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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 6-7, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914561

RESUMO

This article illustrates that health management, as one of the tools of health service, plays an important role in the control and treatment of chronic diseases as well as the history of health management development in China. It was pointed out that currently the concept of health management is not well established in China and the practice of health management in the Chinese market is quite in a mess. Therefore, there is an urgent need for the standardization of health management practice. The China Health Management Association released an organizational standard entitled "Standard for Chronic Disease Health Management" in November, 2019. It is comprehensive, science-based, easy to use and fit into the Chinese situation and it is expected that it will facilitate the development of health management in China.


Assuntos
Assistência à Saúde/organização & administração , China , Doença Crônica/prevenção & controle , Assistência à Saúde/normas , Humanos , Padrões de Referência
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 39-41, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914567

RESUMO

This standard specifies the terms and definitions, processes, components, information systems and information summary, analysis and utilization of health management of major chronic and non-communicable diseases (chronic diseases). It is suitable for medical and health service institutions, health examination institutions and health management-related enterprises to carry out health management services for individuals with major chronic diseases such as cardiovascular diseases, diabetes, cancer, chronic respiratory diseases and so on.


Assuntos
Doença Crônica/prevenção & controle , Assistência à Saúde/organização & administração , Humanos
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(11): 1012-1015, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31770830

RESUMO

De-escalation strategy is the gradual transition of various complex, expensive, high-risk but effective treatments for critically ill patients to simple, safe, physiological but still effective ones. Chronic critical illness refers to patients suffering severe disease or surgical hit who later shift into a chronic state of relapse or even aggravation and stay in the intensive care unit for extended period. Risk factors for surgical related chronic critical illness include advanced age, malnutrition, multiple organ dysfunction and multiple hits. During the treatment of critically ill patients, the strategy of de-escalation therapy should always be implemented, including rational use of antibiotics, de-escalation of liquid therapy (i.e. de-resuscitation), timely removal of ventilator, rapid introduction and with drawal of continuous renal replacement measures, parenteral + enteral nutrition support therapy and timely cessation of sedation.


Assuntos
Tratamento Conservador/métodos , Cuidados Críticos/métodos , Estado Terminal/terapia , Doença Crônica/prevenção & controle , Doença Crônica/terapia , Humanos , Unidades de Terapia Intensiva , Suspensão de Tratamento
5.
BMC Public Health ; 19(1): 1308, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623584

RESUMO

BACKGROUND: In the UK a high proportion of adults with long-term conditions do not engage in regular physical activity. General practice (GP) referral to community-based physical activity is one strategy that has gained traction in recent years. However, evidence for the real-world effectiveness and translation of such programmes is limited. This study aimed to evaluate the individual and organisational impacts of the 'CLICK into Activity' programme - GP referral of inactive adults living with (or at risk of) long-term conditions to community-based physical activity. METHODS: A mixed methods evaluation using the RE-AIM framework was conducted with data obtained from a range of sources: follow-up questionnaires, qualitative interviews, and programme-related documentation, including programme cost data. Triangulation methods were used to analyse data, with findings synthesised across each dimension of the RE-AIM framework. RESULTS: A total of 602 individuals were referred to CLICK into Activity physical activity sessions. Of those referred, 326 individuals participated in at least one session; the programme therefore reached 30.2% of the 1080 recruitment target. A range of individual-, social-, and environmental-level factors contributed to initial physical activity participation. Positive changes over time in physical activity and other outcomes assessed were observed among participants. Programme adoption at GP surgeries was successful, but the GP referral process was not consistently implemented across sites. Physical activity sessions were successfully implemented, with programme deliverers and group-based delivery identified as having an influential effect on programme outcomes. Changes to physical activity session content were made in response to participant feedback. CLICK into Activity cost £175,000 over 3 years, with an average cost per person attending at least one programme session of £535. CONCLUSIONS: Despite not reaching its recruitment target, CLICK into Activity was successfully adopted. Positive outcomes were associated with participation, although low 6- and 12-month follow-up response rates limit understanding of longer-term programme effects. Contextual and individual factors, which may facilitate successful implementation with the target population, were identified. Findings highlight strategies to be explored in future development and implementation of GP referral to community-based physical activity programmes targeting inactive adults living with (or at risk of) long-term conditions.


