Adaptation of the technology readiness levels for impact assessment in implementation sciences: The TRL-IS checklist.

Background: Intervention development is a critical process in implementation research. There are key stages involved in the process to design, pilot, demonstrate and release a technology or an intervention. The Technology Readiness Level (TRL) is a globally accepted instrument for assessing the maturity of research development. However, the original levels do not fit all, and some adjustments are required for its applicability in implementation sciences. Aims: This study aimed to gather the prior knowledge base on TRL in public and population health research; to develop a standard definition of readiness, and to adapt and validate the TRL to an implementation science context (TRL-IS). Materials and methods: A Mixed methods approach has been followed in this study. A scoping review using the PRISMA extension (PRISMA-ScR) informed a nominal expert panel for developing a standard definition of readiness and to modify the TRL following an ontoterminology approach. Then the maturity of six practical case study examples were rated by ten researchers using the modified TRL to estimate inter-rater reliability, and a group of experts provided final content and face validity and feasibility.This mixed methods study included 1) a scoping review to examine the current literature and develop a knowledge base, identify knowledge gaps and to clarify concepts; 2) the development of a standard definition of 'Readiness' and related terms; and 3) adaptation of the TRL to implementation science and development of a checklist to rate the maturity of applications.A standard definition of readiness and related terms was produced by the core team, and an international nominal group (n = 30) was conducted to discuss and validate the definition and terms, and the location of 'Readiness' in the initiation and early development phases of implementation.Following feedback from the nominal group, the development of the TRL-IS was finalised and a TRL-IS rating checklist was developed to rate the maturity of applications. The TRL-IS checklist was tested using six cases based on real world studies on implementation research.The inter-rater reliability of the TRL-IS was evaluated by ten raters and finally six raters evaluated the content and face validity, and feasibility, of the TRL-IS checklist using the System Usability Scale (SUS). Results: Few papers (n = 11) utilised the TRL to evaluate the readiness of readiness of health and social science implementation research. The main changes in the adaption of the TRL-IS included the removal of laboratory testing, limiting the use of "operational" environment and a clearer distinction between level 6 (pilot in a relevant environment) and 7 (demonstration in the real world prior to release). The adapted version was considered relevant by the expert panel. The TRL-IS checklist showed evidence of good inter-rater reliability (ICC = 0.90 with 95 % confident interval = 0.74-0.98, p < .001) and provides a consistent metric. Conclusions: In spite of recommendations made by national and international research funding agencies, few health and social science implementation studies include the TRL as part of their evaluation protocol. The TRL-IS offers a high degree of conceptual clarity between scientific maturity phases or readiness levels, and good reliability among raters of varying experience. This study highlights that adoption of the TRL-IS framework in implementation sciences will bolster the scientific robustness and comparability of research maturity in this domain.

Impact of Chronic Disease Self-Management Program on the Self-Perceived Health of People in Areas of Social Vulnerability in Asturias, Spain.

The Chronic Disease Self-Management Program (CDSMP) focuses on a health promotion perspective with a salutogenic approach, reinforcing the pillars of self-efficacy. The aim of this study was to assess the impact of the CDSMP on Self-perceived Health (SPH) in disadvantaged areas of Asturias, España. The study included vulnerable adults with experience of chronic diseases for over six months, along with their caregivers. The intervention consisted of a six-session workshop led by two trained peers. SPH was evaluated by administering the initial item of the SF-12 questionnaire at both baseline and six months post-intervention. To evaluate the variable "Change in SPH" [improvement; remained well; worsening/no improvement (reference category)], global and disaggregated by sex multivariate multinomial logistic regression models were applied. There were 332 participants (mean = 60.5 years; 33.6% were at risk of social vulnerability; 66.8% had low incomes). Among the participants, 22.9% reported an improvement in their SPH, without statistically significant sex-based differences, while 38.9% remained in good health. The global model showed age was linked to decreased "improvement" probability (RRRa = 0.96), and the "remaining well" likelihood drops with social risk (RRRa = 0.42). In men, the probability of "remaining well" decreased by having secondary/higher education (RRRa = 0.25) and increased by cohabitation (RRRa = 5.11). Women at social risk were less likely to report "remaining well" (RRRa = 0.36). In conclusion, six months after the intervention, 22.9% of the participants had improved SPH. Age consistently decreased the improvement in the different models.

