Improvements In Health Indicators Research Articles

The Driving Factors Important for Evaluation Student's Opinion which Influenced Decision Making of Career Choice: Pediatrics as a Career Choice as an Example.

Background:Reducing the maternal and neonatal mortality rate are the predominant goals of achieving sustainable development for which it is important to ensure adequate health workforce, especially pediatric professionals at all levels of health care. Recent trends reveal a significant decline in the number of doctors opting for pediatrics specialization.Objective:This study was carried out to explore the career preferences of the undergraduate medical students and factors influencing career choice.Methods:This cross sectional study was carried out among 362 undergraduate medical students studying in prefinal and final year during a period of three months. A self administered questionnaire was used to obtain information regarding the career preferences and factors influencing the decision making. Attitudes regarding career choice was assessed using Likert scale and later recoded into binomial variables. Statistical analysis was carried out using SPSS software.Results:Majority of the participants were females (61.8%). The individual choice of specialty revealed that 12.2% of the males and 18.5% of the females wanted to take up pediatrics as their first career choice while 5.5% of the males and 7.7% of the females had pediatrics as their second choice. Overall, more females preferred pediatrics as a career choice compared to the males. The observed difference was statistically significant (p<0.0001).Conclusion:Adequate motivation, driven with passion for patient care can be inculcated at the young age and will go a long way in not only addressing the pediatric needs of the society, but also improve health indicators and sustainable development of the country.

Влияние физической культуры на качество жизни

The aim of the article is to define the role physical culture plays in influencing the quality of life of a modern person and society in general. The phenomenon “quality of life” is analyzed as a combination of the three spheres: physiological, emotional, and spiritual ones. The potential of physical culture in each sphere is revealed. It is shown that the health-improving effect of physical culture is due to an increase in physical activity of a person, while its deficiency provokes a violation of the physiological functions of the body. It is noted that the most effective ways to maintain physical health are feasible physical activity and tempering. A wide range of the emotions experienced, and their intensity determines the influence of physical culture on the physiological sphere of life. The most significant emotional states in the formative relation are mentioned: excitement, enthusiasm, passion, sports anger, rivalry, aggressiveness, pride. The influence of physical culture on the spiritual sphere of human life is due to its value potential. The idea is expressed that the main way for physical culture to influence the spiritual sphere is to develop a value attitude to physical culture as a phenomenon and occupation. It is also noted that physical culture is one of the most powerful means of socialization of people of any age. The conclusion is drawn that to provide a complex impact on the quality of life physical culture is to become a way of life for the modern person. It will improve health indicators, will form active life position, and it will provide self-realization of a person.

ВЗАИМОДЕЙСТВИЕ ЗВЕНЬЕВ ОКАЗАНИЯ МЕДИЦИНСКОЙ ПОМОЩИ: РЕЗУЛЬТАТЫ ОПРОСА ВРАЧЕЙ

Significance. Strengthening providers integration to improve health indicators is an important direction of healthcare development. Purpose. To evaluate the degree of providers interaction and continuity of health care. Material and methods. Forms of interaction between health services, medical organizations and social services have been determined, its prevalence is considered as a characteristic of the level of interaction. The sociological survey of physicians was conducted in October 2020 to identify their opinion about the interaction forms. The responses were compared with the results of a similar survey in 2012. Results. Comparison of the 2012 survey and 2020 survey suggests some improvements in interaction between district physicians and outpatient specialists, however its level is hardly adequate. Interaction between district physicians and emergency care providers in polyclinics has improved. Interaction between polyclinic and hospital physicians before and after hospital admission is very limited and has deteriorated over the period under study. The level of outpatient physicians’ awareness of emergency calls and hospital admissions of their patients is low. Interaction between polyclinics and hospitals on the one hand, and rehabilitation units and social care providers on the other hand, is also low. Information on the location and volumes of care provided to patients is still inaccessible for most physicians. This limits continuity of care. Conclusion. The study shows that the Russian healthcare system remains fragmental. This is the result of low priority of integrative activities, as well as low involvement of health managers in these activities. Scope of application. The need for specifying activities aimed at improving health providers integration as a special subject of health policy has been substantiated. The results can be used by health policy decision-makers, health managers and health professionals.

