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1.
West Afr J Med ; 40(12): 1298-1303, 2023 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-38261017

RESUMO

BACKGROUND: Breast cancer outcomes are poor in Nigeria, partly due to late-stage diagnosis. To assess the impact of past and present interventions, a review of an institutional data base was performed to determine the trend with respect to stage at diagnosis over a decade. METHODS: A retrospective analysis of an institutional data base was performed over a decade. The review period was divided into segments (2013-2015, 2016-2018 and 2019-2022). The latter period (2019-2022), corresponds to a time of more intense community interventions aimed at promoting early diagnosis and treatment around the locality of the teaching hospital. The stage at diagnosis within these periods were compared. The relationship between stage and sociodemographic variables (age, religion, marital status, menopausal status, and level of education) was assessed. RESULTS: There were 910 patients, 144 within the first period (2013-2015), 318 in the second (2016-2018) and 454 in the third period (2019-2022). The majority presented with stage 3 disease (73.8%). There was a significant decline in the proportion of metastatic cases and a concomitant increase in early cases in the latter part of the review. The proportion of metastatic cases reduced from 23.6% (2013-2015), to 15.7% (2016-2018) and 9.3% (2019-2022) (p=0.001). Level of education was significantly associated with stage (p=0.001). CONCLUSION: This study shows a trend towards downstaging of breast cancer in our locality. This trend corresponds to the period of more intense community interventions, justifying the need to further interrogate the direct impact of each of the interventions. This will provide a firm basis for sustaining or improving on current efforts to achieve more robust gains.


CONTEXTE: Les résultats du cancer du sein sont médiocres au Nigeria, en partie en raison d'un diagnostic tardif. Pour évaluer l'impact des interventions passées et actuelles, une revue d'une base de données institutionnelle a été réalisée pour déterminer la tendance en ce qui concerne le stade au moment du diagnostic sur une décennie. MÉTHODES: Une analyse rétrospective d'une base de données institutionnelle a été effectuée sur une décennie. La période de revue a été divisée en segments (2013-2015, 2016-2018 et 2019-2022). La dernière période (2019-2022) correspond à une période d'interventions communautaires plus intensives visant à promouvoir un diagnostic précoce et un traitement autour de la localité de l'hôpital universitaire. Les stades au moment du diagnostic au cours de ces périodes ont été comparés. La relation entre le stade et les variables sociodémographiques (âge, religion, état matrimonial, statut ménopausique et niveau d'éducation) a été évaluée. RÉSULTATS: Il y avait 910 patients, 144 dans la première période (2013-2015), 318 dans la deuxième (2016-2018) et 454 dans la troisième période (2019-2022). La majorité présentait une maladie de stade 3 (73,8 %). On a observé une diminution significative de la proportion de cas métastatiques et une augmentation concomitante des cas précoces dans la dernière partie de la revue. La proportion de cas métastatiques est passée de 23,6 % (2013-2015) à 15,7 % (2016- 2018) et 9,3 % (2019-2022) (p=0,001). Le niveau d'éducation était significativement associé au stade (p=0,001). CONCLUSION: Cette étude montre une tendance à la réduction du stade du cancer du sein dans notre localité. Cette tendance correspond à la période d'interventions communautaires plus intenses, justifiant la nécessité d'interroger davantage l'impact direct de chacune des interventions. Cela fournira une base solide pour soutenir ou améliorer les efforts actuels afin d'obtenir des gains plus robustes. Mots-clés: Sein, Cancer, Stade, Nigéria.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Promoção da Saúde , Hospitais de Ensino , Feminino , Humanos , População Negra/estatística & dados numéricos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Hospitais de Ensino/estatística & dados numéricos , Estudos Retrospectivos , Detecção Precoce de Câncer/estatística & dados numéricos , Detecção Precoce de Câncer/tendências , Bases de Dados Factuais/estatística & dados numéricos , Bases de Dados Factuais/tendências , Nigéria/epidemiologia , Promoção da Saúde/estatística & dados numéricos , Promoção da Saúde/tendências , Escolaridade , Relações Comunidade-Instituição/tendências
5.
Pediatrics ; 149(2)2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35001103

