Healthy Family Newsletter, December 2010

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, January 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, February 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, March 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, April 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, May 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, October 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, November 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Healthy Family Newsletter, December 2012

The Iowa Dept. of Public Health, Iowa's Food Assistance Program provides nutrition assistance to people with low income. It can help you buy nutritious foods for a better diet, this newsletter is provided to help instruct people about healthy food choices.

Do childhood cancer survivors with physical performance limitations reach healthy activity levels?

BACKGROUND: The extent to which physical performance limitations affect the ability of childhood cancer survivors to reach healthy activity levels is unknown. Therefore this study aims to describe the effect of different types of limitations on activity levels in survivors. PROCEDURE: Within the Swiss Childhood Cancer Survivor Study we sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2005 aged <16 years. We measured healthy activity levels using international guidelines and assessed different kinds of performance limitations (visual impairment, weight and endurance problems, cardiorespiratory, musculoskeletal, and neurological problems, pain and fatigue syndromes). RESULTS: The sample included 1,560 survivors (75% response rate), of whom 209 (13.5%) reported they have performance limitations. Forty-two percent of survivors with limitations reached healthy activity levels, compared to 57% of survivors without limitations. Least active were survivors with vision impairments (25% active), weight and endurance problems (27.3%), cardiorespiratory problems (36.4%), and musculoskeletal problems (43.1%). After adjusting for socio-demographic variables and type of cancer, we found that survivors with limitations were 1.4 (95%CI 1.0-2.0; P = 0.047) times more likely to be inactive. CONCLUSIONS: Although many survivors with physical performance limitations maintain healthy activity levels, there is room for improvement. Adapted and targeted physical activity counseling for survivors with performance limitations might help them to raise level of activity and pursue a healthy lifestyle.

Le projet "SYNAPSY": un point de rencontre entre clinique et neurosciences [The "SYNAPSY" project: where psychiatrists and neuroscientists meet].

The National Center of Competence in Research project "SYNAPSY" aims at identifying certain mechanisms of psychiatric and cognitive disorders, in order to improve the understanding and the genesis of such pathologies, and to promote the development of better diagnostic tools and of new therapeutic approaches. It provides an excellent opportunity for clinical psychiatrists and neuroscientists to develop a synergic mode of collaboration. On the basis of questions stemming from clinical practice and in the frame of patients cohorts, various research projects in neuroscience should lead to progresses that may have a considerable impact on clinical practice.

Sociodemographic and Behavioural Determinants of a Healthy Diet in Switzerland.

BACKGROUND/AIMS: The determinants of a healthy diet have not been studied in Switzerland. This study aimed at assessing the individual and behavioural factors associated with a healthy diet in a Swiss city. METHODS: Cross-sectional, population-based study conducted between 2009 and 2013 (n = 4,439, 2,383 women, mean age 57.5 ± 10.3 years) in Lausanne. Food consumption was assessed using a validated food frequency questionnaire. Two Mediterranean diet scores (classic score and specific for Switzerland) and the Harvard School of Public Health alternate healthy eating index were computed. RESULTS: For all three dietary scores considered, living in couple or having a high education were associated with a healthier diet. An unhealthy lifestyle (smoking, sedentary behaviour) or a high body mass index were associated with an unhealthier diet. Participants born in Italy, Portugal and Spain had healthier diets than participants born in France or Switzerland. Women and elderly participants had healthier diets than men and young participants according to 2 scores, while no differences were found for the Swiss-specific Mediterranean score. CONCLUSIONS: In Switzerland, healthy eating is associated with high education, a healthy lifestyle, marital status and country of origin. The associations with gender and age depend on the dietary score considered.

Challenges to patient-centred care in a general internal medicine context: findings from an exploratory study

Introduction. If we are to promote more patient-centred approaches in care delivery, we have to better characterize the situations in which being patient-centred is difficult to achieve. Data from professionals in health and social care are important because they are the people charged with operationalizing patient-centred care (PCC) in their daily practice. However, empirical accounts from frontline care providers are still lacking, and it is important to gather experiences not only from doctors but also from the other care providers. Indeed, experiences from different professions can help inform our understanding of patient care, which is expected to be both patient-centred and collaborative. Methods. This study was based on the following research question: What factors make the provision of PCC difficult to achieve? Sample and setting. A purposeful sampling technique was used, allowing for a series of choices about the participants and their professional affiliation. Because patient-centredness is the focus, 3 professions appeared to be of special interest: general internists, nurses and social workers. The study was undertaken in the General Internal Medicine Division of a teaching hospital located in a North American context. Data Collection. To answer the research question, a methodological approach based on a theory called phenomenology was chosen. Accordingly, semi-structured interviews were used since they generate understanding of the meanings different individuals have of their lived world. Interviews with 8 physicians, 10 nurses and 10 social workers were eventually conducted. Data analysis. An inductive thematic analysis was employed to make sense of the interview data. Results. The thematic analysis allowed identifying various types of challenges to PCC. Although most of the challenges were perceived by all three groups of professionals, they were perceived to a different degree across the professions, which likely reflected the scope of practice of each profession. The challenges and their distribution across the professions are illustrated in Table 1. Examples of challenges are provided in Table 2. Discussion. There is a tension between what is supposed to be done - what stands in the philosophy of patient -centredness - and what is currently done - the real life with all the challenges to PCC. According to some participants' accounts, PCC clearly risks becoming a mere illusion for health care professionals on which too great pressures are imposed.