The Impact of Health Sector Development on Tourism Development

Background: One of the most common mistakes in tourism policy is to focus solely on the tourist attractions without considering the environmental conditions and facilities in the community. Access to quality health services in the destination country is one of the most important facilities for tourists. The present study investigated the effect of improving the health sector on attracting foreign tourists. Methods: The present study was a descriptive-analytical study. To conduct the study, the data of global development indicators (published by the World Bank) from 1996 to 2016 were used. The study sample included 82 developing and developed countries. In order to analyze the data, the test methods based on panel data and the generalized torque regression were applied using Stata 14 software. Results: Findings from the estimates of all 4 models show that development of health and treatment increased the amount of tourist attraction in the world. The 2 indices of health developer for both groups of countries had a significant positive effect on tourism development index (tourist attraction). The findings also showed that other independent variables of the model such as air transport development, poll tax income, improvement of information and communication technology, and business development had a positive and significant effect on attracting foreign tourists. Conclusion: On the one hand, provision of the necessary health facilities and improvement of the health indicators provide one of the most essential facilities needed by tourists. On the other hand, application of these facilities is the goal of tourism. From a social point of view, improving health indicators is a positive aspect for society. Therefore, development of health is one of the essentials of tourism development.

Kutatási kérdőjelek az egészségügyi szervezetfejlesztésének vizsgálatában

A közbeszédben és a szakirodalomban is komoly viták folynak az egészségügy válságáról. A második világháború után az egészségügy volt az a szolgáltatás, amit elsőként kivontak a piaci törvények alól. Az általános és ingyenes egészségügy a háborús társadalmi sokk után reményt és relatív eredményeket is hozott, de ez az 1960-as évek végére megtorpant, miközben a modernizációs folyamatok is jelentősen csökkentek, és „a megoldásra váró új feladatokkal az intézményhálózat tehetetlenül állt szemben.” (Szalai J. 1989:171) A mai egészségügyi rendszer vizsgálatát azzal kezdem, hogy összehasonlítom az alap- és szakellátás területen a múltbeli és a napjainkban keletkezett disszonancia okait, jelenségeit, párhuzamosságait, szervezetlenségeit. Feltételezem, hogy az egészségügyi rendszer eredményes reformját csak az alapproblémák ismeretében, az alap- és a járóbeteg-ellátás korszerűsítésével, szervezeti fejlesztésével lehet elkezdeni.

Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries.

Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, in low-income countries (LICs), indigents are generally excluded from health policies despite the international paradigm of universal health coverage (UHC). Fee exemption interventions have demonstrated their limits and it is now necessary to act on other dimensions of access to healthcare. However, there is a lack of knowledge about the interventions implemented in LICs to support the indigents throughout their care pathway. The aim of this paper is to synthesize what is known about patient navigation interventions to facilitate access to modern health systems for vulnerable populations in LICs. We therefore conducted a scoping review to identify all patient navigation interventions in LICs. We found 60 articles employing a total of 48 interventions. Most of these interventions targeted traditional beneficiaries such as people living with HIV, pregnant women and children. We utilized the framework developed by Levesque et al. (Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18) to analyse the interventions. All acted on the ability to perceive, 34 interventions on the ability to reach, 30 on the ability to engage, 8 on the ability to pay and 6 on the ability to seek. Evaluations of these interventions were encouraging, as they often appeared to lead to improved health indicators and service utilization rates and reduced attrition in care. However, no intervention specifically targeted indigents and very few evaluations differentiated the impact of the intervention on the poorest populations. It is therefore necessary to test navigation interventions to enable those who are worst off to overcome the barriers they face. It is a major ethical issue that health policies leave no one behind and that UHC does not benefit everyone except the poorest.

Health Literacy Interventions to Improve Health Outcomes in Low- and Middle-Income Countries.