RESUMO

Racism and discrimination are the root of many pediatric health inequities and are well described in the literature. Despite the pervasiveness of pediatric health inequities, we have failed to adequately educate and prepare general pediatricians and pediatric subspecialists to address them. Deficiencies within education across the entire continuum and in our health care systems as a whole contribute to health inequities in unacceptable ways. To address these deficiencies, the field of pediatrics, along with other specialties, has been on a journey toward a more competency-based approach to education and assessment, and the framework created for the future is built on entrustable professional activities (EPAs). Competency-based medical education is one approach to addressing the deficiencies within graduate medical education and across the continuum by allowing educators to focus on the desired equitable patient outcomes and then develop an approach to teaching and assessing the tasks, knowledge, skills, and attitudes needed to achieve the goal of optimal, equitable patient care. To that end, we describe the development and content of a revised EPA entitled: Use of Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations. We also highlight the ways in which this EPA can be used to inform curricula, assessments, professional development, organizational systems, and culture change.


Assuntos
Iniquidades em Saúde , Pediatria/métodos , Papel Profissional , Racismo/prevenção & controle , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/tendências , Humanos , Masculino , Pediatria/tendências , Papel Profissional/psicologia , Racismo/psicologia
6.
Evid. actual. práct. ambul ; 25(2): e007012, 2022. tab
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1380121

RESUMO

Durante la última década, presenciamos en Argentina un aumento de la incidencia de infecciones de transmisión sexual(ITS) vinculado con una disminución en el uso de métodos de barrera (MB). De acuerdo a la bibliografía, existen varias categorías de obstáculos para el uso de MB: desigualdades de género, dificultades económicas y/o de accesibilidad, desconfianza respecto de los MB provistos por el Estado respecto de su calidad y/o fecha de vencimiento, o bien, creencias acerca de que la utilización de MB disminuye el placer sexual o que no es necesario su uso cuando la relación de pareja es estable y/o basada en la confianza, el amor y/o la fidelidad. A partir de esta problemática, los autores de este artículo realizamos una búsqueda bibliográfica y revisamos cual es la evidencia que respalda diferentes intervenciones para promover el uso de MB. Encontramos evidencia de moderada calidad que avala la eficacia de intervenciones a nivel comunitario basadas en la teoría sociocognitiva y en el aumento de la oferta y la disponibilidad de preservativos para mejorar el conocimiento sobre el HIV y el uso de estos métodos, sin impacto sobre la incidencia de ITS a nivel poblacional. (AU)


Over the last decade, Argentina has shown an increase in the incidence of sexually transmitted infections (STIs) linked to a decrease in the use of barrier methods (BM). According to the literature, there are several categories of obstacles for the use of BM: gender inequalities, economic and/or accessibility difficulties, mistrust regarding the quality and/or expiry date of state-provided BMs, as well as beliefs that the use of BMs reduces sexual pleasure or that their use is not necessary when the couple's relationship is stable and/or based on trust, love and/or fidelity. In light of this issue, the authors of this article conducted a literature search and reviewed the evidence supporting different interventions to promote the use of BM. They found moderate quality evidence that supports the efficacy of community-level interventions based on socio-cognitive theory and on increasing the supply and availability of condoms to improve knowledge about HIV and the use of these methods, with no impact on the incidence of STIs at the population level. (AU)


Assuntos
Humanos , Masculino , Feminino , Método de Barreira Anticoncepção/tendências , Sexo sem Proteção/estatística & dados numéricos , Avaliação de Eficácia-Efetividade de Intervenções , Argentina , Sífilis/prevenção & controle , Sífilis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções Sexualmente Transmissíveis/epidemiologia , Preservativos/tendências , Coito , Método de Barreira Anticoncepção/estatística & dados numéricos , Revisões Sistemáticas como Assunto , Promoção da Saúde/tendências
7.
J Clin Lipidol ; 15(4): 530-537, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34815066

