Análise comparativa do comportamento verbal nos três níveis de suporte do autismo / Comparative analysis of verbal behavior in the three levels of autism support / Análisis comparativo de la conducta verbal en los tres niveles de apoyo al autismo

OBJETIVO: O presente trabalho teve por objetivo avaliar e comparar a habilidade do comportamento verbal em crianças com distintos níveis de suporte do TEA. MÉTODO: Foram avaliadas onze crianças diagnosticadas com autismo e com faixa etária entre 2 e 7 anos e que apresentassem diversidade entre si quanto ao nível de suporte TEA. Para a averiguação do repertório de comunicação, eles foram avaliados a partir de um instrumento elaborado por uma equipe de profissionais especializados, investigando o comportamento não verbal, ecoico, mando, tato e intraverbal em três tentativas. RESULTADOS: Apesar do número reduzido de participantes, os resultados indicaram que pacientes no nível 3 de suporte apresentam maior comprometimento na comunicação comparado aos demais. O estudo destacou a importância do rastreio de habilidades comportamentais para um planejamento com maior eficácia para a intervenção e concomitantemente evolução clínica, respeitando assim as particularidades e singularidades de cada pessoa no espectro. CONCLUSÃO: Concluiu-se assim, a importância da análise de comportamentos e a investigação detalhada para cada paciente, a fim de que as intervenções sejam focadas em suas reais necessidades.

OBJECTIVE: The present work aimed to evaluate and compare the verbal behavior ability in children with different levels of ASD support. METHOD: Eleven children diagnosed with autism and aged between 2 and 7 years old and who presented diversity among themselves in terms of the level of ASD support were evaluated. To investigate their communication repertoire, they were evaluated using an instrument developed by a team of specialized professionals, investigating non-verbal, echoic, command, tact and intraverbal behavior in three attempts. RESULTS: Despite the small number of participants, the results indicated that patients at level 3 of support have greater impairment in communication compared to the others. The study highlighted the importance of screening behavioral skills for more effective planning for intervention and concomitant clinical evolution, thus respecting the particularities and singularities of each person on the spectrum. CONCLUSION: This concludes the importance of behavioral analysis and detailed investigation for each patient, so that interventions are focused on their real needs.

OBJETIVO: El presente trabajo tuvo como objetivo evaluar y comparar la capacidad de conducta verbal en niños con diferentes niveles de apoyo al TEA. MÉTODO: Se evaluaron once niños diagnosticados con autismo, con edades entre 2 y 7 años y que presentaban diversidad entre sí en cuanto al nivel de apoyo al TEA. Para investigar su repertorio comunicativo, fueron evaluados mediante un instrumento desarrollado por un equipo de profesionales especializados, investigando el comportamiento no verbal, ecoico, de mando, tacto e intraverbal en tres intentos. RESULTADOS: A pesar del pequeño número de participantes, los resultados indicaron que los pacientes en el nivel 3 de apoyo tienen un mayor deterioro en la comunicación en comparación con los demás. El estudio destacó la importancia del cribado de habilidades conductuales para una planificación más eficaz de la intervención y la evolución clínica concomitante, respetando así las particularidades y singularidades de cada persona del espectro. CONCLUSIÓN: Se concluye la importancia del análisis conductual y la investigación detallada de cada paciente, para que las intervenciones estén enfocadas a sus necesidades reales.

The challenges for early intervention and its effects on the prognosis of autism spectrum disorder: a systematic review / Os desafios para a intervenção precoce e seus efeitos no prognóstico do transtorno do espectro autista: uma revisão sistemática

ABSTRACT. Autism spectrum disorder (ASD) is expressed with neurobehavioral symptoms of different degrees of intensity. It is estimated that, for every three cases detected, there are two cases that reach adulthood without treatment. Objective: To establish what challenges are still present in the implementation of early intervention (EI) and its effects on the prognosis of ASD. Methods: A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma) methodology was carried out in the PubMed and ScienceDirect databases in January 2023. The search keywords were "autism spectrum disorder", "early intervention" and "prognosis". Results: Sixteen studies were included, two randomized and 14 non-randomized. Knowledge about the signs of ASD, diagnostic and therapeutic methods, age at the start of treatment, and socioeconomic factors were the main challenges encountered in the implementation of the EI. Conclusion: EI is capable of modifying the prognosis of ASD and challenges in its implementation persist, especially in developing regions with low socioeconomic status.

RESUMO. O transtorno do espectro autista (TEA) expressa-se com sintomas neurocomportamentais de diferentes graus de intensidade. Estima-se que, para cada três casos detectados, existam dois casos que atingem a idade adulta sem tratamento. Objetivo: Estabelecer quais são os desafios ainda presentes na implementação efetiva da intervenção precoce (IP) e quais são os seus efeitos no prognóstico do TEA. Métodos: Revisão sistemática com a metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma) foi realizada nos bancos de dados PubMed e ScienceDirect em janeiro de 2023. As palavras-chave da pesquisa foram "autism spectrum disorder", "early intervention" e "prognosis". Resultados: Dezesseis estudos foram incluídos, sendo dois randomizados e 14 não randomizados. O conhecimento sobre os sinais do TEA, os métodos diagnósticos e terapêuticos, a idade de início de tratamento e os fatores socioeconômicos foram os principais desafios encontrados na implementação da IP. Conclusão: A IP é capaz de modificar o prognóstico do TEA e os desafios em sua implementação ainda afetam, principalmente, regiões em desenvolvimento e de baixo status socioeconômico.

