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Objetivo: Identificar las fortalezas disponibles para la orientación comunitaria de la atención primaria desalud (APS) en el contexto de la evaluación del pilotaje de un programa formativo en salud comunitariapara especialistas internos residentes en Andalucía.Método: Estudio cualitativo explicativo de dise˜no fenomenológico, en el que se analiza la opinión de laspersonas participantes, que fueron 67 profesionales pertenecientes a seis distritos sanitarios de Andalucíaimplicados en el proceso formativo del Proyecto de Apoyo a la Revitalización de la Atención Primaria Activospara la Salud Comunitaria (PARAC).Resultados: Existe consenso en que la formación tiene un papel clave en la orientación comunitaria dela APS. Se identifican como activos los agentes vinculados a la docencia: los/las residentes, jóvenes pro-fesionales en formación que traen perspectivas y enfoques renovados a los centros de salud docentes,donde los/las profesionales deben dar respuesta a las necesidades de sus residentes, coordinados con lasunidades docentes multiprofesionales responsables de la formación de los/las residentes en un sistemasanitario con la vista puesta en el medio y largo plazo con estructuras que permitan organizar y apoyenla labor comunitaria de los centros de salud.Conclusiones: La orientación comunitaria de la APS es un objetivo que requiere el concurso de todos losniveles del sistema sanitario. Conocer y trabajar con los activos de la APS puede aportar propuestas paraavanzar hacia la orientación comunitaria de esta., Objective: To identify the strengths available for the community orientation of primary health care (PHC)in the context of the evaluation of the piloting of a training program in Community Health for ResidentInternal Specialists in Andalusia (Spain).Method: We will conduct a qualitative, phenomenologically-oriented, explanatory research in which theopinion of the participants is analyzed. Sixty-seven professionals from six PHC Districts of Andalusiawhich were part of the training program called Project to Support the Revitalization of Primary Care Assetsfor Community Health (PARAC) were interviewed.Results: There is consensus in giving training a key weight in the community orientation of PHC. For thisreason, those agents linked to training are identified as assets: general practice (GP) trainers, young pro-fessionals in training who bring updated perspectives and approaches to accredited PHC training centers,whose professionals must respond to the needs of their GP trainees, the multi-professional teaching unitsresponsible for the GP trainees training and a medium and long-term health system thinking along withstructures that coordinate and support the community work at the PHC centers.Conclusions: The community orientation of PHC is an objective that requires the participation of all levelsof the health system. Knowing its assets and working with them can contribute to provide proposals toadvance towards a community-oriented PHC system.

BACKGROUND AND OBJECTIVE: Drinking water promotion and access shows promise for preventing weight gain. This study evaluated the impact of Water First, a school-based water promotion and access intervention on changes in overweight. METHODS: Low-income, ethnically diverse elementary schools in Californias Bay Area were cluster-randomized to intervention and control groups. Water First includes classroom lessons, water stations, and schoolwide water promotion over 1 school year. The primary outcome was overweight prevalence (BMI-for-age-and-sex ≥85th percentile). Students (n = 1249) in 56 fourth-grade classes in 18 schools (9 intervention, 9 control) from 2016 to 2019 participated in evaluation at baseline, 7, and 15 months. Data collection was interrupted in 8 additional recruited schools because of coronavirus disease 2019. RESULTS: Of 1262 students from 18 schools, 1249 (47.4% girls; mean [SD] age, 9.6 [0.4] years; 63.4% Hispanic) were recruited. From baseline to 7 months, there was no significant difference in changes in overweight prevalence in intervention schools (-0.2%) compared to control schools (-0.4%) (adjusted ratio of odds ratios [ORs]: 0.7 [confidence interval (CI): 0.2-2.9] P = 0.68). From baseline to 15-months, increases in overweight prevalence were significantly greater in control schools (3.7%) compared to intervention schools (0.5%). At 15 months, intervention students had a significantly lower change in overweight prevalence (adjusted ratio of ORs: 0.1 [CI: 0.03-0.7] P = .017) compared to control students. There were no intervention effects for obesity prevalence. CONCLUSIONS: Water First prevented increases in the prevalence of overweight, but not obesity, in elementary school students.

Background School-based sexuality education is a core component of securing young people’s right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one’s sexual health is associated with knowledge gained from school-based sexuality education and social determinants. Methods The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used. Results Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one’s sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities. Conclusions Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy., CC BY 4.0

This dissertation focuses on women’s participation in mammography screening, which is a vital component of early detection and effective management of breast cancer. All Swedish women in the age group of 40-74 receive an invitation by mail at regular intervals of 18-24 months. However, about 20% of Swedish women fail to attend the mammography screening they were offered. The impact on mortality within a population is contingent on theparticipation rate, underscoring the importance of making efforts to attain a high level of participation. This thesis is an attemt to improve understanding and awareness of the women’s choices and actions that can influence life or death, especially considering that being a woman is the most significant risk factor for breast cancer. The overall aim of this thesis was to explore the phenomenon of women’s participation in mammography screening by exploring the reasons why women refrain from mammography screening from the perspective of non-attending women (Paper I) and factors that affect women’s participation in mammography screening in the Nordic countries. The research was conducted through qualitative and mixed studies review method studies. The data collection methods comprised ten personal interviews (Paper I), and 16 articles (Paper II). Qualitative content analysis was used to analyse the interviews in an indictive approach (Paper I). A deductive approach with segregated mixed research synthesis was used to analyse and summarise findings from articles in systematic review (Paper II). Health Promotion Model by N. Pender was used as a theoretical framework. Participation in mammography screening is a complex phenomenon that has many dimensions. The thesis results underscore the significance of comprehending the unique and subjective encounters of women in the context of mammography screening. These experiences hold substantial sway over their perspectives and actions regarding this procedure. Additionally, the research suggests th

In Japan, there is a lack of physical activity data on health and disease among people with visual impairments, making it difficult to develop specific strategies for health promotion. This study aimed to identify moderate-to-vigorous physical activity (MVPA) among people with visual impairments in Japan, to examine the percentage of them who meet the MVPA recommended activity, and to identify factors related to MVPA. In this cross-sectional study, we analyzed a survey of 169 adults with visual impairments. The relationship between MVPA and related factors was analyzed using binomial logistic regression analysis. The median MVPA was 46 min/day for men and 36 min/day for women, respectively, aged < 65 years, and 26 min/day for men and 34 min/day for women, respectively, aged ≥ 65 years. Seventy-eight percent of the subjects achieved the recommendations by the WHO, and 28% of the subjects < 65 years had achieved the MVPA of 60 min/day recommended by the Japanese Active Guide. Self-efficacy (SE) for PA, recommended PA implementation behavior, subjective walking speed, and exercise habits were significantly associated with MVPA. The current status of MVPA time among people with visual impairments in Japan, as revealed by this study, indicates that it is important to set realistic goals and plan a step-by-step process to achieve the recommendation. In the future, it will be important to develop a program that encourages the improvement of SE and promotes PA., source:https://doi.org/10.3390/ijerph19042244

Healthcare. 2023, 11 (5), P.704

Introduction: Active aging is a European concern that requires health and social professionals to rethink their practices. Methodology: We seek to understand the care model for the elderly in a Group of Health Centers (ACES) in the North of Portugal to deduce the role of rehabilitation nurses in the community. We carried out a qualitative, phenomenological study. The intentional non-probabilistic sample consisted of eight Doctors, eight Nurses and eight Social Workers who develop their activity for people over 65 years old in an ACES. Data collection was carried out through a semi-structured interview, constituting the results of the body of analysis that sustains this research. Results: 83% of participants had no training in gerontology. There were care evaluation focuses, in which all professionals estimated the same data, but there were data necessary for monitoring the elderly that were not evaluated by any professional. The sharing of information for assistance, when it occurred, fell into situations of illness or changes in the social context. Discussion: It was possible to verify that in all themes there is information that converges in the three groups of professionals, mainly in the data collected in the initial evaluation. As advocated by some authors, sharing information and dividing teamwork is important for a more specialized intervention aimed mainly at this age group. Conclusion: In this way, it was possible to perceive that the work of the three groups of professionals interviewed often intersects and that there is a need for data sharing between the multidisciplinary team, with the specialized work of the Rehabilitation Nurse being valued and important., Introducción: El envejecimiento activo es una preocupación europea que requiere que los profesionales sociales y de la salud reconsideren sus prácticas. Metodología: Buscamos comprender el modelo de atención a los ancianos en un Grupo de Centros de Salud (ACES) en el Norte de Portugal para deducir el papel de las enfermeras de rehabilitación en la comunidad. Realizamos un estudio cualitativo, fenomenológico. La muestra no probabilística intencional estuvo constituida por ocho Médicos, ocho Enfermeros y ocho Trabajadores Sociales que desarrollan su actividad para personas mayores de 65 años en un ACES. La recolección de datos se realizó a través de una entrevista semiestructurada, constituyendo los resultados del cuerpo de análisis que sustenta esta investigación. Resultados: El 83% de los participantes no tenían formación en gerontología. Existían focos de evaluación del cuidado, en los que todos los profesionales estimaban los mismos datos, pero había datos necesarios para el seguimiento de los ancianos que no eran evaluados por ningún profesional. El intercambio de información para la asistencia, cuando ocurrió, cayó en situaciones de enfermedad o cambios en el contexto social. Discusión: Fue posible verificar que en todos los temas hay informaciones que convergen en los tres grupos de profesionales, principalmente en los datos recogidos en la evaluación inicial. Como defienden algunos autores, compartir información y dividir el trabajo en equipo es importante para una intervención más especializada dirigida principalmente a este grupo de edad. Conclusión: De esa forma, fue posible percibir que el trabajo de los tres grupos de profesionales entrevistados muchas veces se entrecruza y que existe la necesidad de compartir datos entre el equipo multidisciplinario, siendo valorado e importante el trabajo especializado de la Enfermera de Rehabilitación., Introdução: O envelhecimento ativo é uma preocupação europeia que exige aos profissionais de saúde e sociais repensar as suas práticas. Metodologia: Procuramos compreender o modelo de assistência dos idosos num Agrupamento de Centros de Saúde (ACES) do Norte de Portugal para deduzir o papel dos enfermeiros de reabilitação na comunidade. Realizamos um estudo qualitativo, do tipo fenomenológico. A amostra não probabilística intencional foi constituída por oito Médicos, oito Enfermeiros e oito Assistentes Sociais que desenvolvem a sua atividade para pessoas com mais de 65 anos num ACES. A recolha de dados foi elaborada através de uma entrevista semi-estruturada, constituindo os resultados do corpo da análise que sustenta esta pesquisa. Resultados: 83% dos participantes não possuíam formação em gerontologia. Havia focos de avaliação da assistência, em que todos os profissionais estimavam os mesmos dados, mas havia dados necessários ao acompanhamento dos idosos que não eram avaliados por nenhum profissional. A partilha da informação para a assistência, quando ocorria, recaía nas situações de doença ou de alterações do contexto social. Discussão: Foi possível verificar que em todas as temáticas há informação que converge nos três grupos de profissionais, principalmente nos dados colhidos na avaliação inicial. Tal como defendem alguns autores a partilha de informação e divisão do trabalho de equipa é importante para uma intervenção mais especializada e dirigida principalmente nesta faixa etária. Conclusão: Desta forma foi possível perceber que o trabalho dos três grupos de profissionais entrevistados muitas vezes se cruza e que há necessidade de partilha de dados entre a equipa multidisciplinar, sendo valorizado e importante o trabalho especializado do Enfermeiro de Reabilitação.