RESUMO

Clinical lipidology belongs par excellence to the preventive mode of medical practice. This Roundtable brings two long-time advocates of cardiometabolic prevention and a newly minted preventive cardiologist into a discussion that expands their recent JCL editorial on this topic. Atherosclerosis is a single disease process that leads to approximately 25% of deaths in economically advanced nations and a growing fraction of mortality and morbidity in nations with developing and emerging economies. Our discussants suggest that at least 75% of atherosclerotic cardiovascular disease can be prevented. Diet and lifestyle including physical activity are the cornerstones for this effort. Public and private choices about diet-lifestyle are influenced by economics, education (especially in childhood), inequities, technology, misinformation, and trust. Lipid clinics perform well with pharmacologic treatment of lipid disorders and increasingly give attention to hypertension, obesity, and diabetes as needed. Cardiometabolic prevention in the clinic works best through provider teams. Business considerations and exemplary programs are highlighted.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dieta Saudável/tendências , Promoção da Saúde/tendências , Prevenção Primária/tendências , Comportamento de Redução do Risco , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/economia , Dieta Saudável/economia , Exercício Físico/fisiologia , Exercício Físico/tendências , Promoção da Saúde/economia , Humanos , Serviços Preventivos de Saúde/economia , Serviços Preventivos de Saúde/tendências , Prevenção Primária/economia , Fatores de Risco , Fatores Socioeconômicos
8.
PLoS One ; 16(11): e0259884, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34818364

RESUMO

BACKGROUND: Healthcare professionals (HCPs) play a pivotal role in ensuring access to quality healthcare of patients. However, their role in health promotion (HP) and disease prevention (DP) has not been fully explored. This study aimed at determining how training, attitude, and practice (TAP) of HCPs influence their practice of HP and DP. METHODS: Data on TAP regarding HP and DP were collected from 495 HCPs from twenty-three hospitals in the study area using a standardized questionnaire. Bivariate, univariate, and multivariate analyses were conducted to describe how the TAP of HCPs influence their HP and DP practices. The analysis was further desegregated at the three levels of healthcare (primary, secondary and tertiary levels). RESULTS: Most of the medical doctors 36.12% (n = 173), registered nurses 28.39% (n = 136), and allied health professionals (AHPs) 11.27% (n = 54) indicated the absence of coordinated HP training for staff in their facilities. Similarly, 32.93% (n = 193) of the HCPs, indicated having participated in HP or DP training. Among those that had participated in HP and DP training, benefits of training were positive behaviour, attributions, and emotional responses. When compared at the different levels of healthcare, enhanced staff satisfaction and continuing professional development for HP were statistically significant only at the tertiary healthcare level. Multivariate analysis showed a likelihood of reduced coordinated HP training for staff among medical doctors (Coef 0.15; 95% CI 0.07-0.32) and AHPs (Coef 0.24; 95% CI 0.10-0.59) compared to nurses. Furthermore, medical doctors (Coeff: 0.66; 95% CI: 0.46-0.94) were less likely to agree that HCPs should model good health behavior to render HP services as compared to nurses. CONCLUSION: Training in HP and DP empowers HCPs with the requisite knowledge and attitude necessary for effective practice. Several HCPs at different levels of care had limited knowledge of HP and DP because of inadequate training. We recommend a strategy aimed at addressing the knowledge and attitudinal gaps of HCPs to ensure effective HP and DP services to patients.


Assuntos
Educação/métodos , Pessoal de Saúde/educação , Promoção da Saúde/tendências , Pessoal Técnico de Saúde , Atitude , Atenção à Saúde , Instalações de Saúde , Hospitais , Humanos , Conhecimento , Análise Multivariada , Satisfação Pessoal , Médicos , Prevenção Primária/métodos , Prevenção Primária/tendências , Qualidade da Assistência à Saúde , Percepção Social , África do Sul
9.
Am J Nurs ; 121(12): 54-58, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34792506

RESUMO

This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article discusses the International Council of Nurses Global Nursing Leadership Institute and its integration of the SDGs into a global leadership and policy development program.


