Treatment of the behavioral variant of frontotemporal dementia: a narrative review / Tratamento da variante comportamental da demência frontotemporal: uma revisão narrativa

ABSTRACT Frontotemporal dementia (FTD) is a progressive neurodegenerative disorder accompanied by behavioral and personality changes and/or language deterioration. Its behavioral variant (bvFTD) is the main clinical presentation. Objective: This study aims to investigate the treatment alternatives for bvFTD available so far. Methods: We conducted a narrative review of bvFTD treatment options. We used PubMed and Lilacs databases with the terms "frontotemporal dementia" or "behavioral variant frontotemporal dementia" combined with "treatment," "pharmacological treatment," or "disease-modifying drugs." Results: The articles retrieved and selected in the research pointed out that there is no specific treatment approved for bvFTD so far. The current proposals are limited to handle the cardinal behavioral symptoms of the disorder. Disease-modifying drugs are under development and may be promising, especially in the monogenic presentations of FTD. Conclusions: There are numerous approaches to treat the core symptoms of bvFTD, most of them based on low-quality research. To date, there are no drugs with a disease-specific therapeutic recommendation for bvFTD. Treatments are often investigated guided by primary psychiatric disorders with similar symptoms and should be chosen by the predominant symptom profile.

RESUMO A demência frontotemporal (DFT) é um transtorno neurodegenerativo progressivo acompanhado de deterioração do comportamento e da personalidade e/ou da linguagem. A variante comportamental (DFTvc) é a principal apresentação clínica. Objetivos: Investigar as alternativas de tratamento disponíveis para a DFTvc até o momento. Métodos: Realizou-se uma revisão narrativa das opções de tratamento da DFTvc. Os bancos de dados PubMed e Lilacs foram utilizados com os termos "demência frontotemporal" ou "variante comportamental da demência frontotemporal" combinados com "tratamento", "tratamento farmacológico" ou "drogas modificadoras de doença". Resultados: Os artigos recuperados e selecionados na pesquisa indicaram que não há nenhum tratamento específico aprovado até o momento para DFTvc. As propostas atuais são limitadas ao tratamento dos sintomas comportamentais cardinais do transtorno. As drogas modificadoras de doença estão em desenvolvimento e podem ser promissoras, especialmente nas apresentações monogênicas da DFT. Conclusões: Há inúmeras abordagens para tratar os principais sintomas DFTvc, a maioria delas baseada em pesquisas de baixa qualidade. Até o momento, não existem medicamentos com uma recomendação terapêutica específica para a DFTvc. Os tratamentos são frequentemente investigados guiados por distúrbios psiquiátricos primários com sintomas semelhantes e devem ser escolhidos pelo perfil de sintomas predominante.

Evaluación de tres técnicas para el manejo de conducta odontológica en pacientes con trastorno del espectro autista / Evaluation of three techniques for the dental behavior management in autistic spectrum disorder patients

Objetivo. Evaluar tres técnicas para el manejo de conducta: Desensibilización Sistemática (DS), Método Treament and Education of Autistic and related Communication Handi-capped Children (TEACCH) y la técnica Decir, Mostrar, Hacer (DMH), durante la atención dental a personas con trastorno del espectro autista (TEA). Métodos. Participaron 18 personas del Noreste de México con diagnóstico de TEA, con un rango de 13 a 15 años divididos en tres grupos según la técnica TEACCH, DS y DMH con seis personas por grupo. A los participantes se les realizó una profilaxis dental empleando la técnica de manejo de conducta y comunicación según el grupo, la conducta se evaluó usando las escalas Frankl ́s Behavior Rating Scale (FBRS) y Comfort Behavior Scale (CBS). Se usaron las pruebas Chi cuadrado, ANOVA y t de Student para comparar los resultados. Resultados. La conducta evaluada con la escala de Frankl, fue definitivamente positiva en los grupos TEACCH (33,3%) y DS (16,7%). Conducta positiva semejante en los tres grupos (66,7%). Conducta negativa semejante en DS y DMH (16,7%). Conducta definitivamente negativa solo en el grupo DMH (16,7%). En la escala CBS, solo el grupo DMH presentó aumento del tono muscular (p= 0,013) y tensión facial no sostenida (p= 0,001), al compararlo con TEACCH y DS. Conclusiones. Las tres tecnicas utilizadas son efectivas para el manejo de conducta de las personas con TEA durante el tratamiento dental, sin embargo en la técnica DMH se observó conducta definitivamente negativa y respuesta corporal-conductual que refleja tensión emocional.