Governments seek universal health care to guarantee citizens equal treatment and improve health at the individual and group levels. Scientific articles were searched in databases such as Scielo, Science Direct, Google Scholar y Scopus. The search was limited to publications between 2019 and 2023 in Spanish or English, and freely available. As a result, social marketing is crucial to address public health problems and has been widely used for decades to change behaviors. It is concluded, social marketing promotes health, prevents disease and improves quality of life. It focuses on specific groups, understands needs, and analyzes external factors to generate change. It involves the public and institutions from different sectors through a multidisciplinary team. This has a positive impact on health programs and can influence the behavior of beneficiaries., Los gobiernos buscan atención universal de salud para garantizar a los ciudadanos igualdad de trato y mejorar la salud a nivel individual y grupal. Se buscaron artículos científicos en bases de datos como Scielo, Science Direct, Google Scholar y Scopus. Se limitó la búsqueda a publicaciones entre 2019 y 2023 en español o inglés, y de acceso gratuito. Como resultado, el Marketing social es crucial para abordar los problemas de salud pública y ha sido ampliamente utilizado durante décadas para cambiar comportamientos. Se concluye, el mercadeo social promueve la salud, previene enfermedades y mejora la calidad de vida. Se enfoca en grupos específicos, comprende necesidades y analiza factores externos para generar cambios. Involucra al público y a instituciones de diferentes sectores a través de un equipo multidisciplinario. Esto tiene un impacto positivo en los programas de salud y puede influir en el comportamiento de los beneficiarios.

Introduction: The sick building syndrome has been described as a health condition suffered by workers due to physical, chemical, biological, and psychosocial risk factors of the work environment. Its origin is multifactorial and symptoms disappear when the worker leaves the building. In Colombia there is not an instrument for its diagnosis. Objective: To determine the presence of the sick building syndrome and identify the associated factors in the facilities of an institution providing health services. Methods: The survey of the Technical Prevention Standard 290 (National Institute of Safety and Hygiene at Work, attached to the Ministry of Labor and Social Affairs of Spain) was applied to 70 administrative workers. Results: The results demonstrated the presence of the sick building syndrome, and back pain was identified as the most prevalent symptom. According to the statistical analysis, the associated risk factors were physical and multiple psychosocial factors related to the organization, therefore, strengthening this aspect is suggested. Conclusions: Unlike similar studies, the percentage of the presence of respiratory, eye and allergy-related symptoms was less than 20%, which could be explained by the biosafety and isolation conditions due to the COVID-19 mitigation program therefore; it is advisable to continue maintaining these conditions and carry out a more in-depth study on the origin of the outstanding symptoms., Introducción: el síndrome del edificio enfermo (SEE) ha sido descrito como una afección de salud que sufren los trabajadores debido a factores de riesgo físicos, químicos, biológicos y psicosociales del entorno laboral. Su origen es multifactorial y sus síntomas desaparecen cuando el trabajador abandona el edificio. En Colombia no existe un instrumento para su diagnóstico. Objetivo: determinar la presencia del síndrome de edificio enfermo e identificar los factores asociados en las instalaciones de una institución prestadora de servicios de salud. Métodos: se aplicó la encuesta de la Norma Técnica de Prevención 290 (Instituto Nacional de Seguridad e Higiene en el Trabajo, adscrito al Ministerio de Trabajo y Asuntos Sociales de España) a 130 trabajadores administrativos. Resultados: los resultados mostraron la presencia del SEE y se identificó como síntoma más prevalente el dolor de espalda. De acuerdo con los análisis estadísticos, los factores de riesgo asociados fueron físicos y múltiples factores psicosociales relacionados con la organización, por lo que se sugiere fortalecer este aspecto. Conclusiones: a diferencia de estudios similares, el porcentaje de la presencia de síntomas respiratorios, oculares y relacionados con alergias fue menor al 20%, esto podría ser explicado por las condiciones de bioseguridad y aislamiento debidas al programa de mitigación de la COVID-19, por lo cual es aconsejable seguir manteniendo estas condiciones y realizar un estudio más profundo sobre el origen de los síntomas destacados.

Introduction: Physical inactivity is one of the major risk factors for chronic diseases. This situation in adolescents and young people has become a priority issue in global public health. Objective: To study the association of physical inactivity with lifestyle, demographic factors, sedentary activities, overweight and obesity in school adolescents in Sabaneta, 2017. Methodology: Cross-sectional study, conducted in 7 educational institutions with a random probability sample of 246 students. The Pérez Rojas García test was used to assess physical inactivity. A generalized linear model of binomial family and logit link was estimated to estimate the crude and adjusted OR for the association between the variables of interest and physical inactivity. These were accompanied by 95% confidence intervals. Results: The prevalence of physical inactivity was 62.6%. The odds of physical inactivity were higher among females, overweight and obese individuals, students with alcohol or caffeine consumption, and students who used computers or studied more than 6 hours per day. The odds of physical inactivity were reduced in students of lower class, thin, with psychoactive consumption, and reading more than 6 hours per day.Conclusions: The prevalence of physical inactivity, overweight and obesity among adolescents was high. The associated factors are mostly modifiable and represent an opportunity for improvement., Introducción: La inactividad física es uno de los principales riesgos para enfermedades crónicas. Esta situa-ción en adolescentes y jóvenes se ha convertido en un tema prioritario en la salud pública global. Objetivo: Explorar la asociación entre la inactividad física con los estilos de vida, factores demográficos, actividades sedentarias, sobrepeso y obesidad en adolescentes escolarizados en Sabaneta, 2017.Metodología: Estudio transversal, ejecutado en 7 instituciones educativas con una muestra probabilística aleatoria de 246 estudiantes. Se aplicó el test de Pérez Rojas García para la valoración de inactividad fí-sica. Se estimó un modelo lineal generalizado de familia binomial y link logit para estimar los OR crudos y ajustados para la asociación de las variables de interés y la inactividad física. Se acompañaron con los intervalos de confianza del 95%.Resultados: La prevalencia de inactividad física fue de 62,6%. La posibilidad de inactividad física fue mayor en las mujeres, personas con sobrepeso y obesidad, estudiantes con consumo de licor o cafeína, y entre quienes se dedicaron a usar el computador o estudiar más de 6 horas diarias. Entre los estudiantes de estrato bajo, delgados, con consumo de psicoactivos y que leen más de 6 horas al día la probabilidad de inactividad se redujo.Conclusiones: La prevalencia alta de inactividad física, obesidad y sobrepeso entre adolescentes fue alta. Los factores asociados son en su mayoría modificables, representando una oportunidad de mejora.

Introduction: Children with physical disabilities often present deficient oral hygiene and eating habits that threaten optimal oral health. Objective: To evaluate the result of a preventive program based on multiple intelligences to pro-mote oral health care in children with physical disabilities in Chiclayo - Peru. Materials and Methods: A quasi-experimental, quan-titative, prospective and longitudinal study was carried out from the year 2020, to test a preventive intervention based on multiple intelligences (MI), comparing it with an intervention with traditional methodology, whose purpose was in both cases promote preventive oral health care in 167 boys and girls with physical disabilities from four Special Basic Education Centers (CEBES) in Chiclayo. For the pre- and post-test evaluation using a dental record of oral hygiene practices, oral hygiene index and dietary exposure to sugary carbohydrates, the Mann Whitney U test was required, with a confidence level of 95%. Results: After not very encouraging findings in the pretest for both groups, significant changes were observed in the posttest in favor of the IM-based program, for which 58% of schoolchildren registered an adequate oral hygiene index, 69.2% brushed twice to three times a day and that only 35.8% present regular exposure to carbohydrates. Statistical significance was evidenced in favor of the MI-based intervention for the three indicated variables (p= 0.000). Conclusions: The application of the IM-based program achieved better results in the significant promotion of oral hygiene practices with a favorable record of the IHO and by reducing the exposure to carbohydrates in a vulnerable population., Objetivo: Describir las características de las tesis de licenciatura, satisfacción y motivos para la elección de un tema de estudio. Materiales y Métodos: Estudio transversal que incluyó a dos poblaciones, las tesis y a los tesistas que lograron sustentar sus trabajos desde el año 2015 al 2021 en la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos (Lima, Perú). Se utilizó el análisis documental en un primer momento para registrar datos bibliométricos. La encuesta se utilizó en un segundo momento para recabar información relacionada a los motivos por los cuales escogieron su tema los tesistas y el grado de satisfacción. Resultados: Se examinaron 269 tesis. La mayoría de ellas fueron realizadas por mujeres (n=142; 52,8%). Todas tuvieron un enfoque cuantitativo. El diseño transversal/descriptivo fue el más frecuente (n=207; 77%). De los 114 encuestados, la mayoría de ellos indicó que la decisión de su tema de tesis fue influida por un docente ajeno a su asesor (n= 26; 22,8%). El 49,1% de tesistas estuvo totalmente de acuerdo respecto a lo aprendido sobre investigación al culminar su tesis. Conclusión: Las tesis de licenciatura evidenciaron ser desarrolladas principalmente por mujeres, la mayoría estuvo satisfecho con la elaboración y ejecución de su trabajo académico; se evidenció que los temas de tesis son influenciados principalmente por un docente diferente al asesor de tesis, esto indica que los asesores deben ser más conscientes al momento de guiar al estudiante e influir en las decisiones temáticas, metodológicas y de redacción junto con el asesorado

