specified the occupational risks to which workers are exposed, as well as how to organize prevention, safety and occupational health. Occupational Health Nursing is defined as a nursing specialty that addresses the health status of individuals in their relationship with the workplace, in order to achieve the highest level of physical, mental and social well-being of the working population, taking into account the individual characteristics of the worker, the job and the socio-labour environment in which they develop. Occupational Health Nursing undertakes its basic functions through the surveillance of workers’ health, and constitutes, beside Occupational Medicine, the basic health unit, which in turn is part of the prevention services of both public and private companies. Today there are about 9,000 specialists in Occupational Health Nursing in Spain, an insufficient number to guarantee the prevention of accidents at work and occupational diseases, the early detection of occupational pathology, the promotion of health through modification of lifestyles and the improvement of the well-being of the Spanish working population. Occupational Health Nursing is aware of the challenges that it must face in the coming years and therefore, it relies on competences as fundamental as teaching, management and research to integrate into interdisciplinary projects in occupational health that provide solutions to increasingly complex health and safety problems at work


Asunto(s)
Humanos , Enfermería del Trabajo/métodos , Enfermería del Trabajo/organización & administración , Satisfacción en el Trabajo , Condiciones de Trabajo , Salud Laboral , Promoción de la Salud/organización & administración
4.
Metas enferm ; 22(9): 5-14, nov. 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-185037

RESUMEN

Objetivo: identificar y conocer las políticas alimentarias elaboradas por las comunidades y ciudades autónomas en el territorio español. Método: se realizó una investigación documental. La población de estudio fueron las políticas alimentarias de las comunidades autónomas (CC.AA.), Ceuta y Melilla. Se incluyeron planes de salud y programas nutricionales (integrales o infanto-juveniles) publicados en las páginas web de las administraciones públicas regionales (periodo 2006-2018). Se efectuaron diferentes estrategias de búsqueda para identificar los planes y programas procedentes de administraciones públicas a través de las URL descritas. Se elaboró un checklist ad hoc en función del instrumento TREND para valorar la presencia de seis ítems: objetivos, población, descripción de acciones, método, evaluación de las acciones y difusión de los resultados. Resultados: se obtuvieron 38 planes y programas relacionados con las políticas alimentarias, correspondientes a las 17 CC.AA. y a la ciudad autónoma de Ceuta. El 47,4% (n= 18) fueron planes de salud, uno por CC.AA., incluida Ceuta; el 36,8% (n= 14) fueron programas nutricionales integrales y el 15,8% (n= 6) se trataba de programas de obesidad infanto-juvenil. Todos cumplían los cuatro primeros criterios valorados. Sin embargo, no estaban presentes los criterios cinco y seis en algunos programas. Conclusión: todas las CC.AA. tenían plan de salud y también la ciudad autónoma de Ceuta. Andalucía es la región que más políticas ha desarrollado para afrontar la obesidad como problema de salud. País Vasco, Aragón, Canarias, Castilla-La Mancha, Cataluña y Galicia también han elaborado varios programas para tratar este problema. El abordaje de la alimentación saludable y la obesidad en España es heterogéneo en el ámbito regional


Objective: to identify and understand the food policies conducted by the autonomous communities and cities in the Spanish territory. Method: a documentary research was conducted. The study population was the food policies by the autonomous communities (AACC), Ceuta and Melilla; it included the healthcare plans and nutrition programs (comprehensive or child and youth) published in the websites of regional authorities (period 2006-2018). Different search strategies were used to identify the plans and programs from public authorities through the URLs described. An ad hoc checklist was created based on the TREND tool to assess the presence of six items: objectives, population, description of actions, method, evaluation of actions, and dissemination of results. Results: thirty-eight (38) plans and programs associated with food policies were retrieved, corresponding to the 17 AACCs and the autonomous city of Ceuta; 47.4% (n=18) of these were healthcare plans, one per AACC, including Ceuta; 36.8% (n= 14) were comprehensive nutrition programs, and 15.8% (n= 6) were programs on child-youth obesity. All of them met the first four criteria assessed; however, criteria five and six were not present in some programs. Conclusion: all AACCs have healthcare plans, as well as the autonomous city of Ceuta. Andalusia is the region that has developed more policies to address obesity as a health problem. The Basque Country, Aragon, the Canary Islands, Castille-La Mancha, Catalonia and Galicia have also prepared some programs to deal with this problem. In Spain, healthy eating and obesity are addressed heterogeneously in the regional setting


