A prospective study of stage of change for general health promotion action and health-related lifestyle practices among Chinese adults

Dans une perspective de promotion de la santé, qui vise à donner aux personnes la maîtrise de leur propre santé, la proposition théorique et méthodologique que nous présentons s’intéresse à comprendre comment les inégalités sociales basées sur le genre, l’ethnicité, le statut socioéconomique, etc. conditionnent la capacité des jeunes d’agir pour leur santé. Nous focalisant sur les jeunes (18-24 ans), nous mobilisons la notion de « capacités » d’Amartya Sen (1993) pour concevoir le rôle actif des individus par rapport à leur santé, ainsi qu’une approche intersectionnelle qui, au lieu d’analyser les inégalités sociales de façon isolée, met l’accent sur l’imbrication de celles-ci afin de mieux comprendre les mécanismes qui les produisent. Nos objectifs sont (a) cerner les différentes formes de capacité d’agir qu’on les jeunes pour leur santé prend et à (b) analyser comment cette capacité est conditionnée par les inégalités sociales afin d’ (c) identifier des pistes d’action pour améliorer l’ empowerment des jeunes. Notre démarche méthodologique s’appuie sur deux volets. Un premier volet, à visée exploratoire, utilisera la méthode d’analyse en groupe afin de réaliser un diagnostic de ressources et de contraintes des jeunes pour agir pour leur santé, ainsi que d’identifier les catégories sociales les plus pertinentes pour l’analyse intersectionnelle. Sur cette base, le deuxième volet, basé sur la technique des récits de vie, a pour objectif de saisir l’interaction des inégalités sociales telle qu’elle est vécue par les jeunes et d’analyser comment cette interaction façonne leur capacité d’agir de façon favorable à leur santé. Ainsi, nous décrivons une démarche méthodologique pour l’étude de la capacité d’agir pour la santé afin de proposer une nouvelle grille de lecture, empiriquement fondée, pour la conceptualisation des programmes en promotion de la santé.

Traditionally, health protection and health promotion activities have operated independently of each other in the workplace. Health protection has usually been viewed as encompassing the activities that protect workers from occupational injury and illness ranging from basic safety training to the us

BACKGROUND: Lifestyle has long been associated with the development of many chronic diseases and noncommunicable diseases (NCDs). NCDs are largely preventable through effective interventions by tackling the shared modifiable risk factors, and onset and progress can also be delayed. Therefore, the objectives of this study were to determine the practice of lifestyle and assess the burden of associated risk factors of NCDs among the students of selected colleges of Delhi University. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 450 students from two coeducational colleges of Delhi University. Data were collected in accordance with the World Health Organization STEPwise approach to Surveillance (WHO STEPS) questionnaires. Standardized questionnaires of WHO STEPS methodology for surveillance of chronic diseases for Step 1 and clinical measurement on height, weight and blood pressure (BP) for Step 2 were used. Data were collected in September 2013 to November 2013. RESULTS: Of the 450 students, 56.88% were male, all in the age group of 18–26 years. Only 28.66% of the subjects perform the moderate physical activity during a usual week. During the past 7 days, 59.33% consumed carbonated soft drinks at least 1–2 times/day and 49.11% eaten >2 servings of fast foods per day. Tobacco use (smoking only) was prevalent in around 15.77% of the subjects and alcohol in 20.88%. Majorities use tobacco and alcohol in relation to socialization, peer pressure and for enjoyment. 31.55% of the subjects were overweight and obese and 8.22% underweight, while 1.55% high normal BP. CONCLUSIONS: The present study showed a poor practice of healthy lifestyle with a high burden of lifestyle-related risk factors of NCDs among students of Delhi University. Therefore, the University should emphasize on curriculum for a healthy lifestyle in all faculties as a required subject. Frequent campaigns and educational seminars are to be encouraged for the adoption of healthy lifestyle and health promotions.

