Workplace screening programs for chronic disease prevention: a rapid review

This review examined the effectiveness of workplace screening programs for chronic disease prevention based on evidence retrieved from the main databases of biomedical and health economic literature published to March 2012, supplemented with relevant reports. The review found: 1. Strong evidence of effectiveness of HRAs (when used in combination with other interventions) in relation to tobacco use, alcohol use, dietary fat intake, blood pressure and cholesterol 2. Sufficient evidence for effectiveness of worksite programs to control overweight and obesity 3. Sufficient evidence of effectiveness for workplace HRAs in combination with additional interventions to have favourable impact on the use of healthcare services (such as reductions in emergency department visits, outpatient visits, and inpatient hospital days over the longer term) 4. Sufficient evidence for effectiveness of benefits-linked financial incentives in increasing HRA and program participation 5. Sufficient evidence that for every dollar invested in these programs an annual gain of $3.20 (range$1.40 to $4.60) can be achieved 6. Promising evidence that even higher returns on investment can be achieved in programs incorporating newer technologies such as telephone coaching of high risk individuals and benefits-linked financial incentive

Behavioral Evaluation of the Psychological Welfare and Environmental Requirements of Agricultural Research Animals: Theory, Measurement, Ethics, and Practical Implications

The welfare of agricultural research animals relies not only on measures of good health but also on the presence of positive emotional states and the absence of aversive or unpleasant subjective states such as fear, frustration, or association with pain. Although subjective states are not inherently observable, their interaction with motivational states can be measured through assessment of motivated behavior, which indicates the priority animals place on obtaining or avoiding specific environmental stimuli and thus allows conclusions regarding the impact of housing, husbandry, and experimental procedures on animal welfare. Preference tests and consumer demand models demonstrate that animal choices are particularly valuable when integrated with other behavioral and physiological measurements. Although descriptive assessments of apparently abnormal behavior such as stereotypies and vacuum behaviors provide indications of potentially impoverished environments, they should be used with some caution in drawing welfare conclusions. The development of stereotypies may in some cases be linked to psychiatric dysfunction and reflect underlying neurophysiological impairments, which have implications for the ability to perform flexible behavior and thus the quality of research data provided by this kind of behavioral measurement (e.g., in pharmaceutical research). Environmental modifications, commonly termed enrichment, can have diverse consequences for cognitive function, physiological responses, health, psychological welfare, and research data. Simple practical modifications of housing, husbandry, and experimental design are suggested to improve the psychological welfare of agricultural research animals in accordance with the principles of refining, reducing, and replacing (the 3Rs ), which underlie US Public Health Service Policy, and prevailing public ethics

A Framework For Monitoring Overweight And Obesity In NSW

Monitoring of population weight status is valuable in order to track changes and identify likely causes and implications, and to adjust policy and program priorities. A monitoring framework sets out what information should be collected, when and how it should be collected, and systems for the reporting of this information. The framework covers dietary behaviours, physical activity and sedentary behaviours, food environment factors, physical activity environment factors, socio-demographic and other factors

Building solutions for prevneting childhood obesity. Overview module

The NSW Centre for Overweight and Obesity, the NSW Centre for Physical Activity & Health and the NSW Centre for Public Health Nutrition are funded by the NSW Department of Health and supported by The University of Sydney

Evaluation Framework for NSW Implementation of Healthy Workers Initiative

This document presents a framework for the evaluation of the NSW implementation of the Healthy Workers Initiative being undertaken as part of the National Partnership Agreement on Preventive Health. The NSW Healthy Workers Initiative seeks to address unhealthy lifestyle factors by reaching individuals in the workplace, and supporting behaviour change for healthy lifestyles in and through businesses

Weight and weight related behaviours among NSW students from low SES and non-English speaking backgrounds: Secondary analysis of the NSW Schools Physical Activity and Nutrition Survey 2010

The 2010 SPANS survey showed that the prevalence of overweight and obesity among NSW school students has not increased since 2004, stabilizing at 22.8%. The findings reported in the SPANS Full Report also indicate that many children engage in a range of adverse weight related behaviours and that the prevalence of weight-related behaviours varied according to socioeconomic status (SES) and cultural background. The findings may have implications for policy regarding interventions among school aged children and the design of interventions for different sociodemographic groups. The purpose of the report is to undertake more detailed data analyses regarding socioeconomic and cultural variations in students’ health behaviours, in order to inform the NSW Ministry of Health, Local Health Districts (LHD) and other government and non-government stakeholders

Weight and weight related behaviours among NSW Kindergarten children

The findings from the 2010 NSW Schools Physical Activity and Nutrition Survey (SPANS) show that the prevalence of combined overweight and obesity among Kindergarten children has significantly increased at a rate of 0.17% per annum between 2004 and 2010, from 17.7% to 18.7%, respectively. The rate of increase in combined overweight and obesity has been stronger among boys compared with girls (0.25% pa vs 0.10% pa, respectively). With one-in-five NSW children entering school overweight or obese there is a need for preventive interventions during early childhood and preschool years. The purpose of the report is to inform the NSW Ministry of Health on the weight status and associated behaviours of children in their first year of school

Social work, stress and burnout: A review

Stress and burnout for health care professionals have received increasing attention in the literature. Significant administrative, societal and political changes have impacted on the role of workers and the responsibilities they are expected to assume. Most writers suggest that social work is a highly stressful occupation, with stress deriving in particular from role conflict between client advocacy and meeting agency needs. This article reviewed the social work literature with two questions in mind: Are social workers subject to greater stress than other health professionals? What factors contribute to stress and burnout among social workers? We found that most of the literature was either anecdotal or compared social worker stress with general population norms rather than with stress levels of workers in comparable professions. Such empirical research as is available suggests that social workers may experience higher levels of stress and resulting burnout than comparable occupational groups. Factors identified as contributing to stress and burnout included the nature of social work practice, especially tension between philosophy and work demands and the organization of the work environment. There was some evidence that supervision and team support are protective factors

