Living healthier for longer: comparative effects of three heart-healthy behaviors on life expectancy with and without cardiovascular disease

BACKGROUND: Non-smoking, having a normal weight and increased levels of physical activity are perhaps the three key factors for preventing cardiovascular disease (CVD). However, the relative effects of these factors on healthy longevity have not been well described. We aimed to calculate and compare the effects of non-smoking, normal weight and physical activity in middle-aged populations on life expectancy with and without cardiovascular disease.

METHODS: Using multi-state life tables and data from the Framingham Heart Study (n = 4634) we calculated the effects of three heart healthy behaviours among populations aged 50 years and over on life expectancy with and without cardiovascular disease. For the life table calculations, we used hazard ratios for 3 transitions (No CVD to CVD, no CVD to death, and CVD to death) by health behaviour category, and adjusted for age, sex, and potential confounders.

RESULTS: High levels of physical activity, never smoking (men), and normal weight were each associated with 20-40% lower risks of developing CVD as compared to low physical activity, current smoking and obesity, respectively. Never smoking and high levels of physical activity reduced the risks of dying in those with and without a history of CVD, but normal weight did not. Never-smoking was associated with the largest gains in total life expectancy (4.3 years, men, 4.1 years, women) and CVD-free life expectancy (3.8 and 3.4 years, respectively). High levels of physical activity and normal weight were associated with lesser gains in total life expectancy (3.5 years, men and 3.4 years, women, and 1.3 years, men and 1.0 year women, respectively), and slightly lesser gains in CVD-free life expectancy (3.0 years, men and 3.1 years, women, and 3.1 years men and 2.9 years women, respectively). Normal weight was the only behaviour associated with a reduction in the number of years lived with CVD (1.8 years, men and 1.9 years, women).

CONCLUSIONS: Achieving high levels of physical activity, normal weight, and never smoking, are effective ways to prevent cardiovascular disease and to extend total life expectancy and the number of years lived free of CVD. Increasing the prevalence of normal weight could further reduce the time spent with CVD in the population.

Effects of a health advocacy program to promote physical activity and nutrition behaviors among adolescents: An evaluation of the Young Leaders for Healthy Change program

Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

The shaping of midlife women's views of health and health behaviors

The menopausal transition is a marker of aging for women and a time when health professionals urge women to prevent disease. In this research we adopted a constructivist, inductive approach in exploring how and why midlife women think about health in general, about being healthy, and about factors that influence engaging in healthy behaviors. The sample constituted 23 women who had participated in a women’s wellness program intervention trial and subsequent interviews. The women described lives of healthy eating and exercise, yet, their perceptions of health and healthy behavior at midlife contradicted that history. Midlife was associated with risk and guilt at not doing enough to be healthy. Health professionals provided a very limited frame within which to judge what is healthy. Mostly this was left up to individual women. Those who were successful framed health as “being able to do what you want to do when you want to do it.” In this article we present study findings of how meanings attached to health and being healthy were constructed through social expectations, family relationships, and life experiences.

Supplement use is associated with health status and health-related behaviors in the 1946 British birth cohort.

Use of dietary supplements may be one of a number of health-related behaviors that cluster together. The current study investigated the underlying diet, health-related characteristics, and behaviors of users and nonusers of dietary supplements in a longitudinal study of health. Participants (n = 1776) completed a 5-d food diary including information on dietary supplement use (vitamins, minerals, and nutraceuticals) at age 53 y. Sociodemographic information and data on smoking, alcohol, and physical activity were obtained along with anthropometric measurements, blood pressure, and a blood sample (nonfasting subjects). A significantly greater percentage of women reported supplement use compared with men (45.1 vs. 25.2%). Supplement use was associated with lower BMI, lower waist circumference, higher plasma folate and plasma vitamin B-12 concentrations, nonsmoking, participation in physical activity, and nonmanual social class in women and with plasma folate concentrations and participation in physical activity in men. Nonsupplement users tended to be nonconsumers of breakfast cereals, fruit, fruit juice, yogurt, oily fish, and olive oil and had lower dietary intakes of potassium, magnesium, phosphorus, iron, and vitamin C even after adjustment for sociodemographic and behavioral factors. Overall, supplement users tended to differ from nonsupplement users on a range of health-related behaviors and health status indicators, although there were fewer significant associations in men. Similarly, dietary supplements users tended to have underlying diets that, were healthier and those taking supplements may be the least likely to need them. These results support the notion of a clustering of healthy behaviors and cardiovascular risk factors, particularly for women.

Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji

Nearly one-half of the adult population in Fiji between the ages of 15–64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13–18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.

