Senses and meanings of primary health care academic visions in nursing / Sentidos y significados de las visiones académicas de la atención/cuidado primaria de salud en enfermería / Sentidos e significados das visões acadêmicas da atenção básica/cuidado em enfermagem

Introduction: Primary Health Care (PHC) has acquired different meanings for different people, at specific times and places, which poses important challenges for its understanding. Objective: To analyze the meaning(s) and sense(s) of Primary/Basic Health Care in the academic views on Nursing/Health in the context of undergraduate Nursing courses offered at two public Higher Education Institutions. Materials and methods: Qualitative study with an exploratory approach. Semi-structured interviews and documentary analysis were used as data collection techniques. Results: The senses/meanings of Primary Health Care converge with the population's gateway to the health system at the first care level and with the first contact of a person with the health service. However, it is still considered as a less important service within the care network. Conclusion: Primary Health Care means a relevant possibility for Nursing/Health care through health promotion and disease prevention actions, with a commitment to respond to most of the population's health needs.

Introducción: La Atención Primaria de Salud ha adquirido diferentes significados para diversas personas, en momentos y lugares específicos, lo cual plantea importantes retos para su entendimiento. Objetivo: Analizar los significados y sentidos de la Atención Primaria de Salud desde una visión académica en Enfermería y en el contexto de cursos de pregrado en Enfermería ofrecidos en dos Instituciones Públicas de Educación Superior. Materiales y métodos: Estudio cualitativo con un enfoque exploratorio, para la recolección de datos se emplearon entrevistas semiestructuradas y análisis documental de contenidos. Resultados: Los sentidos/significados de la Atención Primaria de la Salud convergen con el ingreso de la población al sistema de salud en el primer nivel de atención y la primera experiencia de la persona con el servicio de salud. Sin embargo, dicha Atención Primaria todavía se considera un servicio de baja importancia dentro de la red asistencial. Conclusión: La Atención Primaria de Salud representa una posibilidad relevante para el cuidado de Enfermería a través de acciones de promoción de la salud y prevención de enfermedades, que debe fortalecerse para responder la mayoría de las necesidades de salud de la población.

Introdução: A Atenção Primária à Saúde tem adquirido diferentes significados para diferentes pessoas, em momentos e locais específicos, o que coloca desafios importantes para a sua compreensão. Objetivo: Analisar os sentidos e significados da Atenção Primária à Saúde na perspectiva acadêmica em Enfermagem e no contexto dos cursos de graduação em Enfermagem oferecidos em duas Instituições de Ensino Superior Públicas. Materiais e métodos: Estudo qualitativo com abordagem exploratória, utilizou-se entrevistas semiestruturadas para coleta de dados e análise de conteúdo documental. Resultados: Os sentidos/significados da Atenção Primária à Saúde convergem com a entrada da população no sistema de saúde no primeiro nível de atenção e a primeira experiência da pessoa com o serviço de saúde. Contudo, a referida Atenção Básica ainda é considerada um serviço de baixa importância dentro da rede de saúde. Conclusão: A Atenção Primária à Saúde representa uma possibilidade relevante para o cuidado de Enfermagem por meio de ações de promoção da saúde e prevenção de doenças, que devem ser fortalecidas para responder à maioria das necessidades de saúde da população.

The views of general practitioners in Morocco about health promotion at the primary health care services: Qualitative study.

BACKGROUND: Health promotion (HP) is one of the key skills that every general practitioner (GP) should have, according to The World Organization of Family Doctors, but for several reasons, his practice remains insufficient. However, a gap would exist between the GPs' knowledge and their practices about HP. The aims of our study were to explore GPs' perceptions, knowledge, and practices in Morocco about HP and identify their barriers and needs to best practice HP actions. MATERIALS AND METHODS: A qualitative case study was conducted among GPs, via semi-structured interviews following an interview guide. Purposive and snowball sampling were used to select our sample. It contained four themes, perceptions, practices, barriers and needs, and proposals for improvement. The interviews were recorded and then transcribed. Thematic content data analysis was done manually. Favorable ethical approval was obtained from the local ethics committee. RESULTS: Fourteen GPs participated in this study. The sex ratio was at one. GPs' practices were focused on the biomedical model with wide confusion of HP with prevention and therapeutic education. Their roles in HP were considered paramount. The number of patients during consultations, structures' care, and knowledge were the main barriers. The main cited needs were material resources and HP training. CONCLUSION: Our study has made it possible to make an inventory of the practice of HP in Morocco. Participants' practices were based on the curative aspect. There is a crucial need to implement continuing and contextualized training for general practitioners to strengthen their skills in HP. This training will help to succeed in the health-promoting hospital's strategy.