Assuntos
Doença Crônica/prevenção & controle , Exercício , Medicina Geral , Encaminhamento e Consulta , Adolescente , Adulto , Idoso , Serviços de Saúde Comunitária , Feminino , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Medição de Risco , Comportamento Sedentário , Reino Unido , Adulto Jovem
6.
Prensa méd. argent ; 105(9 especial): 495-500, oct 2019. tab, graf
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1046241

RESUMO

In this study, the authors perform a comparative analysis of the psychological and pedagogical aspect of the formation of health culture and the dynamics of the incidence in schoolchildren. The relevance of the study is determined by the fact that, despite the attention to the younger generation, during the educational process, the number of healthy children is decreasing and the incidence of chronic diseases is increasing. The object of the study is the health state of children between 7 and 18 years of age residing in the village of Zavodskoy. The village of Zavodskoy is an urban-type settlement, located near (2 km) the city of Vladikavkaz. The subject of the study is the regularities of the incidence of chronic diseases in schoolchildren. The purpose of the study is to identify the conditions for protecting and improving health in the conditions of the educational process. Based on the literature review and data of the conducted statistical analysis of the dynamics of incidence of chronic diseases for the period of two years, the incidence of chronic diseases in schoolchildren residing in the village of Zavodskoy has been reviewed and systematized. Recommendations on preservation and improvement of health have been provided


Assuntos
Criança , Adolescente , Pacientes Ambulatoriais , Educação em Saúde , Doença Crônica/prevenção & controle , Incidência , Análise Estatística , Estilo de Vida Saudável
7.
J Assoc Physicians India ; 67(8): 66-68, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31562721

RESUMO

Supplemental antioxidants are being prescribed by medical practitioners without considering its ill effects at higher doses. Antioxidants dosing has not been standardized and optimum or recommended daily dose is inconsistent too. Literature and Cochrane database search for review and meta analysis for efficacy of preventing and treating chronic disorders like cardiovascular diseases, diabetes, cancer, infertility etc shows inconclusive or negative results. Despite lack of evidence these drugs are rampantly being prescribed without any specific indication. Antioxidants are extensively being marketed too and their over the counter availability is again is the reason for its inappropriate use by consumers. Need is to practice evidence based medicine, define recommended daily doses with upper intake levels and antioxidants should be prescribed only in profound deficiency states.


Assuntos
Antioxidantes/uso terapêutico , Doença Crônica/prevenção & controle , Humanos
8.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31501236

RESUMO

OBJECTIVES: Food insecurity is an important public health problem facing children in the United States. Although a number of previous studies suggest that food insecurity has negative impacts on health, these studies have not dealt thoroughly with issues of selection bias. We use propensity scoring techniques to approximate the causal effects of food insecurity on children's health and health care use outcomes. METHODS: We use nationally representative data from the 2013-2016 waves of the National Health Interview Study (N = 29 341). Using inverse probability of treatment weighting, a propensity scoring method, we examine a broad range of child health outcomes and account for a comprehensive set of controls, focusing on a sample of children 2 to 17 years old. RESULTS: Household food insecurity was related to significantly worse general health, some acute and chronic health problems, and worse health care access, including forgone care and heightened emergency department use, for children. Compared to rates had they not been food insecure, children in food-insecure household had rates of lifetime asthma diagnosis and depressive symptoms that were 19.1% and 27.9% higher, rates of foregone medical care that were 179.8% higher, and rates of emergency department use that were 25.9% higher. No significant differences emerged for most communicable diseases, such as ear infections or chicken pox, or conditions that may develop more gradually, including anemia and diabetes. CONCLUSIONS: Policies used to reduce household food insecurity among children may also reduce children's chronic and acute health problems and health care needs.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Acesso aos Serviços de Saúde , Indicadores Básicos de Saúde , Doença Aguda/epidemiologia , Adolescente , Asma/epidemiologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Depressão/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Pontuação de Propensão , Dermatopatias/epidemiologia , Estados Unidos/epidemiologia
9.
Medicine (Baltimore) ; 98(33): e16847, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415411

