Brazilian women's use of evidence-based practices in childbirth after participating in the Senses of Birth intervention: A mixed-methods study.

Brazil has a cesarean rate of 56% and low use of Intrapartum Evidence-based Practices (IEBP) of 3.4%, reflecting a medically centered and highly interventionist maternal health care model. The Senses of Birth (SoB) is a health education intervention created to promote normal birth, use of EBP, and reduce unnecessary c-sections. This study aimed to understand the use of intrapartum EBP by Brazilian women who participated in the SoB intervention. 555 women answered the questionnaire between 2015 and 2016. Bivariate analysis and ANOVA test were used to identify if social-demographic factors, childbirth information, and perceived knowledge were associated with the use of EBP. A qualitative analysis was performed to explore women's experiences. Research participants used the following EBP: birth plan (55.2%), companionship during childbirth (81.6%), midwife care (54.2%), freedom of mobility during labor (57.7%), choice of position during delivery (57.2%), and non-pharmacological pain relief methods (74.2%). Doula support was low (26.9%). Being a black woman was associated with not using a birth plan or having doula support. Women who gave birth in private hospitals were more likely not to use the EBP. Barriers to the use of EBP identified by women were an absence of individualized care, non-respect for their choices or provision of EBP by health care providers, inadequate structure and ambiance in hospitals to use EBP, and rigid protocols not centered on women's needs. The SoB intervention was identified as a potential facilitator. Women who used EBP described a sense of control over their bodies and perceived self-efficacy to advocate for their chosen practices. Women saw the strategies to overcome barriers as a path to become their childbirth protagonist. Health education is essential to increase the use of EBP; however, it should be implemented combined with changes in the maternal care system, promoting woman-centered and evidence-based models.

Pragmatic randomized controlled trial of a web-based intervention for alcohol use among Brazilian college students: Motivation as a moderating effect.

BACKGROUND: Web-based personalized normative feedback (PNF) interventions are less effective than their laboratory versions. Participant motivation may account for this reduced effect, but there is only a limited amount of research into the influence of motivation on PNF effectiveness. We evaluated the effectiveness of a web-based PNF in reducing alcohol use and consequences among college students with different motivation levels. METHODS: Pragmatic randomized controlled trial among Brazilian college drinkers aged 18-30 years (N = 4460). Participants were randomized to a Control or PNF group and followed-up after one (T1), three (T2) and six (T3) months. Outcomes were: AUDIT score (primary outcome), the number of consequences, and the typical number of drinks. Motivation for receiving the intervention was assessed with a visual analog scale (range: 0-10). Generalized mixed models assessed intervention effects via two paradigms: observed cases and attrition models. RESULTS: PNF reduced the number of typical drinks at T1 (OR = 0.71, p = 0.002), T2 (OR = 0.60, p < 0.001) and T3 (OR = 0.68, p = 0.016), compared to the control. Motivated students (score ≥3) receiving PNF also reduced the number of typical drinks at T1 (OR = 0.60, p < 0.001), T2 (OR = 0.55, p < 0.001) and T3 (OR = 0.56, p = 0.001), compared to the control. However, the attrition models were more robust at T1 and T2. In contrast, low-motivated students receiving the PNF increased AUDIT score at T3 (b = 1.49, p < 0.001). CONCLUSIONS: The intervention reduced alcohol use, and motivation for receiving the intervention moderated the intervention effects. Motivated students reduced their typical alcohol use, whereas low-motivated students increased their AUDIT score.

Ateneo General: ¿Dale que interveníamos para que el aprendizaje se ponga en juego? / General athenaeum: ¿Do we take action to make learning come into play?

Ateneo del equipo de la Residencia de Psicopedagogía con sede en el Hospital Carlos G. Durand, de la Ciudad de Buenos Aires, donde se reflexiona sobre las intervenciones clínicas en niños y púberes en escolaridad primaria. Se realiza un recorrido teórico sobre conceptos como intervención, niño, sujeto, o juego; y se analiza la relación entre juego y aprendizaje, presentando distintos casos clínicos que reflejan estas intervenciones

Brief Intervention Among Mexican-Origin Young Adults in the Emergency Department at the USA-Mexico Border: Examining the Role of Patient's Preferred Language of Intervention in Predicting Drinking Outcomes.

