Research progress of dyspnea belief intervention in patients with chronic obstructive pulmonary disease / 中国实用护理杂志

Patients with chronic obstructive pulmonary disease have the disease phenomenon of fear of exercise because of dyspnea, which can accelerate the body degradation rate, weaken muscle strength, reverse increase dyspnea, and delay the recovery of the disease. As a result, this article examines the theoretical underpinnings and specific measures of dyspnea belief intervention programs for chronic obstructive pulmonary disease patients at home and abroad, summarizes the limitations of previous studies, and makes pertinent recommendations in an effort to serve as a guide for early patient prevention and the development of scientific and feasible intervention programs.

Evaluation of the effect of meteorological risk forecasting service intervention on acute onset and medical expenses of patients with COPD in Pudong New Area of Shanghai / 上海预防医学

ObjectiveTo evaluate the intervention effect of meteorological risk forecasting service on acute onset and medical expenses of chronic obstructive pulmonary disease（COPD） patients， and to provide scientific basis for the establishment of health management model for chronic obstructive pulmonary disease（COPD） patients. MethodsStudy subjects were recruited from chronic obstructive pulmonary patients aged ≥40 in Pudong New Area. Propensity score matching method was used to determine the intervention group and the control group. The control group received regular health education and follow-up management， and the intervention group was provided with meteorological and environmental risk forecasting services through WeChat， mobile phone short message service（SMS）and telephone. Finally， a total of2 589 subjects were included in the analysis， including 1 300 in the intervention group and 1 289 in the control group. General demographic data， past medical history and family history of COPD， COPD related knowledge and practice survey， COPD related symptom assessment， acute onset， health service utilization and medical expenses before and after intervention were collected through questionnaire survey. The differences of acute attack， health service utilization and related medical expenses between the two groups before and after intervention were compared to evaluate the intervention effect. ResultsIn terms of acute attacks， after intervention， the incidence of acute attacks in the intervention group was lower than that before intervention（χ2=52.901， P<0.001）， and the incidence of acute attacks in the groups with different intervention methods was lower than that before intervention （P<0.001）. WeChat had the best effect， decreasing the incidence by 14.4%， followed by mobile phone SMS SMS decreasing by 12.3%. In terms of utilization of health services， the outpatient rate due to acute attack was lower in the intervention group after intervention than that before intervention （χ2=7.129， P=0.008）， and the outpatient rate due to acute attack was lower in the subjects who received the forecast service through mobile phone SMS than that before intervention （χ2=4.675， P<0.001）. In terms of medical expenses， there was no significant difference between control group and intervention group with different intervention methods before intervention （P>0.05）. After intervention， the difference between the control group and the intervention group with different intervention methods was statistically significant （H=11.864， P<0.05）. The results of multiple comparisons showed that compared with the control group， the average annual medical expenses of patients receiving mobile phone SMS and telephone forecasting services after intervention were lower than those of the control group， and the difference was statistically significant （P<0.05）. ConclusionMeteorological risk forecasting service can reduce the acute onset of COPD， reduce the rate of consultation and medical expenses due to acute onset， and provide scientific basis for the basic COPD health management model.

Oferta de prep em organizações comunitárias: estudo comparativo com serviços convencionais / Prep provision in community organizations: a comparative study with conventional services

RESUMO OBJETIVO: Avaliar se adolescentes de minorias sexuais que iniciaram a profilaxia pré-exposição sexual (PrEP) em organizações comunitárias (OC) apresentam maior vulnerabilidade social e ao HIV em comparação com adolescentes em PrEP de um serviço de saúde convencional. Além disso, avaliar se esses adolescentes tiveram um acesso mais oportuno à profilaxia. MÉTODOS: Estudo demonstrativo da efetividade de PrEP, realizado na cidade de São Paulo, em duas OC, localizadas no centro (OC-centro) e na periferia (OC-periferia), e em um serviço convencional de testagem para o HIV (CTA-centro). Foram elegíveis para PrEP, entre 2020 e 2022, adolescentes homens cisgêneros que fazem sexo com homens (aHSH), travestis, mulheres transexuais e pessoas transfemininas (aTTrans), de 15 a 19 anos, HIV-negativos e com práticas de maior risco para o HIV. Indicadores de acesso oportuno e de vulnerabilidades dos adolescentes iniciando PrEP nas OC foram analisados, tendo por referência o CTA-centro e empregando regressão logística multinomial. RESULTADOS: 608 adolescentes iniciaram PrEP nas OC e CTA-Centro. Adolescentes das OC estiveram associados a um menor tempo de início de PrEP (1-7 dias; OC-periferia: ORa = 2,91; IC95% 1,22-6,92; OC-centro: ORa = 1,91; IC95% 1,10-3,31); e a um menor IDH de moradia (OC-centro: ORa = 0,97; IC95% 0,94-1,00; OC-periferia: ORa = 0,82; IC95% 0,78-0,86). Na OC-periferia houve aumento na chance de os adolescentes serem mais jovens (ORa = 3,06; IC95% 1,63-5,75) e morarem mais próximos ao serviço (ORa = 0,82; IC95% 0,78-0,86, média 7,8 km). Enquanto adolescentes da OC-centro estiveram associados ao maior conhecimento prévio de PrEP (ORa = 2,01; IC95% 1,10-3,91) e a alta percepção de risco (ORa = 2,02; IC95% 1,18-3,44). Não estiveram associadas aos adolescentes das OC as práticas sexuais de maior risco e as situações de vulnerabilidade ao HIV. CONCLUSÕES: A oferta de PrEP nas OC facilitou o acesso de adolescentes vulnerabilizados e pode contribuir para reduzir inequidades.

