Empowerment-based nutrition interventions on blood pressure: a randomized comparative effectiveness trial.

Introduction: Empowerment lifestyle programs are needed to reduce the risk of hypertension. Our study compared the effectiveness of two empowerment-based approaches toward blood pressure (BP) reduction: salt reduction-specific program vs. healthy lifestyle general program. Methods: Three hundred and eleven adults (median age of 44 years, IQR 34-54 years) were randomly assigned to a salt reduction (n = 147) or a healthy lifestyle program (n = 164). The outcome measures were urinary sodium (Na+) and potassium (K+) excretion, systolic (SBP) and diastolic (DBP) blood pressure, weight, and waist circumference. Results: There were no significant differences in primary and secondary outcomes between the two program groups. When comparing each program to baseline, the program focused on salt reduction was effective in lowering BP following a 12-week intervention with a mean change of -2.5 mm Hg in SBP (95% CI, -4.1 to -0.8) and - 2.7 mm Hg in DBP (95% CI, -3.8 to -1.5) in the intention-to-treat (ITT) analysis. In the complete-case (CC) analysis, the mean change was -2.1 mm Hg in SBP (95% CI, -3.7 to -0.5) and - 2.3 mm Hg in DBP (95% CI, -3.4 to -1.1). This effect increases in subjects with high-normal BP or hypertension [SBP - 7.9 mm Hg (95% CI, -12.5 to -3.3); DBP - 7.3 mm Hg (95% CI, -10.2 to -4.4)]. The healthy lifestyle group also exhibited BP improvements after 12 weeks; however, the changes were less pronounced compared to the salt reduction group and were observed only for DBP [mean change of -1.5 mm Hg (95% CI, -2.6 to -0.4) in ITT analysis and - 1.4 mm Hg (95% CI, -2.4 to -0.3) in CC analysis, relative to baseline]. Overall, improvements in Na+/K+ ratio, weight, and Mediterranean diet adherence resulted in clinically significant SBP decreases. Importantly, BP reduction is attributed to improved dietary quality, rather than being solely linked to changes in the Na+/K+ ratio. Conclusion: Salt-focused programs are effective public health tools mainly in managing individuals at high risk of hypertension. Nevertheless, in general, empowerment-based approaches are important strategies for lowering BP, by promoting health literacy that culminates in adherence to the Mediterranean diet and weight reduction.

Intervenção de enfermagem de reabilitação após artroplastia total da anca: revisão sistemática da literatura / Rehabilitation nursing intervention after total hip arthroplasty: a systematic review of the literature

O presente trabalho prende-se com a temática "Intervenção de Enfermagem de Reabilitação após Artroplastia Total da Anca ­ Revisão Sistemática da Literatura", através de uma revisão sistemática da literatura com caráter descritivo exploratório, pela análise de bases de dados científicas e posteriormente, com a aplicação da estratégia PICO, seguindo o Protocolo da Revisão Sistemática da Literatura publicado pela Cochrane, apresentar e descrever os resultados obtidos. A questão "Quais os ganhos em saúde decorrentes da intervenção do enfermeiro de reabilitação após Artroplastia Total da Anca?" foi claramente respondida, concluindo-se que as intervenções passam essencialmente pela reabilitação do paciente, utilizando para o efeito estratégias e técnicas específicas e altamente qualificadas do Enfermeiro de Reabilitação em conjunto com equipa multidisciplinar que acompanha todos os procedimentos no pós-operatório. De facto, os estudos identificados apresentam, na sua maioria, resultados que comprovam a necessidade de implementação de protocolos multidisciplinares de enfermagem de reabilitação, concluindo-se ainda que a avaliação funcional é essencial para determinar o potencial de reabilitação, implementando técnicas de reeducação funcional, planificando a alta clínica e reinserção na comunidade, com o objetivo de prevenir novas fraturas. No decurso da investigação foram analisados, selecionados e avaliados diversos artigos de investigação, sendo considerados válidos para a presente temática dezoito, sendo nove em língua inglesa e nove em língua portuguesa, publicados nos últimos dez anos e de acesso integral, livre e gratuito. Neste sentido os artigos selecionados e considerados válidos indicam claramente a importância do Enfermeiro de Reabilitação, enquanto contributo direto para uma alta bem-sucedida, particularmente, quando associada a sua intervenção a equipas multidisciplinares, contribuindo diretamente para ganhos globais na saúde e reabilitação de pacientes submetidos a artroplastia total da anca.

The present work deals with the theme "Rehabilitation Nursing Intervention after Total Hip Arthroplasty - Systematic Literature Review", through a systematic literature review with an exploratory descriptive character, through the analysis of scientific databases and later, with the application of the PICO strategy, following the Protocol of Systematic Literature Review published by Cochrane, present and describe the results obtained. The question "What are the health gains resulting from the intervention of the rehabilitation nurse after Total Hip Arthroplasty?" it was clearly answered, concluding that the interventions essentially go through the rehabilitation of the patient, using specific and highly qualified strategies and techniques of the Rehabilitation Nurse in conjunction with a multidisciplinary team that monitors all procedures in the postoperative period. In fact, the studies identified present, for the most part, results that prove the need to implement multidisciplinary rehabilitation nursing protocols, concluding that functional assessment is essential to determine the potential for rehabilitation, implementing functional reeducation techniques, planning hospital discharge and reintegration into the community, with the aim of preventing new fractures. In the course of the investigation, several research articles were analyzed, selected and evaluated, being considered valid for the present topic eighteen, nine in English and nine in Portuguese, published in the last ten years and with full, free and free access. In this sense, the articles selected and considered valid clearly indicate the importance of the Rehabilitation Nurse, as a direct contribution to a successful discharge, particularly when associated with its intervention to multidisciplinary teams, contributing directly to global gains in health and rehabilitation of patients submitted total hip arthroplasty.