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Razvoj vakcina ima bogatu istoriju koja je obeležena revolucionarnim iskoracima i razvojem tehnologija koje su značajno uticale na javno zdravlje. Ovaj rad prikazuje istorijski razvoj vakcina, sa posebnim fokusom na nastanak i razvoj iRNK vakcina. Počevši od ranih inovacija u oblasti vakcina, rad pruža sveobuhvatan pregled kako je iRNK tehnologija unela revoluciju ovu oblast. Razmatra se jedinstveni aspekt imunološkog odgovora koji izazivaju iRNK vakcine, ističući njihovu sposobnost da proizvedu snažan i ciljan imunitet protiv patogena. Takođe, rad analizira proces proizvodnje iRNK vakcina, objašnjavajući korake od dizajna plazmida preko sinteze iRNK do enkapsulacije u lipidne nanopartikule. Diskusija uključuje analizu izazova tokom faza razvoja i kako su ti izazovi prevaziđeni. Praćenjem evolucije različitih tehnologija vakcina i naglašavanjem napretka koji su donele iRNK vakcine, ovaj rad naglašava njihov transformativni potencijal u prevenciji infektivnih i tretmanu malignih bolesti., The development of vaccines has a rich history marked by groundbreaking innovations and evolving technologies that have significantly improved public health. This paper explores the historical progression of vaccines, with a particular focus on the emergence and development of mRNA vaccines. Starting from early vaccine innovations, the study provides a comprehensive overview of how mRNA technology has revolutionized the field. It delves into the unique aspects of the immune response elicited by mRNA vaccines, highlighting their ability to produce robust and targeted immunity against pathogens. Additionally, the paper examines the production process of mRNA vaccines, from plasmid design and the synthesis of mRNA strands to their encapsulation in lipid nanoparticles. The discussion includes an analysis of the challenges faced during the development phases and how these have been addressed. By tracing the evolution of vaccine technology and emphasizing the advancements brought by mRNA vaccines, this paper underscores their transformative potential in preventing infectious diseases and treating various conditions. The findings suggest that mRNA vaccines represent a pivotal shift in vaccine development, offering new avenues for future research and application in both infectious diseases and personalized medicine.

Aim Diabetes mellitus (DM) and multiple sclerosis (MS) are two common diseases known to worsen the trajectory of each other, yet it is unknown whether MS is associated with incident DM. Methods Using Danish nationwide registries, we identified all patients aged 18–99 with a first-time primary or secondary discharge diagnosis with MS between 2000 and 2018, with no known DM. These patients were matched with control subjects from the background population in a 1:5 ratio based on age and sex, to assess their risk of DM. Results A total of 13,376 patients with MS and 66,880 matched control subjects were included (33 % men; median age, 42 years [25th–75th percentile, 33–51]). During a median follow-up of 8.3 years (25th–75th percentile, 4.0–13.3), 467 (3.5 %) patients with MS and 2397 (3.6 %) control subjects were diagnosed with DM. The cumulative incidence of DM was similar among patients with MS and control subjects (95 % confidence interval [CI] 6.5 % [5.7–7.2 %] vs. 7.3 % [95 % CI 6.9–7.9 %], respectively), and adjusted analysis yielded a hazard ratio (HR) of 0.98 [95 % CI 0.89–1.09]). The overall risk of incident type 1 diabetes was low and yielded a HR of 1.60 [95 % CI 0.98–1.40] in patients with MS compared with control subject (P = 0.07). Conclusion This study demonstrated that patients with MS had a similar risk of incident DM as compared to age- and sex matched controls from the background population., Aim: Diabetes mellitus (DM) and multiple sclerosis (MS) are two common diseases known to worsen the trajectory of each other, yet it is unknown whether MS is associated with incident DM. Methods: Using Danish nationwide registries, we identified all patients aged 18–99 with a first-time primary or secondary discharge diagnosis with MS between 2000 and 2018, with no known DM. These patients were matched with control subjects from the background population in a 1:5 ratio based on age and sex, to assess their risk of DM. Results: A total of 13,376 patients with MS and 66,880 matched control subjects were included (33 % men; median age, 42 years [25th–75th percentile, 33–51]). During a median follow-up of 8.3 years (25th–75th percentile, 4.0–13.3), 467 (3.5 %) patients with MS and 2397 (3.6 %) control subjects were diagnosed with DM. The cumulative incidence of DM was similar among patients with MS and control subjects (95 % confidence interval [CI] 6.5 % [5.7–7.2 %] vs. 7.3 % [95 % CI 6.9–7.9 %], respectively), and adjusted analysis yielded a hazard ratio (HR) of 0.98 [95 % CI 0.89–1.09]). The overall risk of incident type 1 diabetes was low and yielded a HR of 1.60 [95 % CI 0.98–1.40] in patients with MS compared with control subject (P = 0.07). Conclusion: This study demonstrated that patients with MS had a similar risk of incident DM as compared to age- and sex matched controls from the background population.

Social and community service organizations (SCSOs) may be a promising new environment to more successfully reach people with a lower socioeconomic position (SEP) for smoking cessation support. However, studies that investigate clients’ perspectives of the suitability of SCSOs as a setting to discuss smoking are scarce. This study aimed to (i) investigate the suitability of smoking cessation support provided by SCSOs, according to people with a low SEP, and (ii) explore their reasons for considering it suitable or unsuitable. Semi-structured interviews were conducted with 19 individuals with a low SEP who smoked regularly (N = 14) or had smoked regularly (N = 5). They have been in contact with SCSOs in a specific neighborhood in Amsterdam. Data were analyzed using a thematic approach. Participants generally considered SCSOs as suitable for providing smoking cessation support, as professionals are involved, build a relationship of trust, and offer personalized and holistic support. SCSOs are located nearby and familiar, they provide support in both group and individual settings and might offer additional supportive (group)activities. A number of participants expressed doubts about the waiting time for support, the fact that the needed support might exceed professionals’ expertise, and the lack of aftercare. SCSOs can be an additional opportunity for providing smoking cessation support that aligns with the circumstances of lower SEP people. To harness the potential, smoking cessation could be integrated into education programs and training among professionals could be promoted. Policy changes within and outside SCSOs would be needed.

A toxoplasmose é uma infecção causada pelo parasita Toxoplasma gondii, que envolve complexas interações com o sistema imunológico do hospedeiro. O processo patogênico inclui respostas imunes inatas e adaptativas, com destaque para células fagocíticas e células T na defesa contra o parasita. Comumente, com o envelhecimento, há implicações nos mecanismos imunológicos do indivíduo. A partir de tais premissas, objetivou-se discutir as interfaces da toxoplasmose com o envelhecimento, visando identificar fatores relevantes para os desfechos desse processo de saúde-doença. Para tanto, foi realizada uma revisão narrativa da literatura científica disponível em bancos de dados como Scielo, Google Acadêmico e PubMed. Foi possível identificar que a prevenção da toxoplasmose envolve medidas como higiene alimentar, evitar contato com gatos e triagem sorológica durante a gravidez. O tratamento varia conforme a gravidade da infecção e o estado imunológico do paciente, envolvendo terapia específica contra o parasita e tratamento de suporte para complicações. Compreender a patogênese, implementar medidas preventivas e garantir um manejo terapêutico adequado são fundamentais para reduzir a incidência e o impacto da toxoplasmose na saúde pública, especialmente em grupos de risco como gestantes, pessoas idosas e imunocomprometidas., Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii, which involves complex interactions with the host's immune system. The pathogenic process includes innate and adaptive immune responses, with a highlight on phagocytic cells and T cells in defense against the parasite. Commonly, with aging, there are implications on the individual's immune mechanisms. Based on these premises, the aim is to discuss the interfaces of toxoplasmosis with aging, aiming to identify relevant factors for the outcomes of this health-disease process. For this purpose, a narrative review of the scientific literature available in databases such as Scielo, Google Scholar, and PubMed was carried out. It was possible to identify that toxoplasmosis prevention involves measures such as food hygiene, avoiding contact with cats, and serological screening during pregnancy. Treatment varies according to the severity of the infection and the patient's immune status, involving specific therapy against the parasite and supportive treatment for complications. Understanding the pathogenesis, implementing preventive measures, and ensuring adequate therapeutic management are essential to reduce the incidence and impact of toxoplasmosis on public health, especially in at-risk groups such as pregnant women, elderly individuals, and immunocompromised individuals, La toxoplasmosis es una infección causada por el parásito Toxoplasma gondii, que implica complejas interacciones con el sistema inmunológico del huésped. El proceso patogénico incluye respuestas inmunes innatas y adaptativas, destacando las células fagocíticas y las células T en la defensa contra el parásito. Comúnmente, con el envejecimiento, hay implicaciones en los mecanismos inmunológicos del individuo. A partir de estas premisas, se busca discutir las interfaces de la toxoplasmosis con el envejecimiento, con el objetivo de identificar factores relevantes para los resultados de este proceso de salud-enfermedad. Para ello, se realizó una revisión narrativa de la literatura científica disponible en bases de datos como Scielo, Google Académico y PubMed. Fue posible identificar que la prevención de la toxoplasmosis implica medidas como la higiene alimentaria, evitar el contacto con gatos y el cribado serológico durante el embarazo. El tratamiento varía según la gravedad de la infección y el estado inmunológico del paciente, e implica una terapia específica contra el parásito y tratamiento de apoyo para las complicaciones. Comprender la patogénesis, implementar medidas preventivas y garantizar un manejo terapéutico adecuado son fundamentales para reducir la incidencia y el impacto de la toxoplasmosis en la salud pública, especialmente en grupos de riesgo como mujeres embarazadas, personas mayores e inmunocomprometidas.