ABSTRACT OBJECTIVE: To evaluate whether adolescents from sexual minorities who initiated pre-exposure prophylaxis (PrEP) in community-based organizations (COs) are more socially and HIV-vulnerable compared with their counterparts from a conventional health service. In addition, to evaluate whether these adolescents had more timely access to prophylaxis METHODS: A PrEP demonstration study was conducted in the city of São Paulo in two COs, located in the center (CO-center) and the outskirts (CO-outskirts), and a conventional HIV testing service (CTA-center). Between 2020 and 2022, cisgender male adolescents who have sex with men (aMSM), transgender and gender diverse adolescents (aTTrans) aged 15 to 19 years, HIV-negative, with higher-risk practices for HIV were eligible for PrEP. Indicators of timely access and vulnerabilities of adolescents initiating PrEP in COs were analyzed using CTA-center as a reference and multinomial logistic regression. RESULTS: 608 adolescents initiated PrEP in COs and CTA-center. Adolescents from COs were associated with a shorter time to PrEP initiation (1-7 days; CO-outskirts: ORa = 2.91; 95%CI 1.22-6.92; CO-center: ORa = 1.91; 95%CI 1.10-3.31); and a lower housing Human Development Index (HDI) (CO-center: ORa = 0.97; 95%CI 0.94-1.00; CO-outskirts: ORa = 0.82; 95%CI 0.78-0.86). In CO-outskirts, there was an increased chance of adolescents being younger (ORa = 3.06; 95%CI 1.63-5.75) and living closer to the service (ORa = 0.82; 95%CI 0.78-0.86, mean 7.8 km). While adolescents from the CO-center were associated with greater prior knowledge of PrEP (ORa = 2.01; 95%CI 1.10-3.91) and high-risk perception (ORa = 2.02; 95%CI 1.18-3.44), adolescents from the COs were not associated with higher-risk sexual practices and situations of vulnerability to HIV. CONCLUSION: The provision of PrEP in the COs facilitated access for vulnerable adolescents and may contribute to reducing inequities.

Influencia de la musicoterapia en el paciente durante la atención estomatológica

Ser atendido por el estomatólogo es una de las situaciones que genera más miedo y ansiedad en las personas. Se sugiere que la musicoterapia contribuye a reducir estos síntomas. Teniendo en cuenta que muchos pacientes presentan ansiedad y miedo al ser atendidos en el sillón dental y que necesitan un ambiente más agradable, constituye el motivo que condujo a la realización de este trabajo haciendo uso de la musicoterapia con el objetivo de evaluar su influencia en el paciente durante la atención. Se realizó un estudio de intervención, desde marzo a junio del 2022 en el Servicio Estomatológico, Policlínico Tula Aguilera. La muestra, 40 pacientes, fue seleccionada al azar, independientemente de sentir temor o no al tratamiento estomatológico. Las sesiones se dividieron: primera visita (sin música) y segunda visita (con música). Los datos se recogieron en encuesta. Los niveles de miedo disminuyeron con la aplicación de la terapia, por lo cual se constató que la musicoterapia tiene una notable influencia en los pacientes al desaparecer y disminuir el miedo o sensaciones desagradables durante la atención estomatológica. Todos los pacientes manifestaron satisfacción con el uso de la música, durante el servicio.