Objective. Evaluate three behavior management techniques: Systematic Desensitization (SD), the Treament and Education of Autistic and related Communication Handicapped Children (TEACCH) and Tell, Show, Do (TSD) Method, during dental care for people with Autism Spectrum Disorder (ASD). Methods. Eighteen people from Northeast Mexico diagnosed with autism spectrum disorder participated, with a range of 13 to 15 years, divided in to three groups, according to the TEACCH, SD and TSD technique with six participants per group. A dental prophylaxis was performed on the participants, using the behavior management and communication technique according to the group, the behavior was evaluated using the Frankl's behavior rating scale (FBRS) and Comfort Behavior Scale (CBS). Chi square, ANOVA and Student's t tests were used to compare the results. Results. Behavior evaluated with Frankl scale was definitely positive in TE-ACCH (33.3%) and DS (16.7%) groups. Similar positive behavior in the three groups (66,7%). Similar negative behavior in DS and DMH (16.7%). Definitively negative behavior only in the DMH group (16.7%). With CBS scale, only the DMH group presented increased muscle tone (p= 0.013) and evident not sustained tension in some facial muscles (p= 0.001), when compared with TEACCH and DS by ANOVA analysis. Conclusions. The three techniques evaluated are effective for managing behavior of people with ASD during dental treatment, however, in DMH technique, definitely negative behavior and a corporal-behavioral response were observed, reflecting emotional stress.

Hipnose no controle do medo e da ansiedade em odontopediatria: revisão integrativa da literatura / Hypnosis in the control of pain and anxiety in pediatric dentistry: an integrative literature review

Objetivo: Analisar a literatura científica acerca da eficácia da hipnose como técnica de gestão comportamental para reduzir a dor e/ou a ansiedade no tratamento odontopediátrico. Metodologia: A partir da pergunta norteadora "Qual é a efetividade da hipnose no manejo comportamental de crianças durante o tratamento odontológico?", foi realizada uma busca nas bases de dados BVS, Cochrane Library, Google Acadêmico e PubMed, seguindo uma estratégia de combinação das palavras-chave "Odontopediatria" (Pediatric Dentistry), "Hipnose em Odontologia" (Hypnosis, Dental) e "Ansiedade ao tratamento odontológico" (Dental Anxiety). Não houve restrição com relação ao ano de publicação, idioma ou local em que o estudo foi realizado. A seleção dos estudos foi realizada em três etapas: por meio do processo de leitura dos títulos e resumos, exclusão de artigos duplicados e obtenção e leitura dos artigos completos selecionados. Resultados: De um total de 40 artigos encontrados, quatro foram selecionados, sendo incluídos manualmente mais dois numa busca manual nas referências dos artigos identificados e optou-se por acrescentar duas pesquisas. Desta forma, as referências dos artigos selecionados tornaram-se fontes de identificação de novos artigos, após conferência da lista de referências dos artigos incluídos, totalizando seis artigos analisados. Essas pesquisas foram conduzidas em diversos países como México, Índia, França, Turquia e Estados Unidos. Trezentas e quarenta e uma crianças foram analisadas, com idade variando de quatro a 16 anos. A hipnose, na maioria das pesquisas, foi avaliada antes e durante o procedimento odontológico anestésico local. A frequência cardíaca e a saturação de oxigênio foram medidas utilizadas para avaliar a ansiedade dos pacientes e a resistência física, entre outras ferramentas, foi utilizada para avaliar a dor em três pesquisas. Conclusão: A hipnose diminuiu significativamente a frequência cardíaca, a resistência física (principalmente o choro), a ansiedade e a dor em procedimentos de injeção anestésica local, e aumentou significativamente a cooperação dos pacientes Odontopediátricos, no entanto são necessários mais estudos randomizados sobre esse tema, com padronização metodológica, considerando o alto risco de viés encontrado nas pesquisas.

Aim: To analyze the scientific literature about the effectiveness of hypnosis as a behavior-al management technique used to reduce pain and/or anxiety in the pediatric treatment. Methods: Based on the guiding question "What is the effectiveness of hypnosis in the man-agement of children's behavior during dental treatment?", a bibliographic search was car-ried out on the BVS, Cochrane Library, Google Scholar, and PubMed databases by com-bining the keywords "Pediatric Dentistry", "Hypnosis, Dental", and "Dental Anxiety". There was no restriction concerning year of publication, language, or place. The selection of studies was carried out in three stages: through the process of reading the titles and ab-stracts, by excluding duplicate articles, and obtaining and reading the selected full articles. Results: Out of 40 articles found, we selected four. Two articles were then included manu-ally, totaling six articles.The surveys were conducted in several countries, such as Mexico, India, France, Turkey, and the United States. Three hundred and forty-one children, aged from four to 16 years old, were analyzed. Hypnosis, in most studies, was assessed before and during the local anesthetic dental procedure. Heart rate and oxygen saturation were used to assess patients' anxiety, and physical resistance, among other tools, was used to as-sess pain in three studies. Conclusion: Hypnosis significantly reduced heart rate, physical resistance (mainly crying), anxiety, and pain in local anesthetic injection procedures. Also, it significantly increased the cooperation of pediatric patients; however, more randomized studies on this topic, with methodological standardization, are necessary considering the high risk of bias found in the studies.