A toxoplasmose é uma infecção causada pelo parasita Toxoplasma gondii, que envolve complexas interações com o sistema imunológico do hospedeiro. O processo patogênico inclui respostas imunes inatas e adaptativas, com destaque para células fagocíticas e células T na defesa contra o parasita. Comumente, com o envelhecimento, há implicações nos mecanismos imunológicos do indivíduo. A partir de tais premissas, objetivou-se discutir as interfaces da toxoplasmose com o envelhecimento, visando identificar fatores relevantes para os desfechos desse processo de saúde-doença. Para tanto, foi realizada uma revisão narrativa da literatura científica disponível em bancos de dados como Scielo, Google Acadêmico e PubMed. Foi possível identificar que a prevenção da toxoplasmose envolve medidas como higiene alimentar, evitar contato com gatos e triagem sorológica durante a gravidez. O tratamento varia conforme a gravidade da infecção e o estado imunológico do paciente, envolvendo terapia específica contra o parasita e tratamento de suporte para complicações. Compreender a patogênese, implementar medidas preventivas e garantir um manejo terapêutico adequado são fundamentais para reduzir a incidência e o impacto da toxoplasmose na saúde pública, especialmente em grupos de risco como gestantes, pessoas idosas e imunocomprometidas., Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii, which involves complex interactions with the host's immune system. The pathogenic process includes innate and adaptive immune responses, with a highlight on phagocytic cells and T cells in defense against the parasite. Commonly, with aging, there are implications on the individual's immune mechanisms. Based on these premises, the aim is to discuss the interfaces of toxoplasmosis with aging, aiming to identify relevant factors for the outcomes of this health-disease process. For this purpose, a narrative review of the scientific literature available in databases such as Scielo, Google Scholar, and PubMed was carried out. It was possible to identify that toxoplasmosis prevention involves measures such as food hygiene, avoiding contact with cats, and serological screening during pregnancy. Treatment varies according to the severity of the infection and the patient's immune status, involving specific therapy against the parasite and supportive treatment for complications. Understanding the pathogenesis, implementing preventive measures, and ensuring adequate therapeutic management are essential to reduce the incidence and impact of toxoplasmosis on public health, especially in at-risk groups such as pregnant women, elderly individuals, and immunocompromised individuals, La toxoplasmosis es una infección causada por el parásito Toxoplasma gondii, que implica complejas interacciones con el sistema inmunológico del huésped. El proceso patogénico incluye respuestas inmunes innatas y adaptativas, destacando las células fagocíticas y las células T en la defensa contra el parásito. Comúnmente, con el envejecimiento, hay implicaciones en los mecanismos inmunológicos del individuo. A partir de estas premisas, se busca discutir las interfaces de la toxoplasmosis con el envejecimiento, con el objetivo de identificar factores relevantes para los resultados de este proceso de salud-enfermedad. Para ello, se realizó una revisión narrativa de la literatura científica disponible en bases de datos como Scielo, Google Académico y PubMed. Fue posible identificar que la prevención de la toxoplasmosis implica medidas como la higiene alimentaria, evitar el contacto con gatos y el cribado serológico durante el embarazo. El tratamiento varía según la gravedad de la infección y el estado inmunológico del paciente, e implica una terapia específica contra el parásito y tratamiento de apoyo para las complicaciones. Comprender la patogénesis, implementar medidas preventivas y garantizar un manejo terapéutico adecuado son fundamentales para reducir la incidencia y el impacto de la toxoplasmosis en la salud pública, especialmente en grupos de riesgo como mujeres embarazadas, personas mayores e inmunocomprometidas.

The aim of this study is to study the peculiarities of the eating behaviour of children of primary school age, their food preferences, choice of products and attitudes towards school meals, food habits in the choice of products and attitudes towards the school canteen in the context of the implementation of the school meal reform. Materials and methods. A large-scale medical and sociological study was conducted, which included children (5,401) of primary school age (from 6 to 10 years old) and their parents (4,347 people) from various schools in Kyiv, Vinnytsia, and Donetsk regions. The questionnaires included questions about food preferences, frequency of consumption of different foods, attitudes towards school meals and factors that influence food choices. The collected data were processed and analyzed using descriptive statistics methods in Excel. Research results indicate a significant level of awareness of the importance of a healthy diet by most children, but an insufficient level of water consumption, an insufficient understanding of the importance of nutrition for maintaining health by children, high popularity of high-carbohydrate products and a low level of satisfaction of some parents with school meals. Conclusions. The conducted analytical research revealed several educational and organizational problems related to the introduction of healthy food in schools, especially within the framework of reforming school food programs. According to the Strategy for reforming the school nutrition system, compliance with the principles of healthy nutrition, ensuring high-quality, safe and healthy nutrition, and improving the taste properties of school nutrition compliance with the principles of healthy nutrition, is extremely important for the preservation of children's health and the prevention of chronic non-infectious diseases. The results of our research indicate the need for additional educational programs for children and parents, the gradual introduction of ne

La necessità della società di attivare prevenzione medica ha portato la comunità scientifica a valorizzare le capacità narrative per aumentare la comprensione e accettazione della malattia. Con la diagnosi di tumore cambia tutto: dalla percezione del proprio corpo al rapporto con i familiari ed è solo mediante la narrazione del proprio vissuto di cura che la persona condivide sentimenti, emozioni, paure e preoccupazioni con altri individui, ripercorrendo l’immaginario vissuto e condividendo una personale fase della sua vita. Tale approccio incontra l’esigenza di Humanitas di valutare il progetto “Sorrisi in Rosa” (SiR) dedicato all'affiancamento delle donne in screening o con diagnosi di tumore al seno per evidenziare elementi di impatto e spazi di sviluppo nell’accompagnamento delle pazienti. Attraverso il supporto emotivo e la condivisione delle proprie storie, le pazienti coinvolte nel programma possono sviluppare un senso di comunità e comprensione reciproca. Questo non solo offre un ambiente in cui possono affrontare le sfide della malattia, ma può anche contribuire a ridurre il senso di isolamento che spesso accompagna il cancro al seno. Il monitoraggio condotto dal CREMIT (Centro di Ricerca sull’Educazione ai Media, all’Innovazione e alla Tecnologia), in collaborazione con IRCCS Humanitas si inserisce nella volontà di indagare e comprendere come la narrazione possa rendere la malattia e la cura un processo trasformativo, capace di rileggere e affrontare al meglio il proprio vissuto personale da donna. La ricerca qui presentata, articolata su tre fasi, si sofferma sull’analisi delle narrazioni prodotte all’interno del progetto e del questionario somministrato, con l’obiettivo di migliorare l’assistenza e il sostegno alle donne coinvolte in programmi di screening e di cura del tumore al seno., The need of society to activate medical prevention has led the scientific community to value narrative skills to increase the understanding and acceptance of disease. With the diagnosis of cancer, everything changes: from the perception of one’s body to the relationship with family members, and it is only through the narration of one's experience of treatment that the person shares their feelings, emotions, fears and concerns with other individuals, retracing the imaginary experience and sharing a personal phase of their life. This approach meets Humanitas’ need to evaluate the “Sorrisi in Rosa” (SiR) project dedicated to accompanying women undergoing screening for or diagnosed with breast cancer to highlight the elements of impact and spaces for development in accompanying patients. Through emotional support and sharing their stories, patients involved in the program can develop a sense of community and mutual understanding. This not only provides an environment conducive to coping with the challenges of the disease but can also help reduce the sense of isolation that often accompanies breast cancer. The monitoring by CREMIT (Center for Research on Media Education, Innovation and Technology), in collaboration with IRCCS Humanitas is part of the desire to investigate and understand how storytelling can make illness and treatment a transformative process, capable of rereading and coping better with one’s personal experience as a woman. The research presented here, divided into three phases, focuses on analysing the narratives produced within the project and the questionnaire administered, to improve care and support for women involved in breast cancer screening and treatment programs.