Introduction: The consumption of psychoactive substances (PAS) among schoolchildren suggests a complex phenomenon with multiple negative effects. From the perspective of social determinants and health promotion, the Educational Institution (EI) acts as a decisive agent for participatory actions. The present study aimed to identify individuals and institutional factors associated with the participation of students in an I.E. public of Cali (Colombia) toward the prevention of the consumption of PAS. Materials and methods: This is a case study with a qualitative and quantitative approach. The former involved a documentary analysis for the exploration of the response and the institutional factors of EI, which were selected as a critical case. Meanwhile, to identify the relevant individual factors, a quantitative component was developed through a survey of 156 students (Secondary–Middle School) of that EI. Results: Students identified pressure from friends or classmates as a relevant factor for PAS consumption, indicating that the spaces and prevention processes with the most significant contribution are communication with peers. The curricular work from the areas to strengthen decision-making is also recognized as an institutional factor. Conclusion: Within the healthy schools' strategy, the alliance between the education and health sectors is of crucial relevance for the promotion of the revitalization of spaces and participation processes aimed at preventing the consumption of PAS. The analysis of studies on the development of healthy schools strategy is thus required to generate elements of reflection directed toward the adjustment of the actions facilitating the empowerment of the students and those referring to[...], Introdução: o consumo de substâncias psicoativas (SPA) em estudantes é um fenômeno complexo com múltiplos efeitos negativos. Na perspectiva dos determinantes sociais e da promoção da saúde, a Instituição de Ensino (IE) é um agente decisivo para ações participativas. O objetivo foi identificar fatores individuais e institucionais associados à participação de alunos em uma ie pública de Cali (Colômbia) para prevenir o consumo de spa. Materiais e métodos: estudo de caso com abordagem mista. A abordagem qualitativa envolveu uma análise documental para explorar a resposta e os fatores institucionais da ie selecionada como caso crítico; enquanto para identificar os fatores individuais relevantes, desenvolveu-se um componente quantitativo através de um questionário a 156 alunos (ensino médio) daquela ie. Resultados: os alunos identificam a pressão de amigos ou colegas como fator relevante para o consumo de spa; é evidente que os espaços e processos de prevenção com maior contribuição são a comunicação com os pares. O trabalho curricular das áreas para fortalecer a tomada de decisão também é reconhecido como um fator institucional. Conclusão: na estratégia das escolas saudáveis, a aliança entre o setor da educação e o setor da saúde, assume uma relevância crucial para promover a revitalização de espaços e processos participativos direcionados à prevenção do consumo de spa. Os estudos de análise do desenvolvimento da estratégia de escolas saudáveis ​​são necessários para gerar elementos de reflexão direcionados ao ajuste das ações de empoderamento dos alunos e que os processos de participação juvenil alcancem a necessária continuidade., Introducción: el consumo de sustancias psicoactivas (SPA) en escolares es un fenómeno complejo con múltiples efectos negativos. Desde la perspectiva de los determinantes sociales y la promoción de la salud, la institución educativa (IE) es un agente decisivo para acciones participativas. El objetivo fue identificar factores individuales e institucionales asociados con la participación de estudiantes en una ie pública de Cali (Colombia) para prevenir el consumo de spa. Materiales y métodos: estudio de caso con enfoque mixto. La aproximación cualitativa implicó un análisis documental para explorar la respuesta y factores institucionales de la ie seleccionada como caso crítico; mientras que para identificar los factores individuales relevantes se desarrolló un componente cuantitativo mediante encuesta a 156 estudiantes (secundaria-media) de esa ie. Resultados: los estudiantes identifican como factor relevante para el consumo de spa la presión de amigos o compañeros; se evidencia que los espacios y procesos de prevención de mayor aporte son la comunicación con pares. También se reconoce como factor institucional el trabajo curricular desde las áreas para fortalecer la toma de decisiones. Conclusión: en la estrategia de escuelas saludables, es crucial la alianza entre el sector educativo y el sector salud, para dinamizar espacios y procesos de participación dirigidos a prevenir el consumo de spa. Los estudios de análisis del desarrollo de la estrategia de escuelas saludables son requeridos para generar elementos de reflexión dirigidos al ajuste de las acciones de empoderamiento de los estudiantes y que los procesos de participación juvenil logren la continuidad requerida.

Introduction: Fruit and vegetable consumption as a preventive health measure depends mainly on the perspective of individual lifestyle. The structural processes such as food production models and food policies determine their production, availability, and access. This study aimed to analyze the social determinants of fruit and vegetable consumption in the municipality of Florida, Valle del Cauca, Colombia. Materials and Methods: This is a qualitative case study using a social determination approach. This study includes a documentary review of food policies and discussion groups among key stakeholders. A content analysis was conducted to allow an explicit analysis of the messages and speeches. Results: In the general dimension, deemed as critical processes of determination, the unequal use and possession of land and the exploitation of water sources and policies, from the logic of the free market, increasingly reduce the local strategies for self-support and self-consumption and limit the production and access of fruits and vegetables. In the particular dimension, a critical adverse process includes the armed conflict. However, the exercise of food sovereignty favors the consumption of fruits and vegetables. Conclusion: Food policy at the national and local level discursively recognizes the social determinants of food security; however, in practice, contingent strategies that do not aim at addressing the structural conditions that limit production, availability, access and, therefore, the consumption of fruits and vegetables, should be evaluated., Introdução: o consumo de frutas e verduras como processo de proteção à saúde tem sido analisado principalmente na perspectiva dos estilos de vida individuais, porém processos estruturais como modelos de produção de alimentos e políticas alimentares determinam sua produção, disponibilidade e acesso; o objetivo do estudo foi analisar os processos de determinação social do consumo de frutas e verduras no município da Flórida, Valle del Cauca, Colômbia. Materiais e métodos: estudo qualitativo, do tipo estudo de caso, com enfoque na determinação social; incluiu uma revisão documental de políticas alimentares e grupos de discussão com atores-chave; a análise de conteúdo permitiu explicitar mensagens e discursos. Resultados: na dimensão geral, destacam-se o uso e posse desigual da terra e a exploração dos recursos hídricos como processos determinantes críticos que limitam a produção e o acesso a frutas e verduras; e políticas que, baseadas na lógica do livre mercado, reduzem cada vez mais as estratégias locais de autossustentabilidade e autoconsumo. Na dimensão particular, destaca-se o conflito armado como processo crítico adverso, e o exercício da soberania alimentar, como processo crítico favorável ao consumo de frutas e verduras. Conclusões: a política alimentar a nível nacional e local reconhece, de forma discursiva, as determinações sociais da segurança alimentar, mas na prática privilegia estratégias focalizadas e contingentes que não visam resolver condições estruturais que limitam a produção, a disponibilidade, o acesso e, portanto, o consumo de frutas e verduras., Introducción: el consumo de frutas y verduras como proceso protector de la salud se ha analizado principalmente desde la perspectiva de los estilos de vida individuales; sin embargo, procesos de tipo estructural como los modelos de producción de alimentos y las políticas de alimentación determinan su producción, disponibilidad y acceso. Se planteó como objetivo analizar los procesos de determinación social del consumo de frutas y verduras en el municipio de Florida (Valle del Cauca, Colombia). Materiales y métodos: estudio cualitativo, tipo estudio de caso, con enfoque de determinación social. Incluyó revisión documental de políticas alimentarias y grupos de discusión con actores clave; el análisis de contenido permitió explicitar mensajes y discursos. Resultados: en la dimensión general, resaltan como procesos críticos de determinación, que limitan la producción y el acceso de frutas y verduras, el uso y tenencia inequitativa de la tierra y la explotación de las fuentes hídricas, y unas políticas que desde la lógica de libre mercado reducen cada vez más las estrategias locales de autosostenimiento y autoconsumo. En la dimensión particular, el conflicto armado (como proceso crítico adverso) y los ejercicios de soberanía alimentaria (como proceso crítico favorable al consumo de frutas y verduras). Conclusiones: la política alimentaria nacional y local reconoce, de manera discursiva, las determinaciones sociales de la seguridad alimentaria, pero en la práctica privilegia estrategias focalizadas y contingentes que no apuntan a la solución de condiciones estructurales que limitan la producción, disponibilidad, acceso y, por ende, el consumo de frutas y verduras.

Aim: To identify the results of a commu-nity action training activity on participants’ knowledge, as well as identifying motiva-tions for training, knowledge acquired, and the detection of new training needs. Methodology: Descriptive study using anonymous self-administered questionnai-res addressed to primary and community healthcare professionals in Catalonia.Results: 92% of the participants were women, nurses (30.7%) and psychologists (51.3%). Prior to training, knowledge of community action (4.9 points (2.2), commu-nity participation (5.0 points (2.0) and health assets (5.6 points (2.1)) were scored. At the end of the training the scores were: com-munity action (6.7 points (1.4), community participation (6.4 points (1.8) and health assets (6.8 points (1.6). The main motiva-tions for taking the training were to increase knowledge in community action and to ne-twork with community agents. The following were identified as lessons learned: the need to broaden the understanding of communi-ty action and to acquire resources and parti-cipatory dynamics. The new training needs were related to methodological aspects of community health intervention evaluation and participation strategies.Conclusions: Training has a positive effect on knowledge of community action, community participation and health assets. The motivations for training are to acquire resources in community action and to ne-twork with community agents, and learning is related to resources to promote commu-nity participation. The following are identi-fied as future training actions: methodologi-cal aspects of community action evaluation and participation strategies., Objetivo: Identificar el resultado de una actividad formativa en acción comunitaria sobre los conocimientos de las personas asistentes, así como las motivaciones para formarse, los conocimientos adquiridos y la detección de nuevas necesidades formati-vas. Metodología: Estudio descriptivo a tra-vés de cuestionarios anónimos y auto ad-ministrados a profesionales de la salud del ámbito de atención primaria y comunitaria en Cataluña.Resultados: El 92% de los participantes eran mujeres, enfermeras (30.7%) y psi-cólogas (51.3%). Previo a la formación se puntuaron los conocimientos en: acción comunitaria (4.9 puntos (2.2)), participación comunitaria (5.0 puntos (2.0)) y activos en salud (5.6 puntos (2.1)). Finalizada la for-mación las puntuaciones fueron: acción comunitaria (6.7 puntos (1.4)), participa-ción comunitaria (6.4 puntos (1.8) y activos en salud (6.8 puntos (1.6)). Las principales motivaciones para realizar la formación eran aumentar los conocimientos en acción co-munitaria y hacer red con agentes de la co-munidad. Se identificaron como aprendiza-jes: ampliar la mirada en acción comunitaria y adquirir recursos y dinámicas participati-vas. Las nuevas necesidades formativas se relacionaban con aspectos metodológicos de evaluación de las intervenciones en sa-lud comunitaria y con estrategias de parti-cipación.Conclusiones: la formación tiene un efecto positivo sobre los conocimientos en acción comunitaria, participación comunita-ria y activos en salud. Las motivaciones para formarse son adquirir recursos en acción comunitaria y hacer red con agentes comu-nitarios y los aprendizajes se relacionan con los recursos para promover la participación comunitaria. Se detectan como futuras ac-ciones formativas: los aspectos metodoló-gicos de la evaluación en acción comunita-ria y las estrategias de participación.