A 12-year follow up of principles learned in a pediatric dentistry Master of Public Health dual degree program applied to professional practice.

Introduction: Dental public health professionals play a critical role in preventing and controlling oral diseases. The purpose of this study was to assess the application of public health principles learned in a pediatric dentistry Master of Public Health (MPH) dual degree program to professional practice upon graduation. Methods: Semi-structured interviews were conducted with pediatric dentistry/MPH dual degree alumni who graduated from the program between 2012 and 2023. Interview questions inquired about characteristics of patient population, location of providers' clinic/organization, whether the program was worthwhile to their practice and application of principles learned in the program to their professional practice. Results: Twenty of the 22 program alumni agreed to be interviewed. All alumni thought the program was extremely worthwhile to their practice. They felt the MPH component of the program gave them the public health background and tools they needed to provide comprehensive and holistic care to their patients. Additionally, all alumni reported applying the public health principles they learned in the program to their professional practice through leadership roles, research and teaching that focuses on oral disease prevention and the promotion of dental health. Discussion: Given the importance of a dental public health professionals' role in reducing oral health disparities at the population level, more pediatric dentistry MPH dual degree programs are urgently needed. Additionally, more research is necessary to demonstrate the effectiveness of these programs, which will be critical to helping ensure the value of a dual degree in dentistry and public health is recognized and promoted worldwide.

"Exploring job demands and resources influencing mental health and work engagement among physical therapists: a cross-sectional survey of Norwegian physical therapists."

BACKGROUND: Physical therapists play a vital role in the Norwegian health care system, and their work environment may be a significant determinant for their wellbeing and job performance. OBJECTIVE: 1) Assess differences in work environment, mental health problems, and work engagement between physical therapists working in specialist versus municipal health care services. 2) Assess the relationships between work environment factors and work engagement and mental health problems. METHODS: In this cross-sectional study, 273 physical therapists responded to the Survey for Workplace Health Promotion (response rate = 35%). Independent-sample t-tests, Pearson correlations, and multiple regression analyses were performed. RESULTS: This study did not find any significant differences between physical therapists working in Norwegian hospitals and therapists working in the municipal health care services. Analyses showed that general demands (ß = 0.21), fragmented work tasks (0.18), predictability (-0.17) and social support (-0.34) were associated with mental health problems, while meaningful work (0.41), the opportunity to use one's strengths and potential (0.14), and social support (0.25) were associated with higher work engagement. CONCLUSION: This study highlights the role of poor job design and professional isolation as hindrances to work engagement among physical therapists, whereas work related meaningfulness and peer support promote their health and wellbeing.

The value-for money of preventing and managing periodontitis: Opportunities and challenges.

This article gives an overview of the societal and economic aspects of periodontitis and periodontal care. Despite its largely preventable nature, periodontitis is highly prevalent worldwide and imposes a substantial health and economic burden on individuals and society as a whole. The worldwide estimated direct treatment costs and productivity losses due to periodontitis (including for periodontitis-related tooth loss) amounted to US$ 186 billion and US$ 142 billion in 2019, respectively. The burden of periodontitis is particularly evident in low and disadvantaged populations. Smoking, dietary habits, and presence of systemic diseases along with social and commercial determinants are considered as risk factors for the periodontal diseases. The cost-effectiveness of preventing and managing periodontitis has been explored in several studies but it has been highlighted that there is scope for improvement in defining the methodology and quality of reporting of such studies. A recent report by The Economist Intelligence Unit examined the cost-effectiveness of interventions to prevent and manage periodontal diseases, suggesting that prevention of periodontitis through prevention of gingivitis by means of individual home care would be more cost-efficient than four other examined approaches. Future research in this field is recommended to further decipher the economic burden of periodontitis to society and to assess the value for money of alternative approaches to address periodontitis with particular emphasis on public health preventive strategies and intersectoral care approaches that address the common risk factors of periodontitis and other non-communicable diseases simultaneously.