To be assisted by the odontologist is one of the situations that generates more fear and anxiety in people. It is suggested that the musical-therapy contributes to reduce these symptoms. Keeping in mind that many patients present anxiety and fear when being assisted in the dental armchair and that they need a more pleasant atmosphere, it constitutes the reason that led to the realization of this work making use of the musical-therapy with the objective of evaluating their influence in the patient during the attention. He was carried out an intervention study, from March to June of the 2022 in the Dentistry Service, Clinical Tula Aguilera. The sample, 40 patients, it was selected at random, independently of feeling fear or not to the dentistry treatment. The sessions were divided: first visit (without music) and second visit (with music). The data were picked up in survey. The levels of fear diminished with the application of the therapy, reason why it was verified that the musical-therapy has a notable it influences in the patients when disappearing and to diminish the fear or unpleasant sensations during the dentristry attention. All the patients manifested satisfaction with the music's use, during the service.

Application effect of online supportive disclosure therapy in pre-dimission nurses / 中国实用护理杂志

Objective:To explore the effects of online supportive disclosure therapy on the self-expression level, professional identity, dimission intention, and turnover rate of pre-dimission nurses, in order to provide a reference for nursing managers to stabilize the nursing team.Methods:A quasi experimental research method was used, and a convenient sampling method was used to select 192 pre resigned nurses from Shandong Provincial Third Hospital, the First Affiliated Hospital of Shandong First Medical University, and Shandong First Medical University Affiliated Provincial Hospital from October 2021 to December 2022 as the research subjects. They were divided into a control group and an experimental group by random number table method, with 96 nurses in each group. The control group received routine exit interviews, while the experimental group received online supportive disclosure therapy intervention based on this. The self-expression level, professional identity, dimission intention, and turnover rate of two groups of nurses before and 1, 2 months after the intervention were evaluated.Results:Finally, 94 nurses in the control group and 92 nurses in the experimental group completed the study. There were no significant differences in the self-expression level, professional identity, dimission intention before the intervention between the two groups ( P>0.05). After 1 and 2 months of the intervention, the scores of the Pain Self Disclosure Index, Nurse Professional Identity Rating Scale, and Resignation Intention Scale of the experimental group were 36.33 ± 5.13, 73.88 ± 8.72, 14.18 ± 1.12 and 34.22 ± 6.78, 98.26 ± 11.29, 6.16 ± 1.19, respectively,and the control group were 28.06 ± 8.23, 64.72 ± 10.39, 17.82 ± 1.37 and 44.26 ± 7.62, 79.82 ± 8.66, 9.18 ± 1.06, there were statistically significant differences between the two groups ( t values were -13.54 to -2.11, all P<0.05); there were statistically significant differences in the inter group effects, time effects, and interaction effects of the scores on the Pain Self Disclosure Index, Professional Identity Rating Scale, and Resignation Intention Scale between the two groups ( F values were 5.12 to 14.82, all P<0.05). The turnover rate of nurses in the experimental group was 1.09% (1/92), lower than 8.51% (8/94) in the control group, and the difference between the two groups was statistically significant ( χ2=1.59, P<0.05). Conclusions:Online supportive disclosure therapy can improve the self-expression level and professional identity of pre-dimission nurses, and reduce their willingness to resign and turnover rate.

Impact of nutritional education on knowledge,attitude and practice regarding anemia among school children in Belgaum,India / 《全球健康杂志（英文）》

Background:Anemia is a common public health problem throughout the globe with its main effect not only on health of people but also impact on socioeconomic development.A high prevalence of anemia among school children is an indication of a severe problem highlighting the necessity of proper action to prevent further de-terioration.This study sought to study the impact of nutritional education on knowledge,attitude,and practice regarding anemia among school children.Methods:This is an interventional study among school children of Kendriye Vidyalaya,No.2 Belgaum district,India.Structured and self-administered questionnaires were used to know the knowledge,attitude and practice of student anemia.The data were analyzed using paired t-test and McNemar test.Results:There was significant increment in the mean knowledge and attitude scores of the school children at the post-test evaluation.Overall increase of 51.2％in mean score of knowledge and overall increase of 20.7％in mean score of attitudes was found(P＜0.05).Increase in frequency of consumption pattern of iron rich foods especially ragi,jaggery,green leafy vegetables and sprouted grains was reported.Conclusion:The nutritional education resulted in improvement of knowledge and change in attitude regarding anemia as well as increase in consumption of foods rich in Iron.Therefore,nutritional education is one of the cost-effective and sustainable method for lowering the cases of anemia.