Mobility, the processes and actions of displacement of people, have great consequences in the social, economic, environmental or urban sphere. The means of motorized transport that are used for the mobility of people generate risks for the population’s health, through polluting emissions, noise, greenhouse gases or accidents. In addition, they influence the degree of physical activity and sedentary lifestyle. Together, they affect mental and physical health, and cause the development of diseases. It is for all these reasons that people and citizens must be able to choose sustainable and healthy forms of mobility, for themselves and for the population. To this end, we developed this “the pyramid of healthy and sustainable mobility” whose purpose is to provide guidelines on how to improve this behavior in daily commuting, for an improvement in environmental health. To do this, it orders and graphically graduates the forms of mobility into two main objectives, to improve sustainability and health. In addition, transcendental factors for improvement in both axes are specifically indicated., La movilidad, los procesos y acciones de desplazamiento de las personas, tienen grandes consecuencias en el ámbito social, económico, ambiental o urbanístico. Los medios de transporte motorizado que se utilizan para la movilidad de las personas generan riesgos para la salud poblacional, a través de emisiones contaminantes, ruido, gases de efecto invernadero o accidentes. Además, influyen en el grado de actividad física y del sedentarismo. En conjunto, afectan la salud mental y física, y causan el desarrollo de enfermedades. Es por todo ello que las personas y la ciudadanía debe poder elegir formas sostenibles y saludables de movilidad, para sí y para el conjunto de la población. Con este fin desarrollamos esta “pirámide de la movilidad saludable y sostenible” cuyo fin es aportar pautas sobre cómo mejorar este comportamiento en los desplazamientos diarios, para una mejora de la salud ambiental. Para ello ordena y gradúa gráficamente las formas de movilidad en dos grandes objetivos, mejorar la sostenibilidad y la salud. Además, se señalan específicamente factores trascendentes para la mejora en ambos ejes., A mobilidade, os processos e ações de deslocamento de pessoas, tem grandes consequências na esfera social, econômica, ambiental ou urbana. Os meios de transporte motorizados que são utilizados para a locomoção de pessoas geram riscos à saúde da população, por meio de emissões poluentes, ruídos, gases de efeito estufa ou acidentes. Além disso, influenciam o grau de atividade física e o sedentarismo. Juntos, eles afetam a saúde mental e física e causam o desenvolvimento de doenças. É por todas estas razões que as pessoas e os cidadãos devem poder optar por formas de mobilidade sustentáveis e saudáveis, para si e para a população em geral. Para tal, desenvolvemos esta “pirâmide de mobilidade saudável e sustentável” cujo objetivo é fornecer orientações sobre como melhorar este comportamento nas deslocações diárias, para uma melhoria da saúde ambiental. Para isso, ordena e gradua graficamente as formas de mobilidade em dois objetivos principais, melhorar a sustentabilidade e a saúde. Além disso, são especificamente indicados fatores transcendentais para melhoria em ambos os eixos.

Background: Psychosocial risk factors in the home may impair children’s health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). Methods: This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0–18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. Results: As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81–99%) and PPV values were low to moderate (22–69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% f

In 2021, the public libraries and cultural centers of Gothenburg received initiated a project named “The Healing Force of Literature” (Litteraturens läkande kraft), aimed at promoting mental health among young adults through library programming. It included educating library workers on the topic of mental health, as well as methods of bibliotherapy and shared reading. Such health promotional activities are rare in Swedish public libraries, and the project’s focus on mental health is unique. Against this background, this thesis aims to explore and analyze the mental health promotional projects of the libraries of Gothenburg from a perspective of organizational theory. Methodologically relying on qualitative semi-structured interviews, the thesis explores how librarians relate the health projects to the Public Libraries Act of 2013 (Bibliotekslag 2013) and its task of promoting democracy. It also investigates how the health promotional activities have affected the social infrastructure of the libraries. The thesis shows that the libraries primarily pursue mental health promotion through bibliotherapeutic reading groups around the city. Librarians view mental health promotion as an expression of the democratic mission formulated in the Public Libraries Act. Democracy and health are therefore considered as components of the same essence, and the health promotion is integrated into the existing social infrastructure of the libraries. Despite being positive to the projects, librarians express anxiety of their work becoming too clinical, outside of their perceived professional role and competence. In the final analysis, the health promotional activities, and professional insecurities they imply, reflect the broader legitimacy questions currently surrounding the library as a public institution.

Background: Psychosocial risk factors in the home may impair children’s health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). Methods: This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0–18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. Results: As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81–99%) and PPV values were low to moderate (22–69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% f

Medarbetarnas hälsa och trivsel inom äldreomsorgen är viktiga frågor då antalet äldre som behöver stöd och vård beräknas öka. Vård- och omsorgsarbetare i Sverige är en av de största grupperna av arbetstagare, och de har högst antal sjukskrivna dagar per anställd. Sociala och organisatoriska frågor står för cirka 58 % av sjukfrånvaron på grund av arbetsrelaterade sjukdomar bland medarbetarna inom äldreomsorgen. Tidigare forskning visar att kvaliteten på ledarskapet är en viktig resurs i en sund organisation och anses spela en avgörande roll för att främja de anställdas psykiska välbefinnande och hälsa. Syfte. Syftet var att undersöka vad ett hälsofrämjande ledarskap betyder för medarbetares psykiska hälsa inom kommunal äldreomsorg i Sverige. Metod. En litteraturstudie gjordes där 10 vetenskapliga originalartiklar hämtades från databaserna Medline och CINAHL, artiklarnas resultat analyserades sedan med en tematisk analysmetod. Resultat. Resultatet av analysen gav två huvud teman som var Den hälsofrämjande ledarens sätt att vara och Den hälsofrämjande ledaren skapar förutsättningar samt fyra underteman som svar på studiens syfte. Slutsats. Hälsofrämjande ledarskap inom äldreomsorgen i Sverige bygger på tillit och relationen med de anställda och har betydelse för de anställdas psykiska hälsa genom att bidra till ökat välbefinnande och arbetstillfredsställelse., The health and well-being of the staff in elderly care are prominent issues as the number of elderly people who need support and care is expected to increase. Healthcare workers in Sweden are one of the largest groups of workers, and they have the highest number of sick days per employee. Social and organizational issues account for approximately 58% of sick leave due to work-related illnesses among staff in elderly care. Previous research shows that the quality of leadership is a valuable resource in a healthy organization and is considered to play a crucial role in promoting employees' psychological well-being and health. Aim. The aim was to investigate what health promoting leadership means for employees' mental health in municipal elderly care in Sweden. Method. A literature study was made including 10 scientific original articles were retrieved from the databases Medline and CINAHL the results of the articles were then analysed using a thematic analysis method. Results. The result of the analysis yielded two themes and four subthemes in response to the aim of the study. The health-promoting leader's way of being and the conditions that the leader creates to promote the employees' mental health. Conclusion. Health-promoting leadership in elderly care in Sweden is based on trust and the relationship with the employees and is important for the employees' mental health by contributing to increased well-being and job satisfaction.

Livsstilsrelaterade sjukdomar ökar idag i världen samt i Sverige och genom hälsofrämjande arbete kan riskfaktorer och ohälsosamma levnadsvanor identifieras. Det har föranlett införandet av riktade hälsosamtal till specifika åldersgrupper i flera regioner i Sverige och nu i Region Halland. Det är inte kartlagt hur hälsosamtalsledare upplever att leda riktade hälsosamtal utefter den regionövergripande rutinen i Halland. Syftet med studien var att undersöka samtalsledarnas upplevelser och erfarenheter av att leda riktade hälsosamtal med 40-åringar under pilotinförandet i Region Halland 2023. Metoden som användes var kvalitativ intervjustudie med induktiv ansats. Resultatet ledde till fyra huvudkategorier: Riktade hälsosamtal upplevs meningsfulla, Arbetsredskap som stöd i hälsosamtalet, Betydelsen av samverkan i team samt Påverkansfaktorer i arbetet med riktade hälsosamtal. Slutsats: Hälsosamtalsledarna upplevde riktade hälsosamtal som ett meningsfullt arbete. Den regionsövergripande rutinen med metodstöd upplevdes strukturerad och lätt att arbeta efter, det digitala verktyget webbstöd behöver förbättras för att underlätta arbetet samt öka patientsäkerheten. Kontinuerlig handledning och återkoppling i motiverande samtal (MI) skulle kunna bidra till ökad trygghet i metoden. Tydligt ledarskap, stöd från kollegor och tillräckligt med tid var viktiga påverkansfaktorer vid implementeringen av riktade hälsosamtal. Framtida studier bör fokusera på att utforska deltagarnas upplevelser av hälsosamtalen samt utvärdera om implementeringen lyckats., Lifestyle-related diseases are increasing in the world and in Sweden. Through health promotion work, risk factors and unhealthy lifestyle habits can be identified. This has led to the introduction of targeted health dialogues to specific age groups in several regions in Sweden and now in Region Halland. It has not yet been mapped how healthcare worker's experience leading targeted health dialogues according to the region-wide routine in Halland. The purpose of the study was to investigate the healthcare worker's experiences of leading targeted health dialogues with 40-year-olds during the pilot phase in Region Halland in 2023. The method used was a qualitative interview study with an inductive approach. The results led to four main categories: Targeted health dialogues are experienced as meaningful, Supporting tools in the health dialogues, The importance of cooperation in teams and Influence factors in the work with targeted health dialogues. Conclusion: The healthcare worker's experiencedtargeted health dialogues as meaningful. The region-wide routine with the method was perceived as structured and easy to use, the digital tool “Webbstöd” needs to be improved to facilitate the work and increase patient safety. Continuous supervision and feedback in the Motivational interviewing (MI) method could contribute to increased security in the method. Clear leadership, supportive colleagues and sufficient time wereimportant influencing factors in the implementation of targeted health dialogues. Future studies should focus on exploring the participant's experiences of the health dialogues as well as an evaluation of whether the implementation was successful.