Health professionals' involvement in volunteering their professional skills: a scoping review.

Background: Volunteering positively affects overall health of both volunteers and recipients through social interaction, support and physical activity. Health professionals' volunteering has considerable potential to improve health outcomes in communities. Objectives: This study aimed to summarize published scientific literature regarding volunteering by health professionals. Method: Medine, Embase, Scopus, PsycINFO and CINAHLdatabases were searched to identify eligible studies published between 2010 and 2023. Data on study methods and findings were extracted and synthesized. Results: Of the 144 eligible studies, 80 (56%) used quantitative methods, 46 (32%) used qualitative, 18 (12%) used mixed methods and 8 (6%) were interventional. Doctors (74 studies, 51%) and nurses (n = 40, 28%) were the professions with most reports of volunteering. Half the studies were from USA (n = 77, 53%), followed by UK (n = 19, 13%), Canada (n = 12, 8%), and Australia/New Zealand (n = 11, 8%). International volunteering in low-to-middle-income countries was reported in 64 studies (44%). Providing service and training were the dominant types of activities (n = 90, 62.5%), with health promotion reported in only 4 studies (3%). Studies reported positive impact from volunteering, both professionally and personally. Time and family commitments were the main barriers. Enablers, barriers and impact were summarized in a socio-ecological map. Conclusion: Health professionals volunteer in diverse activities and report multifaceted benefits. Studies of volunteering interventions could enable new, sustainable approaches to health promotion.

Employee Sleep Promotion Programs in Workplace Settings: An Exciting, Viable Area for Lifestyle Medicine.

In the past several decades, our population sleep health has fallen short of recommendations. Moreover, there has been an increase in sleep difficulties amidst COVID-19. Work consumes a huge proportion of our waking lives, and the nature of our work can impact the quantity and quality of employee sleep. Conversely, employee sleep also matters for work-related outcomes as evidence demonstrates poor employee sleep health is associated with increased presenteeism, absenteeism, and health care costs. Given the prevalence of poor sleep health in our population, the changing nature of work and increasing demands on capped time, the worksite represents a promising and potentially underexplored venue for lifestyle medicine practitioners to consider employee sleep health and, where possible, novel employee sleep health promotion programs. This article outlines the impact of work on sleep and reviews the potential for incorporating sleep into lifestyle interventions in workplace settings.

Effects of public transportation use on non-exercise activity thermogenesis and health promotion: a mini-review.

PURPOSE: Public transportation (PT) systems significantly shape urban mobility and have garnered attention owing to their potential impact on public health, particularly the promotion of physical activity. Beyond their transportation functions, PT systems also affect daily energy expenditure through non-exercise activity thermogenesis (NEAT). This mini-review surveys the existing literature to explore the effects of PT use on NEAT levels and subsequent health outcomes. METHODS: A comprehensive literature search was conducted using the electronic databases PubMed, Google Scholar, and Web of Science. Keywords including "public transportation," "non-exercise activity thermogenesis," "physical activity," "health promotion," and related terms were used to identify relevant studies. RESULTS: This review highlights the multifaceted relationship between PT use and health promotion, emphasizing the potential benefits and challenges of increasing NEAT through public transit utilization. Overall, the findings suggest that PT use contributes positively to NEAT levels, and thus improves health outcomes. However, the extent of this impact may vary depending on individual and contextual factors. CONCLUSION: Interventions promoting active transportation modes, including public transit, hold promise for addressing sedentary behavior and fostering healthier lifestyles at the population level.

