New directions for diabetes prevention and management in behavioral medicine

Accelerating diabetes rates have resulted in a global public health epidemic. Lifestyle change is a cornerstone of care, yet regimen demands may result in adherence difficulties. Distress, depression, and other psychosocial concerns are higher in those with diabetes. While interventions, such as the Diabetes Prevention Program appear to be effective, further research is needed to support the translation of interventions to prevent diabetes. Studies assessing optimal approaches to promoting effective decision making, coping and adherence are needed. More information is needed to evaluate the influence and potential of emerging technologies on intervention delivery and quality of life in children and adults with diabetes. Theoretically informed, interdisciplinary studies that consider ecological models are needed to develop a roadmap for policies and diabetes management recommendations. Reduction of diabetes-related health disparities is a critical area for future studies. Behavioral medicine scientists and practitioners are poised to address these and other proposed future research directions to advance diabetes prevention and management.

[How did Japanese rural dwellers become rapidly healthier in the two decades following World War II?: Examining the diverse policy interventions that improved the population's health]

Objective　During the two decades following Japan's World War II surrender in 1945, tremendous improvement in the population's health was observed, particularly in infant mortality and life expectancy. How did Japanese rural dwellers achieve such remarkable health improvement during this relatively short time span while its economy remained heavily damaged following the war? While the efforts from government-driven public health strategies and programs are well known, relatively little is known about the contributions of policies in non-health sectors. Therefore, the main aim is to verify, using literature based sources, whether non-health sectors contributed to the betterment of the population's health in addition to the public health sector policies.Hypotheses　Synergistic efforts of diverse interventions from different policies and programs likely catalyzed the drastic health improvement observed in the Japanese population in the two decades after World War II. The Ministry of Health and Welfare, for example, implemented programs to provide health care services. These are thought to have contributed directly to reducing maternal and child mortality, as well as tuberculosis-related mortality. Additionally, the Ministry of Agriculture and Forestry carried out a nationwide livelihood improvement program to enhance individual and family lifestyles, improve indoor and outdoor environments, and strengthen social solidarity. The ministry also attempted to generate income stability for farmers through an agricultural improvement program to ensure allocation of household income to family health. The Ministry of Education also had an initiative to disseminate the concepts of democracy and rational thought to the Japanese population through a social education program. Through these efforts, superstition and pre-modern customs were reduced, and subsequently health awareness increased, leading to an improvement in the population's health.Conclusion　The public health policies implemented in Japan as well as the integration of various policies and programs addressing livelihoods, economics, and education greatly improved the population's health in a relatively short time. These non-health initiatives intersected with a wide range of health determinants. Verifying these hypotheses in detail would help develop effective measures for international aid to poverty-stricken regions. It also encourages alternative ways through which Japan could overcome its present-day challenges such as a rapidly aging population with limited access to national schemes for social security.

A Facebook-Based Obesity Prevention Program for Korean American Adolescents: Usability Evaluation

INTRODUCTION

Adolescent obesity is one of the most serious global public health challenges. Social networking sites are currently popular among adolescents. Therefore, the obesity prevention program for Korean American adolescents was developed on the most popular social networking site, Facebook. The purpose of this study was to evaluate the usability of a culturally tailored Facebook-based obesity prevention program for Korean American adolescents (Healthy Teens).

METHOD

An explorative descriptive design of usability testing was used. Usability testing employing one-on-one observation, the think-aloud method, audio taping, screen activity capture, and surveys was performed. Twenty participants were recruited from two Korean language schools (mean age, 15.40 ± 1.50 years). Recruitment and user testing was performed between February and April 2014. Content analysis, using the inductive coding approach, was performed by three coders to analyze transcriptions. Descriptive statistics were used to analyze quantitative data including demographic characteristics, perceived usability, eHealth literacy, and health behaviors.

RESULTS

Testing revealed several usability issues in content, appearance, and navigation. Participants' comments regarding content were positive. Although the Facebook platform provided limited flexibility with respect to building the site, participants described the program's appearance as appropriate. Most participants did not experience difficulty in navigating the program.