Crossover studies of pediatric dental sedation are inappropriate

Abstract Crossover studies continue to be published in spite of warnings about their inherent risks in relation to behavioral outcomes. This study took the opportunity of access to secondary data analysis in order to demonstrate the impact of a crossover design on the outcomes of randomized clinical trials aimed at the behavior of children during dental treatment. We evaluated the effect of the sequence of sedative administration, the sedative and the participant's age on the behavior of children undergoing two sequential dental visits. Eighteen uncooperative healthy young children were equally randomly assigned to: (G1) 1.0 mg/kg oral midazolam (first session) and oral placebo (second session); (G2) oral placebo (first) and 1.0 mg/kg oral midazolam (second). One trained observer assessed children's behavior. Data were analyzed by three-way mixed ANOVA. Both midazolam [mean(SD); 71.7%(16.5)] and placebo [48.6%(33.1)] produced more struggling behavior when they were administered in the first session compared to the second one (p=0.001). For the placebo, children aged 2-3 years exhibited more struggling behavior [G1 54.9%(36.2); G2 80.5%(8.3)] than those aged 4-5 years (p=0.04). Also, the reduction of percentage of struggling behavior was higher in G1 for older children (76.2%) and in G2 for younger children (32.9%). There were significant interactions between drug and sequence of administration, and between drug and age. The results of our study confirm the conventional wisdom that crossover study design is inappropriate to evaluate children's behavior/anxiety related-dental treatment under sedation and the results of crossover studies of dental sedation should be treated with extreme caution.

Resumo Pouco se sabe sobre o impacto de um delineamento cruzado nos desfechos de ensaios clínicos randomizados voltados ao comportamento de crianças durante tratamento odontológico. Este estudo objetivou avaliar o efeito da sequência de administração do sedativo, da droga em si e da idade dos participantes no comportamento de crianças que receberam duas consultas odontológicas consecutivas. Dezoito crianças saudáveis não colaboradoras, 2-5 anos de idade, foram randomizadas em dois grupos: G1 - 1,0 mg/kg midazolam oral (primeira sessão) e placebo oral (segunda sessão); G2 - placebo (primeira) e 1,0 mg/kg midazolam oral (segunda). Um observador treinado avaliou o comportamento infantil. Os dados foram analisados por ANOVA de três fatores (alfa=0,05). Midazolam [média(DP); 71,7%(16,5)] e placebo [48,6%(33,1)] resultaram em mais comportamento não cooperativo quando administrados na primeira sessão comparado com a segunda (p=0,001). Com o uso do placebo, crianças de 2-3 anos de idade exibiram mais comportamento não cooperativo [G1 54,9%(36,2); G2 80,5%(8,3)] que as de 4-5 anos de idade (p=0,04). Além disso, a porcentagem de redução do comportamento não cooperativo foi maior em crianças mais velhas em G1 (76,2%) e em crianças mais novas em G2 (32,9%). Considerando a avaliação do comportamento infantil sob sedação, a primeira sessão odontológica influenciou a segunda visita. Os resultados deste estudo confirmam a especulação de que o delineamento cruzado é inadequado para avaliar o comportamento odontológico relacionado à ansiedade/comportamento infantil; os resultados dos ensaios cruzados de sedação odontológica devem ser tratados com extrema cautela.

Cut-Point for Satisfactory Adherence of the Dietary Sodium Restriction Questionnaire for Patients with Heart Failure / Ponto de Corte para Adesão Satisfatória do Questionário de Restrição de Sódio na Dieta em Pacientes com Insuficiência Cardíaca

Abstract Background: The low or non-adherence to reduction of sodium intake has been identified as one of the main precipitating factors of heart failure (HF). The Dietary Sodium Restriction Questionnaire (DSRQ) identifies factors that can interfere with adherence to this recommendation. However, there is still no cut-point to define adherence for this questionnaire. Objectives: To identify the cut-point for satisfactory adherence to the Brazilian version of the DSRQ, (the Questionário de Restrição de Sódio na Dieta, QRSD). Methods: Multicenter study. Patients with HF in outpatient treatment (compensated) and those treated in emergency departments due to acute HF (decompensated) were included. For the cut-point definition, the DSRQ scores were compared between groups. A ROC curve was constructed for each subscale to determine the best point of sensitivity and specificity regarding adherence. A 5% significance level was adopted. Results: A total of 206 compensated patients and 225 decompensated were included. Compensated patients exhibited scores that showed higher adhesion in all subscales (all p <0.05). Scores ≥ 40 points of a total of 45 for the subscale of Attitude and Subjective Norm; scores ≤ eight of a total of 20 for Perceived Behavioral Control; and ≤ three of a total of 15 for Dependent Behavior Control were indicative of satisfactory adherence. Conclusions: Based on the evaluation of patients in these two scenarios, it was possible to determine the cut-point for satisfactory adherence to the reduction of sodium in the diet of patients with HF. Countries with similar culture could use this cut-point, as other researchers could also use the results as a reference for further studies.

