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Objective: To study the long-term effects of weight reduction, quality of life and sense of coherence in a primary health care (PHC)-based programme with two different intensities. Design: Prospective two-armed randomised intervention. Setting: Three PHC centres in south west of Sweden. Subjects: In total, 289 women and men aged 40-65 years with a BMI of 28-35 were recruited for a two-year weight-reduction programme. Participants were randomized to high-intensity or low-intensity groups. Blood samples, physical measurements and questionnaires were analysed. Participants received cookbooks and dietary lectures. The high-intensity group also received Motivational interviewing (MI), dietary advice on prescription (DAP- advice), a grocery store lecture, a website and weekly e-mails. Main outcome measures: Weight, quality of life, risks and health factors. Results: In total, 182 (64%) participants completed the 2-year follow-up. The total sample reduced their weight by 1 kg (p = 0.006). No significant differences regarding weight were found between the groups. Anxiety/depression decreased in EQ5-D (p = 0.021), EQ5-D VAS (p = 0.002) and SOC (p = 0.042). Between the groups, there were significant differences in EQ5-D usual activities (p = 0.004), anxiety/depression (p = 0.013), pain/discomfort (p = 0.041), fruit and vegetables (p = 0.005), HLV anxiety (p = 0.005), and visits to nurses (p = 0.012). Conclusion: The total population lost weight, and the high-intensity and low-intensity programmes did not result in significant differences in terms of weight. The high-intensity programme reported health benefits linked to lower levels of anxiety and depression, increased activity and intake of greens and reduced visits to physicians and nurses.Key points Both groups had a consisting weight- reduction after two years. High intensity did not lead to a significant difference in weight reduction between the groups. The high-intensity group reported more health effects, such as bett, Funding Agency:Sparbanksstiftelsen Varberg - Vetenskapliga rådet in HallandSödra sjukvårdsregionen in Skåne

Purpose: An important task in primary health care (PHC) is to address lifestyle-related diseases. Overweight (OW) individuals make up a large proportion of PHC patients, and they increasingly have lifestyle-related illnesses that influence their quality of life. Structured health promotion and weight reduction programs could help these patients. The objective of this study was to explore the characteristics, lifestyle habits, and health conditions of individuals seeking a health promotion and weight reduction program in PHC. Patients and methods: The study involved a comparative cross-sectional design performed in PHC in southwestern Sweden. The study population comprised 286 participants (231 women, aged 40–65 years, body mass index [BMI] 28–35 kg/m2) who were recruited between March 2011 and April 2014 to the 2-year program by adverts in local newspapers and recruitment from three PHC centers. Two reference populations were used: a general population group and an OW group. The study population data were collected using a questionnaire, with validated questions regarding health, lifestyle, illnesses, and health care utilization. Results: People seeking a health promotion and weight reduction program were mostly women. They had a higher education level and experienced worse general health than the OW population, and they visited PHC more frequently than both reference groups. They also felt more stressed, humiliated, had more body pain, and smoked less compared to the general population. However, they did not exercise less or had a lower intake of fruits and vegetables than either reference population. Conclusion: Individuals seeking a weight reduction program were mostly women with a higher education level and a worse general health than the OW population. They used more health care services compared to the reference groups.