Intervention study on improving medication compliance of patients with osteoporosis in a community in Shanghai / 上海预防医学

Objective To determine the effects of health education on medication compliance and bone mineral density of patients with osteoporosis in community. Methods A total of 123 patients with osteoporosis in A and B community(64 patients in control group and 59 patients in intervention group)received diverse health education and guidance. After a 2-year intervention, knowledge of osteoporosis, health behavior, medication compliance and bone mineral density change were compared between the two groups. Results In the intervention group, the proportions of correctly responding to the questions of osteoporosis were significantly improved before and after intervention(P < 0.05), except the questions of"exercise to what extent is better". Similarly, health behavior and medication compliance were also significantly improved in the intervention group(P < 0.05). In addition, knowledge of osteoporosis, most health behavior and medication compliance were better than those in the control group(P < 0.05). The difference in the bone mineral densitybetween the intervention group and the control group before and after intervention was 0.025±0.322 and -0.139±0.312(P < 0.05), respectively, showing significant differences(P < 0.05). Conclusion Health education for patients with osteoporosis may significantly improve health behavior, medication compliance, bone mineral density, and prognosis of osteoporosis.

Impacto da intervenção educacional sobre suicídio na percepção de enfermeiras e agentes comunitários de saúde / Impact of the educational intervention about suicide on the perception of nurses and community health agents / Impacto de la intervención educativa sobre el suicidio en la percepción de las enfermeras y agentes comunitarios de salud

OBJETIVO: analisar a percepção de enfermeiras e agentes comunitários de saúde em relação ao suicídio antes e após uma intervenção educativa. MÉTODO: estudo quase experimental, do tipo antes e depois, de abordagem qualitativa, baseado no referencial teórico da Transferência de Conhecimento. Participaram do estudo duas enfermeiras e dez agentes comunitários de saúde de uma unidade básica de saúde de Campo Grande, do estado de Mato Grosso do Sul. Foi utilizada a técnica de grupo focal, para a coleta de dados, antes e após a intervenção educativa. A análise dos dados foi realizada por meio da técnica de Triangulação de Métodos. RESULTADOS: emergiram duas categorias da análise dos dados, "a percepção do suicídio nos seus diferentes aspectos", que traz percepções, compreensões e conceitos relacionados ao suicídio e "o contexto da assistência à saúde no comportamento suicida", que mostra como o suicídio é vivenciado pelos profissionais de saúde nos espaços de cuidado. CONCLUSÃO: a intervenção educativa favoreceu mudanças na percepção dos participantes referentes à identificação e abordagem do comportamento suicida, indicando a importância de ações dessa natureza para abordagens inerentes à prevenção do suicídio.

OBJECTIVE: to analyze the perception of nurses and community health agents in relation to suicide before and after an educational intervention. METHOD: a quasi-experimental research, of the before and after study type and with a qualitative approach, based on the theoretical framework of Knowledge Transfer. Two nurses and ten community health agents from a basic health unit in Campo Grande, state of Mato Grosso do Sul, participated in the study. The focus group technique was used for data collection before and after the educational intervention. Data analysis was performed using the technique of Triangulation of Methods. RESULTS: two categories of data analysis emerged: "the perception of suicide in its different aspects", which brings perceptions, understandings, and concepts related to suicide; and "the context of health care in suicidal behavior", which is characterized by how suicide is experienced by the health professionals in care contexts. CONCLUSION: the educational intervention fostered changes in the participants' perception regarding the identification and approach of suicidal behavior, indicating the importance of actions of this nature for approaches concerning suicide prevention.

OBJETIVO: analizar la percepción de enfermeras y agentes comunitarios de salud en relación con el suicidio, antes y después de una intervención educativa. MÉTODO: estudio cuasi experimental, del tipo antes y después, con enfoque cualitativo, basado en el marco teórico de la Transferencia de Conocimiento. Los participantes del estudio fueron dos enfermeras y diez agentes comunitarios de salud de una unidad básica de salud de Campo Grande en el estado de Mato Grosso do Sul. Se utilizó la técnica del grupo focal se utilizó para recopilar datos antes y después de la intervención educativa. El análisis de los datos se realizó mediante la técnica del Método de Triangulación. RESULTADOS: surgieron dos categorías de análisis de datos, "la percepción del suicidio en sus diferentes aspectos", que trae percepciones, entendimientos y conceptos relacionados con el suicidio y "el contexto de la atención en salud en el comportamiento suicida", que muestra cómo los profesionales de la salud experimentan el suicidio en los espacios de atención. CONCLUSIÓN: la intervención educativa favoreció cambios en la percepción de los participantes con respecto a la identificación y el enfoque del comportamiento suicida, lo que indica la importancia de acciones de esta naturaleza para abordajes inherentes a la prevención del suicidio.

Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system

Objective: Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers. Methods: The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services' needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions. Results: HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions. Conclusion: Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step. Clinical trial registration: NCT00881699

Impact of multidimensional interventions on quality of life and depression among older adults in a primary care setting in Brazil: a quasi-experimental study

Objective: To evaluate the impact of multidimensional interventions on quality of life (QoL) and depressive symptoms in Brazilian older adults living in the community. Methods: Longitudinal, quasi-experimental study of older adults receiving conventional primary health care (PHC). The interventions were designed in response to a first round of data collection and validated through pilot testing in groups of older adults from another community. The validated interventions were then applied to an intervention group (IG). To measure their effect, we used the Medical Outcomes Short-Form Health Survey (SF-36) quality of life scale and the Geriatric Depression Scale (GDS-30). Results: The sample comprised 118 participants. IG participants exhibited significant improvement in several QoL domains (SF-36): mental health (p = 0.010), general health perceptions (p = 0.016), and physical functioning (p = 0.045). No such improvement occurred in controls (p > 0.050). The prevalence of depression (GDS-30) fell from 36.7 to 23.3% in the IG, despite no significant difference (p = 0.272). Controls also reported a reduction in depressive symptoms, but only from 44.8 to 41.4% (p = 0.112). Conclusions: This multidimensional intervention was associated with significant improvement in mental health, general health perceptions, and physical functioning in a sample of Brazilian older adults. Clinical trial registration: RBR-92dbtx.

Health promotion for workers focusing on physical activity and sedentary behavior: Epidemiological studies in occupational health at the Physical Fitness Research Institute / 体力科学

Health issues with workers include many aspects that scientific research in physical fitness and sports medicine can contribute to. Nevertheless, in Japan, there are few studies on the health problems in workers reported in the field of physical fitness and sports medicine. One reason could be the difficulty of obtaining cooperation in research from companies. This paper introduces results of epidemiological studies on health problems in workers by the Physical Fitness Research Institute. Our research serves as an example of physical fitness and sports medicine studies, including methods for securing fields for research. For the last decade, various epidemiological studies on worker’s mental health, sleep, non-alcoholic fatty liver disease, and labor related issues have been conducted in our research institute. Most of these studies indicated that lack of physical activity is associated with these indicators in Japanese workers. In recent years, we have also been conducting observational and interventional studies focusing on sedentary behavior in workers. Physical activity is deeply linked to worker’s health, therefore, the important approach to start a research in occupational health is to plan research that solves the company’s health challenges. In occupational health, the needs to promote physical activity and to reduce sitting time are growing under the movement of “Health and Productivity Management” and burden of the COVID-19 pandemic. We believe that current challenges provide an opportunity to advance physical fitness and sports medicine research in occupational health.

Impact of the mHealth strategy in sodium consumption markers: AvaliaSal study / Impacto da estratégia mHealth em marcadores do consumo de sódio: estudo AvaliaSal

ABSTRACT Objective Evaluate the effectiveness of mHealth strategy on sodium consumption markers. Methods Intervention study carried out with 175 adults (20-59 years), from an educational institution of Vitória, Espírito Santo State. Participants were made aware through posters, oral approach and electronic media. Anthropometric, hemodynamic, socioeconomic, health, and dietary practices data was collected in two stages. After the first assessment, participants were randomized into two groups: Intervention Group and Control Group. The Intervention Group included 21 electronic messages and 3 videos on healthy eating focusing on the goal to reduce sodium intake for 3 months. Behavioral changes were assessed using the Generalized Estimation Equation (p-value <0.05). Results At baseline, no significant differences in socioeconomic, anthropometric and health variables, and eating practices between groups were observed. The stock broth cube was the most used ready processed seasoning. After the intervention, a reduction in the use of stock broth was observed only in the intervention group (β=0.615; p=0.016). In addition, 73% of the intervention group participants reported that the messages were clear, 67% reported that they were useful, and 48% stated they followed the guidelines. Conclusion There was a reduction in the frequency of use of stock broth cubes, demonstrating the potential effect of the m-Health strategy on sodium consumption markers in individuals without a hypertension medical diagnosis.

