Physical activity counseling in primary health care in Brazil: a national study on prevalence and associated factors

Abstract Background The aim of this study was to determine the prevalence and correlates of physical activity counseling among physicians and nurses working in primary health care in Brazil. Methods A phone survey was carried out in 2011 with professionals working in primary health care in Brazil. The target sample consisted of 1,600 randomly selected primary care units covering all regions of the country. We successfully interviewed 529 professionals within the sampled units; 182 physicians and 347 nurses. The overall response rate was 49.6%. Multivariable logistic regression was used to estimate correlates of counseling in the whole sample and separately for physicians and nurses. Results The prevalence of regular physical activity counseling for at least six months was 68.9% (95% CI 64.9; 72.8) and was significantly higher among physicians compared to nurses (p < 0.05). Most professionals (93.2%) interviewed were unfamiliar with current physical activity recommendations for health. In the adjusted analysis, physical activity counseling was more frequent among those who report assessing patient’s physical activity (OR = 2.16; 95% CI 1.41; 3.29), those reporting that lack of time was not a barrier for counseling (OR = 0.62 95% CI 0.42-0.93), those who felt prepared to provide physical activity counseling (OR = 2.34; 95% CI 1.50-3.66), and those working at primary care units offering physical activity programs for patients (OR = 2.06; 95% CI 1.33-3.20). In the stratified analysis, only assessing patient’s physical activity was a significant correlate among physicians whereas assessing patient’s physical activity, feeling prepared to provide counseling and working in units with physical activity interventions were significant correlates among nurses. Conclusions Physicians and nurses deemed physical activity counseling of great importance in primary health care in Brazil. However, in order to increase the quality of counseling and the number of professionals engaging in this activity, these health teams require greater knowledge about physical activity (global recommendations for health) as well as training on the application of instruments for assessing physical activity. Moreover, sufficient time must be allowed during consultations for the counseling process, and physical activity promotion programs should be implemented within the primary health care units.

Linking local knowledge, conservation practices and ecosystem diversity: comparing two communities in the Tunari National Park (Bolivia)

Combined approaches to conserve both biological and cultural diversity are seen as an alternative to classical nature conservation instruments. The objective of this study was to examine the influence of urbanization coupled with exclusive conservation measures, on land use, local knowledge and biodiversity in two Quechua speaking communities of Bolivia located within the Tunari National Park. We assessed and compared the links between land use, its transformation through conservation practices, local institutions and the worldviews of both communities and the implications they have for biodiversity at the level of ecosystems. Our results show that in both communities, people’s worldviews and environmental knowledge are linked with an integral and diversified use of their territory. However, the community most affected by urbanization and protected area regulations has intensified agriculture in a small area and has abandoned the use of large areas. This was accompanied by a loss of local environmental knowledge and a decrease in the diversity of ecosystems. The second community, where the park was not enforced, continues to manage their territory as a material expression of local environmental knowledge, while adopting community-based conservation measures with external support. Our findings highlight a case in which urbanization coupled with exclusive conservation approaches affects the components of both cultural and biological diversity. Actions that aim to enhance biocultural diversity in this context should therefore address the impact of factors identified as responsible for change in integrated social-ecological systems.

PREPAID MENTAL HEALTH SERVICES: A NATIONAL PERSPECTIVE

The purpose of this 1982 national survey of all operational prepaid health plans, or PHPs (including health maintenance organizations), was to provide information on the current coverage of PHP mental health and substance abuse services, benefits and service provision, general and mental health organization characteristics, mental health service costs, and physical and mental health service utilization.^ Two survey instruments were designed, pretested and distributed to all operational PHPs throughout the United States. A total of 237 PHPs were surveyed, of which 205 (86.50 percent) completed and returned both questionnaires.^ One result of the rapid growth in the PHP field over the past ten years has been the expansion in both the number of PHPs as well as the organizational characteristics of these PHPs. However, little attention in the research literature has been given to the application of empirical results to the PHP arrangements. This project has attempted to contribute to current knowledge regarding prepaid mental health services from a national perspective, and explore, on a preliminary descriptive basis, the variety of potential service delivery arrangements for physical and mental health services (total services) and for mental health services.^ The study emphasized that PHPs must continue to monitor the costs and utilization of mental health services, particularly in light of the apparent elimination of data collection and statistical summary responsibilities within the federal government regarding PHP activities as well as the proposed legislation to eliminate mandated mental health and substance abuse services from basic health plan benefits for federally qualified PHPs. ^

Legitimising EU Policymaking: What Role for National Parliaments? EPC Discussion Paper, 28 January 2014

The ‘euro crisis’ has sparked a renewed interest in how national parliaments can help to improve the democratic nature of European decision making. According to various treaties, assemblies in the Member States are now guaranteed a full spectrum of rights including access to information, participation and the ability to object to EU legislation. The authors of this Discussion Paper argue that there is still room to refine and promote a more responsible use of existing instruments. Moreover, the possibility of adding new mechanisms to the available toolkit is part of the discussion on the topic but the authors warn that any proposals must be carefully considered on a case-by-case basis, especially in the context of the European economic governance reform process. Ultimately, according to the authors, the most straightforward and effective way for national parliaments to strengthen their direct involvement in EU policy formulation is to focus on building capacity to perform their two key domestic responsibilities: to hold their own governments to account, also on EU affairs, and to maintain the link with voters, including by communicating and debating ‘Europe’ at ‘home’.