Assuntos
Enfermagem Baseada em Evidências/tendências , Liderança , Papel do Profissional de Enfermagem , Formulação de Políticas , Saúde Pública/tendências , Desenvolvimento Sustentável/tendências , Promoção da Saúde/tendências , Humanos , Nações Unidas/tendências
10.
Asian Pac J Cancer Prev ; 22(10): 3115-3120, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34710986

RESUMO

OBJECTIVE: We aimed to determine the interest and changing trends over time in the diagnosis and treatment of bladder cancer and its awareness campaign by examining the Google Trends application as an indicator of people's interest globally. METHODS: Using the Google Trends application, we determined the yearly and country-based relative search volumes of the term "bladder tumor" and of the methods used in the diagnosis and treatment of bladder cancer in the period from January 2004 to December 2019. We compared the median relative search volumes found in the period 2004-2011 (Period 1) with those found in the period 2012-2019 (Period 2). RESULTS: We found that the median relative search volume for bladder cancer decreased in period 2 and this was parallel to the decrease in the incidence rates in North America and Australia (p<0.001). We found that the bladder cancer awareness month did not cause an increase in the online interest (p>0.05). We found that the median relative search volumes of diagnostic cystoscopy and cytology were higher than those of molecular markers and imaging methods in line with guidelines (p<0.001). Also, TURBT was the most sought-term among treatment methods with increasing popularity in the second period (p<0.001). CONCLUSION: People use the internet intensively to search for information about bladder cancer. We think that several types of web-based applications such as "Google Trends" can help determine the behavioural patterns and tendencies of bladder cancer patients and affect the clinical decision-making processes, as well as readily determining the impact of cancer awareness campaigns to bring about an increased awareness in the society for the recognition of the importance of an early diagnosis.


Assuntos
Saúde Global/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Ferramenta de Busca/estatística & dados numéricos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/terapia , Austrália , Biomarcadores Tumorais , Canadá , Estudos Transversais , Cistoscopia/estatística & dados numéricos , Cistoscopia/tendências , Diagnóstico por Imagem/estatística & dados numéricos , Diagnóstico por Imagem/tendências , Saúde Global/tendências , Promoção da Saúde/tendências , Humanos , Incidência , Irlanda , Determinação de Necessidades de Cuidados de Saúde/tendências , Nova Zelândia , Fatores de Tempo , Reino Unido , Estados Unidos , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/patologia
11.
J Gerontol B Psychol Sci Soc Sci ; 76(Suppl 2): S191-S205, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34515775

RESUMO

Healthy aging requires people to adopt and maintain beneficial behaviors in all stages of the life span. Supporting behavior change, including via the motivation to make and maintain those changes, is therefore important for the promotion of healthy aging. The aim of this overview is to introduce theoretical frameworks from the psychology of motivation that lend themselves to the development of effective interventions promoting behavior change conducive to healthy aging. We discuss theoretical frameworks referring to the determinants, properties, and functionality of goals aimed at behavior change, and consider the implications of the various theories for designing interventions to support healthy aging. We first consider theories that focus on beliefs and attitudes as determinants of goals, then we address theories that focus on the structure and content as important properties of goals, and, finally, we examine theories drawing on conscious and nonconscious processes underlying the functionality of these goals. We will present if-then planning and mental contrasting, as well as nudging and boosting, that is, novel strategies of behavior change that support the creation of scalable interventions for healthy aging across the life span. Against this background, new perspectives emerge for modern, state-of-the-art, and individually tailored interventions with the aim of enhancing older people's healthy living.