Pharmacology and biochemistry undergraduate students'concern for a healthy diet and nutrition knowledge

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Public attitudes on the ethics of deceptively planting false memories to motivate healthy behavior

Researchers have proposed that planting false memories could have positive behavioral consequences. The idea of deceptively planting “beneficial” false memories outside of the laboratory raises important ethical questions, but how might the general public appraise this moral dilemma? In two studies, participants from the USA and UK read about a fictional “false-memory therapy” that led people to adopt healthy behaviors. Participants then reported their attitudes toward the acceptability of this therapy, via scale-rating (both studies) and open-text (Study 2) responses. The data revealed highly divergent responses to this contentious issue, ranging from abject horror to unqualified enthusiasm. Moreover, the responses shed light on conditions that participants believed would make the therapy less or more ethical. Whether or not deceptively planting memories outside the lab could ever be justifiable, these studies add valuable evidence to scientific and societal debates on neuroethics, whose relevance to memory science is increasingly acute.

Perceptions of the built environment and associations with walking among retirement village residents

Housing options, such as retirement villages, that promote and encourage healthy behaviors are needed to accommodate the growing older adult population. To examine how environmental perceptions relate to walking, residents of retirement villages in Perth, Australia, were sampled, and associations between a wide range of village and neighborhood environmental attributes and walking leisurely, briskly, and for transport were examined. Perceived village features associated with walking included aesthetics (odds ratio [OR] = 1.72), personal safety (OR = 0.43), and services and facilities (OR = 0.80), whereas neighborhood attributes included fewer physical barriers (OR = 1.37) and proximate destinations (OR = 1.93). Findings suggest that locating retirement villages in neighborhoods with many local destinations may encourage more walking than providing many services and facilities within villages. Indeed, safe villages rich with amenities were shown to be related to less walking in residents. These findings have implications for the location, design, and layout of retirement villages.

Comparison of Body Composition Assessment Methods in Breast Cancer Survivors

Purpose/Objectives: To examine and compare the reliability of four body composition methods commonly used in assessing breast cancer survivors. Design: Cross-sectional. Setting: A rehabilitation facility at a university-based comprehensive cancer center in the southeastern United States. Sample: 14 breast cancer survivors aged 40-71 years. Methods: Body fat (BF) percentage was estimated via bioelectric impedance analysis (BIA), air displacement plethysmography (ADP), and skinfold thickness (SKF) using both three- and seven-site algorithms, where reliability of the methods was evaluated by conducting two tests for each method (test 1 and test 2), one immediately after the other. An analysis of variance was used to compare the results of BF percentage among the four methods. Intraclass correlation coefficient (ICC) was used to test the reliability of each method. Main Research Variable: BF percentage. Findings: Significant differences in BF percentage were observed between BIA and all other methods (three-site SKF, p < 0.001; seven-site SKF, p < 0.001; ADP, p = 0.002). No significant differences (p > 0.05) in BF percentage between three-site SKF, seven-site SKF, and ADP were observed. ICCs between test 1 and test 2 for each method were BIA = 1, ADP = 0.98, three-site SKF = 0.99, and seven-site SKF = 0.94. Conclusions: ADP and both SKF methods produce similar estimates of BF percentage in all participants, whereas BIA overestimated BF percentage relative to the other measures. Caution is recommended when using BIA as the body composition method for breast cancer survivors who have completed treatment but are still undergoing adjuvant hormonal therapy. Implications for Nursing: Measurements of body composition can be implemented very easily as part of usual care and should serve as an objective outcome measure for interventions designed to promote healthy behaviors among breast cancer survivors. - See more at: https://onf.ons.org/onf/38/4/comparison-body-composition-assessment-methods-breast-cancer-survivors#sthash.5djfTS1Q.dpuf

A contribuição das tecnologias não-invasivas de cuidado de enfermagem para o empoderamento feminino na gravidez e no parto: adaptação do modelo de promoção da saúde de Nola Pender

Trata-se de um estudo do tipo estudo de caso, na abordagem qualitativa, que visa a analisar as vivências das mulheres que utilizaram as tecnologias não-invasivas de cuidado de enfermagem durante a gravidez e o parto e discutir quais e como essas tecnologias estimularam o empoderamento nelas. Para isso foram utilizadas referências que abordem conceitos de gênero, empoderamento e tecnologias. Como referencial teórico foi utilizado a de Promoção da Saúde de Nola Pender que, a partir da identificação dos fatores biopsicossociais do indivíduo, busca influenciar comportamentos saudáveis, visando ao bem-estar como proposta de promoção da saúde. O cenário do estudo foi a Casa de Parto David Capistrano Filho, localizada no município do Rio de Janeiro, e contou com a participação de dez mulheres que pariram na Casa. Para a coleta de dados, foi elaborado um diagrama semelhante ao de Pender, contendo alguns aspectos biopsicossociais das mulheres que pudessem ter influência na vivência de empoderamento delas. As entrevistas aconteceram entre os meses de março e maio de 2010. Os dados produzidos foram analisados e transformados em três categorias: características e vivências individuais da mulher; conhecimentos, sentimentos e influências, na gravidez e no parto, a partir do uso das tecnologias; e o resultado do empoderamento. A tecnologia relacional, como o acolhimento, o vínculo e a escuta sensível, influenciou de forma benéfica as mulheres desde o momento que elas iniciaram o pré-natal na Casa, já que no início da gravidez algumas tinham receio com as mudanças do corpo e com as responsabilidades da maternidade. A dor do parto também foi outra preocupação citada por desconhecerem a fisiologia do processo. Mas, através de tecnologias como a de informação, de apoio, de potencialização de expressão corporal, de favorecimento da presença do acompanhante e de respeito de escolha delas, o parto acabou sendo calmo, tranqüilo, acolhedor e prazeroso. Com isso, as tecnologias contribuíram para as vivências de fortalecimento do vínculo com o bebê, na maior autoconfiança em parir e no preparo da maternidade que despertou nelas um desejo de serem pessoas de opiniões próprias e de terem uma formação profissional para garantir um bom futuro para o filho. Percebeu-se, nesse estudo, que as tecnologias favoreceram o empoderamento delas em parir numa Casa de Parto sendo assistidas por enfermeiras obstetras. No entanto, elas ainda se mostram passivas à dominação masculina quando valorizam a capacidade feminina em conquistar o espaço público masculino, mesmo em detrimento de suas reais necessidades, mostrando a importância de mais discussão sobre a temática a fim de vislumbrar novas tecnologias que auxiliem às mulheres a transpor esse empoderamento, adquirido durante a gravidez e o parto, para o seu dia a dia.