Bakgrund: Klimakteriet är en övergångsperiod i kvinnans liv då hon går från att vara reproduktiv till icke reproduktiv. Kvinnans upplevelse är individuell men vanliga symtom är oregelbundet blödningsmönster, värmevallningar, svettningar och sömnproblem. Primärvården bör utgöra första instans för kvinnor som söker för klimakteriebesvär och distriktssköterskan utgör därmed en viktig roll för kvinnor i klimakteriet. Syfte: Syftet med studien var att i primärvårdsperspektiv beskriva distriktssköterskors arbete med klimakteriebesvär hos kvinnor. Metod: Kvalitativ intervjustudie med semistrukturerade frågor. 12 intervjuer transkriberades ordagrant och analyserades med kvalitativ innehållsanalys. Resultat: Distriktssköterskor upplever att på grund av kunskapsbrist, tidsbrist och organisatoriska hinder kan de ej ge kvinnor i klimakteriet en god och adekvat vård. Kvinnor med klimakteriebesvär beskrivs känna sig nonchalerade av vården och önskar information och kunskap om klimakteriet för att bättre kunna hantera de besvär som kan uppkomma. Slutsats: Distriktssköterskor behöver förbättrad kunskap om klimakteriet, klimakteriebesvär, hormoner samt om de östrogenpreparat som de har förskrivning på. För en bättre och jämlik klimakterievård kunde det vara bra med nationella riktlinjer för detta område., Background: The climacteric is a transitional period in a woman's life from being reproductive to non-reproductive. The woman's experience is individual, but common symptoms include irregular bleeding patterns, hot flashes, sweating and sleep problems. Primary care should be the first instance for women seeking treatment for climacteric symptoms, and the district nurse thus plays a vital role for women in the climacteric. Aim: This study aimed to describe district nurses' perception of climacteric symptoms in women from a primary care perspective. Method: Qualitative inductive approach in the form of semi-structured questions. 12 district nurses were interviewed, and data was analyzed based on qualitative content analysis. Results: District nurses fell that they cannot give women in climacteric a reasonable and adequate care due to lack of knowledge, time and organisational obstacles. Women with climacteric symptoms feel neglected by the healthcare system and want information and understanding about the climacteric to be able to handle the problems that may arise. Conclusion: District nurses need improved ability about the climacteric, climacteric symptoms, hormones and the estrogen preparations they have the right to prescribe. For better and equal climacteric care, it could be good to have national guidelines for this area.

Bakgrund: Försämrade sömnvanor hos ungdomar är idag ett växande folkhälsoproblem som ökar både nationellt och internationellt. Ungdomar sover idag i genomsnitt mindre än åtta timmar per natt vilket kan leda till ohälsa. Syftet: Syftet med studien är att belysa skolsköterskors erfarenheter av att arbeta hälsofrämjande med ungdomars sömnvanor. Metod: Denna studie har en kvalitativ metod med en induktiv ansats med förutbestämda intervjufrågor. Sju intervjuer genomfördes med skolsköterskor i olika kommuner i södra Halland, Sverige. Materialet är analyserat med hjälp av en kvalitativ manifest innehållsanalys. Resultat: I resultatet framkom två huvudkategorier: Hälsofrämjande insatser med tillhörande underkategorier: stödja elever att fatta kloka beslut, de individuella samtalen och Samverkan i team med tillhörande underkategorier: teamets betydelse för elevernas hälsa, ökad kunskap och ett aktivt lärande och goda relationer med vårdnadshavare. Konklusion: I denna studie framhävs skolsköterskornas erfarenheter av att arbeta med hälsofrämjande insatser till ungdomar med sömnsvårigheter och dåliga sömnvanor. En välfungerande skolgång med goda sömnvanor genererar välmående individer med goda förutsättningar för ett hälsosammare liv i vuxen ålder, Background: Impaired sleep habits among young people are today a growing public health problem that is increasing both nationally and internationally. Young people today sleep less than an average of eighthours per night, which can lead to ill health. Aim: The aim of this study was to shed light on the school nurse's experiences with working to promote health with young people's sleep habits. Methods: This study has a qualitative method with an inductive approach with predetermined interview questions. Seven interviews were conducted with school nurses in various municipalities in southern Halland, Sweden. The material is analyzed using a qualitative manifest content analysis. Results: The results revealed two main categories: Health-promoting efforts with associated subcategories: supporting students to make wise decisions and the individual conversationsand Collaboration in teams with associated subcategories: the importance of the team for students' health, increased knowledge and active learning, and good relationships with guardians. Conclusions: In this study, the school nurse's experiences of working with health-promoting interventions for young people with sleep difficulties and poor sleep habits are highlighted. A well-functioning schooling with good sleep habits generates well-being individuals with good conditions for a healthier life in adulthood.

This dissertation focuses on women’s participation in mammography screening, which is a vital component of early detection and effective management of breast cancer. All Swedish women in the age group of 40-74 receive an invitation by mail at regular intervals of 18-24 months. However, about 20% of Swedish women fail to attend the mammography screening they were offered. The impact on mortality within a population is contingent on theparticipation rate, underscoring the importance of making efforts to attain a high level of participation. This thesis is an attemt to improve understanding and awareness of the women’s choices and actions that can influence life or death, especially considering that being a woman is the most significant risk factor for breast cancer. The overall aim of this thesis was to explore the phenomenon of women’s participation in mammography screening by exploring the reasons why women refrain from mammography screening from the perspective of non-attending women (Paper I) and factors that affect women’s participation in mammography screening in the Nordic countries. The research was conducted through qualitative and mixed studies review method studies. The data collection methods comprised ten personal interviews (Paper I), and 16 articles (Paper II). Qualitative content analysis was used to analyse the interviews in an indictive approach (Paper I). A deductive approach with segregated mixed research synthesis was used to analyse and summarise findings from articles in systematic review (Paper II). Health Promotion Model by N. Pender was used as a theoretical framework. Participation in mammography screening is a complex phenomenon that has many dimensions. The thesis results underscore the significance of comprehending the unique and subjective encounters of women in the context of mammography screening. These experiences hold substantial sway over their perspectives and actions regarding this procedure. Additionally, the research suggests th

Chronic musculoskeletal pain impacts the individual in multiple aspects of life (biological, psychological, and social). Individuals with knee pain have a higher risk of developingchronic widespread pain and knee osteoarthritis, compared to the general population, and the prevalence of chronic pain is estimated to rise. As a result, there is a global call for more health-promotive research in chronic pain. Hence, this thesis aimed to investigate multiple perspectives on health promotion by studying early factors associated with chronic pain and pain development as well as experiences of health-promoting activities and health literacy in individuals with knee pain. The studies are part of the Halland osteoarthritis (HALLOA) cohort, where 306 individuals with knee pain aged 30-65 years were included. Study I was a cross-sectional descriptive study (n=280), which aimed to investigate pain sensitivity and associations with radiographic knee osteoarthritis, chronic widespread pain, and overweight/obesity. Pain sensitivity was measured with pressure pain thresholds, and overweight was assessed using body mass index, visceral fat area and body fat percentage. Study II was a longitudinal study (n=251), aiming to examine whether or not health status and lifestyle habits have an impact on reporting chronic pain after two years. Lifestyle-related habits were overweight, physical activity, diet, alcohol intake, and tobacco use. Study III was an explorative qualitative study including 22 semi-structured interviews. The study aimed to explore health-promotive activities and was analysed with qualitative content analysis. Study IV had a convergent parallel mixed-methods design (n=221), including 19 interviews, and aimed to understand health literacy among individuals with knee pain. Quantitative variables were health literacy, health status, lifestyle habits, and pain distribution. The findings showed that higher pain sensitivity was associated with being female, having more pain

This dissertation focuses on women’s participation in mammography screening, which is a vital component of early detection and effective management of breast cancer. All Swedish women in the age group of 40-74 receive an invitation by mail at regular intervals of 18-24 months. However, about 20% of Swedish women fail to attend the mammography screening they were offered. The impact on mortality within a population is contingent on theparticipation rate, underscoring the importance of making efforts to attain a high level of participation. This thesis is an attemt to improve understanding and awareness of the women’s choices and actions that can influence life or death, especially considering that being a woman is the most significant risk factor for breast cancer. The overall aim of this thesis was to explore the phenomenon of women’s participation in mammography screening by exploring the reasons why women refrain from mammography screening from the perspective of non-attending women (Paper I) and factors that affect women’s participation in mammography screening in the Nordic countries. The research was conducted through qualitative and mixed studies review method studies. The data collection methods comprised ten personal interviews (Paper I), and 16 articles (Paper II). Qualitative content analysis was used to analyse the interviews in an indictive approach (Paper I). A deductive approach with segregated mixed research synthesis was used to analyse and summarise findings from articles in systematic review (Paper II). Health Promotion Model by N. Pender was used as a theoretical framework. Participation in mammography screening is a complex phenomenon that has many dimensions. The thesis results underscore the significance of comprehending the unique and subjective encounters of women in the context of mammography screening. These experiences hold substantial sway over their perspectives and actions regarding this procedure. Additionally, the research suggests th

Chronic musculoskeletal pain impacts the individual in multiple aspects of life (biological, psychological, and social). Individuals with knee pain have a higher risk of developingchronic widespread pain and knee osteoarthritis, compared to the general population, and the prevalence of chronic pain is estimated to rise. As a result, there is a global call for more health-promotive research in chronic pain. Hence, this thesis aimed to investigate multiple perspectives on health promotion by studying early factors associated with chronic pain and pain development as well as experiences of health-promoting activities and health literacy in individuals with knee pain. The studies are part of the Halland osteoarthritis (HALLOA) cohort, where 306 individuals with knee pain aged 30-65 years were included. Study I was a cross-sectional descriptive study (n=280), which aimed to investigate pain sensitivity and associations with radiographic knee osteoarthritis, chronic widespread pain, and overweight/obesity. Pain sensitivity was measured with pressure pain thresholds, and overweight was assessed using body mass index, visceral fat area and body fat percentage. Study II was a longitudinal study (n=251), aiming to examine whether or not health status and lifestyle habits have an impact on reporting chronic pain after two years. Lifestyle-related habits were overweight, physical activity, diet, alcohol intake, and tobacco use. Study III was an explorative qualitative study including 22 semi-structured interviews. The study aimed to explore health-promotive activities and was analysed with qualitative content analysis. Study IV had a convergent parallel mixed-methods design (n=221), including 19 interviews, and aimed to understand health literacy among individuals with knee pain. Quantitative variables were health literacy, health status, lifestyle habits, and pain distribution. The findings showed that higher pain sensitivity was associated with being female, having more pain

Background School-based sexuality education is a core component of securing young people’s right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one’s sexual health is associated with knowledge gained from school-based sexuality education and social determinants. Methods The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used. Results Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one’s sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities. Conclusions Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy., CC BY 4.0

This dissertation focuses on women’s participation in mammography screening, which is a vital component of early detection and effective management of breast cancer. All Swedish women in the age group of 40-74 receive an invitation by mail at regular intervals of 18-24 months. However, about 20% of Swedish women fail to attend the mammography screening they were offered. The impact on mortality within a population is contingent on theparticipation rate, underscoring the importance of making efforts to attain a high level of participation. This thesis is an attemt to improve understanding and awareness of the women’s choices and actions that can influence life or death, especially considering that being a woman is the most significant risk factor for breast cancer. The overall aim of this thesis was to explore the phenomenon of women’s participation in mammography screening by exploring the reasons why women refrain from mammography screening from the perspective of non-attending women (Paper I) and factors that affect women’s participation in mammography screening in the Nordic countries. The research was conducted through qualitative and mixed studies review method studies. The data collection methods comprised ten personal interviews (Paper I), and 16 articles (Paper II). Qualitative content analysis was used to analyse the interviews in an indictive approach (Paper I). A deductive approach with segregated mixed research synthesis was used to analyse and summarise findings from articles in systematic review (Paper II). Health Promotion Model by N. Pender was used as a theoretical framework. Participation in mammography screening is a complex phenomenon that has many dimensions. The thesis results underscore the significance of comprehending the unique and subjective encounters of women in the context of mammography screening. These experiences hold substantial sway over their perspectives and actions regarding this procedure. Additionally, the research suggests th