Background:Health care systems in many low- and middle-income countries (LMICs) face considerable challenges in providing high-quality, affordable, and universally accessible care. Feasible solutions to these issues require health literacy (HL) interventions for people who live in LMICs. Low HL is a significant problem in many LMICs because of the low levels of general literacy and poorly resourced and functioning health systems. A comprehensive understanding of HL interventions is essential to determine whether these interventions meet the health information needs of people who live in LMICs and to develop other effective HL interventions specifically for people who live in LMICs, improve health outcomes, and reduce inequalities.Methods:A medical research librarian developed and implemented search strategies to identify relevant evidence. Included studies needed to contain HL in LMICs component to understand or evaluate HL interventions that target people who live in LMICs. Two reviewers selected studies, conducted quality assessments, and extracted data by using standard forms. Discussion or third-party adjudication resolved disagreements. The collected data include the design of the study, type of HL intervention, target audience, theoretical influences, approaches to evaluating the intervention delivered, intervention received, intervention fidelity, intervention reach, data analysis, and study outcomes.Key Results:The reviewers systematically analyzed the data from 23 published research studies, including 20 quantitative, 1 qualitative, and 2 mixed-method studies, on HL interventions to improve the health outcomes in LMICs. The various HL interventions for different groups of the population depend on the health outcomes of the study. The reviewers identified four themes: traditional HL interventions, art-based HL interventions, interactive learning strategies, and technology-based HL interventions. The researchers of a few studies also used multicomponent interventions to improve the HL of the population.Discussion:Despite global improvements in health indicators over time, such as decreased mortality and morbidity, significant challenges remain regarding the quality of the delivery of health care in many LMICs. All of the HL interventions were effective and significantly improved the knowledge and awareness of the population. However, based on the literature review, the reviewers found significant evidence that only a limited number of HL interventions are delivered through innovative and technological learning strategies. In addition, the sustainability and scalability of these interventions is not clear. Therefore, future research on sustainability measures for effective HL interventions in LMICs is still needed. [HLRP: Health Literacy Research and Practice. 2020;4(4):e250–e266.]

Investigation of Health Socialization Status in Iran: A Qualitative Study in 2020

Background: There are significant differences in the health status of different social groups, despite governments' commitment to improving health indicators, which can be avoided by intervening appropriately. In this regard, it can be mentioned that the formation of the social deputy in the Ministry of Health of Iran in 2016, which was dissolved in 1998, and the socialization of health were ignored. Due to the ambiguity in the new process of socialization of health, this study aimed to investigate the status of health socialization in the current structure of the country. Method: The present study as a qualitative study carried out through documentation analysis and two in-depth semi-structured interviews with social deputies of two medical universities of Iran. Data were analyzed using the contractual content analysis method. Two in-depth semi-structured interviews were conducted with the social deputies of the universities of Tehran and Ilam, who were selected using convenience sampling to complete the findings. Result: According to the results of content analysis and 23 extracted codes, the socialization of health in Iran is debatable in two main areas, namely strategies and pillars of socializing health which consisted of three and five sub-themes, respectively. At present, the structure and pillars of socializing health and coordination among these pillars are vague and uncertain due to the distribution of responsibilities of the social deputy in other departments of the Ministry of Health and universities. Conclusion: For achieving equity in the socialization of health goals, it is better to clarify the socialization of health stewardship, strategies, and policies in the whole country concerning social issues and dimensions of the health system.

Utilization of integrated health kiosks: A systematic review.