Assuntos
Atitude Frente a Saúde , Controle Comportamental , Cultura , Envelhecimento Saudável , Motivação , Idoso , Controle Comportamental/métodos , Controle Comportamental/psicologia , Comportamentos Relacionados com a Saúde , Promoção da Saúde/tendências , Envelhecimento Saudável/fisiologia , Envelhecimento Saudável/psicologia , Humanos , Teoria Psicológica , Psicologia do Desenvolvimento , Intervenção Psicossocial
12.
Nutrients ; 13(8)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34444903

RESUMO

Relatively little progress has been made in reducing anemia prevalence among women of reproductive age (WRA anemia). Interventions, policies and programs aimed at reducing WRA anemia have the potential to improve overall not only women's, but also children's health and nutrition outcomes. To our knowledge, this is the first review that aimed to compile evidence on the determinants and drivers of WRA anemia reduction in low- and middle-income countries (LMICs). We synthesized the available evidence on the determinants and drivers, including government policies and programs, of WRA anemia and their mitigation strategies across a wide range of countries and geographies, thus contributing to the complex and multifactorial etiology of anemia. We carried out a systematic review of published peer-reviewed and grey literature assessing national or subnational decline in WRA anemia prevalence and the associated drivers in LMICs. Among the 21 studies meeting our inclusion criteria, proximal determinants of healthcare utilization, especially during pregnancy and with the use of contraceptives, were strong drivers of WRA anemia reduction. Changes in other maternal characteristics, such as an increase in age at first pregnancy, BMI, birth spacing, and reduction in parity, were associated with modest improvements in anemia prevalence. Access to fortified foods, especially iron-fortified flour, was also a predictor of a decrease in WRA anemia. Of the intermediate determinants, an increase in household wealth, educational attainment and access to improved sanitation contributed significantly to WRA anemia reduction. Although several common determinants emerged at the proximal and intermediate levels, the set of anemia determinants and the strength of the association between each driver and WRA anemia reduction were unique in each setting included in this review. Further research is needed to provide targeted recommendations for each country and region where WRA anemia prevalence remains high.


Assuntos
Anemia/epidemiologia , Anemia/prevenção & controle , Promoção da Saúde/tendências , Saúde Reprodutiva/tendências , Saúde da Mulher/tendências , Adolescente , Adulto , Países em Desenvolvimento , Feminino , Abastecimento de Alimentos , Carga Global da Doença , Acesso aos Serviços de Saúde/tendências , Humanos , Pessoa de Meia-Idade , Prevalência , Serviços de Saúde Reprodutiva/tendências , Determinantes Sociais da Saúde , Adulto Jovem
13.
J Alzheimers Dis ; 82(3): 1219-1228, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34151804

RESUMO

BACKGROUND: The number of people living with dementia is rising globally due to population aging. Mass media campaigns which aim to reduce the risk of people developing dementia have been conducted across many countries, but few have reported evaluation findings. OBJECTIVE: The present study investigated the impact of the Your Brain Matters dementia risk reduction campaign in Australia. METHODS: The campaign was evaluated by observational cross-sectional surveys of 1000 Australian adults aged 18-75 years before and 24 months after delivery. The national campaign utilized multiple media channels to promote messages about the importance of brain health and reducing the risk of dementia. Dementia risk reduction knowledge, confidence, intentions and actions were measured at baseline and follow-up, and analyzed 2019-2020. RESULTS: Earned television and radio were the most common exposure channels. The proportion of people who understood that it is beneficial to take action to reduce dementia risk before middle age increased (54.1% to 59.4%, OR 1.20 95% CI: 1.01-1.44). There was also an increase (28.5% to 32.8%, OR 1.30, 95% CI: 1.07-1.59) in the proportion who reported taking action to improve brain health. There was no improvement in knowledge about vascular risk factors, or confidence to reduce personal dementia risk. CONCLUSION: The findings showed some receptivity and positive responses to messages about the benefits of taking action to reduce the risk of dementia. The campaign demonstrated the potential for generating news coverage about this issue, which should highlight the preventive benefits of vascular health behaviors.