Introduction: The rising burden of non-communicable diseases poses a great health system challenge in Kenya. Healthcare workers have a critical role to play in health promotion, in addressing patients’ lifestyle risk factors. However, their own lifestyle habits can influence their attitude and practices towards patient care. Opportunistic counselling of patients by health professionals signifies one of the most cost-effective medical interventions in combatting non-communicable diseases. Objective: To determine the attitudes and practice of health promotion for the prevention and management of non-communicable diseases among healthcare workers In Kakamega county. Methods: A cross-sectional mixed method study was carried out from June to July 2018 at Kakamega county referral hospital. For the quantitative method, one hundred and eighty-five doctors and nurses were recruited through stratified sampling. Data on healthcare workers; socio-demographic characteristics, lifestyle practice, attitude, and practice of health promotion was collected through self- administered questionnaires. Frequency and percentage distributions tables were used to initially describe the study population while, Chi- square test of significance was used to evaluate the association between healthcare workers attitudes and practice of health promotion and their socio-demographic features. Secondly, a total of 12 doctors and nurses were purposively selected based on age, gender and profession of participants for the qualitative method. Data on healthcare workers perspective on health promotion and organizational support factors were collected through in-depth interviews. The recorded interviews were transcribed and data analysis was done using content analysis of thematic areas. A verbatim approach was used to describe study findings. Results: 69.2% of the respondents were females, mean age was 36 years and the median years in profession was 12 years. The respondents exhibited good lifestyle practices with alcohol and tobacco prevalence at 30.8 %and 3.8% respectively. 72% of the respondents demonstrated a positive attitude towards health promotion while, 31% showed good health promotion practices. Less than half of the respondents inquired about a patient’s lifestyle practices during routine visit. The study found that healthcare workers with a positive attitude were four times more likely to have good health promotion practices (OR = 3.54, p<0.001). Lastly findings from the in-depth interviews revealed that staff had no written guidelines on health promotion and that the hospital management had abolished the health promotion unit. Conclusion: The results indicated that a positive health professional attitude is a precursor to good health promotive practices. Recommendation: Efforts to build capacity and support for health promotion in health services should be encouraged. Additionally, health Promotion programs for non- communicable disease should not only target the health of general population but also the health of health care workers.
 
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Background The association between heavy weekly alcohol consumption or binge drinking and the risk of major adverse cardiovascular events (MACE) after acute coronary syndromes (ACS) is still unclear. Purpose To determine the risks of MACE at one year follow up according to baseline alcohol consumption, especially in patients with heavy weekly alcohol consumption or binge drinking. Methods We analyzed data of 6053 patients hospitalized in 4 Swiss centres for an ACS and followed over 12 months. Data on alcohol consumption were collected at baseline and at one year follow up after ACS. Binge drinking was defined as the consumption of ≥6 units of alcohol on one occasion, for the 12-months period preceding the one-year follow up. We defined MACE as a composite of cardiac death, myocardial infarction, stroke or clinically indicated target vessel coronary revascularization. We applied Cox regression to assess the risk of MACE associated with heavy alcohol weekly consumption (>14 standard units/week) compared to light consumption (<1 standard unit/week) or abstinence, as well as the risk with binge drinking, compared to no binge drinking, adjusting for baseline differences (age, sex, body-mass index, smoking, diabetes, peripheral artery disease, stroke, hypertension, use of aspirin, anticoagulation, statin, beta-blocker, ACE-inhibitor or ATII receptor blocker). Results At baseline, 817 (13.4%) patients reported heavy weekly alcohol consumption and 717 (11.8%) reported to have at least one episode of binge drinking per month. The risk for MACE at one year follow up was not increased in those with heavy weekly consumption compared to light consumption (8.7% vs. 8.5%, HR 0.96, 95% CI 0.69–1.33, P=0.80) or no consumption (8.7% vs. 10.3%, HR 1.26, 95% CI 0.88–1.80, P=0.21). However, the risk of MACE was higher in those reporting binge drinking with less than one episode a month (9.4% vs. 7.7%, HR 1.67, 95% CI 1.32–2.12, P<0.001), as well as in those with at least one episode of binge drinking per month (13.4% vs. 7.7%, HR 2.07, 95% CI 1.62–2.65, P<0.001), when compared to no binge drinking. Conclusion In contrast to regular heavy alcohol consumption, binge drinking behavior is associated with significant increased risk of MACE 12 months after ACS. Funding Acknowledgement Type of funding sources: None.