Background: In some countries, integrated health kiosks are used to provide some services and information. However; it is still not officially included in many countries' health systems. The purpose of this study was to gather and summarize different aspects of using health kiosks in countries. Methods: Five English databases, including Web of Science, Cochrane Library, PubMed / Medline, Embase and Scopus, were explored from 2001 to 2018, using words related to three concepts: health, design and development, and kiosk. Different dimensions of health kiosks utilization in the world were identified and analyzed thematically. Results: Out of 918 search results, 37 articles were included in the study and analyzed. Most of them were conducted in the United States and addressed the development, implementation, design, or feasibility of utilizing integrated health kiosks. The different aspects of kiosk utilization were categorized into 6 dimensions: services provided, deployment location, user characteristics and variables of accepting kiosks, notable design and construction points, their benefits and effectiveness, and finally, the challenges of using kiosks. Conclusion: This study found that health kiosks are promising, cost-effective and multifunctional tools; if included in the formal health system of countries, they may improve health indicators in countries. However, before deploying, their challenges and concerns need to be investigated and addressed.

School-Based Interventions for Promoting Physical Activity Using Games and Gamification: A Systematic Review Protocol.

Games and/or gamification seem to be a promising area for educational and health research. These strategies are being increasingly used for improving health indicators, even in educational settings; however, there is little information about these terms within the school to promote physical activity (PA). Objective: the aim of this study is to describe a systematic review protocol of school-based interventions for promoting PA in pre-schoolers, children, and adolescent students using games and gamification. Methods: This review protocol is registered in International prospective register of systematic reviews (PROSPERO) (CRD42019123521). Scientific databases include PubMed, Web of Science, SportDiscus, Cochrane Library, ERIC, and PsycINFO. A standardized procedure will be executed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P) checklist for conducting systematic review protocols and the PICOS (Population, Interventions, Comparators, Outcomes, and Study design) tool to address an appropriate search strategy. Detailed information will be extracted, including a quantitative assessment using effect sizes to compare the interventions and a qualitative assessment using the Evaluation of Public Health Practice Projects (EPHPP) tool. Conclusion: This systematic review protocol contributes to establishing future systematic reviews using games and gamification strategies in school settings in order to examine their effect on PA outcomes among youth. Additionally, an update and clarification on the different terms in the school context have been included.

Estratégia Saúde da Família e sua interferência nas internações sensíveis à atenção primária à saúde

O presente estudo buscou analisar a interferência da Estratégia Saúde da Família nas internações por condições sensíveis à atenção primária. Trata-se de revisão integrativa da literatura publicada no período 2013-2018, tendo as seguintes perguntas de pesquisa: é possível utilizar o indicador Internação por Condições Sensíveis à Atenção Primária para avaliação deste nível de atenção? A Estratégia Saúde da Família pode contribuir para a redução dessas hospitalizações? Selecionou-se para análise 35 artigos. A identificação e seleção dos estudos foi feita por meio de buscas de publicações indexadas na base de dados da Biblioteca Virtual em Saúde (BVS) e Portal Capes nos meses de maio e junho de 2019. Constatou-se a utilização do referido indicador como uma das variáveis para a avaliação da Estratégia Saúde da Família. Entende-se que esta estratégia, isoladamente, não impactará na redução desse indicador. Ainda assim, pesquisas indicam que sua expansão está associada à redução das internações sensíveis à atenção primária. Sendo assim, deve-se investir na Saúde da Família e na reorganização do seu processo de trabalho, para que esta seja efetivamente coordenadora do cuidado no nível primário de atenção, possibilitando melhora nos indicadores de saúde.

Legal Regulation in Digital Medicine

The civilized world has achieved enormous progress in digital medicine, which is becoming the basis for further healthcare development. In the near future this can significantly improve people`s life , increase budget efficiency in the sphere of health, improve health indicators and life expectancy of the next generation. In this situation, digital medicine does not fully guarantee exclusion of any data leakage risks. This means that the use of better technologies in health care will require stricter compliance with a complex network of existing laws and regulations, which vary depending on the country, jurisdiction and region (for example, the European Union).However, this global process implementation requires strong political will to protect citizens from confidential data misuse, to increase responsibility of manufacturers and consumers of digital equipment and technologies to their citizens and the state.