Vaccine effectiveness in preventing deaths in people with severe acute respiratory syndrome due to COVID-19 in Blumenau, Brazil, 2021 / Efectividad de las vacunas en la prevención de la muerte por síndrome respiratório agudo grave por covid-19 en Blumenau, Brasil, 2021 / Efetividade vacinal na prevenção de óbitos em pessoas com síndrome respiratória aguda grave por covid-19 em Blumenau, 2021

ABSTRACT Objective to analyze the vaccine effectiveness in preventing deaths attributed to severe acute respiratory syndrome due to COVID-19 (SARS/COVID-19) in adults and the elderly, in Blumenau, state of Santa Catarina, Brazil, 2021. this was a population-based study conducted among individuals aged 20 years and older hospitalized with SARS/COVID-19; each death due to SARS/COVID-19 was considered a "case", and every survivor was considered a "control"; the association between vaccination status and the outcome of "death" was estimated using logistic regression, and vaccine effectiveness was estimated as (1-OR)*100. The study included 1,756 cases of SARS/COVID-19 (59.2% male, mean age of 56 years, 50.4% with elementary education, 68.4% with comorbidities and 39.1% in intensive care), of whom 398 died (cases) and 1,358 survived (controls); vaccine effectiveness was 74% and 85% (20-59 years old) and 72% and 75% (≥ 60 years old), respectively, for those who were partially vaccinated and fully vaccinated. Conclusion vaccines proved to be effective in reducing case fatality ratio due to SARS/COVID-19 in individuals ≥ 20 years old.

RESUMEN Objetivo analizar la efectividad de la vacuna para prevención de muertes por SRAG-COVID en adultos y ancianos de Blumenau, Santa Catarina, Brasil, 2021. Método estudio de base poblacional con personas hospitalizadas por SRAG-COVID mayores de 20 años; las muertes por SRAG-COVID se consideraron casos y todos los supervivientes, controles; la asociación entre el estado de vacunación y la muerte se estimó mediante regresión logística; la efectividad de la vacuna se estimó por (1-OR)*100. Resultados participaram do estudo 1.756 casos de SRAG-COVID (59,2% del sexo masculino, edad media de 56 años, 50,4% con estudios primarios, 68,4% con comorbilidades y 39,1% en cuidados intensivos), dos quais 398 foram a óbito (casos) e 1.358 sobreviveram (controles); la efectividad de la vacuna fue del 74% y el 85% (20 a 59 años) y del 72% y el 75% (60 y más años), entre los que tenían vacunación parcial y completa, respectivamente. Conclusión las vacunas fueran efectivas para reducir la letalidad del SRAG-covid.

RESUMO Objetivo Analisar a efetividade vacinal na prevenção de óbitos atribuídos a síndrome respiratória aguda grave por covid-19 (SRAG-covid) em adultos e idosos, em Blumenau, Santa Catarina, Brasil, 2021. Métodos Estudo populacional, entre maiores de 20 anos de idade internados por SRAG-covid; considerou-se "caso" cada óbito por SRAG-covid, e "controle", todo sobrevivente; estimou-se a associação entre a condição vacinal e o desfecho "óbito" por regressão logística, e a efetividade vacinal, por (1-OR)*100. Resultados Participaram do estudo 1.756 casos de SRAG-covid (59,2% do sexo masculino, idade média de 56 anos, 50,4% com ensino fundamental, 68,4% com comorbidades e 39,1% em cuidado intensivo), dos quais 398 foram a óbito (casos) e 1.358 sobreviveram (controles); a efetividade vacinal foi de 74% e 85% (20-59 anos) e de 72% e 75% (≥ 60 anos), respectivamente, para quem possuía vacinação parcial e vacinação completa. Conclusão Vacinas mostraram-se efetivas na redução da letalidade por SRAG-covid em indivíduos com idade ≥ 20 anos.

Characteristics of ST-Elevation Myocardial Infarction during the SARS-CoV-2 Outbreak

Abstract Background The SARS-CoV-2 outbreak has led to radical transformation in social, economic, and healthcare systems. This may lead to profound indirect consequences on clinical presentation and management of patients with ST-segment-elevation myocardial infarction. Objectives The objective of this study was to describe the characteristics, management, and outcomes of patients admitted with acute myocardial infarction with ST-segment elevation (STEMI), in two tertiary reference hospitals during the SARS-CoV-2 outbreak and compare them with patients admitted in the previous year. Methods We analyzed data from a multicenter STEMI registry from reference centers in the South Region of Brazil from March 2019 to May 2021. The beginning of the COVID-19 outbreak was considered to be March 2020 and compared to the same period in 2019. Only patients with STEMI submitted to primary percutaneous coronary intervention (PCI) were included in the analysis. Mortality rates were compared with chi-square test. All hypothesis tests had a two-sided significance level of 5%. Results A total of 1169 patients admitted with STEMI were enrolled in our registry, 635 of whom were admitted during the pandemic period. The mean age of our sample was 61.6 (± 12.4) years, and 66.7% of patients were male. Pain-to-door time and door-to-balloon time were longer during the pandemic period. However, there was no difference in mortality rates or major adverse cardiovascular outcomes (MACE). Conclusions We observed a stable incidence of STEMI cases in our registry during the SARS-CoV-2 outbreak with higher pain-to-door time and door-to-balloon time, without any influence on mortality rates however.