This dissertation focuses on women’s participation in mammography screening, which is a vital component of early detection and effective management of breast cancer. All Swedish women in the age group of 40-74 receive an invitation by mail at regular intervals of 18-24 months. However, about 20% of Swedish women fail to attend the mammography screening they were offered. The impact on mortality within a population is contingent on theparticipation rate, underscoring the importance of making efforts to attain a high level of participation. This thesis is an attemt to improve understanding and awareness of the women’s choices and actions that can influence life or death, especially considering that being a woman is the most significant risk factor for breast cancer. The overall aim of this thesis was to explore the phenomenon of women’s participation in mammography screening by exploring the reasons why women refrain from mammography screening from the perspective of non-attending women (Paper I) and factors that affect women’s participation in mammography screening in the Nordic countries. The research was conducted through qualitative and mixed studies review method studies. The data collection methods comprised ten personal interviews (Paper I), and 16 articles (Paper II). Qualitative content analysis was used to analyse the interviews in an indictive approach (Paper I). A deductive approach with segregated mixed research synthesis was used to analyse and summarise findings from articles in systematic review (Paper II). Health Promotion Model by N. Pender was used as a theoretical framework. Participation in mammography screening is a complex phenomenon that has many dimensions. The thesis results underscore the significance of comprehending the unique and subjective encounters of women in the context of mammography screening. These experiences hold substantial sway over their perspectives and actions regarding this procedure. Additionally, the research suggests th

Background School-based sexuality education is a core component of securing young people’s right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one’s sexual health is associated with knowledge gained from school-based sexuality education and social determinants. Methods The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used. Results Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one’s sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities. Conclusions Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy., CC BY 4.0

The study examines how a small-scale formative intervention and concepts from both activity theory and salutogenic perspective can be used to support teachers' transformative agency and school development work. The research questions have focused on capacity for change, sense of coherence (SOC) and the significance of local conditions for change initiatives. The theoretical and methodological framework in the study stems from third generation activity theory and salutogenic perspective. The study has a qualitative approach and was conducted through a formative intervention with six teachers, in collaboration with a municipal secondary school. Data have been collected through participant observation, reflection logs and semi-structured interviews, and processed through thematic analysis based on the theoretical standpoints. In addition, the studied school and the intervention group have been analysed as two interacting activity systems. The results show that the prevailing conditions of the individual school greatly affect development initiatives and change processes, as well as the teachers' transformative agency. Furthermore, it appears that emotional aspects and intra- and interpersonal factors have a significant impact on the actions of both teachers and school management. The results also suggest that the SOC concept can be incorporated in formative interventions, both as a facilitating instrument and as a secondary stimulus., I studien undersöks hur en småskalig formativ intervention och koncept från både aktivitetsteori och salutogent perspektiv kan användas för att stödja lärares transformativa agentskap och skolans utvecklingsarbete. Forskningsfrågorna har fokuserat på förändringskapacitet, känsla av sammanhang (KASAM) och de lokala villkorens betydelse för förändringsinitiativ. Studiens teoretiska och metodologiska ramverk utgår från tredje generationens aktivitetsteori och salutogent perspektiv. Undersökningen har en kvalitativ ansats och genomfördes inom ramen för en formativ intervention med sex lärare, i samarbete med en kommunal högstadieskola. Data har samlats in via deltagande observation, reflektionsloggar och semistrukturerade intervjuer, och bearbetats genom tematisk analys utifrån de teoretiska utgångspunkterna. Därtill har den studerade verksamheten och interventionsgruppen analyserats som två interagerande aktivitetssystem. Resultatet visar att den enskilda skolans rådande villkor i hög utsträckning påverkar utvecklingsinitiativ och förändringsprocesser, liksom lärarnas transformativa agentskap. Vidare framgår att emotionella aspekter och intra- och interpersonella faktorer har en betydande inverkan både lärarnas och skolledningens agerande. Resultatet tyder också på att KASAM-konceptet kan inkorporeras i formativa interventioner, både som ett möjliggörande instrument och som sekundär stimulus.

För att främja hälsa och välbefinnande på arbetsplatser börjar ett perspektiv på arbetsmiljöarbete gå från att fokusera på vad som gör människor sjuka, till att fokusera på vad som gör människor friska. Ett hälsofrämjande arbetsmiljöarbete har därmed börjat att växa fram som innebär att utveckla, möjliggöra och bevara det som fungerar bra på arbetsplatsen. Känsla av sammanhang (KASAM), är en teori som myntades av Aaron Antonovsky (2005). Teorin kan användas i ett hälsofrämjande arbetsmiljöarbete då den kan ge en förståelse över vilka faktorer som kan främja hälsa. Begriplighet, hanterbarhet och meningsfullhet är teorins tre komponenter. Genom att stärka komponenterna kan hälsa främjas. Syftet med föreliggande studie är att skapa en förståelse för vilka faktorer som kan stärka känslan av sammanhang i arbetet och vidare beskriva hur känslan av sammanhang upplevs av de anställda på ett detaljhandelsföretag. Genom en abduktiv tematisk analys av åtta semistrukturerade intervjuer, studeras vilka förutsättningar arbetsgivaren ger de anställda för att stärka KASAM. Vidare studeras hur upplevelsen av känslan av sammanhang är ur ett medarbetarperspektiv. Studiens teoretiska referensram utgörs av Antonovskys teori känsla av sammanhang och dess tre komponenter. Utifrån intervjuerna visade det sig att det är ett öppet och familjärt klimat på företaget. Det visade sig även att de anställda stöttar varandra och är engagerade i sitt arbete. Av resultatet framkom att företaget har flera värderingar, varav en är tillsammans, vilket genomsyrar det mesta på företaget. Samtliga av de anställda tar fasta på värderingen tillsammans vilket präglar deras sätt att vara och agera. Genom värderingen tillsammans skapas en gemenskap på det undersökta detaljhandelsföretaget som är av betydelse för att stärka känslan av sammanhang., To promote health and well-being at workplaces, a perspective on work environment management has shifted from mainly focusing on what makes people sick, to another perspective, what makes them healthy and causes well-being. Health-promoting work environment management has thus begun to emerge, which means developing, enabling and preserving what works well in the workplace. Aaron Antonovsky (2005), founded a theory: Sense of coherence (SOC), which can be used in health-promoting work environment management as it can provide an understanding of which factors that can promote health. The SOC theory's components are comprehensibility, manageability, and meaningfulness and by strengthening the components, health can be promoted. The purpose of this study is to create an understanding of which factors that can strengthen the sense of coherence at work and also describe how the sense of coherence is experienced by the employees at a retail company. Through an abductive thematic analysis of eight semi-structured interviews, the prerequisites the employer gives the employees to strengthen SOC are studied. Furthermore, the experience on how the SOC is from the perspective of an employee are studied. The theoretical framework of the study is based on Antonovsky's theory sense of coherence and the three components. Based on the interviews, it turned out that there is an open and familiar atmosphere within the company. It also turned out that the employees support each other and are committed to their work. The results indicate that the company has several values, one of which is togetherness,which permeates most of the company. All employees adhere to the value togetherness, which characterizes their way of being and acting. Through the value togetherness, a fellowship is created within the retail company, which is important for strengthening the sense of coherence.

Background: Altering the choice architecture of decision contexts can assist behaviour change, but the acceptability of this approach has sparked debate. Considering hypothetical interventions, people generally welcome the approach for promoting health, but little evidence exists on acceptance in the real world. Furthermore, research has yet to explore the implementers’ perspective, acknowledging the multidimensionality of the acceptability construct. Addressing these knowledge gaps, this study evaluated the acceptability of a quasi-experimental implementation-effectiveness trial that modified the worksite choice architecture for healthy eating and daily physical activity. Methods: Fifty-three worksites participated in the 12-month intervention and implemented altogether 23 choice architecture strategies (Mdn 3/site), including point-of-choice prompts and changes to choice availability or accessibility. Retrospective acceptability evaluation built on deductive qualitative content analysis of implementer interviews (n = 65) and quantitative analysis of an employee questionnaire (n = 1124). Qualitative analysis examined implementers’ thoughts and observations of the intervention and its implementation, considering six domains of the Theoretical Framework of Acceptability: ethicality, affective attitude, burden, intervention coherence, opportunity costs, and perceived effectiveness. Quantitative analysis examined employees’ acceptance (7-point Likert scale) of eight specific intervention strategies using Friedman test and mixed-effects logistic regression. Results: Implementers considered the choice architecture approach ethical for workplace health promotion, reported mostly positive affective attitudes to and little burden because of the intervention. Intervention coherence supported acceptance through increased interest in implementation, whereas low perceived utility and high intensity of implementation reduced cost acceptance. Perceived effectiveness was mixed an

Educational communities have the potential to project themselves as transforming niches of living conditions around the identification of health needs and the search for alternatives to solve them. Within the framework of the Master's in Public Health at the Universidad de La Sabana, progress has been made in strategies to generate this link, through support in the formulation of a community health program in an educational environment, based on the adaptation of the model Precede-Procede, a method to plan, conduct and evaluate health education interventions. Taking into account the above, the objective of this article is to reflect on the contributions of the model for the formulation of community health programs in educational settings, regarding primary health care and the policies of healthy educational settings, considering that they are referents regulations in the Colombian territory. In summary, this model is considered a favorable option for the formulation of health programs in the educational context because it privileges community participation, addresses contextualized problems and gives the possibility for students to integrate from an early age and educational communities to become social managers of their own health., Las comunidades educativas tienen el potencial de proyectarse como nichos transformadores de las condiciones de vida en torno a la identificación de las necesidades en salud y la búsqueda de alternativas para resolverlas. En el marco de la maestría en Salud Pública de la Universidad de La Sabana se ha avanzado en estrategias para generar este vínculo, a través del acompañamiento en la formulación de un programa de salud comunitaria en un entorno educativo, basados en la adaptación del modelo Precede-Procede, un método para planear, conducir y evaluar intervenciones de educación para la salud. Teniendo en cuenta lo anterior, el objetivo de este artículo es reflexionar sobre los aportes del modelo para la formulación de programas de salud comunitaria en entornos educativos, a propósito de la atención primaria de salud y las políticas de entornos educativos saludables, considerando que son referentes normativos en el territorio colombiano. En síntesis, dicho modelo se considera una opción favorable para la formulación de programas de salud en el contexto educativo porque privilegia la participación comunitaria, aborda problemáticas contextualizadas y da la posibilidad para que desde edades tempranas se integren estudiantes y las comunidades educativas se constituyan como gestoras sociales de su propia salud., As comunidades educativas têm potencial para se projetarem como nichos transformadores das condições de vida em torno da identificação das necessidades de saúde e da busca de alternativas para solucioná-las. No âmbito do Mestrado em Saúde Pública da Universidad de La Sabana, avançou-se nas estratégias para gerar este vínculo, através do apoio na formulação de um programa de saúde comunitária em ambiente educativo, baseado na adaptação do modelo Precede -Proceder, um método para planejar, conduzir e avaliar intervenções de educação em saúde. Levando em conta o exposto, o objetivo deste artigo é refletir sobre as contribuições do modelo para a formulação de programas de saúde comunitária em ambientes educativos, no que diz respeito à atenção primária à saúde e às políticas de ambientes educativos saudáveis, considerando que são normas de referência em território colombiano. Em síntese, esse modelo é considerado uma opção favorável para a formulação de programas de saúde no contexto educacional, pois privilegia a participação da comunidade, aborda problemas contextualizados e dá a possibilidade de os alunos se integrarem desde cedo e comunidades educativas em formação gestores sociais de sua própria saúde.