Improving Demand for Health Services with the Involvement of Community Health Workers: A Case Study of Community Dynamics at Mosango Rural Health Zone in the Democratic Republic of Congo

Introduction: DRC is one of Sub-Saharan Africa country with high infant and maternal mortality. The major problem is the underuse of health services because of inaccessibility on all fronts and also the population under-information to the health and development problems. Community participation is one of the basic requirements and basic principles of the Primary Health Care to solve this problem. That is why we choose Mosango RHZ to assess the improvement of demand for health services with the involvement of community health workers. Methods: We conduct a cross-sectional study carried out in Mosango RHZ in 2019. The study combined a mixed method (quantitative and qualitative) based on the realist evaluation approach which takes into account the Context-Mechanisms-Effects explained in the conceptual framework model. Results: Four predictive factors determine the improvement of health indicators with the involvement of CHWS in activities of the Mosango RHZ: Having attended school (p = 0.000; OR = 0.150); Having sufficient theoretical knowledge on malaria, diarrhoea, pneumonia, malnutrition, availability of inputs to treat these diseases (p = 0.004; OR = 0.192); Having taken the training as CHWS and Having undergone more than one training as CHW (p = 0.013; OR = 0.074). This result corroborated with other studies carried in low- and middle-income countries like DRC. Conclusion: The involvement of CHWs on improving demand for health services is effective in Mosango RHZ. The improvement of health service indicators and the effectiveness of this community intervention were conditioned by capacity building of the CHWs, the availability of inputs and the involvement of the community in the activities of the health zone through the Community Action Cells.

Midwives' Educational Needs in Iran: A Narrative Review.

Background:Midwives have a major role in the improvement of health indicators in every country. In order for midwives to be able to play their role well, they must have sufficient updated knowledge. For this purpose, it is necessary to review their educational needs. The aim of the present research was to review Iranian studies that have investigated midwives’ educational needs.Materials and Methods:In this narrative review, PubMed, Scopus, Web of Science, Google Scholar, ProQuest, Ovid, SID, and Magiran databases were searched for the full texts of Iranian studies published in Persian and English languages in the period of 2000–2018. Review, descriptive, and interventional articles consistent with the research aim were included in this study.Results:Of the 53 found articles, 23 articles that were relevant to midwives’ educational needs in Iran were investigated. The findings of the studies showed that the educational needs of the midwives can be categorized into the four groups of knowledge and performance, communication skills, occupational rules/regulations, and religious rules.Conclusions:The results showed that midwives in Iran have different educational needs. Because the midwifery practice leads to the promotion of public health, it is imperative that midwives have comprehensive knowledge and the skills necessary for providing optimal care. In order to achieve this, short-term and long-term training programs tailored to the needs of midwives are recommended.

Repercusión de la nutrición en la epidemiologia, epigenética y clínica de las enfermedades neoplásicas malignas

Introducción: En el mundo contemporáneo cada vez existen evidencias de la interrelación entre factores nutricionales y la incidencia de enfermedades oncológicas. Cada año se diagnostican 14 millones de casos nuevos de cáncer en el mundo y 8 millones de pacientes mueren por esta causa. Ecuador no escapa a esta problemática. Abordar los factores nutricionales en interrelación con los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas de mayor prevalencia, con vistas a garantizar una mayor promoción de salud y prevención de enfermedades oncológicas altamente prevalentes, es siempre bienvenido. En el presente simposio se efectuará una revisión actualizada de la literatura sobre estos temas con vistas a profundizar en los profesionales los conocimientos habilidades y destrezas en el manejo nutricional con enfoque preventivo y curativo en el paciente oncológico, lo cual permitirá mejorar los indicadores de salud.&#x0D; Objetivo: Evaluar de manera crítica la literatura científica reciente, sobre la interrelación entre los factores nutricionales y los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas con vistas a garantizar una mayor promoción de salud y prevención de enfermedades oncológicas, así como el manejo nutricional de los enfermos con cáncer, lo cual repercutirá favorablemente en los indicadores de salud de la población.&#x0D; Material y métodos: Se realizó una revisión sistemática de la literatura científica publicada en el periodo 2000-2019, realizándose una triangulación, sobre los factores nutricionales y su relación con los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas con vistas a garantizar una mayor promoción de salud y prevención de enfermedades oncológicas altamente prevalentes, lo cual repercutirá favorablemente en los indicadores de salud de la población. Se utilizaron métodos estadísticos descriptivos y el método histórico lógico permitió determinar la secuencia cronológica de los diferentes fundamentos que sustentan la interrelación nutrición y cáncer con un enfoque preventivo curativo inter y transdisciplinario.&#x0D; Resultados: Los referentes teóricos analizados permitieron determinar los aspectos más relevantes de la interrelación de los factores nutricionales y el cáncer, con énfasis en la Epidemiología, Epigenética y Clínica del cáncer a nivel mundial y en Ecuador, todo lo cual contribuirá a elevar las competencias de los profesionales en estos temas y mejorar los indicadores de salud.&#x0D; Conclusiones: El enfoque inter y trans disciplinario de los aspectos nutricionales en interrelación con los epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas que muestran mayor prevalencia, permite elevar las competencias de los profesionales médicos en nutrición y cáncer, todo lo cual contribuirá a garantizar una mayor promoción de salud y prevención de enfermedades oncológicas, así como un adecuado manejo nutricional del paciente oncológico, con una repercusión favorable en los indicadores de salud.