Phenolic compounds as beneficial phytochemicals in pomegranate (Punica granatum L.) peel: A review

Background: It is well established in the literature how exercise prevents chronic diseases. Nevertheless, we still lack knowledge about the ways in which health-related bodily practices might contribute to health promotion. Less is known about pedagogies in public health directed at adult and older-age groups, within non-formal educational settings. Considering a lack of tailored and attractive approaches to health-related bodily practices for adults and older people [Pettigrew et al. 2019. “Encouraging Older People to Engage in Resistance Training: A Multi-Stakeholder Perspective.” Ageing & Society 39 (8): 1806–1825; Van Dyck, D., L. Mertens, G. Cardon, K. De Cocker, and I. De Bourdeaudhuij. 2017. “Opinions Toward PhysicalActivity, Sedentary Behavior, and Interventions to Stimulate Active Living During Early Retirement: Qualitative Study in Recently Retired Adults.” Journal of Aging and Physical Activity 25 (2): 277–286], we argue that there is a need to explore pedagogical practices that might further health promotion with this target group. Purpose: Drawing on Antonovsky’s theory of salutogenesis [1996. “The Salutogenic Model as a Theory to Guide Health Promotion.” Health Promotion International 11 (1): 11–18], the purpose of the study was to investigate how health and physical education (HPE) professionals delivered health-related bodily practices for adults and older people in community-based programmes. Data collection and analysis: A qualitative and grounded theory study design was employed. Participants included six HPE professionals, three health centre coordinators and thirty-four adults and older people enrolled in four community-based programmes from Brazil. Condensed fieldwork was adopted to generate data through three-days visits to each programme. Multiple data sources comprised semi-structured interviews, non-participant observation of health-related bodily practices sessions and documents/materials produced by participants. Data were analysed through open, axial and selective coding, using the constant comparative method [Charmaz 2006. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Book. Vol. 10. London: Sage Publications]. Findings: Three themes were generated to explain the ways HPE professionals worked with adults and older people in health promotion: adopting a holistic view of health, serving as a health resource and nurturing further health resources. These practices included caring attitudes, such as listening carefully to adults and older people, showing attentiveness and responsiveness to them. Moreover, a key finding indicated that the HPE professionals served in their pedagogical practices as health resources, which the adults and older people learned to draw on to cope with life situations and experience health development. Conclusion: The HPE professionals in the four programmes demonstrated they were capable of moving beyond a solely biomedical approach to health and focus on the salutary factors that enable health promotion through the development of a combination of pedagogical practices that were consistent with salutogenesis.

Background: Healthy lifestyle behaviors: diet, physical activity and non-consumption of tobacco and alcohol of health workers are important as they engage in educating the community and people follow them as role models. Objective of this study was to describe the healthy lifestyle practices among field public health workers in one of the districts in Sri Lanka. Methods: Descriptive cross-sectional study was carried out in the Galle district. 303 Public Health Midwives (PHMs) were taken to the sample and Lifestyle practices were assessed using a pre-tested self-administered questionnaire. Results: Overweight and obesity prevalence were 24% and 3.7% respectively. None of them used tobacco or alcohol. Regular balance diet consumption was 57%. 18.2% have consumed 2 or >2 servings of fruit per day. The majority (49.2%) consumed vegetables 3 times per day and 21.8% consumed four or >4 servings per day. 43.6% consumed Sugar and sugar containing food daily. Only 12.2% preferred low-salt food. 21.8% of PHMs consumed oily foods few times a day. The majority (56.8%) of PHMs have engaged in recommended moderate physical activity but only 6.9% engaged in vigorous physical activity. The mean duration of walking time was 463 minutes per week. Conclusions and recommendations: Most lifestyle practices (Dietary and physical activity) are not very healthy among PHMs except for their alcohol and smoking behaviors. Public health workers should be motivated to spend healthy lifestyles by increasing awareness and incorporating healthy lifestyle promotion programs into their routine field work.