Producción Científica, The first waves of the COVID-19 pandemic were times of great change in the lives of university students and their families in Spain. The aim of this study was to explore the psychosocial aspects and preventive measures carried out during the COVID-19 pandemic by students and family members of the nursing degree students of the University of Valladolid (Spain). The number of people surveyed was 877, by means of an ad hoc questionnaire. Relationships between variables were established by means of the Chi-square test and Student’s t-test. In addition, multivariate logistic regression was generated. The significance level used was 0.05. Students and family members maintained preventive measures= such as hand washing, correct use of masks =in closed places, avoiding crowds and maintaining social distance, but at low rates (close to 20% in all cases). Regarding psychosocial aspects, 41.07% of the participants suffered from anxiety and loneliness, while 5.2% needed to take drugs to reduce anxiety or sleep and 66.07% were dependent on technology. Suicidal behavior is related to stress, anxiety, loneliness, poor family relationships, psychotropic drug use and technology abuse. The pandemic has caused life changes in university students and their families at the psychosocial level, generating high figures of suicidal ideation regardless of age. Preventive measures adopted to control the pandemic have not been followed for the most part.

Chronic musculoskeletal pain impacts the individual in multiple aspects of life (biological, psychological, and social). Individuals with knee pain have a higher risk of developingchronic widespread pain and knee osteoarthritis, compared to the general population, and the prevalence of chronic pain is estimated to rise. As a result, there is a global call for more health-promotive research in chronic pain. Hence, this thesis aimed to investigate multiple perspectives on health promotion by studying early factors associated with chronic pain and pain development as well as experiences of health-promoting activities and health literacy in individuals with knee pain. The studies are part of the Halland osteoarthritis (HALLOA) cohort, where 306 individuals with knee pain aged 30-65 years were included. Study I was a cross-sectional descriptive study (n=280), which aimed to investigate pain sensitivity and associations with radiographic knee osteoarthritis, chronic widespread pain, and overweight/obesity. Pain sensitivity was measured with pressure pain thresholds, and overweight was assessed using body mass index, visceral fat area and body fat percentage. Study II was a longitudinal study (n=251), aiming to examine whether or not health status and lifestyle habits have an impact on reporting chronic pain after two years. Lifestyle-related habits were overweight, physical activity, diet, alcohol intake, and tobacco use. Study III was an explorative qualitative study including 22 semi-structured interviews. The study aimed to explore health-promotive activities and was analysed with qualitative content analysis. Study IV had a convergent parallel mixed-methods design (n=221), including 19 interviews, and aimed to understand health literacy among individuals with knee pain. Quantitative variables were health literacy, health status, lifestyle habits, and pain distribution. The findings showed that higher pain sensitivity was associated with being female, having more pain

Introduction: The growing proportion of overweight and obese people worldwide is of great concern as it affects the overall health of people and consequently also their reproductive health. The aim of this literature review is to examine how increased body mass index affects fertility and preconception health in men and women.Methods: A scoping literature review was conducted in February 2021 using PubMed and Medline databases, as well as the Google Scholar search engine. Inclusion criteria consisted of scientific literature, regardless of methodology, and articles published in Slovene and English.Results: The literature search yielded 9 reviews and 5 original quantitative studies published in English in the last 15 years. The results suggest that there is compelling evidence that obese individuals are at increased risk of various health problems in the pre-conception period that may affect their fertility and ability to conceive.Discussion and conclusion: The rising prevalence of high body mass index is changing the reproductive health of men and women. Growing obesity rates, particularly in the Western world, call for greater awareness of this metabolic syndrome and its impact on female and male reproduction. Health professionals working with couples in the pre-conception period should have sufficient knowledge to address the impact of high body mass index on reproductive health and promote a healthy lifestyle., Uvod: Naraščajoča stopnja prekomerne telesne mase in debelosti po vsem svetu ovira zdravje moških in žensk ter posledično vpliva na njihovo reproduktivno zdravje. Namen tega pregleda literature je raziskati, kako povečan indeks telesne mase vpliva na plodnost in zdravje moških in žensk pred spočetjem.Metode: Opravljen je bil pregled literature. Iskanje literature je potekalo februarja 2021 v podatkovnih bazah PubMed in Medline. Drugi iskalni zadetki so bili najdeni s pomočjo Google Učenjaka. Vključitveni kriteriji so zajemali znanstveno literaturo, ne glede na metodološki pristop, v slovenskem in angleškem jeziku.Rezultati: V pregled literature je bilo vključenih devet preglednih in pet izvirnih člankov kvantitativne metodologije. Ugotovitve raziskav kažejo, da imajo posamezniki s povišano telesno težo v predkoncepcijskemobdobju večje tveganje za številne zdravstvene težave, ki lahko vplivajo na njihovo plodnost in sposobnost zanositve.Diskusija in zaključek: Povišanje indeksa telesne mase vpliva na reproduktivno zdravje moških in žensk. Naraščajoča stopnja debelosti predvsem v zahodnem svetu zahteva večjo ozaveščenost o tem presnovnem sindromu in njegovem vplivu na reprodukcijo žensk in moških. Zdravstveni delavci, ki delajo s pari s prekomerno telesno maso v obdobju pred spočetjem, morajo imeti ustrezno znanje za njihovo obravnavo ter spodbujati zdrav način življenja.

The main purpose of prognostic risk prediction models is to identify individuals who are at risk of disease, to enable early intervention. Current prognostic cardiovascular risk prediction models, such as the Systematic COronary Risk Evaluation (SCORE2) and the SCORE2-Older Persons (SCORE2-OP) models, which represent the clinically used gold standard in assessing patient risk for major cardiovascular events in the European Union (EU), generally overlook socioeconomic determinants, leading to disparities in risk prediction and resource allocation. A central recommendation of this article is the explicit inclusion of individual-level socioeconomic determinants of cardiovascular disease in risk prediction models. The question of whether prognostic risk prediction models can promote health equity remains to be answered through experimental research, potential clinical implementation and public health analysis. This paper introduces four distinct fairness concepts in cardiovascular disease prediction and their potential to narrow existing disparities in cardiometabolic health., The main purpose of prognostic risk prediction models is to identify individuals who are at risk of disease, to enable early intervention. Current prognostic cardiovascular risk prediction models, such as the Systematic COronary Risk Evaluation (SCORE2) and the SCORE2-Older Persons (SCORE2-OP) models, which represent the clinically used gold standard in assessing patient risk for major cardiovascular events in the European Union (EU), generally overlook socioeconomic determinants, leading to disparities in risk prediction and resource allocation. A central recommendation of this article is the explicit inclusion of individual-level socioeconomic determinants of cardiovascular disease in risk prediction models. The question of whether prognostic risk prediction models can promote health equity remains to be answered through experimental research, potential clinical implementation and public health analysis. This paper introduces four distinct fairness concepts in cardiovascular disease prediction and their potential to narrow existing disparities in cardiometabolic health.

Introduction Face-it is a randomized controlled trial for women with recent gestational diabetes mellitus (GDM) and their families designed to evaluate the effect of a health promotion intervention on type 2 diabetes mellitus (T2DM) risk and quality of life. This study examined (1) the penetration and participation rates for the Face-it trial, (2) the characteristics of the participating women and the potential differences in characteristics according to partner participation status, and (3) representativity of the women at baseline. Research design and methods We identified women with GDM during pregnancy and invited them and their partners to a baseline examination 10–14 weeks after delivery. Representativity was assessed by comparing the baseline participants with non-participating women, the general population of women with GDM delivering in Denmark, and populations from other intervention trials. Results The penetration rate was 38.0% (867/2279) and the participation rate was 32.9% (285/867). The 285 women who attended baseline had a mean age of 32.7 (±4.8) years and body mass index (BMI) of 28.1 (±5.4) kg/m2, and 69.8% had a partner who participated. The women participating with a partner were more often primiparous, born in Denmark (82.8% vs 68.2%), were younger, and more often had a BMI ≤24.9 kg/m2 (35.7% vs 21.2%) compared with women without a partner. Compared with the general population of women with GDM in Denmark, these women broadly had similar degree of heterogeneity, but had higher rates of primiparity and singleton deliveries, and lower rates of preterm delivery and prepregnancy obesity. Conclusions The penetration and participation rates were acceptable. We found a high rate of partner participation. Overall, women participating with a partner were comparable with those participating without a partner. Participating women were broadly similar to the general national GDM population, however with prepregnancy obesity, multi, Introduction Face-it is a randomized controlled trial for women with recent gestational diabetes mellitus (GDM) and their families designed to evaluate the effect of a health promotion intervention on type 2 diabetes mellitus (T2DM) risk and quality of life. This study examined (1) the penetration and participation rates for the Face-it trial, (2) the characteristics of the participating women and the potential differences in characteristics according to partner participation status, and (3) representativity of the women at baseline. Research design and methods We identified women with GDM during pregnancy and invited them and their partners to a baseline examination 10-14 weeks after delivery. Representativity was assessed by comparing the baseline participants with non-participating women, the general population of women with GDM delivering in Denmark, and populations from other intervention trials. Results The penetration rate was 38.0% (867/2279) and the participation rate was 32.9% (285/867). The 285 women who attended baseline had a mean age of 32.7 (±4.8) years and body mass index (BMI) of 28.1 (±5.4) kg/m 2, and 69.8% had a partner who participated. The women participating with a partner were more often primiparous, born in Denmark (82.8% vs 68.2%), were younger, and more often had a BMI ≤24.9 kg/m 2 (35.7% vs 21.2%) compared with women without a partner. Compared with the general population of women with GDM in Denmark, these women broadly had similar degree of heterogeneity, but had higher rates of primiparity and singleton deliveries, and lower rates of preterm delivery and prepregnancy obesity. Conclusions The penetration and participation rates were acceptable. We found a high rate of partner participation. Overall, women participating with a partner were comparable with those participating without a partner. Participating women were broadly similar to the general national GDM population, however with prepregnancy obesity, multiparity, preterm delive

