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Information about several papers discussed at the 23rd International Conference on Health Promoting Hospitals and Health Services (HPH) conference held in Oslo, Norway on June 10-12, 2015 is presented. Topics include comprehensive health needs, heal care, and cooperation between health care services and institutions. The conference was hoted by the Norwegian Health Promoting Hospitals Network (HPH network).

Background. Acrylamide is one of the contaminants resulting from thermal processing of food products which is known to cause cancer in animals and adversely affect health in humans. Aims. The aim of this paper is to estimate the daily intake of acrylamide (AA) in a child community and identify/quantify the major sources of dietary exposure. Methods. A cross-sectional study was performed in one kindergarten from Cluj-Napoca, Romania, which comprised 78 children aged 4 to 6. Information regarding their food consumption in kindergarten was collected by means of food records performed 10 days/month in 6 different months (3 months in spring and three months in autumn), leading to 60 days for the assessment period. Results. Calculated based on mean acrylamide concentrations in foods and mean consumed food amounts, the total dietary acrylamide exposure among kindergarten children evidenced a mean of 41.65 μg/day (2.22 μg/kg body weight/day) and could increase up to 136.15 μg/day (7.27 μg/kg body weight/day) for a consumer at a high percentile of the distribution (95th to 97.5th). The major foods contributing to the mean level of total dietary exposure were cereals (representing 31.1%), especially white bread (10.7%) and cream of wheat flour (9.2%), and vegetables (30.8 % of total exposure) with potatoes being the major contributor (13.9% of total exposure). The other food groups (meat, fish, meat products, sweets, oil and fats and dairy) represented one third of the mean level of daily acrylamide exposure (contributing 37.7%). Conclusions. The results underline the importance of increasing awareness with regard to food selection and preparation techniques of food products for children in order to decrease their exposure to acrylamide. [ABSTRACT FROM AUTHOR]

Aerobic/anaerobic physical exercise causes a series of stimuli that can induce many biochemical and hormonal changes in the whole body. Hormones are involved in physiological changes produced in the body during exercise. The duration, the intensity and the type of training modulate these hormonal fluctuations. Aging is associated with an alteration of the neuroendocrine system, which leads to a decrease in the sensitivity of endocrine glands to the action of neurohormones and to a reduction in the number, density and affinity of neurohormone receptors. Increased physical activity is accompanied by great energy loss. The imbalance between energy consumption and the much higher energy expenditure results in the activation of adaptive endocrine and neuroendocrine mechanisms of the body to high physical effort. The endocrine profile developed under various physical exercise conditions: acute, high-intensity, prolonged moderate-intensity, prolonged high-intensity exercise or during restitution is dependent on the integrity of the hypothalamic-pituitary-adrenal, hypothalamic-pituitary-gonadal, hypothalamicpituitarythyroid axes and on the sympathetic adrenal medullary system, to which other endogenous and environmental factors are added. The increase in the incidence of diseases, including endocrine disorders closely related to physical exercise and to the absence of physical activity, is an area of wide interest and a public health problem. [ABSTRACT FROM AUTHOR]