Resumo Fundamento: A baixa ou a não adesão à redução de sódio na dieta foi identificada como um dos principais fatores causais da insuficiência cardíaca (IC). O Questionário de Restrição de Sódio na Dieta (QRSD) do inglês Dietary Sodium Restriction Questionnaire (DSRQ) identifica fatores que possam interferir na adesão a essa recomendação. No entanto, anda não existe um ponto de corte que estabelece adesão segundo o QRSD. Objetivos: Identificar o ponto de corte para adesão satisfatória ao QRSD, versão brasileira do DSRQ. Métodos: Estudo multicêntrico. Foram incluídos pacientes com IC em tratamento ambulatorial (compensados) e aqueles tratados em serviços de emergência por IC aguda (descompensados). Para a definição do ponto de corte, os escores do QRSD foram comparados entre os grupos. A curva ROC foi construída para cada subescala para determinar o melhor ponto de sensibilidade e especificidade em relação à adesão. Adotou-se um nível de significância de 5%. Resultados: Foram incluídos 206 pacientes compensados e 225 pacientes descompensados. Os pacientes compensados apresentaram escores que indicaram maior adesão em todas as subescalas (p < 0,05). Escores ≥ 40 pontos de um total de 45 para a subescala "atitude e norma subjetiva"; escores ≤ 8 de um total de 20 para a subescala "controle comportamental percebido"; e escores 3 de um total de 15 para "comportamento dependente" foram indicativos de adesão satisfatória. Conclusões: A avaliação de pacientes com IC atendidos no ambulatório ou na emergência permitiu a determinação dos pontos de corte para adesão satisfatória à restrição dietética de sódio. Países de culturas similares poderiam usar esse mesmo ponto de corte, bem como outros pesquisadores poderiam utilizá-lo como referência para outros estudos.

Premarital Sex Behavior Among Adolescent: The Influence of Subjective Norms and Perceived Behavioral Control Toward Attitudes of High School Student

Abstract@#Introduction: Modernization has brought shifts in social norms especially in adolescents, including their sexual behavior. Girls between the ages 15-19 about 38 million were at risk of pregnancy, 21 million of adolescents had pregnancy experience, and 49% of them were unwanted pregnancies. The aim of the study was to determine the influence of subjective norms and behavioral controls on adolescent attitudes to prevent premarital sex behavior. Methods: This quantitative study used a cross-sectional study design. Data were taken using questionnaires that tested for validity and reliability. The population in this study was high-school students in Trenggalek Regency in East Java Indonesia as one of the regencies with increasing problems related to premarital sexual behavior. The population of this study was high-school students of first grade, second grade, and third grade as the majority of adolescents that conducted the premarital sex behavior were among that age range. Results: 97.3% of students have positive norms conducive to prevention of premarital sex behavior and 98.7% of students have behavioral controls and positive attitudes to prevent premarital sex. Conclusion: Subjective norms and perceived behavioral controls in this study did not affect adolescent attitudes to prevent premarital sex behavior.

Barriers in the Treatment of Early Childhood Caries amongst the General Dentists - A Cross Sectional Study in Bhubaneswar, Odisha, India

Objective: To find out the barriers in treating early childhood caries in children by general dentists. Material and Methods: A cross sectional descriptive study was undertaken among fifty general dentists in Bhubaneswar, Odisha, India, following a simple random sampling. Each selected candidate was given a barrier in childhood caries treatment (BaCCT) questionnaire. Descriptive statistics were used to calculate the absolute and relative frequencies, mean, median and standard deviation. Results: The general dentists exhibited quite a few barriers in providing treatment for early childhood caries. The children don't like to sit on dental chair (74%), they don't like the sound of drill (78%) and they are fearful of dental treatment (86%). Providing care for children can be stressful and troublesome for the dentist (80%) and that they feel time constrained, i.e they do not spend much time with children (70%). Training in the field of management of child behaviour enhances their ability to handle early childhood caries. Conclusion: The general dentists should be given proper training in handling children in their curriculum or through continuing education programmes so that they can act as a larger workforce to be able to treat early childhood caries effectively and efficiently for the benefit of society.