DISCUSSION

Our preliminary findings indicated that participants perceived the Healthy Teens program as usable and useful. This program could be used as a robust platform for the delivery of health education to adolescents. Further research is required to assess the effects of Facebook-based programs on adolescent obesity prevention.

Systems biology approaches to understand the effects of nutrition and promote health

Within the last years the implementation of systems biology in nutritional research has emerged as a powerful tool to understand the mechanisms by which dietary components promote health and prevent disease as well as to identify the biologically active molecules involved in such effects. Systems biology, by combining several '-omics' disciplines (mainly genomics/transcriptomics, proteomics and metabolomics), creates large data sets that upon computational integration provide in silico predictive networks that allow a more extensive analysis of the individual response to a nutritional intervention and provide a more global comprehensive understanding of how diet may influence health and disease. Numerous studies have demonstrated that diet and particularly bioactive food components play a pivotal role in helping to counteract environmental-related oxidative damage. Oxidative stress is considered to be strongly implicated in ageing and the pathophysiology of numerous diseases including neurodegenerative disease, cancers, metabolic disorders and cardiovascular diseases. In the following review we will provide insights into the role of systems biology in nutritional research and focus on transcriptomic, proteomic and metabolomics studies that have demonstrated the ability of functional foods and their bioactive components to fight against oxidative damage and contribute to health benefits.

Global and Public Mental Health Promotion for Empathic Civilisation: the Role of Political Psychocultures

This article draws attention to the relationship between neuroethics, neuropolitics, political psycho-cultures and public and global mental health. In the hegemonic culture of neoliberalism the purpose of life has been reduced to the self-realization in economic and consumerism terms that promotes the hypercompetitive narcissistic or manic self, indifferent to the fate and suffering of others and accommodated to commodification of morals, mental health and well-being. The real public and global mental health promotion is strongly associated with creating a more empathic, less selfish individual and collective mind where people put a greater emphasis on common interests and bioethical values.

Effects of a National Health Education Program on the Medication Knowledge of the Public in Taiwan

Background:

The inappropriate use of medication and inadequate medication knowledge among the general population has long been a concern in Taiwan. One reason for the deficiencies might be the lack of an active role of pharmacists in educating the public. To rectify the situation, in 2002, the Bureau of Pharmaceutical Affairs, Department of Health of Taiwan, began to sponsor a national effort, titled Community Education Program on Medication Use, to involve the expertise of pharmacists in public education.

Objective:

To evaluate the effects of this education program by analyzing the changes in knowledge of drug therapy among the participating public.

Methods:

This was a single-group pre- and post-comparison study. Between September 2003 and January 2004, a total of 955 community residents enrolled in the pharmacist-facilitated education program offered at 31 community universities. The medication knowledge of the participants was evaluated before and after the program. Demographic variables that might affect the education outcomes of the program were also examined.

Results:

Medication knowledge at baseline was positively correlated with education level and negatively correlated with age. Females were more aware of drug-related information than were males. The participants showed a significant improvement in medication knowledge (p < 0.001) at the end of the program. The baseline knowledge score was the most important determinant of the improvement of the posttest score.

Conclusions:

A national education program facilitated by pharmacists can improve the medication knowledge of the participants. Pharmacists should be encouraged to play a proactive role in large-scale health education programs.

Draconian restrictions on visitors help no one

A couple of years ago, I was asked to meet two women who wanted to tell me about John's Campaign. I spent a revelatory hour with Nicci Gerrard and Julia Jones, hearing why they started the campaign and what they hoped to achieve.

[Evaluation of Uruguay's antismoking campaign: progress and challenges at ten years]

In 2005, shortly after ratifying the Framework Convention on Tobacco Control (FCTC), Uruguay began an ambitious tobacco control campaign that brought the country to the global forefront in the fight against smoking. The wide range of measures implemented in a relatively short period and the rigorousness with which policies were implemented and enforced have few precedents, even in the most developed countries. This paper presents a synthesis and update of several papers by the authors that evaluate different aspects of the campaign ten years following ratification of the FCTC. In particular, these research studies highlight the campaign's aggregate impact on the drop in prevalence of current tobacco consumption in adult and youth populations, and on decisions by pregnant women to quit smoking (1, 2), as well as the relative impact of tax policies in relation to non-price tobacco control measures. The analyses are based on observational studies (at the population or individual level) that use external (Argentina and Chile) and internal (nonsmokers) control groups. Pending challenges in the design of antismoking policies are also discussed.