The effects of the RELATo-BRAZIL Intervention Program in early-grade readers: outcomes of a pilot study / Os efeitos do Programa de Intervenção RELATo-BRAZIL em leitores iniciantes: resultados de um estudo piloto

ABSTRACT Purpose: to carry out a pilot study applying the Reading and Language Together - Brazil program (RELATo-Brazil), targeting the development of reading and oral language abilities, aiming to improve phonological awareness skills and vocabulary knowledge in the school context. Methods: 9 children of both genders, aged between 8 and 10, enrolled in the second year of elementary school at a private school in the city of Florianópolis, SC, Brazil, joined in the study. The program was applied within three phases: Phase 1 - pre-intervention, with reading and vocabulary assessment tests; Phase 2 - intervention with sessions of different types, A, B, C and Phase 3 - post-intervention, which consisted of the subjects' reassessment, using the same tests applied in Phase 1. The data were stored in Microsoft Excel spreadsheets and exported for statistical analysis in the IBM SPSS software, the 25th version. The significance level considered was p ≤ 0.05. Results: following 21 intervention sessions, a better performance among the participants was observed when comparing the results of the pre-intervention and post-intervention phases. There is a statistically considerable difference in the percentage distributions of the conceptual vocabulary fields for Furniture and utensils (p=0.028), Places (p=0.009) and Shapes and colors (p=0.047). The reading rate did not show a statistical difference, but the children performed better in reading time and accuracy after the intervention. Conclusion: the data suggest that training in phoneme awareness and oral language and linking them in the context of authentic book reading are effective strategies for improving both reading and oral language skills.

RESUMO Objetivo: realizar um estudo piloto, aplicando o programa Reading and Language Together - Brazil (RELATo-Brazil), com vistas a incentivar o desenvolvimento da leitura e da linguagem oral por meio do trabalho com as habilidades de consciência fonológica e o aprimoramento do vocabulário no contexto escolar. Métodos: participaram do estudo nove crianças, de ambos os gêneros, com idade entre 8 e 10 anos, matriculadas no terceiro ano do ensino fundamental de uma escola particular do município de Florianópolis, Santa Catarina. O programa foi aplicado em três fases: Fase 1- pré-intervenção, com provas de avaliação da leitura e vocabulário, Fase 2 - intervenção com sessões de diferentes tipos. Fase 3 - pós-intervenção, que constou da reavaliação dos sujeitos, utilizando a mesmas provas aplicadas na Fase 1. Os dados foram armazenados em planilhas do programa Microsoft Excel e exportados para análise estatística no software IBM SPSS versão 25. O nível de significância considerado foi de p≤0,05. Resultados: após 21 sessões de intervenção, constatou-se melhor desempenho dos participantes ao comparar os resultados das fases pré-intervenção e pós-intervenção. Há diferença estatisticamente significativa nas distribuições percentuais dos campos conceituais do vocabulário para Móveis e utensílios (p=0,028), Locais (p=0,009) e Formas e cores (p=0,047). A taxa de leitura não mostrou diferença estatística, porém melhor desempenho das crianças em tempo e acurácia da leitura após a intervenção. Conclusão: os dados sugerem que treinar a consciência fonêmica, a linguagem oral e a ligação entre as duas no contexto da leitura real de livros pode ser uma intervenção eficaz na leitura, além de promover competências de linguagem oral.

O percurso pela atenção à crise em saúde mental na cidade do Rio de Janeiro / The journey through mental health crisis care in the city of Rio de Janeiro

Resumo O conceito de crise em saúde metal envolve uma complexa formulação multidimensional, forjada no contexto da Reforma Psiquiátrica Brasileira, que nem sempre é tomado de maneira unívoca pelos envolvidos. Contudo, há de se considerar uma rede capaz de dar respostas adequadas sobre como acolher essa situação, de maneira que o trabalho em rede é uma condição essencial dessa abordagem. Este artigo traz a discussão do manejo da crise em saúde mental nos Centros de Atenção Psicossocial III (CAPS III) do município do Rio de Janeiro, Brasil, a partir da perspectiva dos gestores de saúde de nível central e local, realizada por meio de entrevistas semiestruturadas e analisadas com base na Teoria da Estruturação de Giddens. Este trabalho identificou que o Rio de Janeiro apresenta um modelo de atenção à crise estruturado em rede de atenção centralizada e rede integrada, uma vez que apresenta grande integração da rede de urgência com a Rede de Atenção Psicossocial (RAPS), sobretudo com os CAPS III, e as situações de crises são atendidas preferencialmente em serviços específicos para seu atendimento. Ainda assim, pela perspectiva de Giddens, os CAPS III têm legitimidade para cumprir o papel de atenção à crise em saúde mental.

