Correlation between short-term blood pressure variability parameters with mobil-O-graph pulse wave velocity.

BACKGROUND: Blood pressure variability (BPV) and arterial stiffness show an association with increased cardiovascular events. Evidences demonstrated an association between higher short-term systolic BPV and stiffer arteries. There is no previous study assessed the correlation between BPV and arterial stiffness measured by a Mobil-O-Graph device. We issued to evaluate the correlation between short-term BPV parameters and Mobil-O-Graph pulse wave velocity (PWV) among suspected hypertensive individuals under treatment. METHODS: Mobil-O-Graph device estimated arterial stiffness (oscillometric PWV [oPWV]) in 649 individuals, and they recorded 24-h ambulatory BP; 428 had suspected hypertension and 221 under treatment. We analyzed the correlation between oPWV and measures of BPV: SD of 24 h BP (24-h SD), SD of daytime BP (daytime-SD), and SD of nighttime BP (nighttime-SD), weighted SD of 24-h BP (wSD), coefficient of variation of 24-h BP (CV 24-h) and average real variability (ARV). RESULTS: Oscillometric PWV showed a positive correlation with all systolic BPV measures, in both groups. Among suspected hypertensives: 24-h SD, r = 0.30; SD daytime-SD, r = 0.34; nighttime-SD, r = 0.16; wSD, r = 0.30; CV 24-h, r = 0.24; ARV, r = 0.22. In the treated individuals: 24-h SD, r = 0.46; daytime-SD, r = 0.47; nighttime-SD, r = 0.35; wSD, r = 0.50; CV 24-h, r = 0.43; ARV, r = 0.37, all P < 0.001. Diastolic BPV demonstrated association with some measures of BPV. In suspected hypertensive group: nighttime-SD, r = 0.13; wSD, r = 0.10, both P < 0.001. And in treated individuals: daytime-SD, r = 0.23; wSD, r = 0.22; CV 24-h, r = 0.19 (all P < 0.001), ARV, r = 0.15 (P < 0.05). Systolic daytime-SD in suspected and diastolic CV 24-h in treated group independently predicted oPWV. CONCLUSION: We observed a positive and independent correlation between Mobil-O-Graph pulse wave velocity and BPV measures, strong to systolic BPV and weak to diastolic BP.

Effect of implementation intention on walking in people with diabetes: an experimental approach.

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

Effect of implementation intention on walking in people with diabetes: an experimental approach

ABSTRACT OBJECTIVE To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

Comparison of pulse wave analysis parameters by oscillometry in hypertensive diabetic and nondiabetic patients in a Brazilian outpatient care.

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.

Impact of implementation intentions on physical activity practice in adults: A systematic review and meta-analysis of randomized clinical trials.

OBJECTIVE: The aim of this study was to verify the efficacy of using theory-based strategies on implementation intentions in promoting physical activity (PA) among adults. METHODS: This review was conducted in accordance with the PRISMA recommendations. The search was carried out in seven electronic databases (LILACS, PubMed, SciELO, Cochrane, Web of Science) and two searches of the "grey literature" were performed (Openthesis and OpenGrey). Randomized clinical trials (RCT), published up to September 2016, were considered eligible for this study. Two reviewers independently and systematically evaluated the eligibility criteria, and performed data extraction. A meta-analysis was performed for the purpose of comparing the effect between the intervention and control groups. The effect sizes were grouped in two subgroups with the purpose of more accurately verifying the effect caused by reinforcing the implementation intentions strategy, and using the inverse variance statistical method with random effects models to estimate the main effect of the implementation intention strategy on the PA behavior. Heterogeneity among the studies was evaluated by using I-square statistics, and the Jadad scale to evaluate the quality of included papers. RESULTS: The search resulted in 12,147 records, of which 13 RCTs were considered eligible for this review. Sample age ranged from 18 to 76 years, and participants had conditions such as medullary lesion, coronary disease, obesity, diabetes mellitus, sedentarism or occupational stress. When the summary of the effect was analyzed in the meta-analysis, the result found in the subgroup with reinforcement of the implementation intentions strategy was 0.25 (IC 95% = 0.05-0.45) in favor of the intervention group. This demonstrated that application of the implementation intentions strategy was capable of increasing PA practice in the participants of these studies, in comparison with others that did not use this reinforcement. CONCLUSION: The findings of this review indicated that application of the theory of implementation intentions promoted PA behavior among the adults who received reinforcement of this strategy. The systematic review protocol was registered in the PROSPERO database under the number CRD42018090482.