RESUMO Objetivo Avaliar a efetividade da estratégia mHealth sobre marcadores do consumo de sódio. Métodos Estudo de intervenção realizado com 175 adultos (20-59 anos), vinculados a uma instituição de ensino de Vitória, no Estado do Espirito Santo. Os participantes foram contatados por através da exposição a de um pôster, de abordagem oral e mídia eletrônica. Dados antropométricos, hemodinâmicos, socioeconômicos, de saúde e práticas alimentares foram coletados em dois momentos. Os participantes foram randomizados em dois grupos: Grupo de Intervenção e Grupo de Controle. Durante a intervenção, que durou três meses, os participantes receberam 21 mensagens eletrônicas e assistiram a três vídeos sobre alimentação saudável, com foco na redução do consumo de sódio. Mudanças foram avaliadas por Equação de Estimativa Generalizada e adoção de valor de p<0,05. Resultados Na linha de base, não foram observadas diferenças significativas em relação às variáveis antropométricas, socioeconômicas, de saúde e práticas alimentares entre os grupos. Caldo pronto foi o condimento industrializado mais utilizado pelos participantes durante o estudo. Foi observada uma redução do uso de caldo pronto apenas no Grupo de Intervenção (β=0,615; p=0,016). Além disso, 73% do Gruo de Intervenção relataram que as mensagens foram claras; 67% afirmaram que as mensagens foram úteis e 48% disseram que seguiram as orientações. Conclusão Foi observada uma redução da frequência do uso de caldo pronto, demonstrando potencial da estratégia m-Health sobre marcadores do consumo de sódio em participantes sem diagnóstico de hipertensão.

Programa de remediação com a nomeação rápida e leitura para escolares com dislexia: elaboração e significância clínica / Remediation program with automatized naming and reading for students with dyslexia: elaboration and clinical significance

RESUMO Objetivo: Elaborar um programa de remediação com a nomeação rápida e leitura, bem como verificar a significância clínica da aplicação do programa elaborado em escolares com dislexia. Método: Participaram cinco sujeitos do terceiro ao quinto ano do ensino fundamental, com idade de 8 a 11 anos, de ambos os sexos, com diagnóstico interdisciplinar de dislexia. Todos os escolares foram submetidos na pré e pós-testagem à aplicação das provas de habilidades metalinguísticas e de leitura, compreensão de leitura e da prova de nomeação automática rápida. Resultados: A análise foi realizada pelo Método JT, que permitiu verificar se houve mudança positiva ou negativa e significância clínica na pós-testagem. Os resultados mostraram ter havido significância clínica nas provas de identificação; adição e combinação de sílaba, de fonema final e medial, além de repetição de não palavras, leitura de palavras reais e pseudopalavras, compreensão leitora, além de nomeação automática rápida quando comparada a pré com a pós-testagem. Conclusão: O programa elaborado mostrou-se eficaz e com aplicabilidade, podendo ser utilizado instrumento de intervenção baseada em evidência científica para escolares com dislexia, pois ocorreu significância clínica para o desempenho em leitura.

ABSTRACT Purpose: Elaborate a remediation program with rapid automatized naming and reading, as well as to verify the clinical significance of the elaborated program for students with dyslexia. Method: The study involved five students from 3rd to the 5th grade of elementary school, aged 8 to 12 years, of both genders, with an interdisciplinary diagnosis of dyslexia. All students were submitted to pre- and post-test application of metalinguistic skills and reading test, reading comprehension and rapid automatized naming test. Results: The analysis was performed using the JT method that allowed to verify positive or negative change and clinical significance in the post-testing. The results showed clinical significance in the tests of identification, syllable addition and combination, final and medial phoneme; in addition to nonwords repetition, real words and pseudowords reading, reading comprehension and rapid automatized naming test when comparing the pre- and post-testing. Conclusion: The elaborated program was efficient and applicable as an intervention instrument based on scientific evidence for students with dyslexia since it showed clinical significance for reading performance.

Skill up; gradation of anganwadi workers pertaining to growth chart plotting and interpretation in rural areas of Varanasi district, India

Background: The task of using the growth chart by Anganwadi Workers (AWWs) for growth monitoring requires technical skill. It was hypothesized that skill up-gradation can make a difference in the performance of AWWs in regard with growth monitoring. The aim of the study was to evaluate the effect of intervention in improving skill of AWWs regarding growth chart plotting and interpretation.Methods: It was a field based interventional study, which was conducted in rural areas of Varanasi district, India. A total of 66 AWWs each from Chiraigaon (intervention) and Cholapur (control) community development blocks of Varanasi district was selected for the study. Each AWW was provided 3 weight readings of different ages for plotting and 4 filled growth charts for interpretation. Chi square test has been applied to assess the significant difference.Results: Only around 10% of AWWs could correctly plot all 3 growth charts and similar proportion of AWWs could also correctly interpret all 4 filled growth charts. The planned intervention could significantly improve their skill of growth chart plotting and interpretation and during end line survey 41% and 77% of AWWs could correctly plot all 3 growth charts and interpret all the four growth charts, respectively.Conclusions: The developed hypothesis is proved, and intervention was found effective in significantly improving the skills of AWWs in regard with growth monitoring.