RESUMO

The aim of the present study was to explore the application and its effect of mobile medical treatment to chronic disease health management in physical examination population, and to provide references for comprehensive intervention and management of chronic diseases.From January to December 2016, 300 medical examiners in a general hospital health management center were randomly divided into health management group (155 cases) and control group (145 cases). The control group completed routine physical examination and health-risk assessment and provided corresponding reports, repeated annual physical examination and health-risks assessment. In addition to the routine physical examination and health-risk assessment, the health management group reminded the examiners to pay attention to their lifestyle and dietary habits by moving online and offline dynamic health interventions and provide targeted guidance for high-risk population such as diabetes, obesity, hypertension, etc. A review was made after 2 years. The clinical indexes and chronic disease behavior of patients before and after management were compared, and the effect was evaluated by statistical analysis.After management, all the clinical indexes were significantly improved, and the patients' dietary structure, bad living habits, psychologic state, and other chronic disease behaviors were obviously improved. The proportion of patients with high risk of hypertension, diabetes, and obesity in health management group was significantly lower than that before intervention and control group (P < .05).Using mobile network online, offline dynamic health intervention model can reduce the risk of common chronic diseases in health management objects, this health management model of chronic disease is worth popularizing.


Assuntos
/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Doença Crônica/prevenção & controle , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Medição de Risco/métodos , Telemedicina
10.
BMC Public Health ; 19(1): 1092, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409343

RESUMO

BACKGROUND: Current evidence on chronic disease prevention suggests that interventions targeted at high-risk individuals represents the best way forward. We implemented a step-wise approach in the Danish primary care sector, designed for the systematic and targeted prevention of chronic disease. The intervention centered on a personal digital health profile for all participants, followed by targeted preventive programs for high-risk patients. The present paper examines individual characteristics and health-care usage of patients who took up the targeted preventive programs in response to their personal digital health profile. METHODS: A sample of patients born between 1957 and 1986 was randomly selected from the patient-list system of participating general practitioners in two Danish municipalities. The selected patients received a digital invitation to participate. Consenting patients received a second digital invitation for a personal digital health profile based on questionnaire and electronic patient record data. The personal digital health profile contained individualized information on risk profile and personalized recommendations on further actions. If at-risk or presenting with health-risk behaviour a patient would be advised to contact either their general practitioner or municipal health centre for targeted preventive programs. Attendance at the targeted preventive programs was examined using Poisson regression and chi-squared automatic interaction detection methods. RESULTS: A total of 9400 patients were invited. Of those who participated (30%), 22% were advised to get a health check at their general practitioner. Of these, 19% did so. Another 23% were advised to schedule an appointment for behaviour-change counselling at their municipal health centre. A total of 21% took the advice. Patients who had fair or poor self-rated health, a body mass index above 30, low self-efficacy, were female, non-smokers, or lead a sedentary lifestyle, were most likely to attend the targeted preventive programs. CONCLUSIONS: A personal digital health profile shows some promise in a step-wise approach to prevention in the Danish primary care sector and seems to motivate people with low self-efficacy to attend targeted preventive programs. TRIAL REGISTRATION: Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016 ). Prospectively registered on the 29th of April 2016.


Assuntos
Doença Crônica/prevenção & controle , Serviços Preventivos de Saúde/métodos , Atenção Primária à Saúde , Adulto , Estudos Transversais , Dinamarca , Registros Eletrônicos de Saúde , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos
12.
Aust N Z J Public Health ; 43(5): 484-495, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31390112

RESUMO

OBJECTIVE: The aim of this literature review was to establish the economic burden of preventable disease in Australia in terms of attributable health care costs, other costs to government and reduced productivity. METHODS: A systematic review was conducted to establish the economic cost of preventable disease in Australia and ascertain the methods used to derive these estimates. Nine databases and the grey literature were searched, limited to the past 10 years, and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed to identify, screen and report on eligible studies. RESULTS: Eighteen studies were included. There were at least three studies examining the attributable costs and economic impact for each risk factor. The greatest costs were related to the productivity impacts of preventable risk factors. Estimates of the annual productivity loss that could be attributed to individual risk factors were between $840 million and $14.9 billion for obesity; up to $10.5 billion due to tobacco; between $1.1 billion and $6.8 billion for excess alcohol consumption; up to $15.6 billion due to physical inactivity and $561 million for individual dietary risk factors. Productivity impacts were included in 15 studies and the human capital approach was the method most often employed (14 studies) to calculate this. CONCLUSIONS: Substantial economic burden is caused by lifestyle-related risk factors. Implications for public health: The significant economic burden associated with preventable disease provides an economic rationale for action to reduce the prevalence of lifestyle-related risk factors. New analysis of the economic burden of multiple risk factors concurrently is needed.