Gut Microbiome-Targeted Nutrition Interventions and Growth among Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Background: Childhood malnutrition is a public health challenge of much interest and concern globally. However, a perturbed gut microbiome (GM) may limit some nutrition interventions' effects among healthy children with undernutrition. Objectives: This review aimed to evaluate the effects of GM-targeted nutrition interventions on growth outcomes among children (0-59 mo) using published studies in low- and middle-income countries. Methods: The methods were guided by the Cochrane methodology. The literature search was conducted to include articles published from inception to July 2023 in PubMed, Google Scholar, and Cochrane Databases. We identified and included 35 studies among 11,047 children. The analysis was conducted considering various growth parameters in the qualitative synthesis and weight gain (kg) in the meta-analysis. Results: In the qualitative synthesis, 55.6% of prebiotics, 66.7% of probiotics, 71.4% of synbiotics, and 28.6% of "microbiome complementary feed" studies had significant effects on growth outcomes. Also, prebiotics had more studies with significant effects among healthy children, whereas probiotics, synbiotics, and "microbiome complementary feeds" had more studies with significant effects among children with undernutrition. Nineteen studies were included in the meta-analyses, of which 7 (36.8%) measured GM outcomes. The meta-analysis showed that prebiotics exhibited heterogeneity but had significant effects on weight in the intervention as compared with the control (mean difference [MD]: 0.14 kg; 95% CI: 0.02, 0.25; I2 = 63%, P = 0.02; 4 studies, n = 932). Probiotics had significant effects on weight in the intervention (MD: 0.15 kg; 95% CI: 0.06, 0.25; I2 = 42%, P = 0.05; 8 studies, n = 2437) as compared to the control. However, synbiotics (MD: 0.26 kg; 95% CI: -0.04, 0.56; I2 = 41%, P = 0.17; 4 studies, n = 1896] and "microbiome complementary feed" (MD: -0.03 kg; 95% CI: -0.18, 0.11; I2 = 0%, P = 0.60; 3 studies, n = 733] had no significant effects on weight in the intervention as compared with control. Conclusions: Although probiotics and synbiotics may be effective at enhancing growth among children, the selection of interventions should be contingent upon health status.This trial was registered at www.crd.york.ac.uk/prospero/ as CRD42023434109.

Effectiveness of a hand hygiene training intervention in improving knowledge and compliance rate among healthcare workers in a respiratory disease hospital.

Background: Practicing hand hygiene (HH) is a crucial element of infection control, with healthcare workers (HCWs) playing a vital role in preventing the spread of infection. However, inadequate knowledge and non-compliance to HH protocols pose significant challenges in healthcare settings. This study aimed to evaluate the effectiveness of an HH training intervention in enhancing knowledge and staff compliance within a respiratory disease hospital. Method: A pre-and post-training study was conducted among the healthcare workers in a respiratory disease treatment facility. The intervention comprised a series of 3-hour training sessions conducted over five days, focusing on the World Health Organization's (WHO) recommended guideline "Your Five Moments For Hand Hygiene." These sessions covered proper HH techniques and underscored the repercussions of inadequate compliance. Educational materials related to HH were displayed in prominent locations throughout the facility. The knowledge levels and compliance rate were assessed before and after the intervention. Result: The intervention significantly improved HH knowledge levels and compliance rates among the participants. Marking a significant improvement, the compliance rate of HH protocols increased from 66.0% to 88.3% during the pre-to post-training period, with a concurrent increase in the mean knowledge score from 68.6% to 78.9%. Conclusion: This study underscores the potential of training and education in elevating HH compliance and knowledge among healthcare workers. The findings advocate that healthcare facilities routinely incorporate such interventions into their infection control programs, ultimately improving patient and healthcare worker safety.