Twenty-five-year trends in lifestyle and socioeconomic characteristics in Eastern Finland

Aims: Little is known about changes in lifestyle and socioeconomic characteristics among physical activity subgroups over time. This study aimed at assessing whether the lifestyle and the socioeconomic profile of people with either low total physical activity (TPA) or high TPA changed during 1972—97. Methods: Six independent cross-sectional surveys were carried out among a middle-aged population at five-year intervals in Eastern Finland, 1972—97. The participation rates varied from 71% to 95% (n=33,712). Physical activity during leisure time (LTPA) and occupational physical activity (OPA) were determined by a self-administered questionnaire. TPA was calculated by combining LTPA and OPA. Results: Men with low TPA were older, smoked more, and had a higher BMI than men with high TPA. The increase in BMI was almost fourfold in sedentary men (trend 0.4%/5 years, p=0.023 for trend) than in highly active men (trend 0.1%/5 years, p=0.044 for trend). Education no longer accounted for the socioeconomic difference after 1977. Sedentary women had a higher BMI and smoking prevalence than those with high TPA. The difference in age, education, and marital status disappeared between those two groups after 1977. Conclusions: The lifestyle and the socioeconomic profiles of people with both low TPA and high TPA have changed during 1972—97.

The Future Role of Nursing in Health Promotion

Never before has health promotion been more important than it is today. Nurses in education, practice, and research settings can participate in the advancement of health promotion not only to the mainstream but to the forefront of nursing practice. Historically, nurse educators have taught patients how to manage illness; in the future, the focus must be on teaching people how to remain healthy. Nurses must have an evidence-based understanding of the significant effect that can be made through health promotion interventions and communicate this understanding to the public at large. As more people grow in their awareness of activities that lead to good health and become knowledgeable about their own health status and the health of their families, the overall health of the population will improve.

Emerging Trends in Health and Productivity Management

Many large U.S. employers have generally embraced a Health and Productivity Management (HPM) perspective to guide their multiple employee health management efforts. In looking ahead there are a number of emerging trends that are helping to shape these efforts. As health promotion professionals assess the implications of these trends on their respective role and function within the worksite, it may provide a very useful process for refining strategies for programming and professional development. The identified trends also have a variety of implications for health promotion vendors and the growth of the health management marketplace.

Five-Year Progress Update on the Surgeon General's Call to Action to Support Breastfeeding, 2011

In 2011, Surgeon General Regina Benjamin issued a Call to Action to Support Breastfeeding (Call to Action) in an effort to mobilize families, communities, clinicians, healthcare systems, and employers to take action to improve support for breastfeeding. The Call to Action identified 20 key action steps to address society-wide breastfeeding barriers in six areas: mothers and families, communities, healthcare, employment, research, and public health infrastructure. This report highlights major federal activities that show progress toward answering the Call to Action in the first 5 years since its launch.

[Overview of French public policies promoting health-enhancing physical activity]

Although multiple strategies are used to promote physical activity, they do not cover all sectors. This configuration also raises the question of the harmonization of these national public policies and the existence of intersectoral coordination mechanisms.<np pagenum="026"/> </ce:para>.

Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going?

Since the "2007 summary report of child and adolescent overweight and obesity treatment" published by Barlow, many obesity intervention studies have been conducted in pediatric ambulatory care. Although several meta-analyses have been published in the interim, many studies were excluded because of the focus and criteria of these meta-analyses. Therefore, the primary goal of this article was to identify randomized case-control trials conducted in the primary care setting and to report on treatment approaches, challenges, and successes. We have developed four themes for our discussion and provide a brief summary of our findings. Finally, we identified major gaps and potential solutions and describe several urgent key action items.