Assuntos
Alcoolismo/economia , Doença Crônica/economia , Doença Crônica/prevenção & controle , Assistência à Saúde/economia , Custos de Cuidados de Saúde , Doenças não Transmissíveis/economia , Obesidade/economia , Obesidade/prevenção & controle , Comportamento Sedentário , Fumar/economia , Alcoolismo/terapia , Austrália/epidemiologia , Doença Crônica/epidemiologia , Efeitos Psicossociais da Doença , Custos e Análise de Custo , Humanos , Estilo de Vida , Doenças não Transmissíveis/terapia , Obesidade/epidemiologia , Fumar/efeitos adversos
13.
BMC Cancer ; 19(1): 659, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272420

RESUMO

BACKGROUND: In order to maximize later health, there are established components and guidelines for quality follow-up care of breast cancer survivors. However, adherence to quality follow-up in Canada may not be optimal, and may vary by province. We determined and compared the proportion of patients in each province who received adherent and non-adherent surveillance for recurrence, new cancers and late effects, recommended preventive care, and recommended physician visits for comorbidities. METHODS: Cohorts consisted of all adult women diagnosed with incident invasive breast cancer between 2007 and 2010/2012 in four Canadian provinces (British Columbia (BC) N = 9338; Manitoba N = 2688; Ontario N = 23,700; Nova Scotia (NS) N = 2735), identified from provincial cancer registries, alive and cancer-free at 30 months post-diagnosis. Their healthcare utilization was determined from one to 5 years post-treatment, using linked administrative databases. Adherence, underuse, and overuse of recommended services were evaluated yearly and compared using descriptive statistics. RESULTS: In all provinces and follow-up years, the majority of survivors had more than the recommended number of visits to either an oncologist or primary care physician (range 53.8% NS Year 3; 85.8% Ontario Year 4). The proportion of patients with the guideline-recommended number of oncologist visits varied by province (range 29.8% BC Year 5; 74.8% Ontario Year 5), and the proportion of patients with less than the recommended number of specified breast cancer-related visits with either an oncologist or primary care physician ranged from 32.6% (Ontario Year 2) to 84.4% (NS Year 3). Underuse of surveillance breast imaging was identified in NS and BC. The proportion of patients receiving imaging for metastatic disease (not recommended in the guidelines) in BC, Manitoba, and Ontario (not reported in NS) ranged from 20.3% (BC Year 5) to 53.3% (Ontario Year 2). Compliance with recommended physician visits for patients with several chronic conditions was high in Ontario and NS. Preventive care was less than optimal in all provinces with available data. CONCLUSIONS: Quality of breast cancer survivor follow-up care varies among provinces. Results point to exploration of factors affecting differences, province-specific opportunities for care improvement, and the value of administrative datasets for health system assessment.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Doença Crônica/epidemiologia , Fidelidade a Diretrizes , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/terapia , Sobrevivência , Assistência ao Convalescente , Idoso , Canadá/epidemiologia , Sobreviventes de Câncer , Doença Crônica/prevenção & controle , Comorbidade , Assistência à Saúde , Feminino , Humanos , Pessoa de Meia-Idade , Oncologistas , Médicos de Atenção Primária , Guias de Prática Clínica como Assunto , Medicina Preventiva , Estudos Retrospectivos , Cooperação e Adesão ao Tratamento
14.
Nutr. hosp ; 36(extr.3): 3-7, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184440

RESUMO

La vitamina D es un nutriente esencial cuya deficiencia se ha asociado con el riesgo de aparición de diversas enfermedades crónicas, como la osteoporosis, la hipertensión arterial, la enfermedad cardiovascular, la diabetes, algunos tipos de cáncer e incluso el padecimiento de sobrepeso y obesidad. A pesar de que la vitamina D puede sintetizarse a nivel cutáneo a partir de la exposición a la luz solar, esta fuente no es siempre suficiente para cubrir las necesidades debido al uso de cremas de protección solar y a la baja exposición que se produce durante el invierno, o, como en el caso de las personas enfermas, que salen poco a la calle o se exponen poco a la luz del sol. De hecho, estudios han constatado que al menos la mitad de la población española presenta déficit de vitamina D. Por ello, el aporte dietético es fundamental. Aunque existen diferentes alimentos fortificados con esta vitamina, son pocos los productos que son una fuente natural, entre los que se encuentran los pescados grasos y los huevos. Sin embargo, de acuerdo con diferentes estudios realizados en la población española, existe un bajo consumo de este último grupo de alimentos. De esta manera, sería recomendable fomentar el consumo de huevo entre la población, ya que este alimento, además de tener numerosos nutrientes, contiene una cantidad elevada de vitamina D, lo que contribuye a evitar la aparición de deficiencias y las consecuencias negativas para la salud que ello implica