Assuntos
Encéfalo/fisiologia , Demência/epidemiologia , Demência/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/tendências , Comportamento de Redução do Risco , Adulto , Idoso , Austrália/epidemiologia , Estudos Transversais , Demência/psicologia , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
14.
Med J Aust ; 214 Suppl 8: S5-S40, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33934362

RESUMO

CHAPTER 1: HOW AUSTRALIA IMPROVED HEALTH EQUITY THROUGH ACTION ON THE SOCIAL DETERMINANTS OF HEALTH: Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non-existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID-19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality. CHAPTER 2: ABORIGINAL AND TORRES STRAIT ISLANDER CONNECTION TO CULTURE: BUILDING STRONGER INDIVIDUAL AND COLLECTIVE WELLBEING: Aboriginal and Torres Strait Islander peoples have long maintained that culture (ie, practising, maintaining and reclaiming it) is vital to good health and wellbeing. However, this knowledge and understanding has been dismissed or described as anecdotal or intangible by Western research methods and science. As a result, Aboriginal and Torres Strait Islander culture is a poorly acknowledged determinant of health and wellbeing, despite its significant role in shaping individuals, communities and societies. By extension, the cultural determinants of health have been poorly defined until recently. However, an increasing amount of scientific evidence supports what Aboriginal and Torres Strait Islander people have always said - that strong culture plays a significant and positive role in improved health and wellbeing. Owing to known gaps in knowledge, we aim to define the cultural determinants of health and describe their relationship with the social determinants of health, to provide a full understanding of Aboriginal and Torres Strait Islander wellbeing. We provide examples of evidence on cultural determinants of health and links to improved Aboriginal and Torres Strait Islander health and wellbeing. We also discuss future research directions that will enable a deeper understanding of the cultural determinants of health for Aboriginal and Torres Strait Islander people. CHAPTER 3: PHYSICAL DETERMINANTS OF HEALTH: HEALTHY, LIVEABLE AND SUSTAINABLE COMMUNITIES: Good city planning is essential for protecting and improving human and planetary health. Until recently, however, collaboration between city planners and the public health sector has languished. We review the evidence on the health benefits of good city planning and propose an agenda for public health advocacy relating to health-promoting city planning for all by 2030. Over the next 10 years, there is an urgent need for public health leaders to collaborate with city planners - to advocate for evidence-informed policy, and to evaluate the health effects of city planning efforts. Importantly, we need integrated planning across and between all levels of government and sectors, to create healthy, liveable and sustainable cities for all. CHAPTER 4: HEALTH PROMOTION IN THE ANTHROPOCENE: THE ECOLOGICAL DETERMINANTS OF HEALTH: Human health is inextricably linked to the health of the natural environment. In this chapter, we focus on ecological determinants of health, including the urgent and critical threats to the natural environment, and opportunities for health promotion arising from the human health co-benefits of actions to protect the health of the planet. We characterise ecological determinants in the Anthropocene and provide a sobering snapshot of planetary health science, particularly the momentous climate change health impacts in Australia. We highlight Australia's position as a major fossil fuel producer and exporter, and a country lacking cohesive and timely emissions reduction policy. We offer a roadmap for action, with four priority directions, and point to a scaffold of guiding approaches - planetary health, Indigenous people's knowledge systems, ecological economics, health co-benefits and climate-resilient development. Our situation requires a paradigm shift, and this demands a recalibration of health promotion education, research and practice in Australia over the coming decade. CHAPTER 5: DISRUPTING THE COMMERCIAL DETERMINANTS OF HEALTH: Our vision for 2030 is an Australian economy that promotes optimal human and planetary health for current and future generations. To achieve this, current patterns of corporate practice and consumption of harmful commodities and services need to change. In this chapter, we suggest ways forward for Australia, focusing on pragmatic actions that can be taken now to redress the power imbalances between corporations and Australian governments and citizens. We begin by exploring how the terms of health policy making must change to protect it from conflicted commercial interests. We also examine how marketing unhealthy products and services can be more effectively regulated, and how healthier business practices can be incentivised. Finally, we make recommendations on how various public health stakeholders can hold corporations to account, to ensure that people come before profits in a healthy and prosperous future Australia. CHAPTER 6: DIGITAL DETERMINANTS OF HEALTH: THE DIGITAL TRANSFORMATION: We live in an age of rapid and exponential technological change. Extraordinary digital advancements and the fusion of technologies, such as artificial intelligence, robotics, the Internet of Things and quantum computing constitute what is often referred to as the digital revolution or the Fourth Industrial Revolution (Industry 4.0). Reflections on the future of public health and health promotion require thorough consideration of the role of digital technologies and the systems they influence. Just how the digital revolution will unfold is unknown, but it is clear that advancements and integrations of technologies will fundamentally influence our health and wellbeing in the future. The public health response must be proactive, involving many stakeholders, and thoughtfully considered to ensure equitable and ethical applications and use. CHAPTER 7: GOVERNANCE FOR HEALTH AND EQUITY: A VISION FOR OUR FUTURE: Coronavirus disease 2019 has caused many people and communities to take stock on Australia's direction in relation to health, community, jobs, environmental sustainability, income and wealth. A desire for change is in the air. This chapter imagines how changes in the way we govern our lives and what we value as a society could solve many of the issues Australia is facing - most pressingly, the climate crisis and growing economic and health inequities. We present an imagined future for 2030 where governance structures are designed to ensure transparent and fair behaviour from those in power and to increase the involvement of citizens in these decisions, including a constitutional voice for Indigenous peoples. We imagine that these changes were made by measuring social progress in new ways, ensuring taxation for public good, enshrining human rights (including to health) in legislation, and protecting and encouraging an independent media. Measures to overcome the climate crisis were adopted and democratic processes introduced in the provision of housing, education and community development.