Research on the interaction between physical activity and public health is of growing interest due to its significant influence on the prevention of chronic diseases and the promotion of comprehensive well-being. This bibliometric analysis aims to provide a comprehensive view of the evolution of research in this field, identifying key thematic areas, geographical distribution of scientific production, and its impact on public health policies and clinical practices. The results reveal an increase in the volume of research, reflecting a deeper recognition of the benefits of physical activity on physical and mental health. Growth has been noted in the variety of research approaches, including studies on specific population groups and diverse contexts. These findings suggest an interest in how physical activity can improve quality of life and health at the individual and community levels. The study highlights the contribution of physical activity in the formulation of public health policies and the promotion of active lifestyles. The methodology is based on a systematic review of scientific literature from 2002 to 2023, using databases such as Scopus, with inclusion criteria focused on studies that examine the correlation between variables. Research shows that the United States leads in scientific production, followed by the United Kingdom, Australia, Brazil, Canada and China, with growing participation from countries such as Norway and Mexico., La investigación sobre la interacción entre la actividad física y la salud pública es de creciente interés debido a su influencia significativa en la prevención de enfermedades crónicas y la promoción del bienestar integral, teniéndose en cuenta que el sedentarismo es causante de enfermedades crónicas. Este análisis bibliométrico tiene como objetivo proporcionar una visión comprensiva de la evolución de la investigación en este campo, identificando áreas temáticas clave, distribución geográfica de la producción científica, y su impacto en políticas de salud pública y prácticas clínicas. Los resultados revelan un incremento en el volumen de investigación, reflejando un reconocimiento más profundo de los beneficios de la actividad física en la salud física y mental. Se ha notado un crecimiento en la variedad de enfoques de investigación, incluyendo estudios sobre grupos poblacionales específicos y contextos diversos. Estos hallazgos sugieren un interés en cómo la actividad física puede mejorar la calidad de vida y la salud a nivel individual y comunitario. El estudio resalta la contribución de la actividad física en la formulación de políticas de salud pública y la promoción de estilos de vida activos. La metodología se basa en una revisión sistemática de la literatura científica desde 2002 hasta 2023, utilizando bases de datos como Scopus, con criterios de inclusión enfocados en estudios que examinan la correlación entre las variables. La investigación demuestra que Estados Unidos lidera en producción científica, seguido por el Reino Unido, Australia, Brasil, Canadá y China, con creciente participación de países como Noruega y México.

Objective: To evaluate health promotion and prevention in the Brazilian Unified Health System (SUS) between 2008 and 2022. Method: An epidemiological study was conducted, with an ecological approach, as a time series. APPS-related data available in the Outpatient Information System of the SUS (SIA/SUS) over the last 15 years were used, normalized to every 100,000 Brazilian residents, characterizing the incidence. COVID-19 pre- and post-pandemic periods were outlined to verify its impact on productivity. The data were analyzed with a significance level of 5%. Result: Between 2008 and 2022, 6,933,081,931 APPS were carried out in the SUS. The most frequent modality was home visits (56.3%), and the most common health professionals were health and endemic agents (59.8%). For the entire study period, the incidence was 3,407,327 APPS per 100,000 Brazilian residents, with an annual median of 281,999. Furthermore, there was a significant decreasing trend over the last 15 years (p <0.001), whose annual percentage change was estimated at -6.7%. Disregarding COVID-19 pandemic years, the trend remained to decrease (p = 0.028). At last, when comparing it to the pre-pandemic period, the incidence of APPS were 32% lower in the first, 26% lower in the second, and 21% lower in the third year after the COVID-19 pandemic onset (p <0.001). Conclusion: It was possible to conclude that APPS in the SUS have reduced in the last 15 years.

Dengue is a disease that constitutes a public health problem difficult to control due to the multidimensionality of associated factors and the particularities of the territories. This article analyzes the notion of family empowerment related to the prevention and control of dengue in Córdoba, Colombia. From July to October 2023, using a qualitative approach, semi-structured interviews were conducted with 30 family groups located in the municipalities of San Andrés de Sotavento, San Bernardo del Viento, Pueblo Nuevo, and Montería, selected for being indigenous, Afro-descendant, or rural and urban populations in vulnerable conditions. The results show that families, beyond their particular arrangements in terms of structure and dynamics, are aware of their role in the prevention and control of diseases, identifying the capacities required to face dengue. However, they reproduce narratives of conceptual and power dominance that assign a greater commitment on the part of educational and health agents to promote alternatives that contribute to reducing the risks of dengue. The challenges that must be faced for effective family empowerment are discussed, so that prevention practices gain greater strength., El dengue es una enfermedad que constituye un problema de salud pública difícil de controlar por la multidimensionalidad de factores asociados y las particularidades de los territorios. En este artículo se analiza la noción de empoderamiento familiar relacionada con la prevención y control del dengue en Córdoba, Colombia. De julio a octubre de 2023, a partir de un enfoque cualitativo se realizaron entrevistas semiestructuradas a 30 grupos familiares localizados en los municipios de San Andrés de Sotavento, San Bernardo del Viento, Pueblo Nuevo y Montería, seleccionados por ser territorios indígenas, afrodescendientes o con población rural y urbano en condiciones de vulnerabilidad. Los resultados muestran que las familias, más allá de sus arreglos particulares en términos de estructura y dinámica, son conscientes de su lugar en la prevención y control de enfermedades, identificando las capacidades requeridas para enfrentar el dengue. Sin embargo, reproducen narrativas de dominio conceptual y de poder que asignan un mayor compromiso por parte de los agentes educativos y de salud para el fomento de alternativas que contribuyan a disminuir los riesgos por dengue. Se discuten los desafíos que se deben enfrentar para un efectivo empoderamiento familiar, de modo que las prácticas de prevención cobren mayor vigor.

Dengue is rapidly expanding its transmission area across Brazil and much of South America. In this study, data-mining techniques were used to identify climatic and demographic indicators that could explain the recent (2014–2020) and simultaneous trends of expansion and exacerbation of the incidence in some regions of Brazil. The previous circulation of the virus (dengue incidence rates between 2007 and 2013), urbanization, and the occurrence of temperature anomalies for a prolonged period were the main factors that led to increased incidence of dengue in the central region of Brazil. Regions with high altitudes, which previously acted as a barrier for dengue transmission, became areas of high incidence rates. The algorithm that was developed during this study can be utilized to assess future climate scenarios and plan preventive actions., This work was supported by the HARMONIZE project funded by the Wellcome Trust (224694/Z/21/Z) and the E4Warning project funded by EU’s Horizon Europe research and innovation programme (grant agreement 101086640). The Brazilian Climate and Health Observatory is financed by the Brazilian National Council for Scientific and Technological Development (CNPq, 444665/2023-4). RL was supported by a Royal Society Dorothy Hodgkin Fellowship. RML acknowledges the Beatriu de Pinós program (2021 BP 00197) from the Secretariat of Universities and Research of the Research and Universities Department of the Generalitat de Catalunya., Peer Reviewed, Postprint (published version)

Lupine is gevoelig voor bodemschimmels (vroege uitval) en zaadoverdraagbare ziekten (problemen later in seizoen). Preventie: goede voorvrucht, ruime vruchtwisseling en gezond zaaizaad. De belangrijkste kiemziekten zijn: Pleiochaeta wortelrot, Rhizoctonia en Pythium. Blad- en stengelziekten: Anthracnose, Bruinevlekkenziekte, Rattenkeutelziekte, Phytoophthora wortelrot, Fusarium wortelrot en Botrytis. Verder komen enkele virussen voor die vooral worden veroorzaakt door geïnfecteerd zaaizaad. Als belangrijkste plagen worden Bonenvlieg, en wild- en vogelvraat behandeld. Het aantal gewasbeschermingsmiddelen dat is toegelaten is beperkt. Meer informatie is te vinden in de Teelthandleiding Lupine. Deze factsheet is onderdeel van het SABE-project ‘kennisdelen lupineteelt voor humane consumptie’ in opdracht van en in samenwerking met Proeflab Wageningen en Lekker Lupine. Mede mogelijk gemaakt door het ministerie van LNV en de EU.

Objective: To evaluate health promotion and prevention in the Brazilian Unified Health System (SUS) between 2008 and 2022. Method: An epidemiological study was conducted, with an ecological approach, as a time series. APPS-related data available in the Outpatient Information System of the SUS (SIA/SUS) over the last 15 years were used, normalized to every 100,000 Brazilian residents, characterizing the incidence. COVID-19 pre- and post-pandemic periods were outlined to verify its impact on productivity. The data were analyzed with a significance level of 5%. Result: Between 2008 and 2022, 6,933,081,931 APPS were carried out in the SUS. The most frequent modality was home visits (56.3%), and the most common health professionals were health and endemic agents (59.8%). For the entire study period, the incidence was 3,407,327 APPS per 100,000 Brazilian residents, with an annual median of 281,999. Furthermore, there was a significant decreasing trend over the last 15 years (p <0.001), whose annual percentage change was estimated at -6.7%. Disregarding COVID-19 pandemic years, the trend remained to decrease (p = 0.028). At last, when comparing it to the pre-pandemic period, the incidence of APPS were 32% lower in the first, 26% lower in the second, and 21% lower in the third year after the COVID-19 pandemic onset (p <0.001). Conclusion: It was possible to conclude that APPS in the SUS have reduced in the last 15 years.

Bij het zaaiklaar maken van een akker wordt het land bewerkt, om er gewassen te laten groeien die er van nature niet zouden groeien. Boeren beïnvloeden de natuur dus, maar maken tegelijkertijd ook gebruik van natuurlijke processen die zich in de bodem en in en om het gewas afspelen. Eenmaal gezaaid zal het gewas gaan groeien, een proces dat soms helemaal goed verloopt, maar waar soms bijgestuurd moet worden. De kans bestaat dat onder invloed van ziekten, plagen en onkruiden, de oogst vermindert of zelfs verloren gaat. Een boer of tuinder zal hier dus alert op zijn en volgens een bepaalde strategie het teeltsysteem vormgeven. Met deze strategie wordt bedoeld: of, wanneer en hoe je op natuurlijke processen inspeelt. Je kunt verschillende modellen volgen ten aanzien van ziekten, plagen en onkruiden: 1. Zo veel mogelijk preventieve maatregelen nemen en zo min mogelijk bijsturen tijdens de teelt door samenwerking met de natuur (adaptatiemodel). 2. Direct bijsturen om gewassen gezond te houden door bijvoorbeeld toepassing van chemische middelen (controlemodel). In de praktijk zijn er veel bedrijven die tussen deze twee strategieën in zitten. Er worden wel enkele preventieve maatregelen genomen, maar die zijn onvoldoende om tot een robuust teeltsysteem te komen, waardoor bijsturen tijdens de teelt vaak toch nodig is. Met natuurinclusieve landbouw is het doel om zoveel mogelijk volgens de eerste strategie te werken.