AIMS: Determine if the language in which brief intervention (BI) is delivered influences drinking outcomes among Mexican-origin young adults in the emergency department when controlling for ethnic matching. SHORT SUMMARY: Aim of study was to determine if a patient's preferred language of intervention influences drinking outcomes among Mexican-origin young adults in the emergency department. Results indicate no significant differences in drinking outcomes among those who received BI in Spanish and BI in English. METHODS: This is a secondary data analysis on data from 310 patients randomized to receive a BI completed in Spanish (BI-S) or English (BI-E), with 3- and 12-month follow-up. Outcome measures of interest were drinking days per week, drinks per drinking day, maximum drinks in a day and negative consequences of drinking. RESULTS: There were no significant differences in drinking outcomes among those who received BI in Spanish and BI in English. CONCLUSIONS: Reduced drinking outcomes following BI among Mexican-origin young adults in the emergency department may not have been due to the language used to deliver intervention. Thus, our results provide evidence that language of intervention is not a crucial factor to achieve cultural congruence. In addition, our findings suggest that receiving the intervention is beneficial regardless of language, thus, facilitating real-world implementation.

Psicoterapia conductual en la atención estomatológica en Retrasado Mental no convencional / Behavioral Psychotherapy in the stomatological care for the unconventional mentally retarded patients

Se realizó un estudio de intervención comunitaria en pacientes con retraso mental pertenecientes a la Clínica Estomatológica del Policlínico Universitario # 2 en el 2011 con diagnóstico de caries dental, con el objetivo de modificar el estado de salud bucal en pacientes con retraso mental. El universo y la muestra constituida por 240 pacientes, se precisaron las variables para el estudio: convencional, no convencional, ligero, moderado, severo, profundo, prótesis parcial y total. Se utilizó la psicoterapia conductual además de las acciones de promoción y prevención. Se tuvo en cuenta el gasto económico en el Hospital Celia Sánchez y Hermanos Cordovés por paciente en caso de que fueran hospitalizados para el tratamiento. Las fuentes de información fueron el interrogatorio, la entrevista y la historia clínica individual. Los datos obtenidos se procesaron en una hoja de cálculo Microsoft Excel, empleándose como medida de resumen las medidas de frecuencias absolutas y relativas en tablas estadísticas, se obtuvo como resultados: 20 Retrasados Mental no convencionales atendidos con la psicoterapia conductual, se convirtieron en pacientes convencionales con un ahorro de $3329,6, 10 RM leves se rehabilitaron protésicamente. Se concluye que en los pacientes con retraso mental fue de valor significativo el uso de la psicoterapia conductual(AU)

It was carried out a study of community intervention in mentally-retarded patients belonging to the Dental Clinic from the University Polyclinic 2 in 2011, with the diagnosis of dental caries and the objective of modifying the condition of oral health in mentally-retarded patients. The Universe and the sample were constituted by 240 patients. The variables for the study were: conventional, unconventional, mild, moderate, severe, deep, partial and total prosthesis. The behavioral Psychotherapy was used as well as promotion and prevention actions. It was considered the economic expense of the patients at Celia Sánchez Manduley and Hermanos Cordovés Hospitals in case that they were hospitalized for further treatments. The sources of information were: the surveys, the interviews and the individual medical record. The obtained data were processed in a spreadsheet Microsoft Excel, and the summary measures were the absolute and relative frequencies in statistical charts. The results were the folowing: 20 unconventional-mentally-retarded patients were assisted, with the use of the Behavioral Psychotherapy, they became conventional patients assisted with a saving of $ 3329, 6. Ten mild mentally-retarded patients were prosthetic rehabilitated. It was concluded that in the mentally-retarded patients, the use of Behavioral Psychotherapy was of significant value(EU)

Nivel de conocimientos sobre salud bucal en los trabajadores del Semi-Internado Carlos Manuel de Céspedes de Bayamo, 2014-2015 / Level of knowledge in regards to oral health in workers from the Semi Internal School Carlos Manuel de Cespedes in Bayamo. 2014-2015