The Changes of Sedation in the Department of Pediatric Dentistry, Yonsei University Dental Hospital / 대한소아치과학회지

Sedation is a useful behavior management technique for dental patients who may be uncontrollable or have medical problems. The aim of this study is to investigate the changes in patterns of sedative treatments in pediatric dentistry by analyzing the distribution of patients and used sedative agents.Patients and sedative agents were reviewed based on the electronic medical records (EMR) of the department of pediatric dentistry in Yonsei University Dental Hospital from 2011 to 2016.The number of patients who were treated under sedation generally increased. Male received more sedation treatment than female by 2014, and they became similar from 2015. The treatment percentage of patients with systemic disease decreased in 2013, remained constantly afterwards. The ratio of sedative treatment for the age 4 – 5 and age 6 – 10 generally increased, while that of the age 0 – 2 and older than age 11 decreased. The ratio of the age 3 remained steady. Nitrous oxide was the most frequently used sedative agent. The use of benzodiazepine increased while the use of chloral hydrate decreased.Although the use of sedation has expanded, multidimensional approaches for ensuring safety have been less focused. Therefore, it is necessary to explore further studies for the safety and efficacy of the use of sedation.

Uma leitura da crise da atividade de prevenção: paradoxos atuais e desafios futuros / A reading of the crisis of prevention activities: current paradoxes and future challenges

Introduction: The activity of occupational health and safety professionals is in a paradoxical situation considering, among other aspects, the productivity context, which gives low priority to safety and health, the limitation imposed by the hegemonic conceptual references in the field, the limitation of these professionals' power to act and the highly conflicting and complex character of the occupational world. Objective: In essay form, the article, in dialog with the literature of the field, proposes to reflect on the impasses and challenges of the prevention field. Method: The reflections are based on the experience of the authors both in the practical area as also in research, teaching and extension activities in the field of health surveillance and workers' safety. Results: Even though this field of activity has been recognized as a specialized and legal area for more than 40 years in the country, the magnitude of the data concerning occupational and industrial accidents reveals the limitations and difficulties that these professionals face, and justifies the importance of the analysis of current practices in order to understand the contradictions that lie at the root of the difficulties to achieve prevention. Conclusion: Citizens could pressure corporations to improve their safety practices and concepts. State can also be pressured to create new safety policies.

Introdução: A atividade dos profissionais que atuam no campo da prevenção em saúde e segurança do trabalhador encontra-se diante de situação paradoxal tendo em vista, entre outros aspectos, o contexto produtivista que deixa em segundo plano a segurança e a saúde, a limitação das referências conceituais hegemônicas no campo, as limitações do poder de agir destes profissionais e a própria natureza conflituosa e complexa do mundo do trabalho. Objetivo: Na forma de ensaio, o artigo, em diálogo com a literatura do campo, se propõe a refletir sobre os impasses e desafios da atividade de prevenção. Método: As reflexões se baseiam na experiência dos autores seja no campo prático como em atividades de pesquisa, ensino e extensão na área de vigilância em saúde e segurança do trabalhador. Resultados: Embora a atividade de prevenção tenha sido reconhecida como campo de atuação legal e especializada há mais de 40 anos no país, a magnitude dos dados relativos aos acidentes ocupacionais e industriais mostra limites e dificuldades que esses profissionais enfrentam e justifica a importância da análise das práticas correntes em busca de entender as contradições que estão na origem das dificuldades para o alcance do objeto da prevenção. Conclusão: A sociedade pode cobrar das organizações trabalho seguro e saudável, criando pressão para que mudem suas práticas e conceitos, ou pode pressionar também o Estado para que sejam criadas políticas públicas em relação à segurança.

Manejo odontológico del paciente con hipoacusia neurosensorial profunda bilateral / Dental management of patients with bilateral profound sensorineural hearing loss

Introducción: la hipoacusia es la disminución de la agudeza auditiva o de la capacidad para captar el sonido; esta puede ser neurosensorial, conductiva o mixta. La hipoacusia neurosensorial resulta de alteraciones en el oído interno, nervio auditivo o en los núcleos auditivos del tronco cerebral. El manejo de estos pacientes requiere disposición, conocimientos y calidez para el correcto desarrollo de la atención estomatológica. Objetivo: reportar el manejo odontológico de un paciente con hipoacusia neurosensorial profunda bilateral. Presentación del caso: paciente femenino de 7 años y 10 meses de edad con diagnóstico de hipoacusia neurosensorial profunda bilateral, quien acude a consulta por presentar dolor. A la inspección física, paciente mesofacial, perfil convexo. Intraoralmente se observan tejidos blandos clínicamente sanos, alteraciones de número y posición, caries moderada e higiene deficiente. Durante la inspección clínica la paciente se mostró poco cooperadora (Frankl II). El plan de tratamiento consistió en prevención, operatoria, ortopedia y cirugía. Para el manejo del paciente se incluyó un lenguaje de señas básico con uso de careta y sin cubreboca, modelado con otros pacientes. Se modificó la técnica decir, mostrar y hacer por mostrar/oler, tocar y hacer. Conclusiones: el odontopediatra debe tener las competencias necesarias para la atención integral de pacientes con capacidades diferentes. El manejo de la conducta y el cuidado multidisciplinario del paciente en edades tempranas es fundamental para el éxito del tratamiento. En el caso clínico que se presenta se resalta la efectividad del manejo conductual modificado, lo cual incrementó la posibilidad de éxito de la rehabilitación dental del paciente, así como de su seguimiento(AU)