Abstract The concept of crisis in mental health involves a complex multidimensional formulation, forged in the context of the Brazilian Psychiatric Reform, which is not always taken unequivocally by those involved. However, it is necessary to consider a network capable of providing adequate answers on how to provide care in this situation; thus, networking is an essential condition of this approach. This article discusses the management of the mental health crisis in Psychosocial Care Centers III (CAPS III) in the municipality of Rio de Janeiro, Brazil, from the perspective of central and local health care managers, via semi-structured interviews and analysis based on Giddens' Theory of Structuring. This study found that the municipality of Rio de Janeiro adopts a crisis care model structured into a centralized care network and integrated network, with an emergency network highly integrated with the Psychosocial Attention Network (RAPS), especially with the CAPS III, and the crisis situations are cared for preferably in specific services. Still, from Giddens' perspective, CAPS III have the legitimacy to provide care toward mental health crisis.

Five-Year Follow-Up After Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis and Concomitant Coronary Artery Disease: A Single-Center Experience

ABSTRACT Introduction: There is no consensus on the impact of coronary artery disease in patients undergoing transcatheter aortic valve implantation. Therefore, the objective of this study was, in a single-center setting, to evaluate the five-year outcome of transcatheter aortic valve implantation patients with or without coronary artery disease. Methods: All transcatheter aortic valve implantation patients between 2009 and 2019 were included and grouped according to the presence or absence of coronary artery disease. The primary endpoint, five-year all-cause mortality, was evaluated using Cox regression adjusted for age, sex, procedure years, and comorbidities. Comorbidities interacting with coronary artery disease were evaluated with interaction tests. In-hospital complications was the secondary endpoint. Results: In total, 176 patients had aortic stenosis and concomitant coronary artery disease, while 170 patients had aortic stenosis only. Mean follow-up was 2.2±1.6 years. There was no difference in the adjusted five-year all-cause mortality between transcatheter aortic valve implantation patients with and without coronary artery disease (hazard ratio 1.00, 95% confidence interval 0.59-1.70, P=0.99). In coronary artery disease patients, impaired renal function, peripheral arterial disease, or ejection fraction < 50% showed a significant interaction effect with higher five-year all-cause mortality. No significant differences in complications between the groups were found. Conclusion: Five-year mortality did not differ between transcatheter aortic valve implantation patients with or without coronary artery disease. However, in patients with coronary artery disease and impaired renal function, peripheral arterial disease, or ejection fraction < 50%, we found significantly higher five-year all-cause mortality.

Early stimulation for neuropsychomotor development in children with microcephaly: a systematic review / Estimulação precoce para o desenvolvimento neuropsicomotor de crianças com microcefalia: uma revisão sistemática

ABSTRACT Objective: To systematically review studies on the effects of early stimulation on the neuropsychomotor development of children with microcephaly. Data source: A systematic review was conducted in PubMed/MEDLINE, Virtual Health Library, and Cochrane Library databases. Studies that addressed the use of early stimulation in playful and interactive environments in children with microcephaly were included. There were no restrictions on the publication date or language of the studies. The outcomes assessed were muscle tone, social interaction, fine and gross motor skills, intelligence quotient, socioemotional and adaptive behavior of the child. The methodological quality and the scientific evidence level were assessed using the Risk of Bias in Non-randomized Studies of Interventions, the Revised Cochrane risk of bias tool for randomized trials and the Grading of Recommendations Assessment, Development and Evaluation. Data synthesis: 264 articles were identified, but only 7 met the eligibility criteria. The included studies had a total population of 125 individuals, with sample sizes ranging from 1 to 71 participants. Conclusions: The studies showed low evidence of an effect of early intervention on the outcomes muscle tone, social interaction, fine and gross motor skills, intelligence quotient, and socioemotional and adaptive behavior in children with microcephaly. However, further randomized clinical trials are needed.

RESUMO Objetivo: Revisar, de forma sistemática, estudos sobre a interferência da estimulação precoce no desenvolvimento neuropsicomotor de crianças com microcefalia. Fontes de dados: Trata-se de uma revisão sistemática realizada nas bases de dados United States National Library of Medicine/ Medical Literature Analysis and Retrieval System Online (PubMed/MEDLINE), Biblioteca Virtual em Saúde (BVS) e Cochrane Library. Foram incluídos estudos que abordassem o uso de estímulo precoce em ambientes lúdicos e interativos em crianças com microcefalia. Não foram impostas restrições quanto à data de publicação e ao idioma dos estudos. Como desfechos, avaliaram-se tônus muscular, interação social, habilidades motoras fina e grossa, quociente de inteligência, comportamento socioemocional e adaptativo da criança. A qualidade metodológica dos estudos e o nível de evidência científica foram avaliados pelo Risk of bias in non-randomized studies of interventions, Revised Cochrane risk of bias tool for randomized trials e Grading of recommendations assessment, development and evaluation. Síntese dos dados: Foram identificados 264 artigos, entretanto apenas sete atenderam aos critérios de elegibilidade. Os estudos incluídos totalizam uma população de 125 indivíduos, com amostras que variaram de um a 71 participantes. Conclusões: Os estudos demonstraram a existência de baixa evidência quanto à interferência da intervenção precoce nos desfechos tônus muscular, interação social, habilidades motoras finas e grossas, quociente de inteligência e comportamento socioemocional e adaptativo em crianças com microcefalia. No entanto, novos ensaios clínicos randomizados ainda são necessários.