Effectiveness of an educational strategy to increase plain water consumption in children / Efectividad de una estrategia educativa para incrementar el consumo de agua simple en niños

Abstract: Objective: We tested the effectiveness of the I prefer plain water educational strategy used to increase water consumption in elementary school children. Materials and methods: A community intervention trial was performed in eight public elementary schools in Mexico City. The schools were randomized into an intervention (IG) and a control (CG) group. Each school was provided water dispensers inside the classrooms. The IG received the educational strategy. The strategy was considered effective if the students increased their water consumption by ≥220 ml. Results: Water consumption in the IG increased 167 ml vs. 37 ml in CG (p < 0.001). The goal of the educational strategy for water consumption was achieved in 166/413 children in the IG and 95/364 children in the CG (p < 0.001). Conclusions: I prefer plain water, associated with free access to water inside the classrooms, proved to be effective to increase water consumption.

Resumen: Objetivo: Evaluar la efectividad de la estrategia Prefiero agua simple para incrementar el consumo de agua en niños de escuelas primarias públicas. Material y métodos: Ensayo de intervención comunitaria en ocho escuelas en la Ciudad de México. Las escuelas se aleatorizaron en grupo de intervención (GI) y de control (GC). Se instalaron dispensadores de agua dentro de las aulas. Implementamos la estrategia al GI. Consideramos efectiva la estrategia si los estudiantes incrementaron su consumo de agua en ≥220 ml. Resultados: El incremento global en el consumo de agua del GI fue de 167 ml vs. 37 ml en GC (p <0.001). La efectividad de la estrategia para el consumo de agua se logró en 166/413 niños del GI y en 95/364 niños del GC (p <0.001). Conclusiones: Prefiero agua simple, asociada con libre acceso al agua dentro de las aulas, demostró ser efectiva para incrementar el consumo de agua.

Community-based intervention study on knowledge and training needs of disaster medicine among local residents in a disaster-prone coastal area of Southern India

Background: A state of preparedness to a natural calamity can considerably mitigate loss of life and property and the human suffering and restore normalcy at the earliest. This study aimed at evaluation of knowledge levels on disaster management among community residents in Puducherry.Methods: Community based intervention study involving 150 community residents from a disaster affected coastal area was carried out employing convenient sampling. One-to-one interview was conducted using a structured questionnaire. Intervention through posters, lectures and disaster management mock drills was done. Evaluation was made using the same questionnaire following the intervention. The pre- and post-test evaluation were compared and analysed.Results: The study showed lower levels of knowledge regarding disaster management. Following the intervention there was a significant rise in the knowledge levels (p<0.005).Conclusions: This study may be useful for planning future training needs and IEC strategies for the community regarding disaster management.

Meta analysis of the effect of continuing nursing intervention on high risk patients with diabetic foot / 中国实用护理杂志

Objective@#To evaluate the effect of continuous care on patients with high risk of diabetic foot in China.@*Methods@#A random control of continuing care for patients with diabetes foot at high risk before June 2018 was published in the full text of the Chinese VP full text database (VIP), the full text database (CNKI), the Chinese biomedical literature database (CBM), Wan Fang, PubMed, Science Library. The test (randomized clinical trial), by 2 researchers, according to the inclusion and exclusion criteria, the literature quality was evaluated and extracted by the document quality standard of Cochrane cooperation network, and the different subgroups were divided according to the difference of the determination time of each outcome index, and the RevMan5.3 software was used to match the data. The required literature is analyzed by Meta.@*Results@#A total of 13 randomized clinical trials were included in the Mate analysis, including 1 450 subjects, 721 in the intervention group and 729 in the control group. The results showed that continuous nursing could effectively reduce the value of fasting blood glucose (combined effect MD=-1.34, 95%CI -1.44--1.24, P < 0.01), and effectively reduce the value of glycosylated hemoglobin (combined effect MD=-0.75, 95%CI -1.24- -0.27, P=0.002), and reduce the diabetic foot in patients with diabetic foot risk(combined effect RR=0.31, 95%CI 0.24-0.40, P<0.01). Continuous care could improve patients′ self-management ability and self-foot nursing ability.@*Conclusions@#Continuous care can reduce the fasting blood glucose, glycosylated hemoglobin and the incidence of diabetic foot in high-risk patients with diabetic foot, improve their self-management ability and self-foot nursing ability, which is of great significance to prevent and reduce the occurrence and development of diabetic foot.