Effects of mutual learning in physical education to improve health indicators of Ukrainian students

Introduction. The problem of research and increasing of motor activity modes remains relevant, since motor activity is one of the main factors determining health and the level of physical condition of population. The aim of study was to analyze the impact of the mutual learning program of physical education for improvement the physical and mental fitness of students in Ukraine. Material and Methods. Four groups were used for the survey: 2 experimental groups (male, n=31; female, n=33), which received 64 lessons of physical education, which included intra-subgroup interaction, changing of students, and control of knowledge and skills of each other, and 2 control groups (male, n=32; female, n=31), which received a traditional physical education lessons. Assessment of the somatic health (Ketle index, Robinson index, lifetime index, strength index) and physical preparadness (running tests, trunk from the lying position, throw of a medball). Efficiency of processing, speed of figuring out the work and mental stability were determined using Schultz-Platonov tables. Results . The results suggest about an increase in the functional capacity of cardiovascular and respiratory system among male and female of experimental group. The growth of the physical fitness results was set in lifting the trunk from the lying position to the sitting and throw of medball. After the experiment, positive changes in cognitive parameters were observed in female and male of experimental group. Among control group students, the results were significantly stable. Conclusions . The results suggest that program increased the level of physical and mental fitness of students of both gender and had a significant impact on the indicators of cardiovascular system.