Asunto(s)
Humanos , Dieta Saludable , Política Nutricional , Obesidad/prevención & control , Promoción de la Salud/organización & administración , Investigación Participativa Basada en la Comunidad , Enfermería en Salud Pública , Obesidad/epidemiología , Salud Global , Planificación en Salud/organización & administración
5.
Sante Publique ; Vol. 31(3): 357-365, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31640323

RESUMEN

OBJECTIVE: This article focuses on health promotion laboratories, a Quebec professional development program offered by the Public Health Department of the Montréal Region to teams of professionals and managers working in health promotion within local public health organizations. The objective is to examine the process of translating the knowledge gained by participants as a result of the program over the longer term within the organization. METHOD: This was a qualitative descriptive study. The work was guided by Nonaka's Organizational Knowledge Creation Model. Data were collected from participants at several types of discussion and development events held in the three months following the end of the pilot project. A thematic content analysis was performed using a grid derived from Nonaka's model. RESULTS: The analysis revealed the presence of both externalization and internalization in two of the sites, as well as a considerable volume of combinations in the four sites studied. In the latter case, the learnings reused over the longer term were similar to those that had been transferred in the short term (e.g. ideas and methods relating to partnership, planning, etc.). CONCLUSION: These results are important, in that they confirm the laboratories' potential to propagate the learnings throughout the organization, beyond the short-term gains made by participants during the laboratories. These learnings could potentially pave the way for new practices.


Asunto(s)
Promoción de la Salud/organización & administración , Aprendizaje , Administración en Salud Pública , Humanos , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Quebec
6.
BMC Public Health ; 19(1): 1311, 2019 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-31623589

RESUMEN

BACKGROUND: The mortality of coronary heart disease can be largely reduced by modifying unhealthy lifestyles. However, the long-term effectiveness of interventions for modifying unhealthy diet and physical inactivity of patients with coronary heart disease remain unsatisfactory worldwide. This study aims to systematically design a set of theory-based and evidence-based, individualized, and intelligent interventions for promoting the adoption and maintenance of a healthy diet and physical activity level in patients with coronary heart disease. METHODS: The interventions will be delivered by a mobile health care system called Individualized, Intelligent and Integrated Cardiovascular Application for Risk Elimination. Three steps of the intervention mapping framework were used to systematically develop the interventions. Step 1: needs assessment, which was carried out by a literature review, in-depth interviews and focus group discussions. Step 2: development of objective matrix for diet and physical activity changes, based on the intersection of objectives and determinants from the Contemplation-Action-Maintenance behavior change model. Step 3: formulation of evidence-based methods and strategies, and practical applications, through a systematic review of existing literature, research team discussions, and consultation with multidisciplinary expert panels. RESULTS: Three needs relevant to content of the intervention, one need relevant to presentation modes of the intervention, and four needs relevant to functional features of the application were identified. The objective matrix includes three performance objectives, and 24 proximal performance objectives. The evidence-based and theory-based interventions include 31 strategies, 61 evidence-based methods, and 393 practical applications. CONCLUSIONS: This article describes the development of theory-based and evidence-based interventions of the mobile health care system for promoting the adoption and maintenance of a healthy diet and physical activity level in a structured format. The results will provide a theoretical and methodological basis to explore the application of intervention mapping in developing effective behavioral mobile health interventions for patients with coronary heart disease. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR-INR-16010242. Registered 24 December 2016. http://www.chictr.org.cn/index.aspx.