Objective: To examine the concordance between lifestyle practices and beliefs of people living in Kuwait, and between their lifestyle practices and established evidence-informed recommendations for health. Subjects and Methods: A cross-sectional interview questionnaire study was conducted using a convenience sample of 100 adults living in Kuwait (age range 19-75 years). The interview included sections on demographics, and lifestyle-related practices and beliefs related to smoking, diet/nutrition, physical activity/exercise, sleep, and stress. Diet/nutrition and physical activity/exercise benchmarks were based on international standards. Analyses included descriptive statistics and the χ² test. Results: Beliefs about the importance of nutrition in lifestyle-related conditions were limited, and this was apparent in participants' dietary habits, e.g., low consumption of fruit/vegetables and multigrains: 16 (16%) and 9 (9%) met the recommended guidelines, respectively. Ninety-nine (99%) believed physical activity/exercise affects health overall, and 44 (44%) exercised regularly. Of the sample of 100, 20 (20%) exercised in accordance with evidence-based recommendations for maximal health. Compared with beliefs about other lifestyle-related behaviors/attributes, respondents believed nutrition contributed more than stress to heart disease, cancer, and stroke, and stress contributed more than nutrition to hypertension and diabetes. Conclusion: In this study, our findings showed a discrepancy between lifestyle-related practices and beliefs, and between each of these and evidence-based recommendations for maximal health, i.e., not smoking, several servings of fruit and vegetables and whole-grain foods daily, healthy weight, restorative sleep, and low-to-moderate stress levels.

Stage of change for general health promotion action and health-related lifestyle practices in Chinese adults

SUMMARY African-American women have a twofold prevalence of diabetes, hypertension, and stroke and nearly a threefold higher risk of overall mortality compared to Caucasian women. Many of these potentially preventable health conditions are related to lifestyle. The purpose of this small, cross-sectional, descriptive survey study was to describe the perceived health status, current health-promotion behaviors, and interest in participating in future health-promotion activities among African-American women. We then sought to determine if there was an association between perceived health status and current health-promotion behaviors, and between perceived health status and interest in participating in future health-promotion activities. We administered a modified version of the Behavioral Risk Factor Questionnaire (BRFQ) by mail or telephone to a convenience sample of 53 African-American women living in the San Francisco Bay area. In general, the fairly healthy women reported being physically inactive, eating primarily a low-fat diet, not smoking cigarettes or drinking, and coping fairly well with stress, but not eating the daily recommended five servings of fruits and vegetables. Findings revealed perceived health status was not associated with current health-promotion behaviors or interests in participating in future health-promotion activities. A majority of the women, however, were interested in participating in future health-promotion activities, such as a women's health program, nutrition improvement, and moderate physical activity, indicating potential opportunities for health-promotion interventions that engage African-American women in healthier lifestyles. To help an individual make a future change, such as one's health-promotion practices, health-promotion interventionists must understand the individual's present behavior in the context of that culture.