Introducción: la salud es un punto de encuentro, ahí confluyen lo biológico y lo social, el individuo y la comunidad, la política social y la economía. Objetivo: elevar el nivel de conocimiento sobre salud bucal en los trabajadores del Semi-Internado Carlos Manuel de Céspedes, curso 2014-2015, en el municipio Bayamo, provincia Granma. Método: se realizó un estudio experimental de intervención con pre-prueba y pos-prueba, el universo estuvo constituido por el total de personas de la escuela, a la que pertenecen los 106 trabajadores y todos formaron parte del estudio. Resultados: la aplicación de la intervención educativa demostró ser un instrumento práctico para modificar el nivel de conocimiento y se elevó el nivel de conocimiento de los trabajadores sobre salud bucal. Conclusiones: el nivel de conocimiento, antes de emplear la intervención fue evaluado de mal, el grupo de edad más afectado fue el de 60 años, en cuanto al sexo no se encontraron diferencias, las necesidades de aprendizaje se identificaron mediante las respuestas incorrectas de la encuesta de conocimientos(AU)

Introduction: health is a meeting point, were some factors converge: the biological and the social, the individual and the community, the social policy and the economics. Objective: to increase the level of knowledge on oral health in workers of the Semi-Internal school Carlos Manuel de Cespedes, during the course 2014-2015, in the municipality of Bayamo, Granma province. Method: it was performed an experimental intervention study with pre-test and post-test, the universe consisted of the amount of people in the school, including the 106 workers and they were all part of the study. Results: the application of the educational intervention proved to be a practical tool to change the level of knowledge and this level increased in regards to the oral health. Conclusions: the level of knowledge, before using the intervention was evaluated as bad, the most affected age group was the one of 60, there were no differences in regards to sex, and the learning needs were identified through the incorrect responses of the knowledge survey(EU)

Modificación de conocimientos sobre Infecciones de Transmisión Sexual en adolescentes / Modification of knowledge about Sexually Transmitted Infections in adolescents

Se realizó un estudio de intervención educativa, con los estudiantes de noveno grado del aula 3 de la ESBU 4 de abril del municipio Manzanillo, en el período comprendido de septiembre del 2012 a marzo del 2013 con el objetivo de elevar el nivel de conocimiento sobre las Infecciones de Transmisión Sexual en los adolescentes. Nuestro universo estuvo constituido por 28 estudiantes del noveno grado del aula 3, la muestra quedó formada por los 28 estudiantes que cumplieron con los criterios establecidos para el estudio. Para el trabajo con las variables (edad, sexo, enfermedades que se manifiestan como ITS, vías de transmisión, síntomas y práctica del sexo seguro) se confeccionó una encuesta que sirvió de instrumento de entrada y salida en los ítems modificables. Como medida estadística se utilizó la prueba de los signos. En el grupo de adolescentes estudiados predominaron los de 14 años del sexo femenino y se elevó el nivel de conocimientos sobre las ITS después de la aplicación del programa educativo(AU)

It was carried out an educational intervention study with ninth gradersof the classroom 3 at 4 de Abril Secondary School in Manzanillo, in the period of September, 2012 to March, 2013 with the objective of increasing the level of knowledge on SexuallyTransmitted Infections in adolescents. Our universe was constituted by 28 ninth graders of the classroom 3, and the sample was formed by the 28 students that accomplished the established criteria for the study. For the work with the variables (age, sex, illnesses that are manifested as STI, ways of transmission, symptoms and practice of the safe sex) it was made a survey that served as an entrance and exit instrument in the modifiableitems. As the statistic measure it was used the test of signs. In the group of adolescents those of 14 years of the feminine sex prevailed, and the level of knowledge on STIs increased after the application of the educational program(EU)

Intervención educativa para elevar el conocimiento sobre Alfabetización informacional en Residentes de especialidades médicas / Educative intervention to increase the level of knowledge on Information Literacy in the Residents of medical specialties