Physical exercises have long been linked to numerous health improvements, ranging from cardiovascular to psychiatric. In this review, we take a closer look on its anatomical, physiological and chemical effects on the brain. Starting from the clinical to the cellular level, we will analyze the neurogenesis, anti-inflammatory effects on Brain-Blood Barrier and synaptic plasticity, outlining known molecular aspects that are influenced by physical activity, such as: gene expression, changes of growth factors and neurotransmitter levels and means of reverting molecular mechanisms of ageing. The brain derived neurotrophic factor (BDNF) is one of the central molecules that links the physical exercise to neurogenesis, neuroprotection, cognitive functions, dendritic growth, memory formation and many more. We indicate the correlation between physical activity and mental health in diseases like depression, Alzheimer’s dementia and Parkinson’s disease. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is the leading cause of mortality in hemodialysis patients. Carotid and cardiac ultrasonographic abnormalities are the rule in these patients. The aim of this study is to evaluate the interrelation between these changes and cardiovascular risk factors in our patients. In 54 stable chronic hemodialysis patients current demographic and biochemical parameters were recorded. Ultrasonographic measurement of intima-media thickness, diastolic diameter of common carotid artery, evaluation of carotid atherosclerotic plaques and transthoracic ecocardiography with evaluation of left ventricular mass index and valvular calcifications were performed, and correlated with cardiovascular risk factors. We found a high frequency of ultrasonographic abnormalities. Remarkably, nontraditional cardiovascular risk factors such as malnutrition, anemia and calcium-phosphate imbalance seem more important than traditional risk factors such as age, gender, smoking, diabetes mellitus, arterial hypertension or obesity for these ultrasonographic changes in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Background: The study assessed awareness and use of heated tobacco products (HTPs) and factors that influenced these issues among cigarette smokers from six European countries in 2016 (Wave 1) and 2018 (Wave 2)., Methods: A survey was conducted among a nationally representative sample of cigarette smokers aged 18 years or older from Germany, Greece, Hungary, Poland, Romania and Spain in 2016 (N = 6011) and 2018 (N = 6027; 53% of smokers from the previous wave were retained, regardless of smoking status and dropouts were replaced by a replenishment sample of smokers). Data were collected through face-to-face interviews. Estimates were produced using weighted data. The study presents the cross-sectional results., Results: Awareness of HTPs increased from 8% to 17% between the two waves. At Wave 1, 1.1% of the smokers declared having used HTPs at least once during their lifetime; and at Wave 2, this increased to 1.9% (around 1% or less in four countries, except for Greece and Romania where it was around 4%). Factors associated with HTPs use among those who had ever heard about these products at Wave 1 were country of residence, being a daily cigarette smoker and ever use of electronic cigarettes. At Wave 2, ever use of HTPs was significantly higher among those who had tried to quit smoking combustible cigarettes in the last 12 months, had tried electronic cigarettes during lifetime and perceived HTPs as less dangerous than combustible cigarettes; the country of residence was also associated with HTPs use., Conclusion: This study offers insights into the behaviours and perceptions of European adult smokers regarding HTPs, an important emerging issue in the field of tobacco control., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Objective: The extent to which diabetes (DM) practice guidelines, often based on evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation., Research Design and Methods: Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences., Results: Most LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination plan as well as socioeconomic and ethical-legal contextualization. LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines ( P < 0.001)., Conclusions: A new approach to the contextualization, content development, and delivery of LMIC guidelines is needed to improve outcomes., (© 2018 by the American Diabetes Association.)

Introduction: promotion of a healthy diet and involvement in physical activity among young people has an important impact on their actual and future lifestyle, health and well being., Objectives: this study investigates dietary patterns, physical activity, body mass index (BMI) and weight-related behaviours as well as their interrelationship among Romanian university students., Methods: the study used anonymous questionnaires and was performed in Cluj-Napoca, Romania in 2003 (n = 320) and 2016 (n = 320)., Results: the factor analyse revealed three main dietary structures which were similar at both waves. The first one describes a varied diet. The second one shows a diet rich in white meat, dietary fibres and varied sources of carbohydrates. The last one refers to a diet containing red meat, fat, potatoes, sugar. The first dietary structure protects against overweight and it correlates positively with daily physical activity, while has a negative correlation with using several methods for losing weight. The second dietary factor is also protective for overweight, but has a positive correlation with using several methods for losing weight. It has a negative association with eating frequently in fast food restaurants and with daily physical activity. The last dietary structure is negatively associated with daily physical activity, while being positively associated with eating frequently in fast-food restaurants and with a higher BMI., Conclusions: the study presents trends in dietary patterns, physical activity, BMI and weight related behaviours among Romanian university students between 2003 and 2016 and highlights the existence of several main dietary structures, which seems stable over time.

Aim: The present study investigates the evolution of illicit drug use among Romanian university students from 1999 to 2011., Methods: The study was performed in Cluj-Napoca, Romania, in three phases: in 1999 (T1), in 2003 (T2) and in 2011 (T3). The study was carried out by means of anonymous questionnaires among university students aged 19-24., Results: The results show that among girls the lifetime illicit drugs use increased statistically significantly from 2.5% in 1999 to 7.5% in 2003 and to 15% in 2011. Among boys the trend was also increasing, the prevalence of illicit drug use was 14.2% at T1, 18.1% at T2, and it increased dramatically to 30.6% at T3. The percentage of students reporting cannabis use was almost identical with the total prevalence of illicit drug use. Ecstasy was the second most frequent drug used by the students; its consumption had also an increasing trend during the examined periods (from 0 to 5.6% among girls and from 0.8% to 11.2% among boys). The results of the bivariate correlation analyses show that lifetime illicit drug use was associated with having friends who experimented with illicit drugs both among boys and girls. Moreover, girls who declared stress management problems and depressive episodes were more likely to try illicit drugs, while among boys illicit drug use was associated with poorer academic performance., Conclusions: The data pointed out by our study call for comprehensive actions regarding the prevention of illicit drug use among Romanian young people.