Binge drinking (consuming > or =5 alcoholic drinks on 1 occasion) generally results in acute impairment and has numerous adverse health consequences. Reports indicate that binge drinking may be increasing in the United States. To quantify episodes of binge drinking among US adults in 1993-2001, to characterize adults who engage in binge drinking, and to describe state and regional differences in binge drinking. The Behavioral Risk Factor Surveillance System, a random-digit telephone survey of adults aged 18 years or older that is conducted annually in all states. The sample size ranged from 102 263 in 1993 to 212 510 in 2001. Binge-drinking prevalence, episodes, and episodes per person per year. Between 1993 and 2001, the total number of binge-drinking episodes among US adults increased from approximately 1.2 billion to 1.5 billion; during this time, binge-drinking episodes per person per year increased by 17% (from 6.3 to 7.4, P for trend =.03). Between 1995 and 2001, binge-drinking episodes per person per year increased by 35% (P for trend =.005). Men accounted for 81% of binge-drinking episodes in the study years. Although rates of binge-drinking episodes were highest among those aged 18 to 25 years, 69% of binge-drinking episodes during the study period occurred among those aged 26 years or older. Overall, 47% of binge-drinking episodes occurred among otherwise moderate (ie, non-heavy) drinkers, and 73% of all binge drinkers were moderate drinkers. Binge drinkers were 14 times more likely to drive while impaired by alcohol compared with non-binge drinkers. There were substantial state and regional differences in per capita binge-drinking episodes. Binge drinking is common among most strata of US adults, including among those aged 26 years or older. Per capita binge-drinking episodes have increased, particularly since 1995. Binge drinking is strongly associated with alcohol-impaired driving. Effective interventions to prevent the mortality and morbidity associated with binge drinking should be widely adopted, including screening patients for alcohol abuse in accordance with national guidelines.

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

The study aimed to assess the prevalence and correlates of fruit and vegetable (FAV) consumption and its associations with noncommunicable diseases risk factors among adults in Laos. In a national cross-sectional survey in 2013, 2527 individuals (18-64 years old) responded to a questionnaire, and anthropometric and blood pressure measurements, and biochemistry tests were conducted. On average, participants had 0.99 servings of fruits a day and 1.33 servings of vegetables a day, a combined total of 2.32 servings of FAVs per day. Almost 1 in 5 respondents (18.9%) had 2 or more servings of fruit a day, 8.7% had 3 or more servings of vegetables a day, and 94.7% had less than 5 servings of FAV a day. In adjusted logistic analysis, being a Lao-Tai increased the odds of consuming 2 or more servings of fruits daily. Past month binge drinking decreased the odds of having 3 or more servings of vegetables daily. Higher education and urban residence decreased the odds of inadequate (<5 servings) FAV consumption. In adjusted linear regression analysis, increased FAV consumption was associated with higher body mass index scores. A high prevalence of inadequate FAV consumption was found. Interventions targeting identified modifiable risk factors, including lower education, general obesity, and binge drinking, may potentially increase FAV consumption in Laos.

Background: Alcoholic ketoacidosis (AKA) is an under- recognised presentation seen in chronic alcoholics with a recent history of binge drinking. Metformin- associated lactic acidosis (MALA) is a rare complication of biguanide treatment which is generally induced by overdose or reduced clearance. Both can present with a significant high anion gap metabolic acidosis and hyperlactataemia. Case report: A 52-year-old man with a background history of chronic alcoholism and type 2 diabetes mellitus (T2DM) treated with metformin only (latest HbA1c 7% / 53 mmol/mol) presented to the hospital with vomiting. He was hypotensive and had acute kidney injury (AKI) stage 3. This presentation occurred after an episode of binge drinking 12 hours prior. He had had three similar episodes in the past, two episodes occurring within 24 hours of binge drinking. Venous blood gas measurement on presentation showed a pH of 6.934, lactate of 16 mmol/L and glucose of 21.7 mmol/L, and bedside ketones were 3.2 mmol/L. He was treated according to the hospital diabetic ketoacidosis (DKA) protocol. Discussion: In the presence of a recurrent history of DKA in a patient with chronic alcoholism, AKA should be considered. The mechanism of AKA is complex and occurs in the setting of insulin deficiency and excess glucagon release. Excess ethanol metabolism favours the formation of beta-hydroxybutyrate ketoacid. Counter-regulatory hormones and volume depletion drive lipolysis and ketosis. Repeated episodes of binge drinking- induced renal impairment may have caused metformin accumulation, resulting in hyperlactataemia. Conclusion: We should consider both AKA and MALA in binge drinkers who present with recurrent severe acidosis.