Occupational therapists as contributors to health promotion

Objective: This study was undertaken to explore the views of occupational therapists concerning their competences in health promotion, and their perceptions of how they apply these competences in their daily work. The study also elicited their views on the contributions that occupational therapists could make to health promotion if given the opportunity. Methods: Data were collected in five focus-group discussions with 24 occupational therapists. These discussions were tape recorded and transcribed verbatim; data were analysed using qualitative content analysis. Results: The main findings are that the informants took an individualized salutogenic approach in their work and rarely engaged in health promotion on a systemic or societal level. They believed that their patients and collaborating partners, as well as public officials, remained unaware of their competences in health promotion. Conclusions: The findings of this study could enrich the discussion among occupational therapists on how they could make a more significant contribution to health promotion on a broader level

Self-reported recreational exercise combining regularity and impact is necessary to maximize bone mineral density in young adult women : A population-based study of 1,061 women 25 years of age.

Recreational physical activity in 25-year-old women in Sweden increases bone mineral density (BMD) in the trochanter by 5.5% when combining regularity and impact. Jogging and spinning were especially beneficial for hip BMD (6.4-8.5%). Women who enjoyed physical education in school maintained their higher activity level at age 25. INTRODUCTION: The aims of this study were to evaluate the effects of recreational exercise on BMD and describe how exercise patterns change with time in a normal population of young adult women. METHODS: In a population-based study of 1,061 women, age 25 (±0.2), BMD was measured at total body (TB-BMD), femoral neck (FN-BMD), trochanter (TR-BMD), and spine (LS-BMD). Self-reported physical activity status was assessed by questionnaire. Regularity of exercise was expressed as recreational activity level (RAL) and impact load as peak strain score (PSS). A permutation (COMB-RP) was used to evaluate combined endurance and impacts on bone mass. RESULTS: More than half of the women reported exercising on a regular basis and the most common activities were running, strength training, aerobics, and spinning. Seventy percent participated in at least one activity during the year. Women with high RAL or PSS had higher BMD in the hip (2.6-3.5%) and spine (1.5-2.1%), with the greatest differences resulting from PSS (p < 0.001-0.02). Combined regularity and impact (high-COMB-RP) conferred the greatest gains in BMD (FN 4.7%, TR 5.5%, LS 3.1%; p < 0.001) despite concomitant lower body weight. Jogging and spinning were particularly beneficial for hip BMD (+6.4-8.5%). Women with high-COMB-RP scores enjoyed physical education in school more and maintained higher activity levels throughout compared to those with low scores. CONCLUSION: Self-reported recreational levels of physical activity positively influence BMD in young adult women but to maximize BMD gains, regular, high-impact exercise is required. Enjoyment of exercise contributes to regularity of exercising which has short- and long-term implications for bone health

Children's Experiences of Living With Asthma: Fear of Exacerbations and Being Ostracized

This is the postprint version of the article. The published version of the article can be located here: http://www.sciencedirect.com/science/article/pii/S0882596310001569The aim was to explore children’s experiences of asthma in order to tailor a learning program based on their perspectives. Fifteen children (7 -10 yrs) were interviewed and they narrated about their drawings; a phenomenological and hermeneutical approach was used in the analysis. The findings are described in two themes with five subthemes: fear of exacerbation (bodily sensations, frightening experiences, loss of control) and fear of being ostracized (experiences of being excluded, dilemma of keeping the asthma secret or being open about). Drawings, as applied in the present study, are a good tool for initiating a dialogue with children

Developing lay health worker policy in South Africa: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Over the past half decade South Africa has been developing, implementing and redeveloping its Lay Health Worker (LHW) policies. Research during this period has highlighted challenges with LHW programme implementation. These challenges have included an increased burden of care for female LHWs. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process.</p> <p>Methods</p> <p>The study adopted a qualitative approach to exploring policy development from the perspective of policy actors. Eleven policy actors (policy makers and policy commentators) were interviewed individually. Data from the interviews were analysed thematically.</p> <p>Results</p> <p>Considerations of LHW working conditions drove policy redevelopment. From the interviews it seems that gender as an issue never reached the policy making agenda. Although there was strong recognition that the working conditions of LHWs needed to be improved, poor working conditions were not necessarily seen as a gender concern. Our data suggests that in the process of defining the problem which the redeveloped policy had to address, gender was not included. There was no group or body who brought the issue of gender to the attention of policy developers. As such the issue of gender never entered the policy debates. These debates focused on whether it was appropriate to have LHWs, what LHW programme model should be adopted and whether or not LHWs should be incorporated into the formal health system.</p> <p>Conclusion</p> <p>LHW policy redevelopment focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. Within this process the issue of gender had no champion and never reached the LHW policy agenda. Future research may consider how to incorporate the voices of ordinary women into the policy making process.</p