Características pessoais e institucionais e comportamentos de autocuidado de docentes de enfermagem segundo os modos adaptativos de Roy: estudo em Instituições Públicas do Estado do Rio de Janeiro

Este trabalho enfoca a promoção da vida através de comportamentos saudáveis, tendo como objetivos: delinear o perfil sociodemográfico e institucional/profissional dos docentes de enfermagem e analisar seus hábitos de vida, segundo os modos adaptativos de Roy. Foi utilizada a Teoria de Sister Callista Roy, destacando-se os modos de adaptação: fisiológico, autoconceito e interdependência. Implementou-se o método descritivo, quantitativo, transversal através da técnica de autorelato em amostra de 101 docentes. Para investigar esses aspectos, utilizou-se dois questionários, um deles com a escala de Likert, adaptado para a pesquisa. A produção de dados transcorreu de janeiro a março de 2009, após aprovação do Comitê de Ética em Pesquisa, Protocolo 2187, e concordância das quatro instituições públicas de ensino universitário, do Estado do Rio de Janeiro-Brasil, selecionadas. Os dados obtidos foram submetidos á estatística, aplicando-se medidas de tendência central. Quanto ao perfil docente: predomina a faixa etária de 40 a 59 anos, com 69,3%, de união estável. Relacionando cor e crença religiosa, constatou-se 37,6% de católicos brancos. Dos 50 docentes, 5% têm residência própria, na zona norte. Possuem renda individual acima de 8 salários mínimos, 67,32%, a maioria com vínculo trabalhista. No tempo de serviço, 22,94% situam-se entre 11 a 15 anos, com carga horária de 20 a 40 horas. Quanto à titulação, 42,56% são doutores e 80,2% possuem um tipo de regime estatutário. Concernente aos Modos Adaptativos de Roy foi atribuído, predominantemente, o conceito A- hábitos de vida saudável, aos modos Fisiológicos e de Autoconceito, seguindo-se o de Interdependência, que apresentou quatro conceitos B- em busca de hábitos de vida saudável, sendo o mais homogêneo dos três modos. Identificou-se que o Modo Fisiológico foi heterogêneo, pois os valores das medidas de tendência central se distanciam entre si. Concluindo-se que o pressuposto formulado atendeu parcialmente às expectativas dos docentes por utilizarem, em benefício próprio, seus saberes sobre o cuidar promovendo o bem-estar com qualidade. Considerou-se que a interdependência pode ser conquistada pelos sujeitos, visto que o enfrentamento das suas atividades profissionais, paralelamente ao viver pessoal, pode ser motivo de satisfação com o trabalho docente, remuneração recebida, ambiente institucional, relações de poder/saber no trabalho, além da possibilidade de atender sua necessidade gregária promovendo o convívio com a família e amigos. Lembra-se que lidar com pessoas cujas subjetividades devem ser objetivadas, visando sua compreensão para o atendimento de saúde, exige equilíbrio e progresso das dimensões corporais física, mental e espiritual do profissional.

The Psychological and Health Consequences of Caring for a Spouse With Dementia:A Critical Comparison of Husbands and Wives

Caring for someone with dementia can be demanding, particularly for spouses living with the care recipient. The main goal of this study was to clarify differences in the experience of caregivers who were husbands and wives with respect to burden, health, healthy behaviors, presence of difficult care recipient behaviors, social supports, and the quality of the premorbid relationship. The results of this study support research demonstrating a difference between the caregiving experiences of women and men. It is becoming increasingly apparent that female gender is a marker that places them at increased risk of high burden and less support.

Processos de cuidar em enfermagem:idosos com hipertenção arterial

Tese de doutoramento, Enfermagem, Universidade de Lisboa, com a participação da Escola Superior de Enfermagem, 2014

Plano de Negócio para a aplicação mobile Nutri Consult

Trabalho de projeto apresentado à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Publicidade e Marketing.