Background: The pan-European VACCELERATE network aims to implement the first transnational harmonized and sustainable vaccine trial Volunteer Registry, being a single entry point for potential volunteers of large-scale vaccine trials across Europe. This work exhibits a set of harmonized vaccine trial–related educational and promotional tools for the general public, designed and disseminated by the pan-European VACCELERATE network. Objective: This study primarily aimed to design and develop a standard toolkit to increase positive attitudes and access to trustworthy information for better access and increased recruitment to vaccine trials for the public. More specifically, the produced tools are focused on inclusiveness and equity, and are targeting different population groups, including underserved ones, as potential volunteers for the VACCELERATE Volunteer Registry (older individuals, migrants, children, and adolescents). The promotional and educational material is aligned with the main objectives of the Volunteer Registry to increase public literacy and awareness regarding vaccine-related clinical research or trials and trial participation, including informed consent and legal issues, side effects, and frequently asked questions regarding vaccine trial design. Methods: Tools were developed per the aims and principles of the VACCELERATE project, focusing on trial inclusiveness and equity, and are adjusted to local country-wise requirements to improve public health communication. The produced tools are selected based on the cognitive theory, inclusiveness, and equity of differently aged and underrepresented groups, and standardized material from several official trustworthy sources (eg, COVID-19 Vaccines Global Access; the European Centre for Disease Prevention and Control; the European Patients’ Academy on Therapeutic Innovation; Gavi, the Vaccine Alliance; and the World Health Organization). A team of multidisciplinary specialists (infectious diseases, vaccine r

Objectives: International literature suggests that arts and culture activities may benefit mental health, however, such survey studies conducted in the Danish population are scarce. Further, studies have investigated the associated risk for incident depression, but not for persistent depression. The objective of the current prospective study was to assess associations of engagement in arts and culture activities with incident/persistent depression and also mental wellbeing among Danish adults in the general population. Design: Observational prospective study. Methods: Data stem from a Danish nationally representative panel study of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to Danish register data. An exposure variable was constructed for frequency of attending concerts, theatres, museums, and cinemas. Validated scales were used to assess the presence of depression (PHQ-8) and levels of mental wellbeing (SWEMWBS). Binary logistic regression analyses were conducted to assess the risk of incident depression (among participants free of depression at baseline), as well as the risk of persistent depression (among participants with depression at baseline), while multinomial logistic regression was used to assess odds for moderate and high mental wellbeing (low as base outcome) while adjusting for baseline values. Result: In terms of incident depression, quarterly engagement in arts and culture activities (compared to never) was associated with an OR of.43 (95%CI.23–.80), while 8 times or more was associated with an OR of.53 (.29–.97). In terms of persistent depression, quarterly engagement was associated with an OR of.30 (.10–.90), while 8 times per year or more was associated with an OR of.26 (.07–.92). Similar to the patterns for incident/persistent depression, associations with moderate mental wellbeing showed higher odds for quarterly engagement and 8 times per year or more. Quarterly engagement was also associated with higher odds fo

Non-communicable and chronic diseases (NCDs) encompass enduring conditions like cardiovascular disease, cancer, diabetes, and chronic respiratory issues. These NCDs contribute significantly to global disability and mortality, causing 41 million deaths annually. They are responsible for 71% of all deaths globally, a concerning trend on the rise. Addressing NCDs' risk factors and strategies has gained paramount global attention. Strategies for NCD prevention and control have evolved over the past four decades, driven by a population-based and prevention-oriented approach. Research increasingly attributes NCD occurrence to interconnected risk factors including genetics, lifestyle, metabolism, and social determinants. Recognizing this complexity, the World Health Organization (WHO) and China adopt integrated approaches to combat NCDs on a global and national scale. [...], Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Medicine & Dentistry, Griffith Health, Full Text

INTRODUCTION: Little has previously been reported about the implementation of social risk screening across racial/ethnic/language groups. To address this knowledge gap, the associations between race/ethnicity/language, social risk screening, and patient-reported social risks were examined among adult patients at community health centers. METHODS: Patient- and encounter-level data from 2016 to 2020 from 651 community health centers in 21 U.S. states were used; data were extracted from a shared Epic electronic health record and analyzed between December 2020 and February 2022. In adjusted logistic regression analyses stratified by language, robust sandwich variance SE estimators were applied with clustering on patients primary care facility. RESULTS: Social risk screening occurred at 30% of health centers; 11% of eligible adult patients were screened. Screening and reported needs varied significantly by race/ethnicity/language. Black Hispanic and Black non-Hispanic patients were approximately twice as likely to be screened, and Hispanic White patients were 28% less likely to be screened than non-Hispanic White patients. Hispanic Black patients were 87% less likely to report social risks than non-Hispanic White patients. Among patients who preferred a language other than English or Spanish, Black Hispanic patients were 90% less likely to report social needs than non-Hispanic White patients. CONCLUSIONS: Social risk screening documentation and patient reports of social risks differed by race/ethnicity/language in community health centers. Although social care initiatives are intended to promote health equity, inequitable screening practices could inadvertently undermine this goal. Future implementation research should explore strategies for equitable screening and related interventions.

In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health among adolescents and emerging adults. This position paper reviews existing literature on the effects of the COVID-19 pandemic on SRH, sexual violence, unintended pregnancy, sexually transmitted illness and human immunodeficiency virus rates and highlights issues specific to college-aged males, females, racial/ethnic and sexual minorities, and individuals with disabilities. The need to conceptualize SRH as an integral component of normal development, overall health, and well-being in the context of COVID-19 is discussed. The need to prioritize the design and implementation of developmentally appropriate, evidence-based SRH interventions specifically targeting college students is identified. Furthermore, an intergenerational approach to SRH that includes parents/caregivers and/or college faculty and staff (e.g., coaches, trainers) could facilitate comprehensive SRH prevention programming that enhances sexual violence prevention training programs currently mandated by many colleges. Policies and programs designed to mitigate adverse pandemic-related exacerbations in negative SRH outcomes are urgently needed and should be included in mainstream clinical psychology, not only focused on preventing unwanted outcomes but also in promoting rewarding interpersonal relationships and overall well-being. Recommendations for clinical psychologists and mental health researchers are made.

In dit webinar zal Hester Walda van gemeente de Fryske Marren vertellen over de Groenvisie en uitdagingen m.b.t. groen en biodiversiteit binnen de gemeente.

info:eu-repo/semantics/published

As the Cox administration enters the third year of their administration, they are setting our sights on a new set of bold and impactful priorities for Utah. These new priorities stem from the administration's commitment to building a sustainable future for current and future generations of Utahns, giving equal opportunities for all. These priorities address our state's challenges with growth, with an emphasis on enabling a future with our children and grandchildren nearby. These priorities are also aimed at driving the best investments and use of state resources, and improving how our state government serves Utahns. They are calling this set of priorities "Utah Home" because these priorities are foundational to preserving our home state as a wonderful place to live, work, and recreate. Parts of what make Utah our home include our people, our growth, and our good government—the three guiding pillars of Utah Home. Here is a brief glimpse of what we are addressing with Utah Home: 1) People — education and learning, concerns on social media for minors, physical, mental, and behavioral health; expanding opportunities, preventing domestic violence and sexual assault, support for victims of interpersonal violence, and support for vulnerable families; 2) Growth — water, housing, homelessness, connecting Utah through trails, energy, and the economic future of rural Utah; and 3) Good Government — customer service, employee retention, and wise use of Utah's resources.

Background: Health literacy (HL) is the set of social and cognitive skills that determine person’s level of motivation and the ability to access, understand and use information to promote and maintain good health. The aim of this study is to assess the level of health literacy, and to analyze its relationship with sociodemographic variables, state of health, and use of health services in the population aged 15 and over in the Valencian Community (Spain). Methods: Cross-sectional study based on a sample of 5,485 subjects participating in the Health Survey of the Valencia Community. The HLS-EU-Q16 was used. As outcome variables we considered HL categorized into 2 levels: Inadequate or Problematic HL and Sufficient HL and the standardized literacy index. Prevalence rates and HL means were estimated and OR were calculated to analyze the association between variables. Results: A total of 12.8% of the subjects surveyed presented an inadequate or problematic degree of HL. This percentage was higher in people >85 years (63.1%), with a low level of education (46.5%), in retired people (27.4%) or in other work situations (25.0%), in foreigners (18.1%), in low-income people (16.2%), with a perception of poor health status (26.9%), chronic disease (18.5%) or with activity limitations (56.4% severe, 19.7% not severe). Significant differences were found. With the exception of chronic disease, all the variables analyzed were associated with HL. Low HL was associated with a lower consumption of medicines, a greater use of health services, general medical consultations, poorer knowledge of new health technologies and fewer preventive health visits. Conclusion: The percentage of inadequate or problematic HL was globally not very high, but certain population subgroups notably presented a high degree of inadequate or problematic HL. Raising the HL level of such groups should be regarded as a priority. HL was shown to be associated with the service use and new health technology use. Enh

BACKGROUND: The Swedish Physical Activity on Prescription (PAP-S) is a method for healthcare to promote physical activity for prevention and treatment of health disorders. Despite scientific support and education campaigns, the use has been low. The aim of this study was to perform a process evaluation of an implementation intervention targeting the use of the PAP-S method in primary healthcare (PHC). Specifically, we wanted to evaluate feasibility of the implementation intervention, and its effect on the implementation process and the outcome (number of PAP-S prescriptions). METHODS: This was a longitudinal study using the Medical Research Council guidance for process evaluation of a 9-month implementation intervention among healthcare staff at three PHC centres in Sweden. Data was collected by: participatory observations of the implementation process; questionnaires to the staff before, after and 6 months after the implementation intervention; interviews after the implementation intervention; and number of PAP-S prescriptions. RESULTS: During the implementation intervention, the workplaces' readiness-to-change and the healthcare staff's confidence in using the PAP-S method were favourably influenced, as was the number of PAP-S prescriptions. After the implementation intervention, the number of PAP-S prescriptions decreased to about the same number as before the implementation intervention, at two out of three PHC centres. Four of the six implementation strategies appeared to impact on the implementation process: external facilitation; leadership engagement by a committed workplace management; local PAP-S coordinator taking a leading role and acting as local champion; educational outreach concerning how to use the PAP-S method. CONCLUSION: The implementation intervention was not sufficient to produce sustained change of the healthcare staff's behaviour, nor did it achieve favourable long-term outcome on the number of PAP-S prescriptions. The healthcare staffs' spar