How researchers can translate health evidence into books for children.

The health promotion literature that considers how scientific evidence can be effectively communicated tends to focus on evaluating the effectiveness of communication materials. This has resulted in a knowledge gap regarding effective knowledge translation processes. This study explores the process, reasoning and practices for developing books for children that incorporate evidence-based information to aid understanding of scientific evidence about health and environmental or natural disasters. This study is informed by a systematic review of the literature combined with responses to an email interview with authors of books for children. Nine published studies were included in the systematic review. Twenty-two authors responded to the email survey (25% response rate, following 86 invitations). We report seven key findings to guide the development of health-promoting books for children: (i) understand the needs and expectations of the audience, (ii) articulate the topic and research evidence, (iii) assemble a team with a mix of content knowledge and creative expertise, (iv) format should be chosen to suit the user group and guided by the creative team, (v) early testing with children and their support system is crucial, (vi) develop a dissemination strategy to reach the user group and (vii) engage in reflexivity through evaluation of effectiveness of messaging. The current investigation can guide the process, reasoning and practice of developing books for children that incorporate evidence about health and environmental disasters.

The effect of web-based education on self-care behaviors in cardiovascular patients: application of the pender's health promotion model.

BACKGROUND: Coronary artery disease is the most common cardiovascular disease, the mortality rate of which is increasing significantly. The most important way to prevent a second attack in patients undergoing angioplasty is self-care, which can be influenced by several factors such as the patient's beliefs. Thus, the present study aimed to determine the effect of a web-based intervention based on the Pender's health promotion model in patients with cardiovascular disease. METHODS: The present clinical trial study was conducted with 99 patients undergoing angioplasty treatment referring to Bushehr Heart Specialist Center. Random sampling was done and the participants were divided into two groups (50 subjects in intervention group and 49 subjects in control group). The data collection tool was a three-part questionnaire (including demographic information, a researcher-made questionnaire based on the health promotion model constructs, and self-care behaviors), which was completed in three stages (before, two weeks, and three months after the intervention). In addition to routine hospital services, the intervention group received multimedia training based on the constructs of the Pender's health promotion model from the website. The control group received usual hospital services. Data were analyzed with chi-square, independent T-test and repeated measure ANOVA using SPSS-22 software. RESULTS: The results showed that 2 weeks and 3 months after the intervention, the mean scores of perceived benefits, perceived self-efficacy and perceived social support had a significant increase in the intervention group compared to the control group, but the mean score of perceived barriers had a significant decrease in the intervention group (p < 0.001). Regarding self-care behaviors, after the intervention, the mean scores of self-care behaviors, physical activity, healthy diet, medication adherence and stress management had a significant increase in the intervention group compared to the control group (p < 0.001), but no significant was observed between the two groups in terms of changes in the non-smoking (p = 0.38). CONCLUSION: The results of the study showed that the web-based educational intervention based on the health promotion model is useful in improving the self-care behaviors of cardiac patients undergoing angioplasty. Nursing education and care have a great role in improving the self-care behaviors of cardiovascular patients. TRIAL REGISTRATION: Registration number: IRCT2017080635429N2. Registration date: 09/03/2017 ( https://en.irct.ir/trial/26775 ).

Tele-psychotherapy for individuals with obsessive-compulsive disorder during the COVID-19 outbreak: A qualitative study.

BACKGROUND: One way of delivering psychological services is tele-psychotherapy, which has attracted significant attention as a viable approach. This study aimed to identify important variables in the application of tele-counseling and psychotherapy for the treatment of patients with obsessive-compulsive disorder (OCD) in Isfahan, Iran. MATERIALS AND METHODS: This research employed an exploratory qualitative methodology. The participants of this study consisted of all the clients with OCD and all the psychotherapists in the city of Isfahan. Purposive sampling was employed, and following a series of semi-structured interviews with 35 individuals with OCD and 11 counselors in this area, the sample size reached a saturation point. The data was analyzed by Braun and Clark's thematic analysis method. RESULTS: Based on the findings of Braun and Clark's analysis, three primary themes emerged concerning tele-counseling: opportunities, requirements, and challenges. CONCLUSION: According to the feedback received from therapists and clients, remote services could offer promising prospects to both groups by providing accessible locations and flexible time management. However, to get the full benefits of teletherapy, therapists should consider certain factors to enhance the therapeutic alliance. Moreover, there are challenges that need to be addressed.