This doctoral thesis critically examines green space characteristics and their proximity to residents in their ability to help reduce the global disease burden of non-communicable diseases. By dissecting three pivotal pathways of theorized green space health effects through increased physical activity, increased social cohesion, and reduced air pollution, the thesis aims to provide new insights into which green space characteristics drive these relationships and in which distance they occur. To achieve these aims, this thesis develops reporting guidelines for the research field, a QGIS script for automatization of green space indicator development and uses two complementary sources for data collection. It builds on the self-reported data on physical activity, social cohesion, air pollution, health and mental health from the URBiNAT project and its case studies in the four European satellite neighbourhoods Nantes-Nord (France), Porto-Campanhã (Portugal), Sofia-Nadezhda (Bulgaria), and Høje-Taastrup (Denmark) and complements it with a rigorous spatial analysis. This enabled a rigorous sensitivity analysis based on up to 135 structural equation models per pathway. The results of this doctoral research revealed distinct green space characteristics and proximities that drive each pathway, including thresholds where these associations disappear or even change direction. It concludes that interconnected, multi-use green corridors are more beneficial than isolated patches for all analysed health pathways, challenging current municipal green space strategies to shift focus from mere ratios to green mobility infrastructures. Although rooted primarily in European contexts and of a cross-sectional nature, the doctoral research provides new evidence for urban planning and public health. It emphasizes the practical implications of how to design green spaces to address health concerns. The results not only resonate with the WHO's Urban Health Research Agenda but also provide tangi

Dengue fever, a prevalent and rapidly spreading arboviral disease, poses substantial public health and economic challenges in tropical and sub-tropical regions worldwide. Predicting infectious disease outbreaks on a countrywide scale is complex due to spatiotemporal variations in dengue incidence across administrative areas. To address this, we propose a machine learning ensemble model for forecasting the dengue incidence rate (DIR) in Brazil, with a focus on the population under 19 years old. The model integrates spatial and temporal information, providing one-month-ahead DIR estimates at the state level. Comparative analyses with a dummy model and ablation studies demonstrate the ensemble model’s qualitative and quantitative efficacy across the 27 Brazilian Federal Units. Furthermore, we showcase the transferability of this approach to Peru, another Latin American country with differing epidemiological characteristics. This timely forecast system can aid local governments in implementing targeted control measures. The study advances climate services for health by identifying factors triggering dengue outbreaks in Brazil and Peru, emphasizing collaborative efforts with intergovernmental organizations and public health institutions. The innovation lies not only in the algorithms themselves but in their application to a domain marked by data scarcity and operational scalability challenges. We bridge the gap by integrating well-curated ground data with advanced analytical methods, addressing a significant deficiency in current practices. The successful transfer of the model to Peru and its consistent performance during the 2019 outbreak in Brazil showcase its scalability and practical application. While acknowledging limitations in handling extreme values, especially in regions with low DIR, our approach excels where accurate predictions are critical. The study not only contributes to advancing DIR forecasting but also represents a paradigm shift in integrating advanc, We would like to thank the United Nations Educational, Scientific and Cultural Organisation (UNESCO) and IRCAI (International Research Centre on Artificial Intelligence) for recognising this project as one of the Global TOP 100 AI solutions for sustainable development goals (SDGs). We also thank UNICEF Innocenti for selecting our project as one of the Best of UNICEF Research for 2022. Rachel Lowe acknowledges support from a Royal Society Dorothy Hodgkin Fellowship and the Wellcome Trust grant number 224694/Z/21/Z (HARMONIZE). The authors would like to thank Manuel García-Herranz from UNICEF for participation and contribution at the early stage of this project., Peer Reviewed, "Article signat per 13 autors/es: Alessandro Sebastianelli, Dario Spiller, Raquel Carmo, James Wheeler, Artur Nowakowski, Ludmilla Viana Jacobson, Dohyung Kim, Hanoch Barlevi, Zoraya El Raiss Cordero, Felipe J Colón-González, Rachel Lowe, Silvia Liberata Ullo & Rochelle Schneide", Postprint (published version)

Comisión Europea, Depto. de Nutrición y Ciencia de los Alimentos, Fac. de Farmacia, FALSE, pub, Descuento UCM

Lifestyles in adolescence are an important factor that triggers the development of diseases. In many situations, it will depend on the quality of information that the individual acquires during his or her growth, thus managing to maintain healthy habits or, if applicable, modifying harmful habits. identified, the objective of this study is to contribute to the improvement of the quality of life and promotion of comprehensive human health against the risk of morbidity and mortality in the adolescent population. The research is descriptive, cross-sectional, two instruments were used to collect data. : self-assessment test on “fantastic” lifestyles and a survey on lifestyles with sociodemographic data such as age, sex and BMI, sample made up of 378 students in the eighth year of basic education from a Baccalaureate School in the Machala canton, the results show that in 12-year-old male adolescents, 10.5% have pre-obesity, 8.4% have severe and moderate thinness, 3.5% have mild obesity and 1.4% have medium obesity, while women have 13.5%. % pre-obesity, 8.6% severe thinness and 1.6% mild obesity. According to the age of 13 years, 22.7% of males were severely thin, 21.1% of females were severely thin, and 10.5% were pre-obese; In 14-yearold male adolescents, 33.3% of slight thinness is identified. In conclusion, in the samples studied, cases were identified with important alterations in nutritional status that are related to the lack of healthy nutritional habits., Los estilos de vida en la adolescencia son un importante factor como detonante al desarrollo de enfermedades, dependerá en muchas situaciones a la calidad de información que el individuo adquiera durante su crecimiento, logrando mantener de este modo hábitos saludables o de ser el caso modificando hábitos nocivos identificados, el objetivo del presente estudio es contribuir en mejoramiento de la calidad de vida y promoción de salud humana integral frente al riesgo de morbimortalidad en la población adolescente, la investigación es de tipo descriptivo, transversal, para la recolección de datos se utilizaron dos instrumentos: test de autoevaluación sobre estilos de vida “ fantástico “y una encuesta sobre estilos de vida con datos sociodemográfico como edad, sexo e IMC, muestra conformada por 378 estudiantes de octavo año de educación básica de un Colegio de Bachillerato del cantón Machala, los resultados muestran que en los adolescentes de 12 años de sexo masculino el 10,5% presenta preobesidad, 8,4% delgadez severa y moderada, 3,5% obesidad leve y 1,4% obesidad media, mientras que las mujeres presentan 13,5% preobesidad, 8,6% delgadez severa y el 1,6% obesidad leve. De acuerdo a la edad de 13 años de sexo masculino el 22,7% delgadez severa, el sexo femenino presenta un 21,1% delgadez severa, y 10,5% preobesidad; en los adolescentes de 14 años de sexo masculino se identifica 33,3% de delgadez leve. Como conclusión, en las muestras estudiadas se identificaron casos con alteraciones importantes sobre el estado nutricional que se relacionan a la falta de hábitos nutricionales saludables.

Lifestyles in adolescence are an important factor that triggers the development of diseases. In many situations, it will depend on the quality of information that the individual acquires during his or her growth, thus managing to maintain healthy habits or, if applicable, modifying harmful habits. identified, the objective of this study is to contribute to the improvement of the quality of life and promotion of comprehensive human health against the risk of morbidity and mortality in the adolescent population. The research is descriptive, cross-sectional, two instruments were used to collect data. : self-assessment test on “fantastic” lifestyles and a survey on lifestyles with sociodemographic data such as age, sex and BMI, sample made up of 378 students in the eighth year of basic education from a Baccalaureate School in the Machala canton, the results show that in 12-year-old male adolescents, 10.5% have pre-obesity, 8.4% have severe and moderate thinness, 3.5% have mild obesity and 1.4% have medium obesity, while women have 13.5%. % pre-obesity, 8.6% severe thinness and 1.6% mild obesity. According to the age of 13 years, 22.7% of males were severely thin, 21.1% of females were severely thin, and 10.5% were pre-obese; In 14-yearold male adolescents, 33.3% of slight thinness is identified. In conclusion, in the samples studied, cases were identified with important alterations in nutritional status that are related to the lack of healthy nutritional habits, Los estilos de vida en la adolescencia son un importante factor como detonante al desarrollo de enfermedades, dependerá en muchas situaciones a la calidad de información que el individuo adquiera durante su crecimiento, logrando mantener de este modo hábitos saludables o de ser el caso modificando hábitos nocivos identificados, el objetivo del presente estudio es contribuir en mejoramiento de la calidad de vida y promoción de salud humana integral frente al riesgo de morbimortalidad en la población adolescente, la investigación es de tipo descriptivo, transversal, para la recolección de datos se utilizaron dos instrumentos: test de autoevaluación sobre estilos de vida “ fantástico “y una encuesta sobre estilos de vida con datos sociodemográfico como edad, sexo e IMC, muestra conformada por 378 estudiantes de octavo año de educación básica de un Colegio de Bachillerato del cantón Machala, los resultados muestran que en los adolescentes de 12 años de sexo masculino el 10,5% presenta preobesidad, 8,4% delgadez severa y moderada, 3,5% obesidad leve y 1,4% obesidad media, mientras que las mujeres presentan 13,5% preobesidad, 8,6% delgadez severa y el 1,6% obesidad leve. De acuerdo a la edad de 13 años de sexo masculino el 22,7% delgadez severa, el sexo femenino presenta un 21,1% delgadez severa, y 10,5% preobesidad; en los adolescentes de 14 años de sexo masculino se identifica 33,3% de delgadez leve. Como conclusión, en las muestras estudiadas se identificaron casos con alteraciones importantes sobre el estado nutricional que se relacionan a la falta de hábitos nutricionales saludables.