Assuntos
Equidade em Saúde/tendências , Promoção da Saúde/tendências , Austrália , Comércio , Planejamento em Saúde Comunitária/tendências , Tecnologia Digital/tendências , Saúde Ambiental/tendências , Previsões , Serviços de Saúde do Indígena/tendências , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico , Determinantes Sociais da Saúde/tendências
16.
Lancet Diabetes Endocrinol ; 9(7): 462-470, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33865500

RESUMO

The global surges in obesity and nutrition-related non-communicable diseases (NCDs) have created a need for decisive new food policy initiatives. A major concern has been the impact of ultra-processed foods (UPFs) and ultra-processed drinks on weight gain and on the risk of several NCDs. These foods, generally high in calories, added sugar, sodium, and unhealthy fats, and poor in fibre, protein, and micronutrients, have extensive negative effects on human health and on the environment (due to their associated carbon emission and water use). There is a growing tendency worldwide, and especially in South America, for food companies to add micronutrients to UPFs to make health claims regarding these products, to which food-regulating authorities refer to fake foods. Although more than 45 countries and smaller subregional or urban entities have created taxes on ultra-processed drinks, such as sugar-sweetened beverages, only a few have adopted taxes on snacks and other UPFs, and none have added major subsidies for truly healthy, fresh or minimally processed food for people from lower socioeconomic backgrounds. Another major focus has been on developing effective package labelling. A smaller number of countries have selected the most impactful warning labels and linked them with other measures to create a mutually reinforcing set of policies; a few other countries have developed effective school food policies. We herein present in-depth results from key countries involved in all these actions and in comprehensive marketing controls, and conclude with our recommendations for the future. This field is quite new; progress to date is substantial, but much more is left to learn.


Assuntos
Dieta Saudável/tendências , Ingestão de Alimentos/fisiologia , Fast Foods/efeitos adversos , Promoção da Saúde/tendências , Política Nutricional/tendências , Dieta Saudável/métodos , Dieta Saudável/psicologia , Ingestão de Alimentos/psicologia , Ingestão de Energia/fisiologia , Promoção da Saúde/legislação & jurisprudência , Promoção da Saúde/métodos , Humanos , Política Nutricional/legislação & jurisprudência
17.
Med Sci (Paris) ; 37(4): 315-316, 2021 04.
Artigo em Francês | MEDLINE | ID: mdl-33908844
18.
Biomolecules ; 11(5)2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33922830