Combined Virtual-Reality- and Gym-Based Physical Activity Intervention for Children With a Developmental Disability: Effects on Physical Activity Levels, Motor Skills, and Social Skills.

This study examined the effects of a combined virtual-reality- and gym-based physical activity (PA) program on PA levels, motor skills, and social skills of children with a developmental disability (DD). Twenty-five children with DD were randomly assigned to experimental and control groups. The intervention was conducted for 60 min, two times a week, for 12 weeks. Pre- and postintervention assessments encompassing PA levels measured via Gravity Estimator of Normal Everyday Activity, motor skills evaluated using the Test of Gross Motor Development-Third Edition, and social skills gauged via the Social Skills Rating System-Parent were conducted. Additionally, a follow-up assessment was administered to the experimental group 12 weeks postintervention. The findings unequivocally demonstrate that the combined virtual-reality- and gym-based PA program yielded significant enhancements in PA levels, motor skills, and social skills among children with DD in the experimental group. Notably, these improvements were sustained 12 weeks after the intervention. These findings may help professionals develop and implement better PA programs for children with DD.

Stakeholders' perceptions of value of nature-based interventions in promoting health in people with stress-related illness: a qualitative study.

Stress-related illness is a common and increasing cause for sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Accordingly, nature-based interventions (NBI) for people with stress-related illness have been developed and implemented in southern Scandinavia; however, such interventions are uncommon in the Circumpolar North. Previous studies have examined the effects and experiences of participating in NBI, but research about different stakeholders' perspectives on NBI is lacking. The aim of this study was to explore different key stakeholders' perceptions of the value of NBI in promoting health in people with stress-related illness. Data were collected through semi-structured interviews with 11 persons with stress-related illness experience, 14 healthcare professionals, and 11 entrepreneurs offering NBI. Qualitative content analysis resulted in four categories: Providing opportunity for recovery, Offering new perspectives and opportunity for reflection, Empowering balance and control in life, and Enabling one to overcome barriers. Although the study was conducted in a region where NBI is not widely implemented, the different stakeholders expressed similar perceptions of the value of NBI, indicating that NBI may be a valuable complement to health care which reaches people with stress-related illness needs and promotes their health.

The impact of the world's first regulatory, multi-setting intervention on sedentary behaviour among children and adolescents (ENERGISE): a natural experiment evaluation.

BACKGROUND: Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils. METHODS: With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status. RESULTS: Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings. CONCLUSIONS: This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.

Smokers' perception of the comparative health risks of cigarettes, e-cigarettes and heated tobacco products: a survey among the German population.

BACKGROUND: Tobacco cigarettes, e-cigarettes and heated tobacco products can pose different health risks (harm continuum). As current tobacco smokers could benefit from switching to less harmful products, we aimed to assess current smokers' perceived comparative health risks of these three products and to explore associations between risk perceptions and specific user characteristics. METHODS: We analysed data from 11 waves (2019-2021; N = 5657 current tobacco smokers) of a representative, cross-sectional household survey conducted in Germany. Associations were assessed with multivariable logistic regression models. RESULTS: 55.2% of smokers (95%CI = 53.8-56.5%) ranked cigarettes as the most harmful product. 36.1% of smokers (95%CI = 34.8-37.3%) perceived e-cigarettes and 33.8% (95%CI = 32.5-35.0%) heated tobacco products as more harmful than cigarettes. Misperceptions that e-cigarettes or heated tobacco products are more harmful to health than cigarettes increased over the 3-year study period and were more common among those with lower educational attainment. CONCLUSIONS: Only half of current tobacco smokers in Germany perceive the comparative health risks of cigarettes adequately and such misperceptions have increased recently. As current smokers could benefit most from switching to less harmful products, educational campaigns are needed to inform this group about the health risks of tobacco smoking and the comparative health risks of the various nicotine and tobacco products along the harm continuum.