Lifestyles in adolescence are an important factor that triggers the development of diseases. In many situations, it will depend on the quality of information that the individual acquires during his or her growth, thus managing to maintain healthy habits or, if applicable, modifying harmful habits. identified, the objective of this study is to contribute to the improvement of the quality of life and promotion of comprehensive human health against the risk of morbidity and mortality in the adolescent population. The research is descriptive, cross-sectional, two instruments were used to collect data. : self-assessment test on “fantastic” lifestyles and a survey on lifestyles with sociodemographic data such as age, sex and BMI, sample made up of 378 students in the eighth year of basic education from a Baccalaureate School in the Machala canton, the results show that in 12-year-old male adolescents, 10.5% have pre-obesity, 8.4% have severe and moderate thinness, 3.5% have mild obesity and 1.4% have medium obesity, while women have 13.5%. % pre-obesity, 8.6% severe thinness and 1.6% mild obesity. According to the age of 13 years, 22.7% of males were severely thin, 21.1% of females were severely thin, and 10.5% were pre-obese; In 14-yearold male adolescents, 33.3% of slight thinness is identified. In conclusion, in the samples studied, cases were identified with important alterations in nutritional status that are related to the lack of healthy nutritional habits, Los estilos de vida en la adolescencia son un importante factor como detonante al desarrollo de enfermedades, dependerá en muchas situaciones a la calidad de información que el individuo adquiera durante su crecimiento, logrando mantener de este modo hábitos saludables o de ser el caso modificando hábitos nocivos identificados, el objetivo del presente estudio es contribuir en mejoramiento de la calidad de vida y promoción de salud humana integral frente al riesgo de morbimortalidad en la población adolescente, la investigación es de tipo descriptivo, transversal, para la recolección de datos se utilizaron dos instrumentos: test de autoevaluación sobre estilos de vida “ fantástico “y una encuesta sobre estilos de vida con datos sociodemográfico como edad, sexo e IMC, muestra conformada por 378 estudiantes de octavo año de educación básica de un Colegio de Bachillerato del cantón Machala, los resultados muestran que en los adolescentes de 12 años de sexo masculino el 10,5% presenta preobesidad, 8,4% delgadez severa y moderada, 3,5% obesidad leve y 1,4% obesidad media, mientras que las mujeres presentan 13,5% preobesidad, 8,6% delgadez severa y el 1,6% obesidad leve. De acuerdo a la edad de 13 años de sexo masculino el 22,7% delgadez severa, el sexo femenino presenta un 21,1% delgadez severa, y 10,5% preobesidad; en los adolescentes de 14 años de sexo masculino se identifica 33,3% de delgadez leve. Como conclusión, en las muestras estudiadas se identificaron casos con alteraciones importantes sobre el estado nutricional que se relacionan a la falta de hábitos nutricionales saludables.

Lifestyles in adolescence are an important factor that triggers the development of diseases. In many situations, it will depend on the quality of information that the individual acquires during his or her growth, thus managing to maintain healthy habits or, if applicable, modifying harmful habits. identified, the objective of this study is to contribute to the improvement of the quality of life and promotion of comprehensive human health against the risk of morbidity and mortality in the adolescent population. The research is descriptive, cross-sectional, two instruments were used to collect data. : self-assessment test on “fantastic” lifestyles and a survey on lifestyles with sociodemographic data such as age, sex and BMI, sample made up of 378 students in the eighth year of basic education from a Baccalaureate School in the Machala canton, the results show that in 12-year-old male adolescents, 10.5% have pre-obesity, 8.4% have severe and moderate thinness, 3.5% have mild obesity and 1.4% have medium obesity, while women have 13.5%. % pre-obesity, 8.6% severe thinness and 1.6% mild obesity. According to the age of 13 years, 22.7% of males were severely thin, 21.1% of females were severely thin, and 10.5% were pre-obese; In 14-yearold male adolescents, 33.3% of slight thinness is identified. In conclusion, in the samples studied, cases were identified with important alterations in nutritional status that are related to the lack of healthy nutritional habits., Los estilos de vida en la adolescencia son un importante factor como detonante al desarrollo de enfermedades, dependerá en muchas situaciones a la calidad de información que el individuo adquiera durante su crecimiento, logrando mantener de este modo hábitos saludables o de ser el caso modificando hábitos nocivos identificados, el objetivo del presente estudio es contribuir en mejoramiento de la calidad de vida y promoción de salud humana integral frente al riesgo de morbimortalidad en la población adolescente, la investigación es de tipo descriptivo, transversal, para la recolección de datos se utilizaron dos instrumentos: test de autoevaluación sobre estilos de vida “ fantástico “y una encuesta sobre estilos de vida con datos sociodemográfico como edad, sexo e IMC, muestra conformada por 378 estudiantes de octavo año de educación básica de un Colegio de Bachillerato del cantón Machala, los resultados muestran que en los adolescentes de 12 años de sexo masculino el 10,5% presenta preobesidad, 8,4% delgadez severa y moderada, 3,5% obesidad leve y 1,4% obesidad media, mientras que las mujeres presentan 13,5% preobesidad, 8,6% delgadez severa y el 1,6% obesidad leve. De acuerdo a la edad de 13 años de sexo masculino el 22,7% delgadez severa, el sexo femenino presenta un 21,1% delgadez severa, y 10,5% preobesidad; en los adolescentes de 14 años de sexo masculino se identifica 33,3% de delgadez leve. Como conclusión, en las muestras estudiadas se identificaron casos con alteraciones importantes sobre el estado nutricional que se relacionan a la falta de hábitos nutricionales saludables.

American Indian (AI) adolescents who practice healthy behaviors of sleep, nutrition, physical activity, and limited screen time can lower their lifetime risk of diet-sensitive disease. Little is known about how AI parenting practices influence the health behaviors of youth. The objective of this qualitative study was to explore how a group of AI parents of youths at risk of disease influenced their youths health behaviors after a family intervention. A secondary objective was to understand the role of AI parents in supporting and sustaining health behavior change in their youths following the intervention. Semi-structured in-depth interviews were conducted with AI parents (n = 11) and their young adolescents, 10-15 years old (n = 6). Parents reported facilitators to how they enacted healthy lifestyle behaviors, including family togetherness, routines, youth inclusion in cooking, and motivation due to a health condition in the family. Barriers to enacting healthy behaviors included a lack of time, a lack of access to health resources, negative role modeling, and the pervasiveness of screen media. Three major themes about the role of AI parenting emerged inductively from the interview data: Parenting in nontraditional families, Living in the American grab-and-go culture, and Being there and teaching responsibility. The importance of culture in raising youths was emphasized. These findings inform strategies to promote long-term adherence to behavior changes within the intervention. This study contributes to public health conversations regarding approaches for AI youths and families, who are not well represented in previous health behavior research.

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’ sparse k

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’ sparse k

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’ sparse k

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’ sparse k

Background: Vaccines have been one of the most re-levant inventions in the field of public health, due to the power they have to eradicate epidemics and prevent complications and deaths. Despite this, reluctance and hesitation have prevailed.Objective: To evaluate the confidence and reluctance towards the vaccine against SARS-CoV-2 (COVID-19) by the population of Las Salinas of Baní, Peravia pro-vince. Methodology: This study is a positivist paradigm, des-criptive, observational, prospective, and cross-sectional. The total population was 708 adults, residing in the community of Salinas de Baní, with a random sample of 170 patients. The data were collected using a form (an-nex # 1) applied in the period August-September 2021. Results: 20.69% of the population trust the vaccine; the confidence level most attributed was level 10 with 36.45%; 46.52% of the population is satisfied with the level of knowledge they have about the vaccine; the age group with the greatest hesitancy about using the vac-cine is 21-29 years old, with 12.94% of the population and religion was not an influential factor in getting vac-cinated.Conclusións: Despite the rapid development and in-troduction of COVID-19 vaccines and not having enough information about them, the majority of this population attribute a high level of confidence to it., Introducción: Las vacunas han sido uno de los inventos más relevantes en el ámbito de la salud pública, debido al poder que tienen de erradicar epidemias y prevenir complicaciones y muertes. Sin embargo, la renuencia ha predominado. Objetivo: evaluar la confianza y renuencia ante la vacu-na contra el SARS-CoV-2 (COVID-19) por parte de la población de las Salinas de Baní, provincia Peravia. Metodología: Paradigma positivista, de tipo descripti-vo, observacional, prospectivo y de corte transversal. La población total fue de 708 personas adultas, residentes en la comunidad de las Salinas de Baní, con una mues-tra aleatoria de 170 pacientes. Los datos fueron recolec-tados mediante un formulario (anexo #1) aplicado en el período agosto-septiembre 2021. Resultados: El 20.69% de la población confía en la va-cuna; el nivel de confianza mayormente atribuido fue el nivel 10 con un 36.45%; el 46.52% de la población está conforme con su acerca de la vacuna; el grupo etario con mayor duda sobre aplicarse la vacuna es el de 21-29 años, y la religión no fue un factor influyente para vacunarse. Conclusiones: A pesar del rápido desarrollo e introduc-ción de las vacunas contra la COVID-19, la mayoría de la población le atribuyen un alto nivel de confianza.

