XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017

This article presents an introduction to the Health Belief Model (HBM). The HBM states that the perception of a personal health behavior threat is influenced by at least three factors: general health values, interest and concern about health; specific beliefs about vulnerability to a particular health threat; and beliefs about the consequences of the health problem. Once an individual perceives a threat to his health and is simultaneously cued to action, if his perceived benefits outweighs his perceived costs, then the individual is most likely to undertake the recommended preventive health action. Key words: health promotion, health belief model, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy. Content available only in Romanian.

Health Belief Model

Estimates of global seasonal influenza-associated respiratory mortality: a modelling study

https://repositorio.insa.pt/bitstream/10400.18/2252/1/observacoes_8_2014_artigo7.pdf

Vigilância da gripe em Portugal no inverno 2013/2014

Wolmir Ercides Péres 1,2,* , Andreia F. S. Ribeiro 3, Ana Russo 3 and Baltazar Nunes 1,4 1 Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; bnunes@ensp.unl.pt 2 Campus Petrolina, Universidade de Pernambuco, Petrolina CEP 56328-900, Pernambuco, Brazil 3 Instituto Dom Luiz (IDL), Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisbon, Portugal; afsribeiro@fc.ul.pt (A.F.S.R.); acrusso@fc.ul.pt (A.R.) 4 Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, Lumiar, 1649-016 Lisbon, Portugal * Correspondence: wolmir.peres@upe.br

https://www.mdpi.com/2225-1154/8/2/32/pdf

Correction: Péres, W. E., et al. The Association between Air Temperature and Mortality in Two Brazilian Health Regions. Climate, 2020, 8, 1

This study aimed to compare the magnitude of educational inequalities in self-reported and examination-based hypertension and hypercholesterolemia and to assess the impact of self-reported measurement error on health inequality indicators. We used the Portuguese National Health Examination Survey data (n = 4911). The slope index of inequality (SII) and the relative index of inequality (RII) were used to determine the magnitude of absolute and relative education-related inequalities. Among the 25–49-year-old (yo) men, absolute and relative inequalities were smaller for self-reported than for examination-based hypertension (SIIeb = 0.18 vs. SIIsr = − 0.001, p < 0.001; RIIeb = 1.99 vs. RIIsr = 0.86, p = 0.031). For women, the relative inequalities were similar despite differences in self-reported and examination-based hypertension prevalence. For hypercholesterolemia, self-reported relative inequalities were larger than examination-based inequalities among the 50–74-yo men (RIIsr = 2.28 vs. RIIeb = 1.21, p = 0.004) and women (RIIsr = 1.22 vs. RIIeb= 0.87, p = 0.045), while no differences were observed among 25–49-yo. Self-reported data underestimated educational inequalities among 25–49-yo men and overestimated them in older individuals. Inequality indicators derived from self-report should be interpreted with caution, and examination-based values should be preferred, when available.

Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease?

https://repositorio.insa.pt/bitstream/10400.18/2995/1/Boletim_Epidemiologico_Observacoes_N11_janeiro-marco_2015_artigo2.pdf

Modelo de crenças em saúde na decisão da toma da vacina antigripal

Sunlight exposure is responsible for a large number of dermatological diseases. The purpose of this study was to estimate the prevalence of hazardous sun exposure and adherence to sun protective behaviours and its associated factors in adults from the Portuguese population. A total of 4,797 participants aged between 25 and 74 years old answered the sun exposure module of the National Health Examination Survey questionnaire, which was performed in 2015. Hazardous sun exposure and sun protective behaviours were assessed for a typical summer day during leisure time. Descriptive statistics and Poisson regression were used to examine associations between hazardous sun exposure and adherence to sun protective behaviours with population characteristics. Among the 4,797 participants, prevalence of hazardous sun exposure was 76.4 and 67.4% among men and women, respectively. It was mainly associated with younger age, lower education level and practice of regular physical activity. The prevalence of nonadherence to sun protective behaviours was 38.6 and 22.3%, among men and women, respectively. Education and income were inversely associated with adherence to sun protective behaviours. Individuals residing in regions displaying higher UV indexes had higher prevalence of sun protective practices. The prevalence of hazardous sun exposure and nonadherence to sun protective behaviours is considerable in the Portuguese population. The association between these indicators and sociodemographic factors in the population, reinforces the importance of developing sun protection messages directed at specific target audiences.

Baltazar Nunes

Papers

Vigilância da gripe em Portugal no inverno 2013/2014

Correction: Péres, W. E., et al. The Association between Air Temperature and Mortality in Two Brazilian Health Regions. Climate, 2020, 8, 1

Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease?

Modelo de crenças em saúde na decisão da toma da vacina antigripal

Sun exposure and sun protective behaviours in Portugal: results from the first National Health Examination Survey (INSEF 2015)