Mountains of the world - Sustainable development in mountain areas: The need for adequate policies and instruments

This brochure deals with policies and policy instruments needed to promote sustainable development in mountain areas. The first part presents an overview of key issues in mountain development, and principles and strategies that should be adopted. Each principle contains a checklist for policy-makers. The second part presents national and regional case studies of successful approaches and initiatives relating to mountain policy from all over the world. The brochure concludes with a call for multi-level initiatives and partnerships. This full-colour publication is part of the Mountains of the World series. It was prepared for the 2002 World Summit on Sustainable Development in Johannesburg by an international panel of experts coordinated by CDE. It was commissioned and funded by the Swiss Agency for Development and Cooperation (SDC).

Academic research instruments and instrumentation needs, 1992 /

Mode of access: Internet.

Practical aspects of the use of AC-DC transfer instruments. /

Mode of access: Internet.

Boiler and turbine room instruments; serial report of the Prime Movers Committee (1925-1926)

Mode of access: Internet.

Space measurements survey: Instruments and spacecraft, October 1957-March 1965.

Mode of access: Internet.

The National measurement system for length and related dimensional measurements /

Includes bibliographical references.

Le musée du Conservatoire national de musique : 1er [&] 2e supplément au catalogue de 1884 /

Contains two supplements listing instruments added to the collection since the 1884 catalogue.

A pénzügyi eszközök szerepe az Európai Unió kohéziós politikájában (Cohesion policy - The role of financial instruments)

A tanulmány az Európai Unió strukturális és kohéziós alapjaiból létrehozott pénzügyi eszközök szerepét és perspektíváit elemzi. A téma aktualitását adja, hogy jelenleg zajlik a 2014–2020-as uniós költségvetési és programozási időszak előkészítése, amelynek során a pénzügyi eszközök az uniós elképzelések szerint az eddigieknél lényegesen jelentősebb szerepet játszanak majd. A szerző áttekinti a kohéziós politika keretében működő pénzügyi eszközök jelenlegi rendszerének legfőbb jellemzőit, bemutatja azokat a gyökeres változásokat, amelyek 2014-től kezdődően várhatóan jellemezni fogják a kapcsolódó szabályozási környezetet, végül pedig ismerteti a gyakorlatban működő jelentősebb programokat, amelyek referenciapontként is használhatók a programok tervezése során. _____ The paper examines the role and perspectives of financial instruments established from the structural and cohesion funds of the European Union. Hungary is one of the most significant beneficiaries of the structural and cohesion funds, therefore the interested national actors should know well the new support forms, in order to use them successfully in the next programming period. The article gives an overview about the current structure of financial instruments in the framework of the cohesion policy. The comprehensive changes of the regulatory environment expected from 2014 are also presented, and finally the major instruments in practice will be reviewed, that can serve as reference points in planning of future programmes.

The trajectory of social housing policy in Brazil: From the National Housing Bank to the Ministry of the Cities

This paper discusses social housing policy in Brazil since the 1990s by analyzing government programs’ institutional arrangements, their sources of revenues and the formatting of related financial systems. The conclusion suggests that all these arrangements have not constituted a comprehensive housing policy with the clear aim of serving to enhance housing conditions in the country. Housing ‘policies’ since the 1990s – as proposed by Fernando Collor de Mello, Itamar Franco, Fernando Henrique Cardoso and ´ Luis Inacio Lula da Silva’s governments (in the latter case, despite much progress towards subsidized investment programs) – have sought to consolidate financial instruments in line with global markets, restructuring the way private interests operate within the system, a necessary however incomplete course of action. Different from rhetoric, this has resulted in failure as the more fundamental social results for the poor have not yet been achieved.

The trajectory of social housing policy in Brazil: From the National Housing Bank to the Ministry of the Cities

This paper discusses social housing policy in Brazil since the 1990s by analyzing government programs’ institutional arrangements, their sources of revenues and the formatting of related financial systems. The conclusion suggests that all these arrangements have not constituted a comprehensive housing policy with the clear aim of serving to enhance housing conditions in the country. Housing ‘policies’ since the 1990s – as proposed by Fernando Collor de Mello, Itamar Franco, Fernando Henrique Cardoso and ´ Luis Inacio Lula da Silva’s governments (in the latter case, despite much progress towards subsidized investment programs) – have sought to consolidate financial instruments in line with global markets, restructuring the way private interests operate within the system, a necessary however incomplete course of action. Different from rhetoric, this has resulted in failure as the more fundamental social results for the poor have not yet been achieved.