Chronic glaucoma, with its risk of irreversible blindness, is one of the major public health problems in Morocco and the world. Its identification, because of the almost asymptomatic nature of the disease, is the first if not the only means available to control it or at least to act when there is still time, so as not to become blind without realizing it

Hemophilia A and B are rare bleeding disorders caused by mutations in the F8 and F9 genes encoding the coagulation factor VIII (FVIII: C) and factor IX (FIX: C)

This literature review focuses on mechanisms that are involved in the phenomenon of “sedentary behavior” such as television viewing and work sitting, considering its impact on susceptibility to cardiovascular diseases and type 2 diabetes. As such the review tries to provide information on how the physical inactivity may be responsible for the development of chronic diseases. “Inactivity” is a term that can be used to describe the time that people spend not doing exercise. In terms of physical movement, “inactivity” can be determined as a minimal movement that the body implements. In terms of metabolic consumption, “inactivity” symbolizes a dimension in which the energy expenditure is equivalent to a resting metabolic trend. However, the study on the behaviour of sedentary can provide a wider spectrum of factors that concur to the development of diseases and a statement of the energy expenditure in sedentary actions. In sedentary behaviors are included reading, television viewing, work sitting, driving, or commuting, meditation or eating, talking with friends or on the telephone or other actions that do not include physical exercise. During the past decades many efforts have been made to try to determinate and quantify the physical activity in terms of validity and reliability estimation, and its incidence on morbidness. Since the past centuries until today it was noticed a general decrease in human energy expenditure and an increase in the sedentary lifestyle. Investigations have been also carried out on the alleged effects of the activity on morbidness. Clearly there is a need to review the research findings over the past years to provide an overview of the current state of knowledge on the underlying mechanisms governing the phenomenon of inactivity observed during prolonged period.

Study background: Considering that preventable mortality is still a significant problem in European countries and large differences exists between these countries, this study first analyses which expenditures, as percentage of the Gross Domestic Product (GDP) are related to preventable mortality. Secondly, quantitative and qualitative healthcare indicators as well as life style indicators are introduced to investigate their contribution to explain preventable mortality.

Methods: The study is cross-sectional, using data of international databases (like Eurostat and OECD) of 31 European countries. The years the data were collected vary between 2009 and 2014. The following indicators are used to explain preventable mortality: percentage of GDP expenditures on healthcare, education, and social protection, quantitative and qualitative healthcare indicators (% vaccinated children, % women screened on cervical cancer and breast cancer, the overall volume of prescribed antibiotics, standardised infant mortality, Acute Myocardial Infarction (AMI) mortality rate after hospital admission, and % of persons aged 16 and over reporting unmet needs for medical care), and life style indicators (% low reading literacy, % smokers, % of adults with insufficient physical activity, % obese persons, alcohol consumption, and exposure to air pollution). Significant indicators are analysed by forward regression.

Results: Expenditure on social protection is strongest related to preventable mortality. Significant correlations between quantitative and qualitative health care indicators disappear when social protection expenditure is introduced as explaining variable. Besides social protection expenditure, alcohol consumption and physical activity contribute to preventable mortality.

Conclusion: Strengthening the comprehensiveness and expenditures of social protection policy is essential to reduce preventable mortality. Also, this study provides concrete examples for focused action.

Background: Mayor’s Wellness Councils are community-based coalitions designed to improve the health and wellbeing of communities. Although they reach millions of people, little is known about whether council websites are informative. The aim of this study was to recommend an approach for the website content of Mayor’s Wellness Councils based on Community Coalition Action Theory.

Method: Internet searches were conducted to identify Mayor’s Wellness Councils for the 50 most populated United States Metropolitan Statistical Areas. We evaluated all 24 of existing councils with websites.

Results: The mission statement was the most frequently described construct followed by outcomes and implementation. After these three constructs, convener group, and coalition membership were presented most frequently. The least frequently described construct was assessment and planning. Twenty-five percent of the websites had no information related to the six Community Coalition Action Theory constructs, essential information for consumers.

Discussion: This study provides guidance on how the content of Mayor’s Wellness Council websites can be presented to maximally inform consumers about their activities and impact. We recommend incorporating all six Community Coalition Action Theory constructs with a particular emphasis on assessment and planning to best convey the functioning and effectiveness of Mayor’s Wellness Councils. Improving Mayor’s Wellness Councils for consumers can have direct and indirect positive effects for public health and community wellbeing.

Purpose: Homeless and Street-Involved Youth (SIY) often face substantial physical and emotional challenges and barriers accessing healthcare services. The objectives of the study are to: 1) obtain demographic information for Canadian SIY living in Toronto, Ontario; 2) evaluate self-perceptions of physical and mental health and 3) determine healthcare services used barriers to healthcare access and their association with self-reported health status.

Methods: Enhanced Street Youth Surveillance (E-SYS) is a repeated cross-sectional study of SIY, ages 15-24 years, across major urban centers in Canada. E-SYS conducts a nurse-administered survey and collects biological samples. We looked at descriptive statistics and chi-square tests to test for bivariate associations from E-SYS Cycle 6 (2010).