The case for and against the regulation of food marketing directed towards children

Trabalho final de mestrado integrado em Medicina (Hematologia), apresentado á Faculdade de Medicina da Universidade de CoimbraAs Hemofilias A e B são as deficiências de fatores da coagulação mais comuns e definem-se pela ausência ou diminuição dos níveis de FVIII e FIX, respetivamente. Resultam de mutações nos genes que codificam os referidos fatores e caracterizam-se pela sua hereditariedade ligada ao sexo. A sua apresentação clínica nas formas graves (a maioria) é muito típica, sendo a hemartrose o seu sinal clássico. Nesta situação, mesmo que não exista história familiar, o diagnóstico não apresenta dificuldades significativas. Contudo, no que diz respeito a uma deficiência de FVIII, terá sempre que se descartar a hipótese se estar perante uma DvW e não uma Hemofilia A, devido à semelhança clínica e laboratorial. Nas formas leves, a sua apresentação mais tardia, implica não só excluir a DvW, como a HAA, pelos mesmos motivos. Assim sendo, estes são distúrbios abordados ao longo desta revisão. A terapêutica da hemofilia sofreu uma tremenda evolução nas últimas três décadas. Atualmente, dispõe-se de concentrados de fator derivados de plasma e recombinantes que, especialmente em países desenvolvidos, permitem a sua administração pelo doente ou família, na sua própria casa. Este progresso permitiu um considerável aumento na sobrevivência e uma marcada redução da incapacidade devidas aos danos articulares característicos da hemofilia. As recomendações terapêuticas assentam numa abordagem profilática contínua iniciada precocemente e mantida pelo menos até ao início da vida adulta. No entanto, poucas certezas existem ainda sobre as doses ótimas a serem administradas, a frequência da sua administração e o momento ótimo em que o doente deve abandonar a terapêutica profilática e iniciar tratamento apenas on demand. Já quase ultrapassado o flagelo das infeções pelo HIV, HBV e HCV, a principal e mais grave complicação do tratamento da hemofilia é, nos dias de hoje, o desenvolvimento 5 de inibidores. Também nesta área é necessário mais estudos que determinem as doses ótimas da ITI e as possíveis vantagens do uso de fármacos adjuvantes. Prevê-se que num futuro próximo sejam desenvolvidos e aprovados concentrados de fator com semi-vidas mais longas e metodologias de terapia génica. Assim sendo, esta revisão tem como objetivo apresentar os conceitos propostos atualmente pela comunidade científica no que concerne à abordagem da Hemofilia, desde o seu diagnóstico até às complicações do seu tratamento e perspetivas futuras. Com este intuito, foi realizada a pesquisa da literatura científica publicada até 2014 na base de dados PubMed, com recurso aos meios disponibilizados pela Biblioteca do Centro Hospitalar e Universitário de Coimbra. Após o levantamento dos artigos publicados na área, procedeu-se à seleção dos artigos, inicialmente com base no título e, posteriormente, pela leitura dos resumos daqueles que mostraram ser relevantes. Por último, sempre que possível, obteve-se a versão completa dos artigos cujo resumo demonstrou conter informação pertinente no âmbito da abordagem clínica das HemofiliasHemophilia A and B are the most common deficiencies of coagulation factors and are defined by the absence or decreased levels of FVIII and FIX, respectively. They are a result of the gene mutations of FVIII and FIX and are characterized by their sex-linked inheritance. In severe forms, which are the majority, the clinical presentation is typical, with hemarthrosis being the classical sign. Therefore, in the presence of a hemarthrosis, even if there is no family history, the diagnosis does not present significant difficulties. However, if FVIII deficiency is suspected, it’s important to discard the hypothesis of a vWD, due to the similar clinical and laboratory features. In mild forms, their later presentation implies not only discard vWD, but also AHA, for the same reason. Consequently, these are two disorders discussed throughout this review. The treatment of hemophilia has undergone tremendous development in the last three decades. Currently, plasma-derived and recombinant factor concentrates are available, especially in developed countries, enabling home infusion therapy by either the patient or his family. This progress has led to a significant increase in survival and a marked reduction of joint damage and consequent disability. Nowadays, prophylactic factor replacement is considered the standard care of hemophilia, starting in early childhood and continuing at least until early adulthood. However, there are few certainties about the optimal doses, its administration frequency and when prophylactic therapy should be stopped. Since the HIV, HBV and HCV infection issue is almost overcome, the main and most serious complication of hemophilia is, these days, the inhibitors development. Also in this field, further studies are needed to determine optimal doses of ITI and the possible advantages of adjuvant drugs. We hope that, in the near future, longer half-life coagulation products and emerging methodology based on gene transfer are developed and approved to hemophilia treatment. 7 Therefore, this review aims to present the currently proposed concepts by the scientific community regarding the approach of Hemophilia, from diagnosis to treatment complications and future prospects. For this purpose, a search of the scientific literature published until 2014 in the PubMed database was performed, using the resources made available by the Library of Coimbra’s University Hospital. After the assessment of articles published in the area, it was performed the article selection, initially based on the title and then by reading the abstracts of those who proved to be relevant. Finally, wherever possible, we obtained a full version of the articles shown to contain in their abstract relevant information within the clinical approach of hemophili