Introducción: la Alfabetización Informacional se considera un vehículo idóneo para que los ciudadanos adquieran competencias que les faculten para el aprendizaje a lo largo de la vida. Objetivo: evaluar la eficacia del programa educativo para elevar el conocimiento y autopercepción sobre competencia informacional de los residentes de especialidades médicas: Medicina General Integral (MGI) y Estomatología General Integral (EGI) del Policlínico Docente Luis E. de la Paz Reina, Yara. Granma. Método: se aplicó un programa educativo sustentado en la aplicación de un programa de Alfabetización Informacional. Las variables fueron: análisis de la información, alfabetización informacional. La muestra estuvo constituida por los 36 Residentes de MGI y EGI de 1er año en el período de noviembre 2014 a marzodel 2015. Resultados: se logró que aumentara el conocimiento de los residentes de especialidades médicas en temáticas fundamentales: búsquedas bibliográficas, necesidades de información, Alfabetización Informacional, entre otras. Conclusiones: se demostró la eficacia del programa educativo para incrementar el conocimiento de los residentes de especialidades médicas al elevar el nivel de conocimientos con una significación estadística de confiabilidad del 95 por ciento, que demostró la utilidad del curso de Alfabetización Informacional en profesionales de la salud(AU)

Introduction: information Literacy is considered an ideal vehicle for citizens to acquire skills that enable them to learn throughout life. Objective: to evaluate the effectiveness of the educational program in order to increase the knowledge and self-perception about information competence of the interns of medical specialties: General Medicine (GM) and General Dentistry (GD) of the Teaching Polyclinic Luis E. de la Paz Reina inYara. Granma. Method: it was applied an educational program supported by the implementation of an information literacy program. The variables were: information analysis, information literacy. The sample consisted of 36 interns of GM and GD of 1st year in the period of November, 2014 to March of 2015. Results: we obtained an increase on the interns knowledge of medical specialties in fundamental subjects: literature searches, information needs, information literacy, among others. Conclusions: it was proved the effectiveness of the educational program to increase the interns knowledge of medical specialties by increasing the level of knowledge with a statistical significance of reliability of 95 percent, demonstrating the usefulness of Information Literacy course in health professionals(EU)

Early intervention for bipolar disorder: current imperatives, future directions / Intervenção precoce no transtorno bipolar: necessidades atuais, rumos futuros

OBJECTIVES: The objective of this article is to discuss the rationale/background for early intervention in bipolar disorder. METHOD: Narrative review. RESULTS: There are often significant delays before the diagnosis of bipolar disorder is made and effective management initiated. Growing evidence from both preclinical and clinical literature points to a clear need for improved early identification and early intervention in bipolar disorder. Increasing efforts are being applied to the identification of those at high risk of onset of bipolar disorder. It is hoped that identification of an early prodrome of illness will allow preventative measures to be taken. CONCLUSIONS: There is a clear rationale for improved early identification and early intervention in bipolar disorder.

OBJETIVOS: O objetivo do artigo é discutir os fundamentos para a intervenção precoce no transtorno bipolar. MÉTODO: Revisão narrativa. RESULTADOS: Frequentemente existe um atraso significativo com relação ao momento em que o transtorno bipolar é detectado e o início do tratamento. Evidências crescentes oriundas de estudos pré-clínicos e clínicos apontam para a clara necessidade de melhorar a detecção e o tratamento precoces no transtorno bipolar. Esforços também tem sido direcionados para a identificação de indivíduos em alto risco. Espera-se que a identificação do pródromo do transtorno bipolar permita a instauração de medidas preventivas. CONCLUSÕES: Existem bases claras para o investimento na melhora da detecção e tratamento precoces do transtorno bipolar.

Early intervention for bipolar disorder: current imperatives, future directions.

OBJECTIVES: The objective of this article is to discuss the rationale/background for early intervention in bipolar disorder. METHOD: Narrative review. RESULTS: There are often significant delays before the diagnosis of bipolar disorder is made and effective management initiated. Growing evidence from both preclinical and clinical literature points to a clear need for improved early identification and early intervention in bipolar disorder. Increasing efforts are being applied to the identification of those at high risk of onset of bipolar disorder. It is hoped that identification of an early prodrome of illness will allow preventative measures to be taken. CONCLUSIONS: There is a clear rationale for improved early identification and early intervention in bipolar disorder.