Theta-burst stimulation as a therapeutic tool in neurological pathology: a systematic review.

TBS (theta-burst stimulation) is a novel therapeutic approach in a wide range of neurological diseases. The present systematic review aims to identify the various protocols used in the last years, to assess study quality and to offer a general overview of the current state of the literature. The systematic review was conducted according to the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. We applied the following inclusion criteria: (1) population over 18 years old with diagnosed neurological disorders, (2) patients treated with sessions of theta-burst stimulation, (3) randomized-controlled clinical trials, (4) articles in the English language, and (5) studies that report response and score reduction on a validated scale of the investigated disorder or remission rates. We included in the final analysis 56 randomized controlled trials focusing on different neurological pathologies (stroke, Parkinson`s disease, multiple sclerosis, tinnitus, dystonia, chronic pain, essential tremor and tic disorder), and we extracted data regarding study design, groups and comparators, sample sizes, type of coil, stimulation parameters (frequency, number of pulses, intensity, stimulation site etc.), number of sessions, follow-up, assessment through functional connectivity and neurological scales used. We observed a great interstudy heterogenicity that leads to a difficulty in drawing plain conclusions. TBS protocols have shown promising results in improving various symptoms in patients with neurological disorders, but larger and more coherent studies, using similar stimulation protocols and evaluation scales, are needed to establish guideline recommendations.

Gender differences in the magnitude of the associations between eating disorders symptoms and depression and anxiety symptoms. Results from a community sample of adolescents.

BACKGROUND: Studies reporting comorbidities of eating disorders (EDs) with depression and anxiety disorders during adolescence used clinical samples of female adolescents with few attempts to present the magnitude of these associations in population-based samples and to assess gender differences in the strength of these associations. AIMS: This study assesses significant gender differences in the association of anorexia nervosa (AN) and bulimia nervosa (BN) symptoms with depression and generalized anxiety symptoms in a community sample of adolescents. METHOD: We collected anonymous self-reported data from 235 adolescent boys and 471 adolescent girls, through an online platform. To identify correlations between symptoms of AN and BN, and symptoms of depression and generalized anxiety, we used the Mann-Whitney U test. To identify differences between independent correlation coefficients, we converted each correlation coefficient into a z-score using Fisher's r-to-z transformation and, making use of the sample size employed to obtain each coefficient, we compared the z-scores. RESULTS: The magnitude of the associations between EDs symptomatology and depression and anxiety symptomatology was similar in adolescent boys and girls. CONCLUSION: Our results show an urgent need to address EDs prevention in adolescent girls and boys from the community.

Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire.

Objective: Empirical data on health literacy (HL) for Romania is almost inexistent. The present study aimed to validate the HLS-EU-Q16 questionnaire for the Romanian population and explore the predictors of HL in the North-West Region of the country. Methods: A non-experimental, cross-sectional study was conducted between March and November 2019 on a representative, stratified random sample of 1,622 participants from the North-Western Region of Romania. Exploratory Factor Analysis (EFA), Principal component analysis (PCA), Pearson correlations, and Chronbach's Alpha were used to validate the scale. Linear regressions were conducted to assess the determinants of health literacy. Results: Results obtained for the HL scale support its factorial component and reliability, with a Cronbach's alpha of α = 0.84. Age, gender, education and self-reported health status were identified as determinants of HL. Conclusion: Study findings indicate that the Romanian version of HLS-EU-Q16 is psychometrically sound and comparable to the original version. These results provide the first validated tool to measure HL in Romanian and the first population level data for Romania.

Prospects of COVID-19 Vaccination in Romania: Challenges and Potential Solutions.

The rapid advancement in vaccine development represents a critical milestone that will help humanity tackle the COVID-19 pandemic. However, the success of these efforts is not guaranteed, as it relies on the outcomes of national and international vaccination strategies. In this article, we highlight some of the challenges that Romania will face and propose a set of solutions to overcome them. With this in mind, we discuss issues such as the infrastructure of vaccine storage and delivery, the deployment and administration of immunisations, and the public acceptance of vaccines. The ways in which Romanian society will respond to a national COVID-19 vaccination campaign will be contingent on appropriate and timely actions. As many of the problems encountered in Romania are not unique, the proposed recommendations could be adapted and implemented in other countries that face similar issues, thereby informing better practices in the management of the COVID-19 pandemic.