Introduction: hearing loss is reduced auditory acuity or a decrease in the ability to perceive sound. It may be sensorineural, conductive or mixed. Sensorineural hearing loss results from alterations in the inner ear, the auditory nerve or the auditory brainstem nuclei. Dental management of these patients requires willingness, knowledge and warmth on the part of the dental practitioner. Objective: report the dental management of a patient with bilateral profound sensorineural hearing loss. Case presentation: a female patient aged 7 years and 10 months diagnosed with bilateral profound sensorineural hearing loss attends consultation for dental pain. At physical inspection, it is observed that the patient is mesofacial with a convex profile. Intraoral examination found clinically healthy soft tissue, tooth alterations in number and position, moderate decay and poor hygiene. During clinical inspection, the patient was uncooperative (Frankl II). Treatment consisted in prevention, restoration, orthopedics and surgery. Management of the patient included use of basic sign language and a mask without the practitioner wearing a facemask, and modeling with other patients. The technique of say, show and do was replaced by show / smell, touch and do. Conclusions: pediatric dentists should have the skills required for the comprehensive care of patients with different capabilities. Behavior management and multidisciplinary care of very young patients is essential for a successful treatment. The clinical case herein presented highlights the effectiveness of modified behavior management, which increased the chances of success in the patient's dental rehabilitation and follow-up(AU)

Prediction of cardiovascular disease in Korean population: based on health risk appraisal of national health screening program

Health risk appraisal (HRA) is a systematic approach for collecting information regarding individual risk factors, predicting the probability of disease occurrence and death, and linking patients with interventions to promote health and prevent disease. Because the risk factors of cardiovascular disease are well established, several cardiovascular disease risk prediction models have been developed over multiple decades. The health risk appraisal prediction model of the Korean national health screening program will be revised and updated using the latest well-validated studies to reflect the current characteristics of the Korean population and to improve the effectiveness of education and behavioral modifications. It is necessary to provide various tools such as a web page and smartphone application to increase the utility of this program in the future.

Effects of an Adolescent Obesity Management Educational Program on Middle and High School Teachers in South Korea

PURPOSE: This study aimed to examine the effects of an adolescent obesity management educational program (AOMEP) on middle and high school teachers. METHODS: A quasiexperimental, pretest post-test design was performed to test primary variables, including adolescent obesity management knowledge, attitudes, perceived behavioral control, and behavioral intention based on the concepts presented in the Theory of Planned Behavior. RESULTS: A total of 61 teachers participated. The experimental group (n = 30) received 15 hours of AOMEP, whereas the control group (n = 31) did not receive any. The experimental group showed significant improvement in knowledge (t = 2.53, d = .65, p = .014) and attitude (t = 2.77, d = .71, p = .008) toward adolescent obesity management compared to the control group. However, there were no significant differences in perceived behavioral control or behavioral intention between the groups. CONCLUSIONS: AOMEP may be utilized as an effective obesity management program for adolescent students in schools.

Timely Interventions can Increase Smoking Cessation Rate in Men with Ischemic Stroke

PURPOSE: Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke. METHODS: Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months. RESULTS: Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was 58.25 ± 11.23 years and mean initial National Institutes of Health Stroke Scale score was 4.68 ± 5.46. The TI group showed a higher point smoking success rate compared with the CC group (p= .003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group. CONCLUSION: Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

Predictors of Intention to Quit Smoking in Elderly Smokers following a Stroke / 기본간호학회지

PURPOSE: This study was done to identify factors based on the theory of planned behavior that predict smoking cessation in elderly smokers following a stroke. METHOD: Between March and May 2013, data related to intention, attitude toward the behavior, subjective norm, and perceived behavioral control, were collected through questionnaire from 223 elders who smoked and who had a stroke. Data analysis was performed using PASW (SPSS) 18.0 program, and included t-test, one-way ANOVA, Pearson correlation coefficients, and multiple stepwise liner regression analysis. RESULTS: Results showed a positive correlation between intention and attitude toward the behavior (r=.494, p<.001), subjective norm (r=.390, p<.001), and perceived behavioral control (r=.189, p=.005). These variables such as perceived behavior control, subjective norm, number of cigarettes per day, and usefulness of quitting smoking explained 50% of intention to quit smoking. CONCLUSION: The results of this study indicate that there is a need to develop smoking cessation nursing strategies for elderly smokers following a stroke in order to provide effective counseling on subjective norm and perceived behavioral control.