Asunto(s)
Enfermedad Coronaria/prevención & control , Ejercicio , Promoción de la Salud/organización & administración , Telemedicina/organización & administración , Adulto , Femenino , Promoción de la Salud/métodos , Humanos , Inteligencia , Masculino , Persona de Mediana Edad , Medicina de Precisión , Telemedicina/métodos
7.
Rev Infirm ; 68(254): 32, 2019 Oct.
Artículo en Francés | MEDLINE | ID: mdl-31587849

RESUMEN

The inauguration of a fitness path at the Carémeau University Hospital Campus was an opportunity for teams at the Nîmes University Hospital Centre to participate in an inter-service Nordic walking challenge. It was an opportunity to discover a particular sporting discipline, promote team cohesion in services and enjoy physical activity in a friendly atmosphere.


Asunto(s)
Ejercicio , Promoción de la Salud/organización & administración , Relaciones Interprofesionales , Cuerpo Médico de Hospitales/psicología , Francia , Hospitales Universitarios , Humanos
8.
Ned Tijdschr Tandheelkd ; 126(9): 437-441, 2019 Sep.
Artículo en Holandés | MEDLINE | ID: mdl-31522209

RESUMEN

In a general dental practice, attention was drawn to a patient by numerous deep carious cavities following bariatric surgery. In the research literature, indications can be found for a negative influence of bariatric surgery on oral health. Risk factors for caries, such as the number of cariogenic bacteria in saliva, inadequate quantity and quality of saliva, gastrooesophageal reflux and vomiting may be become more pronounced. Additionally, dietary habits will change due to the altered anatomy of the gastro-intestinal tract. Negative effects of bariatric surgery on periodontal tissue have also been found. However, it is conceivable that patients who are overweight already have poorer oral health prior to bariatric surgery,due to lifestyle and dietary habits, than comparable people who are not overweight. Health education programmes prior to and following bariatric surgery seem to have a positive effect on oral health. Initiating more research into oral health related to bariatric surgery is recommended.


Asunto(s)
Cirugía Bariátrica , Caries Dental , Promoción de la Salud/organización & administración , Cirugía Bariátrica/efectos adversos , Caries Dental/epidemiología , Humanos , Salud Bucal
9.
Glob Health Action ; 12(1): 1659098, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31496422

RESUMEN

Background: HIV/AIDS prevention has historically encountered many obstacles. Understanding the factors affecting HIV/AIDS prevention is central to designing and implementing suitable context-specific interventions. Research relating to HIV prevention in the Middle East and North African region is required to address the gradually increasing HIV epidemic. Objective: This study aimed to explore the perspectives of employees/health care professionals who are working or have worked within HIV prevention in Sudan and Yemen on the challenges and facilitating factors facing HIV prevention. Methods: A qualitative approach was employed using an open-ended questionnaire. Sixteen stakeholders from governmental and non-governmental agencies participated in the study. The questionnaire focused on the various challenges and facilitating factors facing HIV prevention as well as proposed possible solutions from the perspectives of the participants. The data were analysed using thematic analysis. Results: The study illustrated the similarities in context and HIV prevention systems between Sudan and Yemen. Thematic analysis resulted in three main themes: I) much is achieved despite difficulties; II) a programme left to be paralysed; this theme addressed the main obstacles facing HIV prevention in Sudan and Yemen generating a total of six sub-themes; III) comprehensive change is needed. The participants drew focus and attention to vital changes required to improve the delivery of HIV prevention services. Conclusion: Increased financial support for HIV prevention in Sudan and Yemen is urgently needed. De-stigmatisation and increased political support, advocacy and improved legislation for people living with HIV (PLHIV) are required for the sustainability and effectiveness of HIV prevention programmes in Sudan and Yemen. Civil society organisations must be aided and supported in their role in engaging key populations.