Citizen science as a vehicle to address multiple policy objectives: Case studies from Australia.

ISSUE ADDRESSED: Despite increasing interest in citizen science as an approach to engage members of the public in research and decision making about health and wellbeing, there is a lack of practical evidence to guide policy and practice organisations to utilise these approaches. In this study we investigated how and why citizen science came to be incorporated into the work of two policy organisations. METHODS: We offer two in-depth case studies of Australian government organisations which have utilised citizen science in environmental and healthy ageing policy. Interviews with organisational informants and relevant documents were analysed inductively to explore how citizen science came to be adopted, legitimised and supported. RESULTS: Citizen science was utilised to address multiple organisational objectives, including increasing community participation in science; enhancing individuals' wellbeing, learning, and skills, and generating data to support research and policy in a relatively cost-effective manner. In both cases, grant funding was a mechanism to support citizen science, with project delivery facilitated through academic-policy partnerships and led by external academic or community partners. CONCLUSION: Although citizen science is relatively new in policy and practice settings, this study underscores the value of these approaches in realising co-benefits for organisations, academics, and community members. The support and advocacy of senior managers as 'champions', and a willingness to invest in trialling new approaches to address policy problems are necessary ingredients to foster acceptance and legitimacy of citizen science. SO WHAT?: Citizen science initiatives can be strategically utilised by health promotion organisations to enact priorities related to genuine community involvement, support research and innovation and facilitate collaboration and partnerships between academic, policy and community stakeholders.

Opportunities to optimise care and choice in joint replacement surgery using a digitally delivered, holistic PreHab pathway.

PURPOSE: To describe the implementation and evaluation of a hospital-initiated, community-based, digital prehabilitation program (My PreHab Program: MPP) for adults referred for elective joint replacement. METHODS: MPP was implemented July 2022 and comprises a personalised digital health screen that guides the provision of self-management resources. Adults (>18 years) referred and accepted, or already waitlisted, for total knee/hip replacement surgery were eligible. Individuals requiring category 1 (urgent) or emergency surgery and those without a mobile phone were excluded. Implementation and intervention outcome measures (program adoption, equity of reach, fidelity, acceptability, appropriateness, feasibility, engagement, preliminary surgical outcomes) were explored via study-specific measures and hospital records. RESULTS: Of those invited (N = 689), 77.8% participated. Participants and non-participants were similar in key demographic variables except regional invitees were more likely to participate than metropolitan (88.0% vs 75.4%, p = .002) and non-participants tended to be older (median age = 69.0 vs 64.0, p = .005). Participants reported on average four modifiable risk factors: most commonly chronic pain (79.1%), obesity (57.3%), and frailty (40.9%). Most participants (80.4%) reviewed all resources provided and reported action/intention to address issues identified (90.9%). Participants perceived MPP as acceptable (3.2/5), appropriate (3.3/5), and feasible (3.4/5). Early trends for participants progressing to surgery (n = 33) show a reduced length of stay (MPP = 4.3, baseline = 5.3 days). CONCLUSION: MPP demonstrated high adoption, fidelity, and participant engagement. It is acceptable, appropriate and feasible and has the potential to be scaled-up digitally at low-cost. Modifiable risk factors were prevalent and early indications suggest this preoperative intervention may benefit both patients and the healthcare system.

Assessing the Evidence Base for School-Based Promotion and Prevention Interventions: Introduction to the Series.