Vitamin D is an essential nutrient whose deficiency has been associated with the risk of various chronic diseases such as osteoporosis, hypertension, cardiovascular disease, diabetes, some types of cancer and even overweight and obesity. Although vitamin D can be synthesized at the skin from exposure to sunlight, this source is not always sufficient to meet the needs. For example, the use of sunscreen or the low exposition to the sunlight limits the syntheses. In fact, studies have found that at least half of the Spanish population has vitamin D deficits. Therefore, the dietary contribution is fundamental. Although there are different foods fortified in this vitamin, few products are natural source of it, as fatty fish and eggs. However, according to different studies carried out in the Spanish population, there is a low consumption of this food group. In this way, it would be advisable to promote egg consumption among the population, since this food, in addition to having many nutrients, contains a high amount of vitamin D, which contributes to avoid the appearance of deficiencies and the consequences health consequences that this implies


Assuntos
Humanos , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/dietoterapia , Proteínas do Ovo/administração & dosagem , Doença Crônica/prevenção & controle , Vitamina D/administração & dosagem , Osteoporose/dietoterapia , Osteoporose/prevenção & controle , Deficiência de Vitamina D/metabolismo , Vitamina D/metabolismo
15.
Nutr. hosp ; 36(extr.3): 25-29, jul. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184444

RESUMO

Objetivos: mensajes recientes han animado a disminuir el consumo de lácteos al señalarlos como prescindibles o incluso perjudiciales en relación a ciertas patologías. El objetivo del presente trabajo consiste en revisar el valor nutricional de este grupo de alimentos y su consumo aconsejado. Métodos: búsqueda bibliográfica relacionada con el tema. Resultados: los lácteos aportan proteínas de alto valor biológico, vitaminas y minerales, especialmente calcio y vitaminas B2 y B12, así como ácidos grasos esenciales y algunos antioxidantes, entre otros nutrientes. Aunque su grasa es mayoritariamente saturada (65%), parece no afectar adversamente al riesgo cardiovascular y puede tener incluso un ligero efecto protector. Más de un 75% de los individuos tiene ingestas de calcio inferiores a las recomendadas, y dado que más del 50% del calcio de la dieta proviene de lácteos, aumentar su consumo puede ser recomendable. La ingesta moderada de leche durante el embarazo se asocia positivamente con el peso al nacer del descendiente y con su longitud y contenido mineral óseo durante la infancia. En adultos el consumo de lácteos se asocia con menor riesgo de síndrome metabólico, enfermedad coronaria e infarto de miocardio, cáncer colorrectal y de vesícula y diabetes tipo 2; en personas mayores, se asocia a un menor riesgo de fragilidad, sarcopenia y fracturas vertebrales. Conclusiones: la población desconoce cuál es el valor nutricional de los lácteos y su consumo aconsejable (2-4 raciones/día). Los últimos estudios avalan la necesidad de tener un consumo adecuado en todas las etapas de la vida por su relación con la prevención y el control de enfermedades crónicas. El consumo de lácteos es menor de 2 raciones/día en el 37,1% de los niños y en el 42,3% de los adultos, por lo que conviene mejorar esta situación


Objective: messages that are given recently have encouraged to reduce the consumption of dairy products, by noting them as dispensable or even harmful in relation to certain pathologies. The objective of this present work is to review the nutritional value of this group of foods and their recommended consumption. Methods: bibliographic search related to the topic. Results: dairy products provide proteins of high biological value, vitamins and minerals, especially calcium and vitamins B2 and B12, as well as essential fatty acids, and some antioxidants, among other nutrients. Although its fat is mostly saturated (65%), it does not seem to adversely affect cardiovascular risk and may even have a slight protective effect. More than 75% of individuals have calcium intakes lower than recommended, and since more than 50% of the calcium in the diet comes from dairy products, increasing their consumption may be recommended. Moderate milk intake during pregnancy is positively associated with birth weight and length of the offspring and bone mineral content during childhood. In adults, dairy consumption it is associated with a lower risk of metabolic syndrome, coronary heart disease and myocardial infarction, colorectal and gallbladder cancer, and type 2 diabetes. Moreover in older people it is associated with a lower risk of sarcopenia and vertebral fractures. Conclusions: the population ignores what is the nutritional value of dairy products and their advisable consumption (2-4 servings / day). The latest studies support the need to have an adequate consumption in all stages of life due to its relationship with the prevention and control of chronic diseases. Dairy consumption is less than 2 servings / day in 37.1% of children and 42.3% of adults, so it would be desirable to improve this situation