Asunto(s)
Eficiencia Organizacional , Infecciones por VIH/prevención & control , Promoción de la Salud/organización & administración , Femenino , Apoyo Financiero , Personal de Salud , Humanos , Entrevistas como Asunto , Masculino , Vigilancia de la Población , Investigación Cualitativa , Sudán , Encuestas y Cuestionarios , Yemen
10.
Implement Sci ; 14(1): 81, 2019 08 14.
Artículo en Inglés | MEDLINE | ID: mdl-31412894

RESUMEN

BACKGROUND: The National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control and Prevention funded six national organizations to scale and sustain multistate delivery of the National DPP lifestyle change intervention (LCI). This study aims to describe reach, adoption, and maintenance during the 4-year funding period and to assess associations between site-level factors and program effectiveness regarding participant attendance and participation duration. METHODS: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation from October 2012 to September 2016. Multilevel linear regressions were used to examine associations between participant-level demographics and site-level strategies and number of sessions attended, attendance in months 7-12, and duration of participation. RESULTS: The six funded national organizations increased the number of participating sites from 68 in 2012 to 164 by 2016 across 38 states and enrolled 14,876 eligible participants. By September 2016, coverage for the National DPP LCI was secured for 42 private insurers and 7 public payers. Nearly 200 employers were recruited to offer the LCI on site to their employees. Site-level strategies significantly associated with higher overall attendance, attendance in months 7-12, and longer participation duration included using self-referral or word of mouth as a recruitment strategy, providing non-monetary incentives for participation, and using cultural adaptations to address participants' needs. Sites receiving referrals from healthcare providers or health systems also had higher attendance in months 7-12 and longer participation duration. At the participant level, better outcomes were achieved among those aged 65+ (vs. 18-44 or 45-64), those who were overweight (vs. obesity), those who were non-Hispanic white (vs. non-Hispanic black or multiracial/other races), and those eligible based on a blood test or history of gestational diabetes mellitus (vs. screening positive on a risk test). CONCLUSIONS: In a time of rapid dissemination of the National DPP LCI the findings of this evaluation can be used to enhance program implementation and translate lessons learned to similar organizations and settings.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Promoción de la Salud/organización & administración , Guías como Asunto , Promoción de la Salud/economía , Humanos , Ciencia de la Implementación , Estilo de Vida , Evaluación de Programas y Proyectos de Salud , Estados Unidos
11.
Bull World Health Organ ; 97(8): 570-574, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31384075

RESUMEN

Problem: The measures for long-term care prevention that the Japanese government had introduced in 2006 were unsuccessful because of the failures to identify high-risk individuals and to enrol enough participants in the community prevention programme. Approach: The Japanese government shifted its primary strategy from a high-risk strategy to a community-based population strategy in 2015, by reforming the Long-term Care Insurance Act. This act is focusing on community-based care and social determinants of health. The Act and the government's plans for long-term care prevention are inspired by a social participation intervention called ikoino saron, that is gathering salons for people older than 65 years. These salons, managed by local volunteers, are held once or twice a month in communal spaces within walking distance of community members' homes and have a low participation fee. At the gatherings, older people can meet and interact with others through enjoyable, relaxing and sometimes educational programmes. Local setting: Japan has the world's largest ageing population, with 27.7% (35.2 million/126.7 million) of people older than 65 years. Relevant changes: Studies have shown that participation in the salons was associated with a halved incidence in long-term care needs and about one-third reduction in the risk of dementia onset. Evidence also suggests that financially vulnerable older adults were more likely to participate in such interventions. In 2017, 86.5% (1506/1741) of the Japanese municipalities had implemented the salons. Lessons learnt: Integrated care for long-term care prevention should consider interventions targeting the whole community in addition to high-risk individuals.


Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Promoción de la Salud/organización & administración , Envejecimiento Saludable , Participación Social , Anciano , Anciano de 80 o más Años , Demencia/prevención & control , Femenino , Humanos , Japón/epidemiología , Cuidados a Largo Plazo/organización & administración , Masculino , Determinantes Sociales de la Salud
12.
BMC Public Health ; 19(1): 1180, 2019 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-31455327

RESUMEN

BACKGROUND: Enabling behaviour change in health care is a complex process. Although the use of theory to inform behaviour change interventions is advocated, there is limited information about how this might best be achieved. There are multiple models of behaviour change, however, due to their complexity they can be inaccessible to both researchers and healthcare practitioners. To support health care practitioner behaviour change, this was addressed by the development of the Theoretical Domains Framework (TDF) in 2005. Citations of the TDF and associated papers have increased exponentially. Although not predicted or intended by the authors, the TDF has also been used to investigate health behaviour change interventions. Therefore our aim was to narratively synthesize empirical evidence on how the TDF and subsequent iterations have been applied in health behaviour change to inform future intervention development. METHODS: Systematic search of four online databases, combined with searches for citations of key papers and key author searches, resulted in 3551 articles eligible for screening. Of these 10 met the pre-determined inclusion criteria. Screening of full-texts, data extraction and quality appraisal were independently performed by both authors. Disagreements regarding eligibility were resolved through discussion. RESULTS: Of the 10 included studies three used the TDF and seven used subsequent iterations, the Capability, Opportunity, Motivation to Behaviour / Behaviour Change Wheel to assess and /or categorise behavioural determinants to identify relevant behaviour change techniques. Two studies reported feasibility testing. Most interventions were targeted at diet and exercise. Eight reported an explicit and systematic process in applying the framework. CONCLUSION: There is limited evidence of how the framework has been used to support health behaviour change interventions. In the included studies the process of using the framework is not always reported in detail or with clarity. More recent studies use a systematic and judicious process of framework application. From the limited evidence available we tentatively suggest that the steps proposed in the BCW appear to be sufficient for development of interventions that target health behaviour change interventions. Further research is needed to provide evidence in how the framework may be most effectively applied to intervention development. PROTOCOL REGISTRATION: PROSPERO CRD42018086896 .


Asunto(s)
Conductas Relacionadas con la Salud , Promoción de la Salud/organización & administración , Teoría Psicológica , Humanos , Narración , Ensayos Clínicos Controlados Aleatorios como Asunto
14.
Medicine (Baltimore) ; 98(35): e16977, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31464944

RESUMEN

BACKGROUND: Nutrition is an important modifiable factor in combating overweight and obesity among adolescents. School has been indicated as an effective environment for influencing eating behavior; however, recent reviews assessing school-based interventions specifically for adolescents are scarce. Therefore, we propose the present systematic review with the aim to comprehensively review the quantitative and qualitative literature on the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. METHODS: We will search MEDLINE/PubMed, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, and ADOLEC. We will include randomized controlled trials (RCT), non-RCT, and controlled before-after studies. Risk of bias will be assessed using the EPOC Risk of Bias Tool for RCT, Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCT or controlled before-after, as well as the Critical Appraisal Skills Program (CASP) checklist for qualitative studies. We will analyze the overall strength of the evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Two independent researchers will conduct all evaluations and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed by the RevMan 5.3 software. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols. RESULT: This review will evaluate the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. The primary outcome will be changes in adolescent food consumption. Secondary outcomes will be biological parameters (e.g., body mass index (BMI), waist circumference (WC), body composition, etc); biochemical parameters (e.g., glycemia, triglycerides, total cholesterol, etc); qualitative evidences that support or explain the effect of school-based food and nutrition education interventions on adolescent food consumption. CONCLUSION: The findings of this systematic review will summarize the latest evidence of the effects of school-based food and nutrition education interventions on adolescent health promotion. The findings will be an available reference for school-based interventions and other further research. REGISTRATION: PROSPERO CRD42019116520.