Epidemiología, epigenética y clínica de las enfermedades oncológicas

Introducción: Cada año se diagnostican 14 millones de casos nuevos de cáncer en el mundo y 8 millones de pacientes mueren por esta causa. Ecuador no escapa a esta problemática. Abordar los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas de mayor prevalencia, con vistas a garantizar un diagnóstico precoz y un tratamiento oportuno, con el empleo de las más novedosas técnicas, es siempre bienvenido. En el presente simposio se efectuará una revisión actualizada de la literatura sobre estos temas con vistas a profundizar en los profesionales los conocimientos habilidades y destrezas en el manejo integral del paciente oncológico, con enfoque de riesgo, lo cual permitirá mejorar los indicadores de salud.&#x0D; Objetivos: Evaluar de manera crítica la literatura científica reciente, sobre los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas con enfoque de riesgo con vistas a garantizar un diagnóstico precoz y un tratamiento oportuno, lo cual repercutirá favorablemente en los indicadores de salud de la población.&#x0D; Metodología: Se realizó una revisión sistemática de la literatura científica publicada en el periodo 2000-2017, realizándose una triangulación, sobre los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas con enfoque de riesgo, con vistas a garantizar un diagnóstico precoz y un tratamiento oportuno, lo cual repercutirá favorablemente en los indicadores de salud de la población. Se utilizaron métodos estadísticos descriptivos y el método histórico lógico permitió determinar la secuencia cronológica de los diferentes fundamentos que intervienen en la prevención, diagnóstico, tratamiento y pronóstico de estas enfermedades con un enfoque inter y trans disciplinario.&#x0D; Resultados: Los referentes teóricos analizados permitieron determinar los aspectos más relevantes de la epidemiología del cáncer a nivel mundial y en Ecuador, determinar qué factores epigenéticos influyen su génesis, describir las manifestaciones clínicas de las enfermedades oncológicas más prevalentes, haciendo énfasis en novedosos métodos diagnósticos y terapéuticos, que repercuten favorablemente en el pronóstico, todo lo cual contribuirá a elevar las competencias de los profesionales en estos temas y mejorar los indicadores de salud.&#x0D; Las temáticas específicas que se abordarán en este simposio son las siguientes:&#x0D; - Epigenética y cáncer&#x0D; -Epidemiología y clínica oncológica de las enfermedades prevalentes. Estrategias de diagnóstico precoz y tratamiento oportuno.&#x0D; - Inmunología del cáncer&#x0D; -Agentes infecciosos y cáncer&#x0D; -Aproximación clínico - epidemiológica en el cáncer bucal.&#x0D; Conclusiones: El enfoque inter y trans disciplinario de los aspectos epidemiológicos, epigenéticos y clínicos de las enfermedades oncológicas que muestran mayor prevalencia, con enfoque de riesgo, permite elevar las competencias de los profesionales médicos, todo lo cual contribuirá a un diagnóstico precoz y tratamiento oportuno, que incida favorablemente en los indicadores de salud, disminuyendo la morbi mortalidad por estas patología.&#x0D;

Intuitive eating is associated with improved health indicators at 1-year postpartum in women with gestational diabetes mellitus.

We evaluated the associations between intuitive eating during and after pregnancy with metabolic health at 1-year postpartum in women with gestational diabetes mellitus and in high-risk gestational diabetes mellitus subgroups. One hundred seventeen women who consented and completed the French intuitive eating questionnaire during and after pregnancy were included. We found an association between intuitive eating during and after pregnancy with lower body mass index, weight retention, fasting glucose, and HbA1c at 1-year postpartum in women with gestational diabetes mellitus and in high-risk gestational diabetes mellitus subgroups with overweight/obese or with prediabetes in the postpartum period. Our results suggest that intuitive eating could be an effective intervention for weight and glucose control in women with gestational diabetes mellitus.

Impacts of the community block grant programme on school resources, environment and management in Indonesia

ABSTRACTIndonesia launched the large-scale community-based block grant programme, the PNPM Generasi, in 2007 with the intention to improve the health and education of children. This study estimates the impacts of the PNPM Generasi on school resources, classroom environments, and school management. While the PNPM Generasi increased community and parental participation in school management, it did little to improve school resources and classroom learning and teaching environments. The existence of heterogeneous impacts across school types and provinces is confirmed. Compared with the notable improvements in health indicators reported in previous studies, the impacts of the PNPM Generasi on school resources and classroom environments are limited.

O papel do enfermeiro no diagnóstico precoce do câncer de mama na atenção primária

O objetivo deste estudo é compreender o papel do enfermeiro no diagnóstico precoce do câncer de mama, descrever as ações e estratégias utilizadas para tal objetivo e conhecer as suas percepções acerca do seu papel nesta situação em uma Unidade Básica de Saúde no Município de Juazeiro-BA. Trata-se de uma pesquisa qualitativa de característica descritiva, com todos os enfermeiros da zona IV da cidade de Juazeiro-BA. Após a coleta dos dados, os mesmos foram agrupados e analisados por meio da técnica do método de Bardin. Os resultados encontrados mostraram que os profissionais apresentam conhecimento acerca do câncer de mama e do seu rastreamento, contudo, ainda deficitários e confusos. Há necessidade de políticas públicas que priorizem a capacitação dos profissionais para que possa refletir na melhoria dos indicadores de saúde.