RESUMO

Food-derived bioactive peptides are being used as important functional ingredients for health-promoting foods and nutraceuticals in recent times in order to prevent and manage several diseases thanks to their biological activities. Bioactive peptides are specific protein fractions, which show broad applications in cosmetics, food additives, nutraceuticals, and pharmaceuticals as antimicrobial, antioxidant, antithrombotic, and angiotensin-I-converting enzyme (ACE)-inhibitory ingredients. These peptides can preserve consumer health by retarding chronic diseases owing to modulation or improvement of the physiological functions of human body. They can also affect functional characteristics of different foods such as dairy products, fermented beverages, and plant and marine proteins. This manuscript reviews different aspects of bioactive peptides concerning their biological (antihypertensive, antioxidative, antiobesity, and hypocholesterolemic) and functional (water holding capacity, solubility, emulsifying, and foaming) properties. Moreover, the properties of several bioactive peptides extracted from different foods as potential ingredients to formulate health promoting foods are described. Thus, multifunctional properties of bioactive peptides provide the possibility to formulate or develop novel healthy food products.


Assuntos
Aditivos Alimentares/química , Aditivos Alimentares/farmacologia , Promoção da Saúde/métodos , Anti-Infecciosos/química , Anti-Hipertensivos/química , Antioxidantes/química , Suplementos Nutricionais , Aromatizantes/química , Aditivos Alimentares/metabolismo , Promoção da Saúde/tendências , Humanos , Peptídeos/química , Compostos Fitoquímicos/química , Compostos Fitoquímicos/metabolismo , Compostos Fitoquímicos/farmacologia
19.
Gerokomos (Madr., Ed. impr.) ; 32(1): 8-11, mar. 2021.
Artigo em Espanhol | IBECS | ID: ibc-202041

RESUMO

OBJETIVO: Conocer e interpretar las experiencias y los significados que las personas mayores que viven en comunidad atribuyen al envejecimiento satisfactorio. MÉTODO: Investigación cualitativa, con enfoque hermenéutico dialéctico de George Gadamer, realizada en zona metropolitana de Uruguay, años 2015-2016; participaron 23 personas mayores. RESULTADOS: se identificaron las categorías conciencia histórica con tres subcategorías: familia, sociedad y estado en el que vivimos, y categoría carga de la tradición con dos subcategorías: juicios y límites. CONCLUSIONES: se logró conocer las percepciones sobre envejecimiento satisfactorio desde las vivencias de personas mayores, enfatizando en las relaciones familiares como pilar fundamental de sostén para mantenerse activos y saludables. Es importante la promoción de la salud. Las personas mayores tienen un cuerpo que sufre dolencias; manteniéndose en actividad, son personas con salud mental, ya que ellos manifiestan que mientras la mente anda, todo puede salir bien. La expectativa se centra en ser resiliente, siendo este el punto principal de seguir día a día en el camino


OBJECTIVE: To know and interpret the experiences and meanings attributed by elderly people living in community to satisfactory aging. METHOD: qualitative research, with a dialectical hermeneutic approach by George Gadamer, carried out in the metropolitan area of Uruguay, 2015-2016; 23 elderly people participated. RESULTS: categories were identified: historical awareness with three subcategories: family, society and state in which we live; another category carries the tradition with two subcategories: judgments and limits. CONCLUSIONS: it was possible to know the perceptions of successful aging from the experiences of older people, emphasizing family relationships as a fundamental pillar of support to stay active and healthy; health promotion is important, older people have a body that suffers ailments, staying active, they are people with mental health, since they referenced that while the mind walks everything can go well. The expectation is focused on being resilient, this being the main point to follow day by day along the way


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Envelhecimento Saudável/psicologia , Relações Familiares/psicologia , Promoção da Saúde/tendências , Adaptação Psicológica , Rememoração Mental , Conhecimentos, Atitudes e Prática em Saúde , População Institucionalizada , Uruguai/epidemiologia , Preconceito/psicologia
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