Manejo de conducta no convencional en niños: hipnosis, musicoterapia, distracción audiovisual y aromaterapia: revisión sistemática / Unconventional behavior management in children: Hypnosis, music therapy, audiovisual distraction and aromatherapy: A systematic review

Objetivos: Conocer técnicas de apoyo no convencionales para el manejo de conducta en niños. Esta revisión se realizó mediante revistas indexadas de los últimos 10 años. A pesar que las técnicas tradicionales utilizadas en odontopediatría pueden ser satisfactorias, en la actualidad existe controversia sobre el uso de algunas de ellas. El rechazo por parte de los padres, así como las diversas implicaciones éticas y legales han llevado a que se revalúen muchas actitudes y técnicas, especialmente aquellas de tipo aversivo, lo cual ha conducido a intensificar la investigación en este campo con el fin de buscar nuevas alternativas. La musicoterapia es un tipo de sugestión en la que el niño es animado a la fantasía, evocando sentimientos placenteros para el paciente llevándolo a un estado de relajación. Con la aromaterapia se crea un ambiente cálido para el paciente, volviéndolo menos predispuestos a sentir dolor, disminuye su ansiedad y está más complacido con el servicio. En la distracción audiovisual (técnica que dio mejores resultados) la concentración de los niños, auditiva y visual, queda atrapada en la película que estén viendo desconectándose parcialmente del ambiente odontológico. Se concluye, que son necesarias nuevas técnicas en el manejo de conducta del paciente pediátrico que deben estar acordes a los avances tecnológicos de nuestra era y que promuevan la salud.

Objectives: To know the unconventional support techniques for managing children behavior. This review was performed by indexed journals over the past 10 years. Although traditional techniques used in dentistry may be satisfactory, there is currently controversy over the use of some of them. The rejection by the parents as well as various legal and ethical implications has result in reassess many attitudes and techniques, especially those of aversive type. This has led to intensify research in this field in order to search for new alternatives. Music therapy is a kind of suggestion in which the child is encouraged to fantasy, evoking pleasant feelings for the patient taking it to a state of relaxation. The use of aromatherapy creates a warm atmosphere for the patient, making it less likely to feel pain, reduces anxiety and is more pleased with the service. In the audiovisual distraction n (technique that gave better results) the concentration of the children, auditory and which promote health.

Conceptos generlles sobre aba en niños con trastorno del espectro autista / General concepts concerning applied behaviour analysis (ABA) in children suffering autistic spectrum disorders (ASD)

Los trastornos del espectro autista (TEA) son entidades que generan discapacidad. Diversas intervenciones psicofarmacológicas y psicosociales modulan algunas de las alteraciones comportamentales asociadas y mejoran la calidad de vida de las personas afectadas y de sus cuidadores. La terapia ABA es una de las intervenciones psicosociales más conocidas y utilizada en población con TEA. Mediante de la formulación de preguntas clave y sus respuestas, este artículo realiza una breve descripción de los aspectos históricos, las principales características y los fundamentos teóricos del ABA. Se discuten los resultados de diversos estudios que señalan las limitaciones metodológicas de las investigaciones sobre la efectividad de esta terapia y sus implicaciones para la práctica clínica.

Autistic spectrum disorders (ASD) cause disability. Psychopharmacological and psychosocial interventions modulate some of the associated behavioural alterations and improve the quality of life for those affected and the people caring for them. Applied behaviour analysis (ABA) therapy is one of the most well-known psychosocial interventions and is used with populations suffering ASD. This article gives a brief description of the historical aspects, the main characteristics and theoretical foundations regarding applied behaviour analysis (ABA) by formulating key questions and their (expected) responses. The results of some pertinent studies are discussed, pointing out the methodological limitations of research into the effectiveness of this therapy and its implications for clinical practice.