Introduction. The sports medical examination is considered the starting point for any athlete before taking up physical or sporting activity. The main objective is the detection of cardiac pathologies that could be life-threatening, such as sudden death of athletes.Material and method. Observational and descriptive study of a cohort of athletes, in the year 2021, who underwent a mandatory sports medical examination for competition performed by a company specialized in this purpose, according to a protocol registered and previously established in sports clubs of two Spanish provinces with the support of nursing staff.Results. A total of 7340 athletes aged 3-17 years participated, with 1693 females and 5647 males. A total of 112 cases of cardiac pathologies were obtained, constituting 0.69% of the sample. Sixty athletes were aware of their cardiac pathology and 52 were not. In the group of unknown cardiac pathologies, 5.9% required surgical intervention, 21.1% are under revision, and 73% were discharged. Of these, eight had to stop practicing their sport due to the risk of sudden death of athletes. Likewise, the fundamental role of nursing in the application of this protocol was determined. Conclusions. A low prevalence of cardiac diseases was observed, representing 1.50% of the sample. The sports medical examination applied to children and adolescent athletes is effective in detecting cardiac pathology., Introducción y objetivo. El reconocimiento médico-deportivo es considerado como un punto de partida para cualquier deportista antes de incorporarse a la actividad física o deportiva. El objetivo principal es la detección de patologías cardiacas que pudieran poner en riesgo su vida, como la muerte súbita del deportista.Material y método. Estudio observacional y descriptivo de una cohorte de deportistas, en el año 2021, a los que se le realizó un reconocimiento médico deportivo obligatorio para la competición en una empresa especializada para ello, de acuerdo con un protocolo registrado y establecido previamente en los clubes deportivos de dos provincias españolas con el apoyo del personal de enfermería.Resultados. Participaron 7.340 deportistas con edades comprendidas entre los 3-17 años. Sexo femenino: 1.693 y masculino: 5.647. Se obtuvieron un total de 112 casos de patologías cardiacas, un 0,69% de la muestra. Tenían conocimiento de su patología cardiaca 60 deportistas y 52 no la conocían. En el grupo de patologías cardiacas no conocidas, un 5,9% requirió intervención quirúrgica, el 21,1% se encuentra en revisión y el 73% fue dado de alta. De todos ellos, ocho tuvieron que dejar de practicar el deporte que realizaban por riesgo de muerte súbita del deportista. Asimismo, se determinó el rol fundamental de enfermería en la aplicación de este protocolo. Conclusiones. Se determinó una baja prevalencia de enfermedades cardiacas, representando el 1,50% de la muestra. El reconocimiento médico deportivo aplicado para niños y adolescentes deportistas es efectivo para detectar patología cardiaca.

Introduction: The increase in the incidence of diabetes mellitus has led to public health consequences. Several individuals with diabetes lose sensitivity and may present foot deformities, resulting in diabetic foot. Knowing about self-care deficits can allow for planning healthcare in the management of diabetic foot and improve the patient’s quality of life. Objective: To identify, from the scientific literature, the main self-care deficits present in elderly people with diabetic foot ulcers, based on Orem’s self-care deficit theory. Materials and methods: This is an integrative review study. The search for studies was performed in January 2022, using the descriptors “diabetic foot”, “self-care,” and “aged.” The following virtual library and databases were used: BVS, Lilacs, Medline and BDEnf via PubMed. The adaptation of the Prisma flowchart was used. A synthesis of the articles was performed with the description of the main results and self-care deficits according to Orem’s self-care theory. Results: Socioeconomic conditions, skin characteristics, activities, leisure and rest, diet, neurological conditions, and lack of knowledge about the need for therapeutic support and treatment were the main factors related to self-care deficits. Conclusion: The scientific evidence generated provides a foundation for carrying out new studies on the theme, as well as assisting in decision-making by nurses to adopt measures that assist in the self-care of this population group, in addition to guiding this population regarding the necessary care., Introdução: o aumento da incidência do diabetes mellitus vem acarretando consequências à saúde pública. Muitos indivíduos com diabetes perdem a sensibilidade e podem desenvolver deformidades nos pés, ocasionando o pé diabético. Conhecer os déficits de autocuidado pode permitir o planejamento da assistência à saúde no manejo do pé diabético e melhorar a qualidade de vida do paciente. Objetivo: identificar, a partir da literatura científica, os principais déficits de autocuidado presentes em idosos com úlceras de pé diabético, fundamentando na teoria do déficit de autocuidado de Orem. Materiais e método: trata-se de um estudo do tipo revisão integrativa. A busca dos estudos ocorreu em janeiro de 2022, a partir dos descritores “pé diabético”, “autocuidado” e “idoso”. Utilizaram-se as bases de dados e biblioteca virtual: BVS, Lilacs, Medline e BDEnf por meio da PubMed. A adaptação do fluxograma Prisma foi utilizada. Uma síntese dos artigos foi realizada com a descrição dos principais resultados e déficits de autocuidado conforme a teoria de autocuidado de Orem. Resultados: condições socioeconômicas, características da pele, atividades, lazer e repouso, alimentação, condições neurológicas e falta de conhecimento sobre a necessidade de suporte terapêutico e de tratamento foram as principais situações relacionadas aos déficits de autocuidado. Conclusão: a evidência científica gerada serve como base para realizar novos estudos sobre a temática, assim como auxilia na tomada de decisões por parte do enfermeiro para adotar medidas que auxiliem no autocuidado desse grupo populacional, além de orientar essa população quanto aos cuidados necessários., Introducción: el aumento de la incidencia de la diabetes mellitus ha tenido consecuencias para la salud pública. Muchos individuos con diabetes pierden sensibilidad y pueden desarrollar deformidades en los pies, dando lugar al pie diabético. Conocer los déficits de autocuidado puede permitir la planificación de la asistencia sanitaria en el manejo del pie diabético y mejorar la calidad de vida del paciente. Objetivo: identificar, desde la literatura, los principales déficits de autocuidado presentes en adultos mayores con úlceras de pie diabético, con base en la teoría del déficit de autocuidado de Orem. Materiales y método: se trata de una revisión integradora. La búsqueda de estudios se realizó en enero de 2022, utilizando los descriptores “pie diabético”, “autocuidado” y “anciano”. Se utilizaron las siguientes bases de datos y bibliotecas virtuales: BVS, Lilacs, Medline y BDEnf a través de PubMed. Se utilizó la adaptación del diagrama de flujo Prisma. Se realizó una síntesis de los artículos con la descripción de los principales resultados y déficits de autocuidado según la teoría de autocuidado de Orem. Resultados: condiciones socioeconómicas, características de la piel, actividades, ocio y descanso, alimentación, condiciones neurológicas y desconocimiento de la necesidad de apoyo terapéutico y tratamiento fueron las principales situaciones relacionadas a los déficits de autocuidado. Conclusiones: se destaca la importancia de la educación sanitaria, el manejo terapéutico, los cuidados individualizados y el uso de una herramienta de consultas de enfermería para apoyar la prevención del pie diabético y mejorar la calidad de vida de los ancianos.