Práticas em saúde bucal de agentes comunitários de saúde vinculados à estratégia saúde da família com e sem equipe de saúde bucal / Practice in oral health community health workers linked to family health strategy with and without team oral health

bjetivo ­ Avaliar as características socioeconômicas, processo de trabalho, capacitação, comportamento, autopercepção do conhecimento e acesso das famílias ao serviço odontológico em saúde bucal entre os grupos de Agentes Comunitários de Saúde (ACS) vinculados a Unidade de Saúde da Família (USF) com e sem Equipe de Saúde Bucal (ESB). Métodos ­ Trata-se de um estudo transversal de cunho quantitativo. No total, 162 sujeitos participaram do estudo, sendo 81 ACS vinculados a USF com ESB (Grupo 2) e 81 ACS vinculados a USF sem ESB (Grupo 1). Para a coleta dos dados, utilizou-se um questionário previamente testado. Foram aplicados os testes Qui-Quadrado e Exato de Fischer para verificar diferenças entre os grupos de ACS. O nível de significância adotado nos testes foi de 5%. Resultados ­ Constatou-se diferença estatística significativa entre os grupos de ACS somente nas questões que abordaram o tema capacitação em saúde bucal (p<0,0002) e acesso das famílias ao serviço odontológico (p<0,0001). Conclusão ­ Os ACS que atuam em PSF com Equipe de Saúde Bucal tem autopercepção mais positiva sobre o acesso das famílias ao serviço de saúde bucal, e receberam mais capacitação em Saúde Buca

Objective ­ To evaluate the characteristics socioeconomic, work process, training, behavior, perception of knowledge and access of households to service dental oral health between of Community Workers Health (CHW) Unit linked to Family Health with and without Oral Health Team. Methods ­ This was a cross-sectional study of quantitative. A total of 162 subjects participated in the study, with 81 CHW linked to Family Health Unit with Oral Health Team (Group 2) and 81 ACS linked to Family Health Unit without ESB (Group 1). To collect the data, we used a previously tested questionnaire. Chi-square and Fisher exact tests were used to assess the differences between the CHW groups. The significance level used in the tests was 5%. Results ­ There was significant statistical difference between the CHW groups only on issues that focused on training in oral health (p <0.0002) and household access to dental care (p <0.0001). Conclusion ­ CHW who work in Family Health Unit with Oral Health Team has more positive perception on household access to oral health services, and received more training in Oral Health.

Evaluation of knowledge of Oral Health of Community Health Agents connected with the Family Health Strategy.

The aim of this study was to evaluate the knowledge of Community Health Agents (CHA) about the oral health/disease process, and compare the results between those who work in Family Health Teams (FHT), with and without Oral Health Teams (OHT). The participants in this study were 162 subjects, representing 66% of the total number of CHA in the municipality, and 81 of them are connected with Family Health Units (FHU) with OHT, and 81 CHS with FHUs without OHT. Data were collected from October to December 2013, by application of a questionnaire, containing personal and professional data, and 12 validated questions about knowledge of the oral health/disease process. The Mann-Whitney test was applied to verify differences between the groups. Statistically significant differences were verified between the groups of CHA when the total scores of questions about the oral health/disease process were analyzed (p < 0.0021). It was concluded that knowledge about the oral health/disease process, of the CHAs connected with a FHU with an OHT was better when compared with that of CHAs connected with a FHU without an OHT.

Evaluation of knowledge of Oral Health of Community Health Agents connected with the Family Health Strategy / Avaliação do conhecimento em saúde bucal de agentes comunitários de saúde vinculados à Estratégia Saúde da Família

The aim of this study was to evaluate the knowledge of Community Health Agents (CHA) about the oral health/disease process, and compare the results between those who work in Family Health Teams (FHT), with and without Oral Health Teams (OHT). The participants in this study were 162 subjects, representing 66% of the total number of CHA in the municipality, and 81 of them are connected with Family Health Units (FHU) with OHT, and 81 CHS with FHUs without OHT. Data were collected from October to December 2013, by application of a questionnaire, containing personal and professional data, and 12 validated questions about knowledge of the oral health/disease process. The Mann-Whitney test was applied to verify differences between the groups. Statistically significant differences were verified between the groups of CHA when the total scores of questions about the oral health/disease process were analyzed (p < 0.0021). It was concluded that knowledge about the oral health/disease process, of the CHAs connected with a FHU with an OHT was better when compared with that of CHAs connected with a FHU without an OHT.