Usefulness, Reliability, Quality, and Content of Portuguese Language YouTube Videos on COVID-19

Abstract Objective: To investigate the usefulness, reliability, quality, and content of Portuguese-language YouTube videos on COVID-19. Material and Methods: Three keywords selected on Google Trends were searched on YouTube, and the 60 first videos listed with each term were analyzed. Two calibrated researchers evaluated the reliability (DISCERN Modified Scale), the quality (Global Quality Score - GQS), and the usefulness of videos for the users (COVID-19 Specific Score - CSS). The number of views, likes, and engagement were also analyzed. The data were evaluated by the Mann-Whitney test and Spearman correlation (α=5%). Results: 59 videos were included. The average scores of quality, reliability, and usefulness were 3.0 (±1.1), 3.2 (± 0.8), and 1.5 (± 0.9), respectively. Two-thirds of the videos (64.4%) had low/moderate quality, and the majority (76.2%) were about signs and symptoms. The numbers of views (p=0.005), likes (p=0.006), and engagement (p=0.014) were significantly higher in moderate/good quality videos. The number of comments (p=0.007), duration of videos (p=0.004), and the DISCERN score (p<0.001) were significantly higher in videos made by health professionals. The general quality of the videos was positively correlated to the CSS scores, number of views, likes, and engagement (p<0.05). Conclusion: Most videos had moderate quality and reliability and low usefulness for the users.

Avaliação de intervenção psicológica positiva para a promoção de saúde de aposentados / Evaluación de intervención psicológica positiva para promoción de la salud de jubilados / Evaluation of a positive psychology intervention for health promotion of retirees

RESUMO Este estudo teve como objetivo avaliar a intervenção psicológica positiva para promoção de saúde de aposentados, a partir da avaliação dos participantes, no que se refere à satisfação com o programa e com o moderador, clareza/compreensão/aplicação dos conteúdos e manutenção da aplicação ao longo de tempo, com delineamento longitudinal misto e avaliação pré (T1), pós-teste (T2) e seguimento (T3 - 03 meses). Participaram 65 aposentados que responderam ao questionário misto de avaliação do programa. Análises quantitativas indicaram maiores médias para satisfação com o programa e com o moderador; e menor média para tempo de duração do programa. 77,7% participantes em T2 e 87,2% em T3 utilizaram nas suas vidas os conteúdos trabalhados no programa. Foi observada manutenção da aplicação dos conteúdos de empatia, autocuidado, otimismo, gratidão, perdão e autoperdão. Resultados positivos demonstram que este modelo de intervenção para promoção de saúde - com base na psicologia positiva e TCC - apresenta potencial para ser aplicado em contextos de saúde pública e promoção de envelhecimento ativo.

RESUMEN Este estúdio evaluó una intervención psicológica positiva para La promoción de la salud de jubilados, basado em laevaluación de los participantes, encuanto a satisfacción com el programa y com el moderador, claridad/comprensión/aplicación de los contenidos y mantenimiento de La aplicaciónen el tiempo, condiseño longitudinal mixto y evaluación pre (T1), posterior a laprueba (T2) y seguimiento (T3 - tres meses). Participaron 65 jubilados que respondieron los cuestionarios de evaluación del programa. Los análisis cuantitativos indican promedios más altos para satisfacción conel moderador y programa; y más bajo para laduración del programa. 77.7% de los participantes en T2 y 87.2% en T3 usaron en sus vidas los contenidos trabajados em el programa. Se observo mantenimiento de la aplicación de lãs variables empatía, autocuidado, optimismo, gratitud, perdón y autoperdón. Los resultados positivos demuestran que este modelo de intervención presenta potencial de ser aplicado en contextos de salud pública y promoción Del envejecimiento activo.

ABSTRACT This study aimed to evaluate a Positive Psychology programme for health promotion of retirees, based on evaluation of participants with regard to levels of satisfaction with the programme/group and with the moderator, comprehension and application of contents and maintenance/long-term application of contents. A mixed longitudinal design, with pre-test (T1), post-test (T2), and follow-up (T3 - three months) evaluations was used. 65 retirees answered a programme evaluation questionnaire. Quantitative results indicated higher mean rates for satisfaction with the moderator and programme; and lower rates for the programme length/duration. Qualitative analysis indicated that 77.7% of the sample at T2, and 87.2% at T3 reported having used contents of the programme in their lives. Maintenance of application of contents was observed for empathy, self-care, optimism, gratitude, forgiveness and self-forgiveness. Positive outcomes demonstrate this pattern of intervention for health promotion - based on Positive Psychology and CBT - presents the potential to be applied within public health contexts for the promotion of active aging.