Objective: To describe the characteristics of the use of a preventive app by the Peruvian population during its first year of operations between 2019 and 2020. Materials and methods: A descriptive, cross-sectional and retrospective study, in which the database of the Salud Total preventive app, concerning the demographic characteristics of and usage by the Peruvian population, was reviewed during its first year of operations. Sociodemographic variables (sex and age) and usage (health data, pathological findings, frequency of use, and type and number of services requested) were analyzed. The analysis and processing of descriptive data were performed using Microsoft Excel Results: The number of users who downloaded and registered in the app was 9,737 people. A similar sex ratio was found, and the 21- to 50-year-old group prevailed. A total of 2,254 health data voluntarily entered by the users, out of which the most reported were weight and height (45.3 %), blood pressure (20.4 %), hemoglobin (17.1 %) and waist circumference, were collected. Pathological findings such as high blood pressure (25.7 %) and overweight (58.5 %), among others, were found in the recorded data. Likewise, 1,072 different health services were requested through the app, among which medical care (58 %) and laboratory tests (32 %) stood out. Conclusions: Users were able to register in and interact with a preventive app in order to monitor their well-being. Moreover, they used it both to add their health data and to request remote medical care. This could be a new intervention tool for taking preventive actions, managing timely care of diseases and offering a new data source for health research., Objetivo: Describir las características del uso de una app preventiva en la población peruana durante su primer año de operaciones, en el periodo comprendido entre el 2019 y 2020. Materiales y métodos: Estudio de tipo descriptivo, transversal y retrospectivo, donde se revisó la base de datos de la app preventiva Salud Total respecto a las características demográficas y forma de uso en la población peruana durante su primer año de operaciones. Se analizaron las variables sociodemográficas (sexo y edad) y las formas de uso (los datos de salud ingresados, los hallazgos patológicos encontrados, la recurrencia de uso y el tipo y la cantidad de servicios solicitados). El análisis y procesamiento de los datos descriptivos se realizaron con el programa Microsoft Excel. Resultados: El número de usuarios que descargaron y se registraron en la app fue 9737 personas. Con respecto al sexo, la proporción fue similar, y el grupo etario predominante fue entre 21 y 50 años. Se obtuvieron 2304 datos de salud que los usuarios registraron voluntariamente, de los cuales los más reportados fueron el peso y la talla (45,3 %), seguidos de la presión arterial (20,4 %), la hemoglobina (17,1 %) y la circunferencia abdominal. Se encontraron hallazgos patológicos en los datos registrados tales como la presión arterial elevada (25,7 %) y el peso elevado (58,5 %), entre otros. Asimismo, los usuarios solicitaron por medio de la app un total de 1072 servicios de salud de diversos tipos, entre los cuales destacan la atención médica (58 %) y el laboratorio clínico (32 %). Conclusiones: Los usuarios pudieron registrarse e interactuar con una app preventiva con el fin de controlar su bienestar, y la usaron tanto para añadir sus datos de salud como para solicitar servicios médicos de forma remota, lo que puede significar una nueva herramienta de intervención para direccionar acciones preventivas, la atención oportuna de enfermedades y una nueva fuente de datos para la investigación en salud.

INTRODUCTION: While prevention is increasingly important in the dairy sector, implementation of cost-effective preventive measures is often lacking. To increase the use of these measures and consequently improve animal welfare and reduce financial losses for farmers, it is necessary to know the drivers and constraints of farmers to engage in prevention.METHODS: Therefore, we invited farmers to participate in an online questionnaire, which contained questions about their behavior toward either claw health or calf health. We used the theory form the Stage of Change model, COM-B, as well as the Theory of Planned Behavior to formulate our questions. We used the responses of 226 farmers in our analyses, who were equally distributed over the two groups of diseases.RESULTS AND DISCUSSION: We found that 63.5% of responding farmers were in the action phase or the maintenance phase to prevent claw diseases and even more (85.4%) to prevent calf diseases. The responses also suggest that many farmers have the knowledge and skills to implement preventive measures for both claw and calf diseases. The scores for social and physical opportunities for calf diseases were significantly higher than for claw diseases and all other COM-B components were also numerically higher for calf diseases. This suggests that farmers' perception of taking preventive measures against claw diseases is more difficult than taking preventive measures against calf disease. The automation of preventive behavior scored relatively low for both groups of diseases, which suggests that farmers may need reminders to persist in their activities and support to create habitual prevention behaviors. From these results, we concluded that creating social norms, supporting discussions among farmers, and using environmental adaptations may result in more preventive behavior.

Objective: To determine the degree of association between work stress and self-perception of health in physicians and nurses of the emergency area of the Hospital de Especialidades San Juan, in the city of Riobamba, Chimborazo, Ecuador during the year 2020. Methods: Descriptive observational study. Results and Conclusions: A considerable negative correlation between EL and PHC was evidenced, highlighting that the greater the exposure to occupational stress, the lower the self-perception of health of the health personnel investigated. A predominance was observed in health professionals working in the emergency area who were exposed to EL and whose health perception was affected., Objetivo: Determinar el grado de asociación entre el estrés laboral y la autopercepción de salud en médicos y enfermeras del área de emergencia del Hospital de Especialidades San Juan, de la ciudad de Riobamba, Chimborazo, Ecuador durante el año 2020. Método: Descriptiva observacional. Resultados y conclusiones: Se evidenció una correlación negativa considerable entre EL y APS, destacando que mientras mayor es la exposición al estrés laboral menor será la autopercepción de salud del personal de salud investigado. Se pudo observar un predominio en profesionales de la salud que laboran en el área de urgencia expuestos a EL y con afectación de su percepción de salud.

Comisión Europea, Depto. de Nutrición y Ciencia de los Alimentos, Fac. de Farmacia, FALSE, pub, Descuento UCM

Syfte: Att studera hur tidigare kariesaktiva patienter har ändrat sina vanor med resultatet minskad kariesaktivitet. Frågeställningen var: ”Hur lyckas tidigare kariesaktiva patienter ändra sina vanor?”. Material och metod: Studien genomfördes på Tandvårdshögskolan i Malmö med ett slutgiltigt urval som bestod av sex informanter varav fyra var patienter på Tandvårdshögskolan och två på Folktandvården i Malmö. Inklusionskriterierna var tidigare kariesaktiva med nu avstannad kariessjukdom, fyllda 18 år och som talade flytande svenska. För datainsamlingen genomfördes kvalitativa semistrukturerade intervjuer med efterföljande dataanalys med kvalitativ innehållsanalys. Resultat: Den ena kategorin som identifierades var: Den varierande drivkraften som omfattade subkategorierna den positiva drivkraften och den negativa drivkraften. Den andra kategorin var: Det externa stödets vara eller icke vara omfattande externt positivt inflytande och en önskan om externt stöd (under sårbara tider). Slutsats: Informanterna lyckades med en beteendeförändring som initierades av stöd, i form av information, eller drivkrafter, i form av funktion, estetik eller rädsla. När informanterna kände sig lyssnade på, involverade, motiverade och handlingskraftiga kunde de förstå hur de skulle kunna förändras från att vara kariesaktiva till kariesinaktiva., Aim: To study how previously caries-active patients have changed their habits with the result reduced caries activity. The research question was, "How does previous caries-active patients manage to change their habits?" Material and method: The study was conducted at The Faculty of Odontology at Malmö University with a final sample of six informants, of whom four were patients at the faculty and two at the Public Dental Health Service in Malmö. The inclusion criteria were previously caries-active with now arrested caries disease, 18 years and above and fluent in Swedish. For data collection, qualitative semi-structured interviews were conducted with subsequent data analysis using qualitative content analysis. Results: One category that was identified was: The varied driving force which included the subcategories the positive driving force and the negative driving force. The second category was: The presence or absence of external support including external positive influence and a desire for external support (during vulnerable times). Conclusion: The study showed that the informants managed a behavioral change which was initiated by support, in the form of information, or by driving force, in the form of function, aesthetics or fear. When the informants felt listened to, involved, motivated and driven, they could understand how they could change from being caries-active to caries-inactive.

Syfte: Att studera hur tidigare kariesaktiva patienter har ändrat sina vanor med resultatet minskad kariesaktivitet. Frågeställningen var: ”Hur lyckas tidigare kariesaktiva patienter ändra sina vanor?”. Material och metod: Studien genomfördes på Tandvårdshögskolan i Malmö med ett slutgiltigt urval som bestod av sex informanter varav fyra var patienter på Tandvårdshögskolan och två på Folktandvården i Malmö. Inklusionskriterierna var tidigare kariesaktiva med nu avstannad kariessjukdom, fyllda 18 år och som talade flytande svenska. För datainsamlingen genomfördes kvalitativa semistrukturerade intervjuer med efterföljande dataanalys med kvalitativ innehållsanalys. Resultat: Den ena kategorin som identifierades var: Den varierande drivkraften som omfattade subkategorierna den positiva drivkraften och den negativa drivkraften. Den andra kategorin var: Det externa stödets vara eller icke vara omfattande externt positivt inflytande och en önskan om externt stöd (under sårbara tider). Slutsats: Informanterna lyckades med en beteendeförändring som initierades av stöd, i form av information, eller drivkrafter, i form av funktion, estetik eller rädsla. När informanterna kände sig lyssnade på, involverade, motiverade och handlingskraftiga kunde de förstå hur de skulle kunna förändras från att vara kariesaktiva till kariesinaktiva., Aim: To study how previously caries-active patients have changed their habits with the result reduced caries activity. The research question was, "How does previous caries-active patients manage to change their habits?" Material and method: The study was conducted at The Faculty of Odontology at Malmö University with a final sample of six informants, of whom four were patients at the faculty and two at the Public Dental Health Service in Malmö. The inclusion criteria were previously caries-active with now arrested caries disease, 18 years and above and fluent in Swedish. For data collection, qualitative semi-structured interviews were conducted with subsequent data analysis using qualitative content analysis. Results: One category that was identified was: The varied driving force which included the subcategories the positive driving force and the negative driving force. The second category was: The presence or absence of external support including external positive influence and a desire for external support (during vulnerable times). Conclusion: The study showed that the informants managed a behavioral change which was initiated by support, in the form of information, or by driving force, in the form of function, aesthetics or fear. When the informants felt listened to, involved, motivated and driven, they could understand how they could change from being caries-active to caries-inactive.