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Valor Nutritivo , Laticínios , Ácidos Graxos Essenciais/administração & dosagem , Nutrientes/administração & dosagem , Doença Crônica/prevenção & controle , Gorduras na Dieta , Dieta Hiperlipídica
16.
Nutrients ; 11(6)2019 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-31208133

RESUMO

Growing evidence support association between polyphenol intake and reduced risk for chronic diseases, even if there is a broad debate about the effective amount of polyphenols able to exert such protective effect. The present systematic review provides an overview of the last 10-year literature on the evaluation of polyphenol intake and its association with specific disease markers and/or endpoints. An estimation of the mean total polyphenol intake has been performed despite the large heterogeneity of data reviewed. In addition, the contribution of dietary sources was considered, suggesting tea, coffee, red wine, fruit and vegetables as the main products providing polyphenols. Total flavonoids and specific subclasses, but not total polyphenols, have been apparently associated with a low risk of diabetes, cardiovascular events and all-cause mortality. However, large variability in terms of methods for the evaluation and quantification of polyphenol intake, markers and endpoints considered, makes it still difficult to establish an evidence-based reference intake for the whole class and subclass of compounds. Nevertheless, the critical mass of data available seem to strongly suggest the protective effect of a polyphenol-rich dietary pattern even if further well targeted and methodologically sound research should be encouraged in order to define specific recommendations.


Assuntos
Doença Crônica/prevenção & controle , Dieta/métodos , Polifenóis/análise , Promoção da Saúde/métodos , Humanos
17.
BMC Public Health ; 19(1): 841, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31253112

RESUMO

BACKGROUND: Our objective was to determine the influence of the HealtheSteps™ lifestyle prescription program on physical activity and modifiable risk factors for chronic disease in individuals at risk. METHODS: One hundred eighteen participants were recruited from 5 sites in Southwestern Ontario, Canada and randomized to either the intervention (HealtheSteps™ program, n = 59) or a wait-list control group (n = 59). The study comprised three phases: an Active Phase (0 to 6 months) consisted of bi-monthly in-person lifestyle coaching with access to a suite of eHealth technology supports (Heathesteps app, telephone coaching and a private HealtheSteps™ social network) followed by a Minimally-Supported Phase I (6 to 12 months), in which in-person coaching was removed, but participants still had access to the full suite of eHealth technology supports. In the final stage, Minimally-Supported Phase II (12 to 18 months), access to the eHealth technology supports was restricted to the HealtheSteps™ app. Assessments were conducted at baseline, 6, 12 and 18 months. The study primary outcome was the 6-month change in average number of steps per day. Secondary outcomes included: self-reported physical activity and sedentary time; self-reported eating habits; weight and body composition measures; blood pressure and health-related quality of life. Data from all participants were analyzed using an intent-to-treat approach. We applied mixed effects models for repeated measurements and adjusted for age, sex, and site in the statistical analyses. RESULTS: Participants in HealtheSteps™ increased step counts (between-group [95% confidence interval]: 3132 [1969 to 4294], p < 0.001), decreased their sitting time (- 0.08 [- 0.16 to - 0.006], p = 0.03), and improved their overall healthful eating (- 1.5 [- 2.42 to - 0.58], p = 0.002) to a greater extent compared to control at 6 months. Furthermore, exploratory results showed that these individuals maintained these outcomes 12 months later, after a minimally-supported phase; and retained improvements in sedentary time and improved healthful eating after 18 months. No differences in self-reported physical activity, health-related quality of life, weight, waist circumference or blood pressure were observed between groups at 6 months. CONCLUSIONS: Our findings suggest that HealtheSteps™ is effective at increasing physical activity (i.e., step counts per day), decreasing weekday sitting time, and improving healthful eating in adults at increased risk for chronic disease after 6 months; however, we did not see change in other risk factors. Nonetheless, the maintenance of these behaviours with minimal support after 12 and even 18 months indicates the promise of HealtheSteps™ for long-term sustainability. TRIAL REGISTRATION: The trial was registered on April 6, 2015 with ClinicalTrials.gov (identifier: NCT02413385 ).