Schools are an important component in the mental health system of care for youths. Teachers and other school staff have unique opportunities to promote emotional wellness and prevent mental health conditions. Although numerous programs are available, identifying evidence-based and effective options is a significant challenge. This introduction lays out the rationale and methodology of the Assessing the Evidence Base (AEB) Series, a collection of systematic reviews of school-based mental health promotion and prevention approaches recommended by the National Academies of Sciences, Engineering, and Medicine for students in kindergarten through grade 12. Authors of the current AEB Series used the rating criteria derived from the 2014 AEB Series, which provided systematic reviews of a wide spectrum of interventions for mental and substance use disorders. Like its predecessor, the current series upholds a high standard of scientific rigor while ensuring that the information is easily accessible to various stakeholders in education, behavioral health, and communities. It describes the universal features included in each systematic review, such as a rating of the level of evidence for interventions, intervention program components, identification of interventions that have yielded positive outcomes for students from underserved populations, and a review of cost data. The AEB systematic reviews will serve as an important tool for decision makers involved in managing limited resources for various programs in school-based mental health services by synthesizing large bodies of research for use by leaders in education and behavioral health.

The role of community pharmacists as oral health advisors in the management of oral effects of asthma medications: an exploratory survey.

OBJECTIVES: To investigate community pharmacists' attitudes, confidence, practice, knowledge, and barriers towards the management of oral side effects of asthma medications. METHODS: A paper-based questionnaire was developed from previous research, trialled, and validated. Convenience sampling through web search was used to identify pharmacy practices across Cairns, Queensland, Australia. Practices were contacted by email and phone before hand-delivering and collecting questionnaires. KEY FINDINGS: Thirty eight community pharmacist responses were descriptively analysed. Community pharmacists surveyed within the Cairns region feel that it is within their role to help manage the side effects of asthma medications. Many feel this is best conveyed during inhaler dispensing and instruction. Current advice is more prompted rather than preventative. Pharmacists routinely advise patients of mouth-rinsing following inhaler use, however the link to preventing side effects is not clearly communicated. Pharmacists are confident in recognizing and managing common side effects such as oral thrush and dry mouth, but fewer are aware of dental decay and gingivitis. Many identify a lack of guidelines as the largest barrier to providing preventive oral health advice. CONCLUSIONS: Cairns community pharmacists already self-perceive their role in the management of oral side effects of asthma medications. Advice given to patients is practical but does not clearly convey the causative associations between asthma medications and their potential oral side effects. Patient education is prompted more by enquiry rather than a preventative approach. The development of standardized practice protocols and integration within undergraduate degrees or continuing education may benefit the community-pharmacist delivered care.

Analysis of Madrid Primary Health-Care staff for the implementation of exercise prescription.

OBJECTIVE: To assess the self-perception of nurses and general practitioners (GPs) toward Physical Activity on Prescription (PAP) in Madrid Primary Health-Care (PHC). DESIGN: A survey-cohort study. SITE: Nurses and GPs of Madrid PHC System. PARTICIPANTS: A total of 319 GPs and 285 nurses' responders. MEASUREMENTS: Data were analyzed under a classification tree analysis by four predictor variables: (i) Health professional (Nurses/GPs); (ii) Exercise prescription collaboration with all health professionals: physicians, nurses, psychologists, physical therapists, sports medicine physicians, sports scientists, nutritionists, and teachers (Yes/No); (iii) PA promotion collaboration with Sports Scientists (Yes/No); and (iv) The stage of change of PHC staff to PA promotion (0-4 Likert scale). RESULTS: Regarding the predictor variable (i), responders without PA guidelines knowledge and positive attitude to collaborate with nurses in PA promotion are more GPs of female sex (nurses n=33 and GPs n=175) than male sex (nurses n=3 and GPs n=59) (p<.001). For the predictor variable (ii) only 9.30% of PHC staff with a positive attitude to collaborate with all health professionals in PA promotion and exercise prescription. For the predictor variable (iii) was shown low collaboration with sports physicians and sports scientists under a multidisciplinary PAP approach (26.50% responders). Finally, in the predictor variable (iv) Staff maintaining PAP for at least 6 months, self-considered active, and with PAP knowledge want to collaborate with Sports scientists (Yes=233; No=133). CONCLUSIONS: Nurses and GPs are conscious of health-related PA benefits despite the lack of PAP knowledge and lack of willingness to collaborate with other health personnel, exercise professionals, and community resources available.