Job satisfaction among nurses in area hospitals of Djidja and Covè: Determinants and development of intervention in 2021 in Benin

In Benin, nurses complain of insufficient job satisfaction. This study is the third part of a mixed research project. The aim of this article was to develop an intervention to improve nurses' job satisfaction. Participatory action research with intervention mapping was carried out in 2021. Purposive sampling was used. Interviews and panel discussions were held with 40 participants, nurses and administrative staff from the Djidja and Covè area hospitals. A number of internal factors contributed to the nurses' job satisfaction. However, external factors also militated in favor of insufficient job satisfaction among nurses. This confirms the results of quantitative evaluation of nurses' job satisfaction, in line with a number of authors. The panelists agreed ona major workshop and satisfaction improvement program. They agreed on quantified objectives, a logic model, terms of reference, a logical framework and an evaluation plan. Participants also agreed on the development of nursing work management tools. The determinants of nurses' job satisfaction are examined in depth, some of which are confirmed, also confirming a lack of job satisfaction. The workshop will focus on three interventions selected from the literature, merged and adapted by the participants. None of these interventions has been tested in sub-Saharan Africa. Intervention implementation and evaluation will be the subject of future research. Key words: Benin; Job satisfaction; Nurses; Action research; Determinants; Intervention.Pour citer cet article: ADOGNIBO S. Gérardetal. Job satisfaction among nurses in area hospitals of Djidja and Covè: Determinants and development of intervention in 2021 in Benin. Revue de Médecine et de Santé Publique

Availability of resources for paediatric hearing care in a South African province

Background: Unavailability of healthcare resources can lead to poor patient outcomes. The latter is true for infants with hearing loss and require early hearing detection and intervention (EHDI). Aim: To determine the availability and distribution of resources for EHDI in state hospitals in the Eastern Cape (EC) province, South Africa. Setting: Sixteen state hospitals (nine district, four regional and three tertiary hospitals). Methods: Descriptive cross-sectional survey completed between July 2022 and October 2022. Results: Thirteen hospitals had audiologists (n = 4) or speech therapists and audiologists (n = 9). Specific to equipment, 10 hospitals had a screening otoacoustic emissions or automated auditory brainstem response, 8 hospitals had diagnostic middle ear analysers and only 3 hospitals had diagnostic auditory brainstem response and/or auditory steady state response. Twelve hospitals did not have visual response audiometry (VRA) and 94% had no hearing aid verification systems. Budget allocations were uneven, with only 10 hospitals, i.e., 4 districts, all regional and 2 tertiary hospitals being allocated varying amounts. Subsequently, only 50% provided newborn hearing screening, 56% provided diagnostic evaluations and 14 hospitals fitted hearing aids. Conclusion: Results revealed a limited and uneven distribution of resources, which negatively impacted the provision of EHDI. Even distribution of healthcare resources and further research aimed at strengthening hearing health services is recommended as these could potentially improve equitable access to EHDI and the overall quality of healthcare provided. Contribution: This study highlights the need for even distribution of resources and strengthening of health systems, especially in the dawn of the National Health Insurance.

Neutrófilos en el diagnóstico de infarto del miocardio tipo 4a / Neutrophils in the Diagnosis of Type 4 Myocardial Infarction

Introducción: El infarto del miocardio tipo 4a es una complicación del intervencionismo coronario percutáneo que incrementa el estado inflamatorio de los pacientes. Objetivo: Evaluar el valor diagnóstico del conteo absoluto de neutrófilos en la aparición de infarto del miocardio tipo 4a. Métodos: Se realizó una cohorte prospectiva en el Hospital Hermanos Ameijeiras. El universo estuvo constituido por 412 pacientes a los que se les realizó intervencionismo coronario percutáneo en el período comprendido de noviembre de 2018 a enero de 2021, la muestra fue de 232 pacientes. Se definieron variables clínicas, anatómicas, e inflamatorias. Resultados: Existieron diferencias significativas entre los pacientes con infarto tipo 4a y los que no tuvieron esta complicación según las variables clínicas: edad, índice de masa corporal, diabetes mellitus, enfermedad renal crónica y disfunción sistólica ventricular. La elevación del conteo absoluto de neutrófilos posterior al proceder con un área bajo la curva de 0,947 tuvo buena capacidad de discriminación de esta complicación (p = 0,000). En el diagnóstico de infarto periproceder el conteo absoluto de neutrófilos fue 7,35 posterior al proceder, tuvo una sensibilidad de 91,3 por ciento una especificidad de 96,2 por ciento. Conclusiones: Los neutrófilos fueron sensibles y específicos para el diagnóstico de infarto del miocardio tipo 4a(AU)

Introduction: Type 4 myocardial infarction is a complication of percutaneous coronary intervention that increases the inflammatory state of patients. Objective: To evaluate the diagnostic value of the absolute neutrophil count in the occurrence of type 4 myocardial infarction. Methods: A prospective cohort was carried out at Hermanos Ameijeiras Clinical Surgical Hospital. The universe consisted of 412 patients who underwent percutaneous coronary intervention from November 2018 to January 2021, two hundred thirty-two (232) patients form the sample. Clinical, anatomical and inflammatory variables were defined. Results: There were significant differences between patients with type 4 infarction and those who did not have this complication according to the clinical variables such as age, body mass index, diabetes mellitus, chronic kidney disease and ventricular systolic dysfunction. The subsequent elevation of the absolute neutrophil count when proceeding with an area under the 0.947 curve had good ability to discriminate this complication (p = 0.000). In the diagnosis of periprocedural infarction, the absolute neutrophil count was ≥ 7.35 after the procedure, it had 91.3percent sensitivity and 96.2percent specificity. Conclusions: Neutrophils were sensitive and specific for the diagnosis of type 4 myocardial infarction(AU)