Asunto(s)
/estadística & datos numéricos , Educación en Salud/organización & administración , Promoción de la Salud/organización & administración , Servicios de Salud Escolar/organización & administración , Adolescente , Salud del Adolescente , Glucemia , Índice de Masa Corporal , Pesos y Medidas Corporales , Conducta Alimentaria , Humanos , Lípidos/sangre , Proyectos de Investigación
15.
Arch. med. deporte ; 36(192): 208-214, jul.-ago. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-185176

RESUMEN

Objetivos: Determinar el tipo de personal médico, las prioridades y actividades para la protección y promoción de la salud de las Federaciones Nacionales de Natación (FNN) según su nivel económico y determinar si aplicaban los programas relacionados con la salud de la Federación Internacional de Natación (FINA).Método: Se realizó un estudio descriptivo transversal mediante una encuesta confidencial distribuida a las 208 FNN adscritas a la FINA. La encuesta fue validada y se obtuvo su fiabilidad estadística (coeficiente α de Cronbach de 0,8642 para n = 15). Las FNN se dividieron según su nivel económico en FNN de países desarrollados (n=66) y FNN de países en desarrollo (n = 142) siguiendo la clasificación de la Organization for Economic Cooperation and Development (2016). Análisis: Se realizó una comparación estadística de las medias mediante la prueba U de Mann-Whitney. Resultados: Respondieron 80 FNN en desarrollo (56,3 %) y 55 desarrolladas (83,6 %). Hubo diferencias en la presencia de fisioterapeutas (FNN en desarrollo: 31,2%, desarrolladas: 58,1%, p < 0,005) y psicólogos (11,2% vs 21,8%; p = 0,096). La máxima prioridad para ambos grupos fue el Máximo rendimiento de los nadadores de élite, aunque Aumentar el número de nada-dores de élite era de mayor importancia para las FNN en desarrollo (4,1 vs 3,95; p < 0.05). Los Programas de Prevención de ahogamiento fueron los más frecuentes en ambos grupos, pero con diferencias significativas entre ellos (FNN En desarrollo: 58,7% vs FNN Desarrolladas: 74,5%; p = 0,058). Conclusiones: Las FNN no disponían del personal necesario para promover la salud de sus nadadores. La mayor prioridad de las FNN en desarrollo era Aumentar el número de atletas de élite, pero tenían bajos niveles de Prevención de lesiones, Vuelta a competir tras una lesión y de Exámenes médicos preparticipación, aunque en las FNN desarrolladas también eran bajos. La Prevención de ahogamiento fueron los programas más frecuentes pero la Salud de la población en general, la del atleta recreativo y el "Deporte Seguro" (sin acoso sexual) eran cuestiones de baja prioridad para todas


Purposes: To determine the profile of the medical personnel, the priorities and the activities/ researches of the National Swimming Federations of Developing and Developed countries with respect to the athletes' health protection and the promotion of health in the general population. Method: A descriptive transversal study through a confidential survey that was circulated to the 208 FINA National Member Federations. A statistical validity and reliability was obtained (Cronbach α coefficient of 0.8642 for n = 15). The NFs were divided based on their economic level, NFs of developed (n = 66) and developing countries (n = 142) following the classification of the Organization for Economic Co-operation and Development, (2016). Analysis: A statistic comparison of measures with the test U of Mann- Whitney was executed. Results: 80 of the NFs from developing countries (56.3%) responded and 55 NFs from developed countries (83.6%). Evident differences were found in Presence of physiotherapists (Developing NFs: 31.2%, Developed NFs: 58.1%; p<0.005) and psycho-logists (11.2% vs 21.8%; p = 0.096). Top priority for both groups was Performance of the elite athletes, however Increasing the numbers of elite athletes was of major importance for the Developing NFs (4.1 vs 3.95, p < 0.05). The programs based around drowning prevention are the most prevalent of the programs run by both (58.7% vs 74.5%; p = 0.058). Conclusion: The NFs did not have the necessary personnel to promote the health of their athletes. Top priority for the Developed NFs was to Increase the numbers of elite athletes but they have low levels of Prevention of injuries programs. Coming back after an injury and Medical examination preparation were also low in Developed and in Developing NFs. Prevention of drowning program was the most frequent program/activity for health of general population, for the recreational athlete and "Save Sport" (without sexual abuse) they were questions of low priority for all of them