Assuntos
Doença Crônica/prevenção & controle , Exercício/psicologia , Promoção da Saúde/métodos , Estilo de Vida Saudável , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Autorrelato
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 726-730, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238627

RESUMO

Objective: To assess the follow-up situstion and changes of policies related to the prevention and control on chronic non-communicable diseases (NCDs), in various provinces from 2011 to 2017. Methods: Three national assessment programs on the prevention and control capacity of NCDs were carried out from September 2012 to March 2013, September 2014 to March 2015, and July to November 2018 respectively. Data related to the capacity on policy implementation among the 31 provinces, autonomous regions, municipality directly under the central government and Xinjiang Production and Construction Corps, were collected through online surveys. Results: The rate of data collection in all the provinces reached 100%, for all three surveys. In 2011, 2013, and 2017, the capacity for policy development special funding was distributed for prevention and control NCDs under the provincial fiscal revenue by 27 provinces (84.4%), 26 provinces (81.3%) and 25 provinces (78.1%), and the numbers of provincial governments leaders attended the local activities related to prevention and control NCDs was 15 (46.9%), 13 (40.6%) and 19(59.4%), respectively. From 2009 to 2011, 14 (43.8%) proposals related to the topics on prevention and control of NCDs, were raised at the provincial People's Congress and Political Consultative Conference, while from 2011 to 2013 and2014 to 2017, 13 (40.6%) and 12 (37.5%) were respectively raised. In terms of capacity for policy development, numbers of provincial comprehensive plan which targeting prevention and control of NCDs reached 6 (18.8%), 20 (62.5%) and 27 (84.4%) in 2011, 2013, and 2017 respectively. In 2011, 2013 and 2017, numbers of provincial special plans that targeting on NCDs or the risk factors of NCDs prevention and control were 0, 1, and 3, respectively. Conclusions: Under the continuous introduction of international and national policies related to prevention and control on NCDs, capacity for policy formulation in various provinces has been greatly improved. However, a slight progress has been made in the capacity for policy making. The increase of capacity building on policy making regarding prevention and control of NCDs, at the provincial government level, has become a key issue.


Assuntos
Doença Crônica/prevenção & controle , Serviços de Saúde Comunitária/organização & administração , Organizações de Planejamento em Saúde/organização & administração , Política de Saúde , Doenças não Transmissíveis/prevenção & controle , Recursos Humanos/tendências , China , Humanos , Fatores de Risco , Inquéritos e Questionários
19.
BMC Public Health ; 19(1): 729, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185993

RESUMO

BACKGROUND: While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. METHODS: A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. RESULTS: A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. CONCLUSIONS: The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.


Assuntos
Doença Crônica/prevenção & controle , Assistência à Saúde/organização & administração , Análise de Sistemas , Humanos , Políticas
20.
J Infect Public Health ; 12(5): 608-614, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31248815

RESUMO

In 2016, the government of Saudi Arabia launched the National Transformation Program to ensure the realisation of Kingdom's Vision 2030. One of the strategic objectives is Health Promotion against Health Risks (Public Health System and Health Disasters Management). The new Institutional Transformation and Health Care Model involves actions focusing on diseases prevention and strengthening the primary health care system. Success of the new Health Care Model in Saudi Arabia is only possible when considering assessment of factors influencing national prevalence of health risk factors and early detection of chronic diseases. This notion mandates availability of national screening programs that are able to identify individuals at risk or asymptomatically suffering from chronic diseases. This review is aiming to provide an overall overview of current governmental national screening programs in Saudi Arabia, to assess utilisation and outcomes of screening services in Saudi Arabia and assessment of effectiveness of current national screening programs.


Assuntos
Doença Crônica/prevenção & controle , Assistência à Saúde/organização & administração , Triagem Neonatal , Humanos , Recém-Nascido , Neoplasias/diagnóstico , Prevalência , Fatores de Risco , Arábia Saudita
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