O objetivo deste estudo foi avaliar os conhecimentos de Agentes Comunitários de Saúde (ACS) sobre o processo saúde/doença bucal, comparando resultados entre os que atuam em Equipes de Saúde da Família (ESF), com e sem Equipes de Saúde Bucal (ESB). Participaram do estudo 162 sujeitos, representando 66% do total de ACS do município, sendo 81 deles vinculados à Unidade de Saúde da Família (USF) com ESB, e 81 ACS à USF sem ESB. Os dados foram coletados de outubro a dezembro de 2013, por meio da aplicação de um questionário contendo dados pessoais, profissionais e 12 questões validadas sobre conhecimentos do processo saúde-doença bucal. Foi aplicado o teste Mann-Whitney para verificar diferenças entre os grupos. Verificou-se que houve diferenças estatisticamente significativas entre os grupos de ACS, quando se analisou o total de escores das questões sobre o processo saúde-doença bucal (p < 0,0021). Conclui-se que os conhecimentos sobre processo saúde/doença bucal dos ACS vinculados à USF com ESB são melhores quando comparado aos ACS vinculados à USF sem ESB.

[Impact of the activation of intention to perform physical activity in type II diabetics: a randomized clinical trial]. / Impacto da ativação da intenção na prática da atividade física em diabéticos tipo II: ensaio clínico randomizado.

Type II diabetes mellitus is a highly prevalent disease among the adult Brazilian population, and one that can be controlled by interventions such as physical activity, among others. The aim of this randomized controlled study was to evaluate the impact of a traditional motivational strategy, associated with the activation of intention theory, on adherence to physical activity in patients with type II, diabetes mellitus who are part of the Unified Health System (SUS). Participants were divided into a control group (CG) and an intervention group (IG). In both groups, the traditional motivational strategy was applied, but the activation of intention strategy was only applied to the IG Group. After a two-month follow-up, statistically significant differences were verified between the groups, related to the practice of walking (p = 0.0050), number of days per week (p = 0.0076), minutes per day (p = 0.0050) and minutes walking per week (p = 0.0015). At the end of the intervention, statistically significant differences in abdominal circumference (p = 0.0048) between the groups were observed. The conclusion drawn is that the activation of intention strategy had greater impact on adherence to physical activity and reduction in abdominal circumference in type II diabetics, than traditional motivational strategy.

Impacto da ativação da intenção na prática da atividade física em diabéticos tipo II: ensaio clínico randomizado / Impact of the activation of intention to perform physical activity in type II diabetics: a randomized clinical trial

O diabetes mellitus, tipo II, é uma doença com alta prevalência na população adulta brasileira e que pode ser controlada, dentre outras intervenções, por meio da atividade física. Este estudo teve como objetivo avaliar o impacto de uma estratégia motivacional tradicional, bem como sua associação à estratégia de ativação da intenção, na adesão à atividade física, nos portadores do diabetes mellitus, tipo II, usuários do Sistema Único de Saúde (SUS), por meio de um ensaio clínico randomizado. Os participantes foram alocados em Grupo Controle (GC) e Grupo Intervenção (GI). Ambos os grupos receberam uma estratégia motivacional tradicional, porém, somente o GI recebeu a estratégia de ativação da intenção. Após dois meses de seguimento, observaram-se diferenças estatisticamente significativas entre os grupos, relativas à prática de caminhada (p = 0,0050), número de dias por semana (p = 0,0076), minutos por dia (p = 0,0050) e minutos por semana (p = 0,0015) de caminhada. Ao final das intervenções, observaram-se, também, diferenças na circunferência abdominal (p = 0,0048) entre os grupos. Conclui-se que a estratégia de ativação da intenção teve maior impacto na adesão à prática de atividade física e diminuição da circunferência abdominal de diabéticos, tipo II, do que a estratégia motivacional tradicional.

Type II diabetes mellitus is a highly prevalent disease among the adult Brazilian population, and one that can be controlled by interventions such as physical activity, among others. The aim of this randomized controlled study was to evaluate the impact of a traditional motivational strategy, associated with the activation of intention theory, on adherence to physical activity in patients with type II, diabetes mellitus who are part of the Unified Health System (SUS). Participants were divided into a control group (CG) and an intervention group (IG). In both groups, the traditional motivational strategy was applied, but the activation of intention strategy was only applied to the IG Group. After a two-month follow-up, statistically significant differences were verified between the groups, related to the practice of walking (p = 0.0050), number of days per week (p = 0.0076), minutes per day (p = 0.0050) and minutes walking per week (p = 0.0015). At the end of the intervention, statistically significant differences in abdominal circumference (p = 0.0048) between the groups were observed. The conclusion drawn is that the activation of intention strategy had greater impact on adherence to physical activity and reduction in abdominal circumference in type II diabetics, than traditional motivational strategy.