Asunto(s)
Natación/normas , Promoción de la Salud/normas , Países Desarrollados , Países en Desarrollo , Organizaciones de Normalización Profesional/normas , Deportes/normas , Natación/legislación & jurisprudencia , Promoción de la Salud/organización & administración , Federación para Atención de Salud/normas , Estudios Transversales , Estadísticas no Paramétricas , Rol
16.
Lancet ; 394(10194): 261-272, 2019 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-31327370

RESUMEN

Oral diseases are a major global public health problem affecting over 3·5 billion people. However, dentistry has so far been unable to tackle this problem. A fundamentally different approach is now needed. In this second of two papers in a Series on oral health, we present a critique of dentistry, highlighting its key limitations and the urgent need for system reform. In high-income countries, the current treatment-dominated, increasingly high-technology, interventionist, and specialised approach is not tackling the underlying causes of disease and is not addressing inequalities in oral health. In low-income and middle-income countries (LMICs), the limitations of so-called westernised dentistry are at their most acute; dentistry is often unavailable, unaffordable, and inappropriate for the majority of these populations, but particularly the rural poor. Rather than being isolated and separated from the mainstream health-care system, dentistry needs to be more integrated, in particular with primary care services. The global drive for universal health coverage provides an ideal opportunity for this integration. Dental care systems should focus more on promoting and maintaining oral health and achieving greater oral health equity. Sugar, alcohol, and tobacco consumption, and their underlying social and commercial determinants, are common risk factors shared with a range of other non-communicable diseases (NCDs). Coherent and comprehensive regulation and legislation are needed to tackle these shared risk factors. In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.


Asunto(s)
Atención Odontológica/organización & administración , Reforma de la Atención de Salud/organización & administración , Enfermedades de la Boca/terapia , Salud Bucal , Sacarosa en la Dieta/efectos adversos , Industria de Alimentos , Salud Global , Promoción de la Salud/organización & administración , Humanos , Enfermedades de la Boca/etiología , Odontología Preventiva/organización & administración , Salud Pública
17.
Rev Esp Salud Publica ; 932019 Jul 15.
Artículo en Español | MEDLINE | ID: mdl-31298227

RESUMEN

This paper presents a strategic analysis of the prevention of smoking in Spain. After a review of the situation of the epidemic and of the current prevention policies with the data available in 2019, it identifies the main problems to improve the prevention of smoking, while proposing strategies and key actions for the future. Considering as major objectives reducing the initiation of smoking and helping smokers quit, the different strategies of action and the key actions to be developed. In addition to helping smokers to stop smoking from the health services, key preventive actions include several public policies including taxation, banning advertising and other forms of promotion, the regulation of tobacco packaging, the expansion of smoke-free spaces, and information to the public on its effects. Some of them have followed a positive path for prevention in Spain but for others there is wide room for improvement. The MPOWER strategy of the WHO offers a guide for the development of the most effective tobacco control policies. In its light it is recommended to put emphasis on actions related to expanding smoke-free areas, to develop distance support services to stop smoking, to periodically carry out advertising campaigns of wide coverage to encourage quitting, to reinforce support for quitting in health care services, to finance pharmacological treatments, to expand the advertising ban to electronic devices that release nicotine, and to increase the tax burden on tobacco and other products delivering nicotine.