Background: According to World Health Organization about 75% of cardiovascular diseases and type 2 diabetes and 40% of all cases of cancer could be prevented if the risk factors tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol could be eliminated. Patients often need help in monitoring themselves to make the proper lifestyle changes and it is important that adequate support is provided to enable the patients to take control over their health. Motivational interviewing is a framework that can help to facilitate this movement. The aim of this study was to describe how patients in primary health care settings experience lifestyle discussions based on motivational interviewing. Methods: This study has a descriptive design and qualitative content analysis was used as the method. Sixteen patients who had each visited a registered nurse for lifestyle discussions were interviewed. Results: The results show that the lifestyle discussions could enable self-determination in the process of lifestyle change but that certain conditions were required. Mutual interaction between the patient and the nurse that contributes to a sense of well-being in the patients was a necessary condition for the lifestyle discussion to be helpful. When the discussion resulted in a new way of thinking about lifestyle and when patient initiative was encouraged, the discussion could contribute to change. The patient’s free will to make a lifestyle change and the nurse’s sensitivity in the discussions created fertile soil for change. Conclusions: This study focuses on MI-based discussions, and the result shows that a subset of patients, who self-reported that they are motivated and aware of their role in making lifestyle changes, appreciate these strategies. However, it is not known whether discussions would be experienced in the same way if RNs used another method or if patients who were less motivated, engaged, or aware of their role in making lifestyle changes were intervi, Research funding: County of Halland, Sweden

Introduction Health promotion practice is an important work assignment within the entire health and medical care sector. Nurses are important for the development and implementation of health promotion in clinical practice. Aim The aim was to describe how district nurses view health promotion practice and how it was implemented in clinical practice following a training initiative. Design The study has a descriptive design and a qualitative method. Methods The sample consisted of three focus groups with 16 participants. The interviews were conducted as a conversation with focus on the district nurses view of health promotion and its implementation in clinical practice. The data have been processed using manifest qualitative content analysis. Results Three categories, titled Training as motivation, Lack of grounding and Lack of scope were identified. The result demonstrated that training provides motivation, but also the importance of grounding in the organization and the need for scope in performing health promotion practice. Discussion Our results show that the training initiative has contributed positively to the district nurses' view of health promotion practice, but that they also feel that there are obstacles. The district nurses in our study suggest that health promotion practice should be more visible, and not something that is done when time permits. Conclusion The district nurses feel motivated and have an enthusiasm for health promotion practice but more time and resources are required to design successful health-promoting initiatives. Before implementing a major training initiative for healthcare personnel in health promotion, it is essential to examine whether the conditions for this exist in the organization

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HTML (Hyper Text Markup Language) introducerades som ett enkelt och plattformsoberoende språk med syftet att göra information tillgänglig över hela världen och är idag det mest kända och använda språket på webben. När HTML skapades var det huvudsakliga användningsområdet publicering. Efter hand ökade mognaden hos användarna och behovet av mer avancerade tillämpningar ökade. Fler och fler började då inse begränsningarna med HTML och dess enkla struktur. Metaspråket XML (eXtensible Markup Language) är ett universellt format för att strukturera dokument och data på Internet. Utveck-lingen av XML startade 1996 och antogs som en W3C-rekommendation (World Wide Web Consortsium) i februari 1998. Syftet med XML var att skapa ett betydligt mer flexibelt språk än HTML, utan att för den skull göra det mer komplext. Syftet med uppsatsen är att undersöka om det nödvändiga underhållet av presenterad information på webben (WWW) förbättras med hjälp av XML samt undersöka hur XML kan underlätta EDI (Electronic Data Interchange)via Internet. Uppsatsen fakta och påståenden bygger på en s k kvalitativ bearbetning d v s textmaterial i form av rapporter, specifikationer och böcker. I min undersökning har jag kommit fram till att XML kommer att bli ett av morgondagens stora format, både vad gäller skapandet av Internetapplikationer och som meddelandeformat för informationsöverfö-ring. Med XML kan allt från en enkel fil till avancerade affärsdokument skapas. Det som jag anser håller tillbaka XML i dagsläget är samtidigt en av dess styrkor, nämligen flexibiliteten, det vill säga möjligheten att deklarera egna märkord. Genom den här sortens flexibilitet blir även språket mer komplext jämfört med ett språk som t ex HTML. Ett av del-målen W3C satte upp vid skapandet var just att enkelheten skulle bibehållas. Detta delmål har delvis gått förlorat i XML. XML-familjen är idag relativt komplex. Samtidigt välkomnas förslagen till förbättringar och utbyggnad av utvecklarna, då det är kringstandardern