Physical activity in adolescence - with special reference to cardiovascular health

Liikunta ja sydän- ja verisuoniterveys nuorilla Aikuisiällä ilmenevien sydän- ja verisuonisairauksien kehitys alkaa lapsuudessa. Vähäinen liikunta lisää vaaraa sairastua sydän- ja verisuonisairauksiin sekä vaikuttaa haitallisesti näiden sairauksien riskitekijöihin läpi elämän. Tämän tutkimuksen tavoitteena oli tutkia nuorten liikuntaa ja sen yhteyttä sydän- ja verisuoniterveyteen. Sydän- ja verisuoniterveyttä tutkittiin riskitekijöiden sekä valtimon laajentumiskyvyn avulla. Tutkittavat koostuivat nuorista, jotka osallistuivat pitkäaikaisen sepelvaltimotaudin ehkäisytutkimuksen (STRIP) 13-vuotistutkimuskäynnille ja jotka raportoivat vapaa-ajan liikuntatottumuksensa (n=560). Liikunnan lisäksi nuorten pituus, paino, verenpaine ja olkavaltimon laajentumiskyky mitattiin sekä analysoitiin laboratorionäytteitä (otettiin verinäyte) ja selvitettiin ruoankäyttöä. Vähäinen vapaa-ajan liikunta oli yleistä etenkin tytöillä. Vapaa-ajallaan vähän liikkuvat pojat viettivät enemmän aikaa televisio- ja tietokoneruudun ääressä kuin vapaa-ajallaan paljon liikkuvat pojat. Äidin, toisin kuin isän, vapaa-ajan liikunta ja paino olivat yhteydessä lapsen vapaa-ajan liikuntaan. Vähän liikkuvat tytöt olivat olleet jo kahden vuoden iästä saakka useammin ylipainoisia kuin runsaammin liikkuvat ikätoverinsa. Sydän- ja verisuonisairauksien riskitekijöiden kasautuminen oli tavallisempaa vähän kuin paljon liikkuvilla nuorilla. Vähän liikkuvilla pojilla oli lisäksi huonompi olkavaltimon laajentumiskyky kuin paljon liikkuvilla pojilla. Tämä on tärkeä löydös, koska valtimon laajentumiskyky kuvannee sydän- ja verisuoniterveyttä jo ennen rakenteellisten muutosten ilmaantumista. Useat nuoret, etenkin tytöt, liikkuivat vähän vapaa-ajallaan. Vähäisellä vapaa-ajan liikunnalla oli haitallinen yhteys sydän- ja verisuonisairauksien riskitekijöihin sekä valtimon laajentumiskykyyn. Nuorten kannustaminen liikunnalliseen elämäntapaan on erittäin tärkeää sydän- ja verisuoniterveyden edistämiseksi sekä nuoren että kansanterveyden kannalta.

Integration in project business : mechanisms for integrating customers and the project network during the life-cycle of industrial projects

This thesis focuses on integration in project business, i.e. how projectbased companies organize their product and process structures when they deliver industrial solutions to their customers. The customers that invest in these solutions run their businesses in different geographical, political and economical environments, which should be acknowledged by the supplier when providing solutions comprising of larger and more complex scopes than previously supplied to these customers. This means that the suppliers are increasing their supply range by taking over some of the activities in the value chain that have traditionally been handled by the customer. In order to be able to provide the functioning solutions, including more engineering hours, technical equipment and a wider project network, a change is needed in the mindset in order to be able to carry out and take the required responsibility that these new approaches bring. For the supplier it is important to be able to integrate technical products, systems and services, but the supplier also needs to have the capabilities to integrate the cross-functional organizations and departments in the project network, the knowledge and information between and within these organizations and departments, along with inputs from the customer into the product and process structures during the lifecycle of the project under development. Hence, the main objective of this thesis is to explore the challenges of integration that industrial projects meet, and based on that, to suggest a concept of how to manage integration in project business by making use of integration mechanisms. Integration is considered the essential process for accomplishing an industrial project, whereas the accomplishment of the industrial project is considered to be the result of the integration. The thesis consists of an extended summary and four papers, that are based on three studies in which integration mechanisms for value creation in industrial project networks and the management of integration in project business have been explored. The research is based on an inductive approach where in particular the design, commissioning and operations functions of industrial projects have been studied, addressing entire project life-cycles. The studies have been conducted in the shipbuilding and power generation industries where the scopes of supply consist of stand-alone equipment, equipment and engineering, and turnkey solutions. These industrial solutions include demanding efforts in engineering and organization. Addressing the calls for more studies on the evolving value chains of integrated solutions, mechanisms for inter- and intra-organizational integration and subsequent value creation in project networks have been explored. The research results in thirteen integration mechanisms and a typology for integration is proposed. Managing integration consists of integrating the project network (the supplier and the sub-suppliers) and the customer (the customer’s business purpose, operations environment and the end-user) into the project by making use of integration mechanisms. The findings bring new insight into research on industrial project business by proposing integration of technology and engineering related elements with elements related to customer oriented business performance in contemporary project environments. Thirteen mechanisms for combining products and the processes needed to deliver projects are described and categorized according to the impact that they have on the management of knowledge and information. These mechanisms directly relate to the performance of the supplier, and consequently to the functioning of the solution that the project provides. This thesis offers ways to promote integration of knowledge and information during the lifecycle of industrial projects, enhancing the development towards innovative solutions in project business.