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

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

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

Bacterial vaccines have become a crucial tool in combating antimicrobial resistance (AMR) in poultry. The overuse and misuse of antibiotics in poultry farming have led to the development of AMR, which is a growing public health concern. Bacterial vaccines are alternative methods for controlling bacterial diseases in poultry, reducing the need for antibiotics and improving animal welfare. These vaccines come in different forms including live attenuated, killed, and recombinant vaccines, and they work by stimulating the immune system to produce a specific response to the target bacteria. There are many advantages to using bacterial vaccines in poultry, including reduced use of antibiotics, improved animal welfare, and increased profitability. However, there are also limitations such as vaccine efficacy and availability. The use of bacterial vaccines in poultry is regulated by various governmental bodies and there are economic considerations to be taken into account, including costs and return on investment. The future prospects for bacterial vaccines in poultry are promising, with advancements in genetic engineering and vaccine formulation, and they have the potential to improve the sustainability of the poultry industry. In conclusion, bacterial vaccines are essential in combating AMR in poultry and represent a crucial step towards a more sustainable and responsible approach to poultry farming.

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’ sparse k

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

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

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

Beleid, advies - Intensiveringsplan over de preventie van vogelgriep. In dit plan zijn ook de aanbevelingen van het Deskundigenberaad Zoönosen (DB-Z) meegenomen. Het deelbestand betreft de kamerbrief, Evaluatie Roadmap Vogelgriep, en Intensiveringsplan over de preventie van vogelgriep. Minister Adema (LNV) en minister Kuipers (VWS) informeren in de kamerbrief de Tweede Kamer over de intensivering van de aanpak van vogelgriep. De ministers sturen het intensiveringsplan preventie vogelgriep met deze Kamerbrief mee.

Beleid - Intensiveringsplan over de preventie van vogelgriep. In dit plan zijn ook de aanbevelingen van het Deskundigenberaad Zoönosen (DB-Z) meegenomen.

This thorough study analyses the amounts of 43 minerals and trace elements in non-traditional wheat grains, flakes, and undigested flake portions using ICP-MS and establishes declines in their respective contents after the flake production. It also identifies appropriate dietary intakes, in vitro digestibility values, retention factors, and metal pollution indexes. The element contents in wheat flakes are lower than in wheat grains after the hydrothermal treatment process, and their declines are: Na (48-72%), Ce (47-72%), Sr (43-55%), Tl (33-43%), Ti (32-41%), U (31-44%), Ho (29-69%), Cr (26-64%), Zr (26-58%), Ag (25-52%), and Ca (25-46%). The flakes significantly contributed to the recommended dietary intake or adequate intake of particular elements for men of all categories as follows: Mn (143%) > Mo > Cu > Mg = Cr > Fe (16%); for women: Mn (up to 183%) > Mo > Cu > Cr = Mg > Fe (7-16%); for pregnant women aged 19-30: Mn (165%) > Mo > Cu > Mg > Cr (25%); and finally, for lactating women: Mn (127%) > Mo > Cu > Mg > Cr (17%). The contributions to the provisional tolerable weekly or monthly intakes of all toxic elements were established as being within the official limits. The daily intakes for non-essential elements were also calculated. The retention factors were calculated to assess the element concentrations in the undigested part using the digestibility values (87.4-90.5%). The highest retention factors were obtained for V (63-92%), Y (57-96%), Ce (43-76%), Pb (34-58%), Tl (32-70%), Ta (31-66%), and Ge (30-49%). K, Mg, P, Zn, Ba, Bi, Ga, Sb, Cu, Ni, and As appear to be released easily from flake matrices during digestion. The metal pollution index has been confirmed as being lower for non-traditional wheat flakes when compared with grains. Importantly, 15-25% of the metal pollution index assessed for native flakes remains in the undigested flake portion after in vitro digestion.

National Ministry of Health of Argentina indicated that the worst epidemic of dengue until now occurred during the 2019-2020 period in that country. In order to reflect on the failures in the control and prevention of this disease, our general aim is to understand the meanings and practices about the dengue problem that circulate among health agents and neighbors in a locality in the province of Buenos Aires. Our particular aim is to analyze how the difficulties of access to health services, in the organizational and psycho-socio-cultural dimension in a locality in the province of Buenos Aires, could be linked to the beginning and spread of dengue outbreaks that are observed in the official records. We found problems related to the high demand in public hospitals guards and the obtaining of shifts. We observed the lack of focus control actions and chemical blockades in the houses of people affected by dengue, neighbors that delay in assistance to health services and a meaning about the disease among neighbors as a mild health problem. This meaning is undone by the bodily experience of dengue., En Argentina, el dengue ha demostrado su poder de propagación una vez más, entre 2019 y 2020, mixturándose con el principio de la pandemia del COVID-19. Para reflexionar acerca de las fallas en el control y prevención de esta enfermedad, nuestro trabajo tiene como objetivo amplio comprender los sentidos y prácticas que diferentes actores y actoras en un municipio del conurbano de Buenos Aires establecen en torno a la problemática del dengue. Nuestro objetivo particular es analizar cómo las dificultades de acceso a los servicios sanitarios, en la dimensión organizacional y psico-socio-cultural en un municipio de la provincia de Buenos Aires, podrían estar vinculadas a la aparición de brotes de dengue que se observan en los registros oficiales. Hallamos problemas vinculados a la alta demanda de las guardias de los hospitales públicos y a la obtención de turnos. Observamos la falta de acciones de control de foco y bloqueos químicos en las casas de las personas afectadas por dengue, demoras o dificultades en la concurrencia a los servicios de salud por parte de las vecinas y los vecinos, y la consideración de la enfermedad entre las vecinas como problema de salud leve, significación que se deshace ante la vivencia corporal del dengue.

A pesar de las exuberantes cifras de infectados y fallecidos por la COVID-19, existen familias que no se infectaron. Objetivo: Describir las medidas preventivas y costumbres en las familias no contagiadas por la COVID-19 durante el confinamiento. Método: Investigación cualitativa descriptiva, participaron 13 madres de familia oriundas de Ferreñafe sin ningún integrante afectado por la COVID-19. Los datos se recolectaron mediante la entrevista semiestructurada a través de llamadas telefónicas y se procesaron de manera manual, con el análisis de contenido temático. Resultados: Se obtuvo 4 categorías: a) Medidas preventivas al salir del hogar: uso de mascarilla, alcohol y distanciamiento social, b) Medidas preventivas en el hogar: lavado de manos, desinfección del hogar y de lo que ingresa, c) Restricción de reuniones familiares y uso de redes sociales, d) Cambio de hábitos alimentarios y uso de remedios caseros. Conclusiones: Las familias cambiaron algunas costumbres o prácticas, cumplieron con el confinamiento, el distanciamiento social, restringieron las reuniones familiares, usaron mascarillas de tela, alcohol medicinal, y lejía. Además, incrementaron la frecuencia del lavado de manos, la higiene del hogar, la alimentación saludable, el uso de redes sociales, unido al uso de remedios caseros utilizados comúnmente para prevenir o tratar las enfermedades respiratorias., Despite the exuberant figures of those infected and deceased by COVID-19, there are families that were not infected. Objective: To describe the preventive measures and customs in families not infected by COVID-19 during confinement. Method: Descriptive qualitative research, 13 mothers from Ferreñafe with no member affected by COVID-19 participated. The data was collected through the semi-structured interview through telephone calls and processed manually, with thematic content analysis. Results: Four categories were obtained: a) Preventive measures when leaving the home: use of a mask, alcohol and social distancing, b) Preventive measures at home: hand washing, disinfection of the home and what enters, c) Restriction of family gatherings and use of social networks, d) Change of eating habits and use of home remedies. Conclusions: The families changed some customs or practices, complied with the confinement, social distancing, restricted family gatherings, used cloth masks, medicinal alcohol, and bleach. In addition, they increased the frequency of hand washing, home hygiene, healthy eating, the use of social networks, together with the use of home remedies commonly used to prevent or treat respiratory diseases., Apesar dos números exuberantes de infectados e falecidos pela COVID-19, há famílias que não foram infectadas. Objetivo: Descrever as medidas preventivas e costumes em famílias não infectadas pelo COVID-19 durante o confinamento. Método: Pesquisa qualitativa descritiva, participaram 13 mães de Ferreñafe sem membro afetado pelo COVID-19. Os dados foram coletados por meio de entrevista semiestruturada por meio de ligações telefônicas e processados manualmente, com análise de conteúdo temática. Resultados: Foram obtidas quatro categorias: a) Medidas preventivas ao sair de casa: uso de máscara, álcool e distanciamento social, b) Medidas preventivas em casa: lavagem das mãos, desinfecção da casa e do que entra, c) Restrição de reuniões e uso familiar das redes sociais, d) Mudança de hábitos alimentares e uso de remédios caseiros. Conclusões: As famílias mudaram alguns costumes ou práticas, cumpriram o confinamento, distanciamento social, reuniões familiares restritas, máscaras de pano usadas, álcool medicinal e alvejante. Além disso, aumentaram a frequência de lavagem das mãos, higiene doméstica, alimentação saudável, uso de redes sociais, juntamente com o uso de remédios caseiros comumente usados para prevenir ou tratar doenças respiratórias.