Influences of Perceived Behavior Control and Self-efficacy on Proper Hand Cleansing and Hand Washing Practices among Pre-practicum Nursing Students / 기본간호학회지

PURPOSE: The purpose of the study was to investigate hand washing practice and proper hand cleansing among first and second year nursing students who are prone to be exposed to nosocomial infections, and to identify the influence of perceived behavior control and self-efficacy on hand washing practices and proper hand cleansing. METHOD: Data for 91 students were collected from a nursing college in a metropolitan city in Korea. Data were analyzed using descriptive, t-test, one way ANOVA, Pearson correlation coefficient, and multiple regression with SPSS/WIN 19.0. RESULT: The mean score for hand washing practice was 38.35 out of a possible score of 48, and the mean sore for proper hand cleansing was 18.63 out of a possible score of 28. The significant factors affecting student hand washing practice were 'residential type' (p=.016), 'perceived behavior control' (p=.021), and 'self-efficacy' (p=.033) which explained 19.9% of the variance. The significant factors affecting proper hand cleansing by the students were 'perceived behavior control' (p<.001) and 'regular exercise' (p=.026) which explained 29.8% of the variance. CONCLUSION: These results indicate a need for education programs on hand washing including strategies to improve perceived behavior control and self-efficacy to promote more effective hand washing practices.

Correlação entre domínios de qualidade de vida e lócus de controle da saúde em idosos residentes na comunidade / Correlation between domains of quality of life and locus of health control incommunity resident elderly

Objetivos: verificar as correlações existentes entre qualidade de vida, lócus de controle da saúde e dadossociodemográficos em uma amostra de idosos residentes na comunidade.Métodos: este estudo teve um delineamento quantitativo e transversal. A amostra foi composta por 113 idosos, com idades entre 60 e 98 anos. Os instrumentos utilizados foram: ficha de dados sociodemográficos, Escala de Lócus deControle da Saúde e Avaliação de Qualidade de Vida Abreviada (WHOQOL-Bref). Para a análise estatística utilizamos o coeficiente de correlação de Pearson, o teste t de Student e a Análise de Variância (ANOVA). Os resultados com valores de p menores que 0,05 foram considerados estatisticamente significativos.Resultados: verificou-se correlação positiva moderada entre número de atividades de lazer e domínio psicológico da qualidade de vida (r=0,320; p=0,001), assim como entre número de atividades de lazer e domínio meio ambiente da qualidade de vida (r=0,320; p=0,001). Os resultados apontaram ainda para correlação fracamente positiva entre domínio físico da qualidade de vida e lócus de internalidade (r=0,220; p=0,019), anos de escolaridade (r=0,206; p=0,029) e número de atividades de lazer (r=0,282; p=0,002).Conclusões: o lócus de controle da saúde mostrou correlação com a qualidade de vida no idoso. De um modo geral, os idosos que apresentaram lócus de controle interno e também os que possuíam uma vida mais ativa evidenciaram maior qualidade de vida.

Aims: To analyze the correlation between quality of life, locus of control and socio-demographic data in community resident elderly.Methods: A cross-sectional, quantitative study was performed. The sample was constituted by 113 senior citizens with ages ranging from 60 to 98 years. The instruments used were a Socio-demographic Data Form, a Locus ofControl Scale and a Short Quality of Life Evaluation (WHOQOL-Bref). For statistical analysis we used the Pearson correlation coefficient, the Student t test and analysis of variance (ANOVA). Results with p values below 0.05 were considered statistically significant.Results: There was moderate positive correlation between the number of leisure activities and psychological domain of quality of life (r=0.320, p=0.001) and environment domain of quality of life (r=0.320, p=0.001). The results also indicated weak positive correlation between the physical domain of quality of life and locus of internality (r=0.220, p=0.019), years of education (r=0.206, p=0.029) and number of leisure activities (r=0.282, p=0.002).Conclusions: A correlation between the types of locus of control and quality of life in the elderly was demonstrated.In general, older people who had internal locus of control and also those who possessed a more active life showed ahigher quality of life.

Propuestas no-farmacológicas demanejo del comportamiento en niños / Non pharmacological approaches for the behavior management of children

Existen en la literatura técnicas diferentes a las farmacológicas que pueden ser utilizadas para acondicionar psicológicamente al niño durante el tratamiento odontológico. Estas técnicas, consideradas de manejo del comportamiento, tienen el objetivo de prevenir, disminuir o ayudar a enfrentar la ansiedad y miedo dental del paciente, sirviendo como importantes aliadas del cirujano-dentista que atiende niños. Este trabajo presenta una revisión de evidencias científicas sobre las propuestas de manejo del comportamiento que pueden ser utilizadas en el consultorio odontológico con bebés, niños de edad preescolar y escolar.

There are in the literature techniques different from the pharmacological ones, which can be used for conditioning psychologically the child during dental treatment. These techniques, considered as behavioral management, have the aim to prevent, reduce or help to confront the anxiety and fear of dental patient, serving as important allies for the dentist who takes care of children. This paper presents a review of scientific evidence on the approaches of behavior management that can be used in the dental clinic with babies, preschool and school children.