Surgical treatment of Stanford type A aortic dissection after coronary artery stenting / 中国胸心血管外科临床杂志

@#Objective    To retrospectively analyze the surgical treatment of Stanford type A aortic dissection after coronary artery stenting, and to explore the surgical techniques and surgical indications. Methods    Clinical data of 1 246 consecutive patients who underwent operations on Stanford type A aortic dissection from April 2016 to July 2019 in Beijing Anzhen Hospital were retrospectively analyzed. Patients with Stanford type A aortic dissection after coronary artery stenting were enrolled. Results    Finally 19 patients were collected, including 16 males and 3 females with an average age of 54±7 years ranging from 35 to 66 years. There were 11 patients in acute phase, 15 patients with AC (DeBakey Ⅰ) type and 4 patients with AS (DeBakey Ⅱ) type. In AC type, there were 10 patients receiving Sun's surgery and 5 patients partial arch replacement. Meanwhile, coronary artery bypass grafting was performed in 7 patients and mitral valve replacement in 1 patient. Stents were removed from the right coronary artery in 4 patients. In this group, 1 patient died of multiple organ failure in hospital after operation combined with malperfusion of viscera. Eighteen patients recovered after treatment and were discharged from hospital. The patients were followed up for 30 (18-56) months. One patient underwent aortic pseudoaneurysm resection, one thoracic endovascular aortic repair, one emergency percutaneous coronary intervention due to left main artery stent occlusion, and one underwent femoral artery bypass due to iliac artery occlusion. Conclusion    Iatrogenic aortic dissection has a high probability of coronary artery bypass grafting at the same time in patients with Stanford type A aortic dissection after coronary artery stenting. Complicated type A aortic dissection after percutaneous coronary intervention should be treated with surgery aggressively.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Transcriptome Sequencing on Treatment of Kidney Deficiency and Blood Stasis-thin Endometrium in Rats with Bushen Huoxue Prescription Through Enema / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Bushen Huoxue enema in treating the rat model of kidney deficiency and blood stasis-thin endometrium （KDBS-TE） by transcriptome sequencing. MethodThe rat model of KDBS-TE was established by administration of tripterygium polyglycosides tablets combined with subcutaneous injection of adrenaline. The pathological changes of rat endometrium in each group were then observed. Three uterine tissue specimens from each of the blank group， model group， and Bushen Huoxue enema group were randomly selected for transcriptome sequencing. The differentially expressed circRNAs， lncRNAs， and miRNAs were screened， and the disease-related specific competitive endogenous RNA （ceRNA） regulatory network was constructed. Furthermore， the gene ontology （GO） functional annotation and the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment were performed for the mRNAs in the network. ResultCompared with the blank group， the model group showed endometrial dysplasia， decreased endometrial thickness and endometrial/total uterine wall thickness ratio （P<0.01）， and differential expression of 18 circRNAs， 410 lncRNAs， and 7 miRNAs. Compared with the model group， the enema and estradiol valerate groups showed improved endometrial morphology and increased endometrial thickness and ratio of endometrial to total uterine wall thickness （P<0.05）. In addition， 21 circRNAs， 518 lncRNAs， and 17 miRNAs were differentially expressed in the enema group. The disease-related specific circRNA-miRNA-mRNA regulatory network composed of 629 nodes and 664 edges contained 2 circRNAs， 34 miRNAs， and 593 mRNAs. The lncRNA-miRNA-mRNA regulatory network composed of 180 nodes and 212 edges contained 5 lncRNAs， 10 miRNAs， and 164 mRNAs. The mNRAs were mainly enriched in Hippo signaling pathway， autophagy-animal， axon guidance， etc. ConclusionBushen Huoxue enema can treat KDBS-TE in rats by regulating specific circRNAs， lncRNAs， and miRNAs in the uterus and the ceRNA network.

Design and evaluation of a mobile-based intervention for Maya adults during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has had a direct impact on mental health. Inter national organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treat ment option for common mental health problems. However, the evidence regarding these ap proaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-as sessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous pop ulation. Future studies might consider developing similar interventions for other indigenous communities in Latin America.

Introducción: La pandemia de COVID-19 tuvo impacto directo en la salud mental. Organizaciones internacionales han enfatizado la vulnerabilidad de los pueblos indígenas. Los enfoques de salud mental digital brindan terapia en línea como una opción de tratamiento basada en evidencia, efectiva y accesible; sin embargo, los datos son limitados en población indígena. El objetivo de este estudio fue describir el diseño, desarrollo y evaluación de la eficacia de una intervención en línea autoaplicada sobre síntomas psicológicos de depresión, ansiedad y miedo al COVID-19 en una muestra de población maya. Método: Se diseñó un es tudio cuantitativo longitudinal prospectivo, donde se midió a un solo grupo antes y después de recibir la intervención en línea, implementada de abril a septiembre de 2021, que constó de seis sesiones impartidas vía WhatsApp, en español y maya. Resultados: La evaluación inicial se implementó con 82 participantes que fueron evaluados mediante el Cuestionario de Salud del Paciente, Escala para el Trastorno de Ansiedad Generalizada y Escala de Miedo al COVID-19; 18 participantes permanecieron para la evaluación posterior. Se observaron di ferencias estadísticas en las medidas pre- y post- de depresión y ansiedad, pero no miedo al COVID-19. Conclusiones: Este estudio arrojó resultados positivos de la primera intervención de salud mental en línea implementada en la población indígena latinoamericana. Estudios futuros podrían considerar el desarrollo de intervenciones similares para otras comunidades indígenas en América Latina.