Educational Interventions to Improve Safety and Health Literacy Among Agricultural Workers: A Systematic Review.

Health and safety education for farmers has the potential to increase the level of health, safety literacy, and thereby improve farmers' health and quality of life. The aim of this paper is to provide a systematic review of the published literature documenting different educational interventions for agricultural workers that have the improvement of health and/or safety literacy as an outcome. A systematic search was conducted in PubMed, Embase, Scopus and PsycINFO databases for articles focusing on educational interventions for farmers' health and safety. From the 3357 initial hits, 36 unduplicated records met the inclusion criteria. The articles included in the review used educational interventions for farmers with the purpose of preventing farm-induced diseases and injuries, increasing the health and well-being of farmers, and promoting good manufacturing practices. The educational approaches considered varied from lectures, videos, newsletters, games, and community fairs, to involving the community in designing the intervention and training farmers to deliver the intervention to the community. Interventions that used evidence-based theories, which took into account cultural aspects and individual factors, used biomarkers as a behavior change measurement, and involved the community in the development of the intervention had the best results in terms of behavior change. The strategies of educational interventions identified in this review that produced good results have the potential to inform future researchers and policy makers in the design and implementation of public health interventions, programs and policies to improve the health of farmers and their families.

Paediatric head injuries treated in a children's emergency department from Cluj-Napoca, Romania.

The aim of the study was to describe paediatric head injuries and identify factors that led to advanced care. Incident cases of head injuries that sought care from December 2008 to October 2010 at Children's Emergency Hospital Cluj-Napoca were evaluated. The main outcome was transfer or admission to advanced care. From a total of 3053 children treated for an injury, 1541 (50.4%) presented with head injury. A total of 960 (62.3%) of the children with a head injury required advanced care treatment. Young children were more likely to suffer a head injury than older children, but a higher proportion of older children required advanced care (70.3%). Children who suffered a head injury as a consequence of road traffic were almost five times more likely to require advanced care (OR: 4.97; 3.09-8.06) than being released. Our results suggest that data on injuries provide evidence-based information on the nature of injuries children are prone to, and what activity, type, and mechanism of injury impact Romanian children.

Epidemiology of Road Traffic Injuries Treated in a Large Romanian Emergency Department in Tîrgu-Mures Between 2009 and 2010.

OBJECTIVE: Road traffic injuries are one of the leading causes of preventable unintentional injury. The European Injury Database estimated that in European Union (EU)-27 countries, road traffic injuries account for 10% of all injuries treated in the emergency department or admitted to the hospital, accounting for 4.2 million victims each year. We examined the characteristics and outcomes of road traffic injuries treated in a large emergency department in Romania by different types of road users. METHODS: Secondary data analysis was conducted on a sample of patients who suffered a transport-related injury and received care at the Emergency Department of Mures County Emergency Hospital in Romania. Data was collected by 2 trained emergency physicians between March 2009 and July 2010, as part of the European Injury Database project. Information about demographics, mechanism, nature, place of occurrence, and activity of injury; treatment and follow-up; and mode of transport were described for 5 different categories of road users: animal-drawn vehicle (operator and passenger), passenger car (driver and passenger), motorcycle (driver and passenger), bicyclist, and pedestrian. RESULTS: A total of 2,782 patients were treated in the emergency department, of which 718 (25.8%) were road traffic injuries. The male-to-female ratio was 2:1. The highest percentage of patients were injured in passenger cars (49%), followed by motorcycles (16.7%). For both types of road users, the majority of patients were between the ages of 18 and 29. Pedestrian injuries accounted for 14.6%, of which a third were children up to the age of 17 and 40% were adults and elderly over the age of 50. The majority of patients were injured due to contact with a moving object (48.1%), followed by contact with static object (23.5%), then falling, stumbling, jumping, or being pushed (19.6%). Contusion and bruises (54.9%) were the most common diagnosis, followed by fractures (20.1%) and open wounds (10.2%) for all road user categories. The most common part of the body injured for all road user categories was the head region (42.3%). Of the 34.9% patients treated and admitted to the hospital, 30% had a length of stay between 4 and 7 days. CONCLUSIONS: Understanding the extent, nature, and characteristics of road traffic injuries may help to identify vulnerable road users in specific settings and implement the most effective prevention strategies targeting the most affected populations.