Results: A total of 195 SIY, with a mean age of 21.1 years (SD=2.4), were surveyed from Toronto and 60.8% were males. Commonly reported healthcare access points were youth drop-in centers, family doctors, street nurses, or hospital/emergency rooms. More than half (52.3%) reported barriers to accessing healthcare. SIY who reported fair or poor physical (p<0.01) and mental (p<0.03) health reported significantly more barriers than those reporting good to excellent physical and mental health, respectively. There were no differences in healthcare access barriers by gender, ethnicity, education or history of abuse.

Conclusion: Toronto SIY represent a vulnerable population, particularly given their low use of primary health care. Obtaining timely and appropriate health care services may be crucial to SIY well-being and outcomes. Further research is needed to identify the best approaches to improve access to healthcare for SIY in Canada.

Objective: To describe the numbers and activities of GPs with training in special competencies who have been registered in the Netherlands.

Design: Inventory of GPs who were documented in 16 registers in the year 2015, followed by an online survey.

Setting: General practice in the Netherlands

Subjects: GPs with special competencies.

Main outcome measures: Numbers per register, hours spent per month on activities related to special competencies.

Results: Overall 2833 registered GPs were identified. 1112 GPs responded to the online survey, including 219 GPs with special clinical competencies (51.8% response) and 55 GPs with special non-clinical competencies (59.8% response). The numbers per register varied, with less than 100 GPs in many registers but higher numbers for palliative care, echography, ophthalmology, travelers’ advice, obstetrics and quality consultants. High variation was seen in hours spent per month, highest for GPs with non-clinical competencies (mean: 19.6 hours) and lowest for GPs with registration as quality consultant (mean: 4.0 hours).

Discussion: GPs with special competencies (excluding quality consultants) comprise 9.7% of Dutch GPs. Their role and added value in the healthcare system should be a topic of research.

Over recent years, Europe has been facing up the spreading problem of Vaccine Hesitancy (VH). Since 2002-2005, a pilot question has been included in the annual World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) Joint Reporting Form (JRF), in order to monitor and understand the motivation behind the increasing number of reports on vaccine hesitancy

Objective: There is a paucity of research on the content of Primary Care Provider (PCP)-patient discussions regarding physical activity especially content on environmental factors related to physical activity. Variable coverage of environmental factors by PCPs could manifest as inconsistent patient behavioral responses which is what research has demonstrated. Knowing the extent to which PCPs discuss environmental factors would provide additional insight into designing more effective physical activity interventions for primary care settings. Therefore, we examined PCP’s coverage of environmental factors when counseling patients about physical activity.

Methods: For this cross-sectional study, 22.1% (n=104) of the PCPs practicing in the urban core of a large, metropolitan area self-reported whether they addressed any of the following six environmental factors when counseling patients about physical activity: places for physical activity, presence/absence of sidewalks/ trails/paths, traffic, home exercise equipment, safety from crime and aesthetics. In addition, they indicated the types of resources they used and needed to help convey information to patients about environmental factors. Multiple regression analysis was used to identify characteristics related to the number of environmental factors addressed.

Results: Twenty-five percent of the PCPs did not address any of the six environmental factors when counseling patients about physical activity. The regression analysis showed that being male, needing more resources (e.g., in-house staff) and a lighter patient load were significantly associated with addressing fewer environmental factors.

Conclusion: Providing PCPs with adequate resources could help them convey information to patients about environmental factors and potentially improve behavioral- and health-related patient outcomes.

Background: Item-Response Theory (IRT) is a modern psychometric technique able to develop a true score measure of Health-Related Quality Of Life (HRQOL) from survey data. The purpose of this study was to investigate both Physical Inactivity (PIA) and HRQOL as predictors of survival, with the aid of IRT.

Methods: Data for this research came from the 2001-02 NHANES and its corresponding linked mortality file. PIA status was determined from survey questions regarding moderate and vigorous leisure-time physical activity. HRQOL was assessed by entering five perceived health variables into a single parameter IRT model. Cox proportional hazards regression was used to model the effects of PIA and HRQOL on survival time while controlling for confounding variables (age, sex, race and income).

Results: A total of 5,985 adults were included in this analysis with a mean person-year follow-up of 9.24 years and 965 deaths. Adjusted model showed a significant (p = .006) three-way (HRQOL×PIA×SEX) interaction, requiring a stratified analysis. Among females, those with poor HRQOL had shorter survival time (Hazard Ratio (HR) = 3.08, 95% CI: 1.24, 7.65) than those with good HRQOL. Physically inactive females showed shorter survival time (HR = 1.88, 95% CI: 1.24, 2.85) as compared to those who were not physically inactive. Since the two-way (HRQOL×PIA) interaction was significant (p = .004), the analysis for males was further stratified by PIA status. Among males who were physically inactive, those with poor HRQOL showed shorter survival time (HR = 2.39, 95% CI: 1.46, 3.90) than their counterparts with good HRQOL. Among males with poor HRQOL, those who were physically inactive showed shorter survival time (HR = 4.25, 95% CI: 2.30, 7.83) than their counterparts who were not physically inactive.

Conclusion: Results from this study support both HRQOL and PIA as predictors of survival time. Health promotion programs should include physical activity in adults with poor HRQOL.