Meta anaLysis of the effect of continuing nursing intervention on high risk patients with diabetic foot / 中国实用护理杂志

Objective To evaluate the effect of continuous care on patients with high risk of diabetic foot in China. Methods A random control of continuing care for patients with diabetes foot at high risk before June 2018 was published in the full text of the Chinese VP full text database (VIP), the full text database (CNKI), the Chinese biomedical literature database (CBM), Wan Fang, PubMed, Science Library. The test (randomized clinical trial), by 2 researchers, according to the inclusion and exclusion criteria, the literature quality was evaluated and extracted by the document quality standard of Cochrane cooperation network, and the different subgroups were divided according to the difference of the determination time of each outcome index, and the RevMan5.3 software was used to match the data. The required literature is analyzed by Meta. ResuLts A total of 13 randomized clinical trials were included in the Mate analysis, including 1 450 subjects, 721 in the intervention group and 729 in the control group. The results showed that continuous nursing could effectively reduce the value of fasting blood glucose (combined effect MD=-1.34,95% CI -1.44--1.24, P < 0.01), and effectively reduce the value of glycosylated hemoglobin (combined effect MD=-0.75, 95% CI-1.24--0.27, P=0.002), and reduce the diabetic foot in patients with diabetic foot risk(combined effect RR=0.31, 95% CI 0.24-0.40, P<0.01). Continuous care could improve patients′ self-management ability and self-foot nursing ability. ConcLusions Continuous care can reduce the fasting blood glucose, glycosylated hemoglobin and the incidence of diabetic foot in high-risk patients with diabetic foot, improve their self-management ability and self-foot nursing ability, which is of great significance to prevent and reduce the occurrence and development of diabetic foot.

Analysis of 30 clinical trials on rare neurological diseases in children / 中华实用儿科临床杂志

Objective@#To explore the methods for generating evidence on health outcomes in children with rare diseases.@*Methods@#The data from 30 clinical trials on rare neurological diseases in children from January 2008 to December 2018 were collected and analyzed.Statistical analysis was conducted on the relationship between the study sponsor and the study center, the number of participants and the prevalence rate.@*Results@#Thirty studies involved 6 types of diseases, including 14 kinds of diseases.(1) All global multicenter studies (14 items) were initiated by pharmaceutical companies, whereas most of single-center studies (6/7 kinds, 86%) and multiple centers within one country(7/9 kinds, 78%) were initiated by investigators.There was a significant correlation between the research center and the research sponsor(P<0.001). (2) Most of the drugs studied were selected based on previous clinical trials (9/30 items) and animal experiments (9/30 items). (3) The median number of participants included 39 cases (10-215 cases), and 60%(18/30 items) of the studies was fewer than 50 cases.(4) Study design: 53%(16/30 items) of studies were randomized controlled studies, 33%(10/30 items) studies were open-label single-arm studies, and 14% (4/30 items) were randomized cross-over trials.Seventy-five percent(12/16 items)of randomized controlled studies were initiated by pharmaceutical companies, 50%(5/10 items) open-label single-arm studies and all randomized cross-over trials were initiated by investigators.There was a statistical correlation between the study sponsors and the study design method (χ2=7.602, P=0.022). (5) Outcome index: Scale score was used as the primary outcome in half of studies.Other studies used symptom improvement or pathological changes.@*Conclusions@#Clinical trials in rare diseases enrolled fewer participants than that in non-rare diseases, and the study design method was relatively simple.Therefore, it is necessary to further improve the level of evidence of clinical research of rare diseases through global and multi-center recruitment, initiation of pharmaceutical companies and improving the study design method.

Introduction on 'assessing the risk of bias of individual studies' in systematic review of health-care intervention programs revised by the Agency for Healthcare Research and Quality / 中华流行病学杂志

This paper summarizes the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions revised by the Agency for Healthcare Research and Quality (AHRQ) and introduces how to use Revman software make risk of bias graph or risk of bias summary. AHRQ tool can be used to evaluate following study designs: RCTs, cohort study, case-control study (including nested case-control), case series study and cross-sectional study. The tool evaluates the risk of bias of individual studies from selection bias, performance bias, attrition bias, detection bias and reporting bias. Each of the bias domains contains different items, and each item is available for the assessment of one or more study designs. It is worth noting that the appropriate items should be selected for evaluation different study designs instead of using all items to directly assess the risk of bias. AHRQ tool can be used to evaluate risk of bias individual studies when systematic reviews of health care interventions is including different study designs. Moreover, the tool items are relatively easy to understand and the assessment process is not complicated. AHRQ recommends the use of high, medium and low risk classification methods to assess the overall risk of bias of individual studies. However, AHRQ gives no recommendations on how to determine the overall bias grade. It is expected that future research will give corresponding recommendations.