A systematic review of the effects of nutrition programmes in high schools

Introduction/Objectives: Obesity rates are reaching alarming levels. Adolescence is a critical period for the prevention of nutritional problems, as it is a time of development of one's own eating habits. These habits will persist into adulthood, so showing adolescents healthy lifestyle patterns is important. The ideal option would be through school-based nutrition intervention programmes. The main objective of this article is to investigate the effectiveness of intervention programmes based on nutritional knowledge and the behaviour of adolescents aged 11-19 years. Method: To carry out this systematic review we employed Scopus, PubMed, and Web of Science as databases and a search period that spanned the last 10 years, following the PRISMA statement. Subsequent to the search, 110 articles were found. Finally, 19 articles were selected for in-depth analysis after a thorough screening. Results: The results show that, in general, intervention programmers have improved the nutritional knowledge of high school students, which means an improvement in their eating behaviours. In addition, these programmes increase their levels of physical activity. However, gender differences are observed, with girls being more concerned about maintaining a balanced diet. Conclusion: In conclusion, schools are an ideal environment for developing programmes that interfere in adolescent eating behaviour.

Introducción/Objetivos: Las tasas de obesidad están alcanzando niveles alarmantes. La adolescencia es un periodo crítico para la prevención de problemas nutricionales, ya que es un momento de desarrollo de los propios hábitos alimentarios. Estos hábitos permanecerán en la edad adulta, por lo que es importante mostrarles a los adolescentes patrones de estilo de vida saludable. La opción ideal sería a través de programas de intervención nutricional en las escuelas. El objetivo principal de este artículo es investigar la efectividad de los programas de intervención basados en el conocimiento y comportamiento nutricional en adolescentes de 11 a 19 años. Métodos: Para llevar a cabo esta revisión sistemática utilizamos como bases de datos Scopus, PubMed y Web of Science y un periodo de búsqueda que abarcó los últimos diez años, siguiendo la declaración Prisma. Después de la búsqueda, se encontraron 110 artículos. Finalmente, 19 artículos fueron seleccionados para un análisis en profundidad después de una revisión exhaustiva. Resultados: Los resultados muestran que, en general, los programas de intervención han mejorado los conocimientos nutricionales de los estudiantes de secundaria, lo que significa una mejora en sus conductas alimentarias. Además, estos programas aumentan sus niveles de actividad física. Sin embargo, se observan diferencias de género, estando las chicas más preocupadas por mantener una dieta equilibrada. Conclusiones: En conclusión, las escuelas son un ambiente ideal para el desarrollo de programas que interfieren en la conducta alimentaria de los adolescentes.

Influencia de la musicoterapia en el paciente durante la atención estomatológica

Ser atendido por el estomatólogo es una de las situaciones que genera más miedo y ansiedad en las personas. Se sugiere que la musicoterapia contribuye a reducir estos síntomas. Teniendo en cuenta que muchos pacientes presentan ansiedad y miedo al ser atendidos en el sillón dental y que necesitan un ambiente más agradable, constituye el motivo que condujo a la realización de este trabajo haciendo uso de la musicoterapia con el objetivo de evaluar su influencia en el paciente durante la atención. Se realizó un estudio de intervención, desde marzo a junio del 2022 en el Servicio Estomatológico, Policlínico Tula Aguilera. La muestra, 40 pacientes, fue seleccionada al azar, independientemente de sentir temor o no al tratamiento estomatológico. Las sesiones se dividieron: primera visita (sin música) y segunda visita (con música). Los datos se recogieron en encuesta. Los niveles de miedo disminuyeron con la aplicación de la terapia, por lo cual se constató que la musicoterapia tiene una notable influencia en los pacientes al desaparecer y disminuir el miedo o sensaciones desagradables durante la atención estomatológica. Todos los pacientes manifestaron satisfacción con el uso de la música, durante el servicio.

To be assisted by the odontologist is one of the situations that generates more fear and anxiety in people. It is suggested that the musical-therapy contributes to reduce these symptoms. Keeping in mind that many patients present anxiety and fear when being assisted in the dental armchair and that they need a more pleasant atmosphere, it constitutes the reason that led to the realization of this work making use of the musical-therapy with the objective of evaluating their influence in the patient during the attention. He was carried out an intervention study, from March to June of the 2022 in the Dentistry Service, Clinical Tula Aguilera. The sample, 40 patients, it was selected at random, independently of feeling fear or not to the dentistry treatment. The sessions were divided: first visit (without music) and second visit (with music). The data were picked up in survey. The levels of fear diminished with the application of the therapy, reason why it was verified that the musical-therapy has a notable it influences in the patients when disappearing and to diminish the fear or unpleasant sensations during the dentristry attention. All the patients manifested satisfaction with the music's use, during the service.