Balance, gait performance and muscular strength in the elderly

Fracture incidence is higher in urban than in rural inhabitants. Background factors such as physical activity and workload may have an influence on the tendency to fall, leading to fractures. We found that elderly women with a recent fracture of the distal radius appear to have impaired balance, an impairment that seems to normalise with time after fracture. The aim of this study was also to get normative data for healthy subjects of functional performance, such as balance, gait performance and muscular strength. Different populations were investigated. Men and women 50, 60, 70 and 80 years of age and women of 40 years from an urban and a rural area were investigated. Background factors such as age, gender, housing, medical status, workload and sparetime activities were collected. Urban subjects had significantly inferior balance compared with rural subjects and this difference increased with increasing age. The urban subjects walked faster but the rural subjects took longer steps. Sparetime activities correlated with balance and step length and workload with walking speed. Muscular strength of knee extension was significantly lower in the urban men and women in almost all age groups. This difference was not pronounced in knee flexion except for the oldest subjects. To investigate whether any of the clinical balance and gait performance tests could be related to computerised balance and muscular strength tests, 230 women, of 75 years of age were examined. The computerised balance platform test, could not be related to any of the clinical balance tests, gait performance tests or muscular strength tests. The clinical balance test was correlated with walking speed and step length. Extension and flexion strength of the knee and ankle dorsiflexion were also related to walking speed and step length. The heavier an individual was, the slower she walked and the shorter her steps, despite having stronger knee muscles. Women over the age of 65, who had participated for more than 20 years in physical exercise groups, had significantly better balance, gait performance and muscular strength of the knee and were less in need of home aid compared to urban women of the same age. When the active women were compared with age-matched rural women this difference was less pronounced. The results of this study emphasise the necessity of using correct normative data as regards balance, gait performance and muscular strength when different populations are compared

Nordiska högskolan för Folkhälsovetenskap (NHV) ett nordiskt utbildnings- och Kunskapscentrum för Folkhälsovetenskap

Nordiska högskolan för folkhälsovetenskap (NHV), en institution på universitetsnivå som lyder under Nordiska ministerrådet, har en lång erfarenhet av utbildning och kunskapsspridning av folkhälsovetenskap. I den här artikeln presenteras NHV:s uppdrag och inriktning med fokus på forskning, forskarutbildning samt dess specifika roll som ett Nordiskt Kunskapscentrum för Health Promotion.Unique knowledge is collected at the Nordic school of public health (NHV) regarding public health in the five Nordic countries. Students as well as teachers/researchers are recruited from all the Nordic countries. There are ongoing efforts made to strengthen research activities between the Nordic countries, especially within the fields of health promotion and the Nordic Research Academy in Mental Health. The establishment of the Knowledge Center for health promotion provides unique possibilities to further deepen this work. A pilot study recently performed within the Nordic research network for health promotion shows that fields that should be given priority to be studied from a health promotion perspective are the health of children and elderly, different aspects of inequality in health, methods used to evaluate studies and projects and cooperation between researchers, practitioners, politicians and journalists. It is also important to compare Nordic health promotive work with what such a work is done in Europe and globally

Occupational therapists as contributors to health promotion

Objective: This study was undertaken to explore the views of occupational therapists concerning their competences in health promotion, and their perceptions of how they apply these competences in their daily work. The study also elicited their views on the contributions that occupational therapists could make to health promotion if given the opportunity. Methods: Data were collected in five focus-group discussions with 24 occupational therapists. These discussions were tape recorded and transcribed verbatim; data were analysed using qualitative content analysis. Results: The main findings are that the informants took an individualized salutogenic approach in their work and rarely engaged in health promotion on a systemic or societal level. They believed that their patients and collaborating partners, as well as public officials, remained unaware of their competences in health promotion. Conclusions: The findings of this study could enrich the discussion among occupational therapists on how they could make a more significant contribution to health promotion on a broader level