Asunto(s)
Cese del Hábito de Fumar/métodos , Tabaquismo/epidemiología , Tabaquismo/prevención & control , Política de Salud , Promoción de la Salud/métodos , Promoción de la Salud/organización & administración , Humanos , Política Pública , Fumar/economía , Fumar/legislación & jurisprudencia , España/epidemiología , Organización Mundial de la Salud
18.
Int J Equity Health ; 18(1): 115, 2019 07 24.
Artículo en Inglés | MEDLINE | ID: mdl-31340832

RESUMEN

The concept of intersectionality has gradually been introduced to health inequality research, adding depth and breadth to the way inequalities in health are approached. We conducted a scoping review with the purpose to systematically map, describe and analyze the literature about intersectional inequalities in mental health. For eligibility, the study had to analyze and report inequality defined by combinations of socioeconomic position, gender, race/ethnicity, sexual orientation or religion. The mental health outcome had to be measured as self-reported symptoms assessed through validated scales, or disorders assessed through diagnostic interviews. The search strategy was applied in two databases and the screening process yielded 20 studies. The interaction of intersectional positions showed no consistent patterns in mental health across studies, but both synergistic and antagonistic effects were observed. In most studies an absolute measure of inequality was used and few studies analyzed factors potentially explaining the intersectional inequalities. Taken together, the findings of this review highlight the value of assessing intersectional inequalities across population groups for priority setting and action on mental health inequalities.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/estadística & datos numéricos , Servicios de Salud Mental/organización & administración , Adulto , Grupos Étnicos , Femenino , Promoción de la Salud/organización & administración , Humanos , Masculino , Salud Mental/estadística & datos numéricos , Factores Sexuales , Clase Social , Factores Socioeconómicos
20.
BMC Pregnancy Childbirth ; 19(1): 253, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31331285

RESUMEN

BACKGROUND: During pregnancy and postnatally, women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. In 2014-2016, UK-based charity Best Beginnings used an embedding model to embed three of their resources - the Baby Buddy app, Baby Express magazine, and 'From Bump to Breastfeeding' DVD - into maternity and early years care pathways at three sites in the north of England. A mixed-methods evaluation comprising an impact evaluation and a process evaluation was undertaken. Here we report findings from the process evaluation that aimed to understand the embedding process, explore maternity and early years' professionals' views and use of the resources, explore women's engagement with and views of the resources, and identify barriers and facilitators to the embedding process. METHODS: We carried out semi-structured interviews with stakeholders (professionals involved in embedding) and observations of embedding activities to understand how embedding worked. Surveys of postnatal women were conducted over a two-month period both prior to, and after, the resources had been embedded, to ascertain engagement with and views of the resources. A survey of professionals was carried out post-embedding to understand how, where and when the resources were used in practice, and professionals' views. Descriptive and thematic analyses were undertaken. RESULTS: Thirty stakeholders took part in interviews. Surveys were completed by 146 professionals, and by 161 and 192 women in the pre and post-embedding phases respectively. Themes derived from analysis of qualitative data were 'Implementation of the embedding model', 'Promotion and distribution of, and engagement with, the resources', 'Fit with care pathways', and 'Perceptions of the resources'. While survey responses indicated that embedding of the resources into practice was not yet complete, those who had used the resources believed that they had helped increase knowledge, build confidence and support relationship-building. CONCLUSIONS: Incorporating supportive parenting resources into maternity and early years' care pathways requires a planned embedding approach, committed champions, and senior management support. Findings indicate largely positive views of women and professionals, and suggest the resources can be a beneficial aid for families.


Asunto(s)
Promoción de la Salud , Conducta Materna/psicología , Educación Prenatal , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Promoción de la Salud/organización & administración , Humanos , Conducta en la Búsqueda de Información , Servicios de Salud Materna , Participación del Paciente/métodos , Embarazo , Educación Prenatal/métodos , Educación Prenatal/organización & administración , Evaluación de Programas y Proyectos de Salud/métodos , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Apoyo Social , Reino Unido
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