Gut microbiota composition in pediatric populations with obesity: a systematic review / Composición de la microbiota intestinal en población pediátrica con obesidad: una revisión sistemática

The increasing prevalence of obesity among children and adolescent’s wide is a public health problem, resulting from the interaction of genetic, environmental and lifestyle factors. Obesity can lead to dysbiosis of the gut microbiota. This systematic review aims to gather scientific information available on the composition of gut microbiota in children/ adolescents with overweight/obesity. Research studies were identified through a scientific database (PubMed). The key words used were “Obese” OR “Overweight” AND “adolescent” OR “children” AND “microbiota”. Observational and intervention studies in children/adolescents having either overweight or obesity were included in this review, belonging to the last ten years – from December 2012 to October 2022. The initial search resulted in 409 references, 379 of them were excluded because the participants had major pathologies other than obesity or overweight. From the remaining articles, others were excluded due to not providing information on the number of participants, or not including data on microbiota composition. A total of 16 articles were selected: 12 observational studies and 4 intervention studies. Among the observational studies that compared overweight/obesity vs. normal weight or metabolically unhealthy obese vs. metabolically healthy obese children/adolescents, at least two studies found higher levels of Firmicutes, Proteobacteria, Bacteroidales, Adlercreutzia, Bifidobacterium, Escherichia coli, and Clostridium. Moreover, lower abundances of Bacteroidetes, Verrucomicrobia, Bacteroides, and Akkermansia were observed. Regarding intervention studies consisting of supplementation of oligofructose- enriched inulin and a weight reduction program, higher proportions of Actinobacteria were observed after the intervention. Clostridia was also found in higher abundances after interventions that used a combined strength and endurance training program and a weight reduction program. The findings suggest that obesity decreased microbiota diversity and increases species associated with inflammation. The results are consistent with previous studies in adults. This information will be useful for designing dietary interventions to prevent or reverse dysbiosis in individuals with obesity.(AU)

La creciente prevalencia de obesidad en niños y adolescentes es un problema de salud pública, resultado de la interacción de factores genéticos, ambientales y de estilo de vida. La obesidad puede provocar una disbiosis de la microbiota intestinal. Esta revisión sistemática tiene como objetivo recopilar información científica disponible sobre la composición de la microbiota intestinal en niños/adolescentes con sobrepeso/obesidad. Los estudios de investigación se identificaron a través de una base de datos científica (PubMed). Las palabras clave utilizadas fueron “obeso” O “Sobrepeso” Y “adolescente” O “niños” Y “microbiota”. En esta revisión se incluyeron estudios observacionales y de intervención en niños/adolescentes con sobrepeso u obesidad, pertenecientes a los últimos diez años, de diciembre de 2012 a octubre de 2022. La búsqueda inicial resultó en 409 referencias, de las cuales 379 fueron excluidas porque los participantes tenían patologías mayores además de la obesidad o el sobrepeso. De los artículos restantes, se excluyeron otros por no proporcionar información sobre el número de participantes o por no incluir datos sobre la composición de la microbiota. Se seleccionaron un total de 16 artículos: 12 estudios observacionales y 4 estudios de intervención. Entre los estudios observacionales que compararon el sobrepeso/obesidad frente al peso normal o los niños y adolescentes obesos metabólicamente no saludables frente a los obesos metabólicamente sanos, al menos dos estudios encontraron niveles más altos de Firmicutes, Proteobacterias, Bacteroidales, Adlercreutzia, Bifidobacterium, Escherichia coli y Clostridium. Además, se observaron menores abundancias de Bacteroidetes, Verrucomicrobia, Bacteroides y Akkermansia. En cuanto a los estudios de intervención consistentes en suplementación con inulina enriquecida con oligofructosa y un programa de reducción de peso, se observaron mayores proporciones de Actinobacteria después de la intervención. Los clostridios también se encontraron en mayor abundancia después de las intervenciones que utilizaron un programa combinado de entrenamiento de fuerza y resistencia y un programa de reducción de peso. Los hallazgos sugieren que la obesidad disminuye la diversidad de la microbiota y aumenta las especies asociadas con la inflamación. Los resultados son consistentes con estudios previos en adultos. Esta información será útil para diseñar intervenciones dietéticas que prevengan o reviertan la disbiosis en individuos con obesidad.(AU)

Intervención psicoeducativa en familiares de educandos con trastornos del espectro autista

Fundamento: el trastorno del espectro autista es una entidad de origen neurobiológico, caracterizada por una variedad de signos y síntomas. Objetivo: elevar el nivel de conocimiento en familiares de educandos con trastorno del espectro de autismo. Métodos: se realizó un estudio cuasiexperimental, de intervención educativa en los nueve Servicios de Rehabilitación de las áreas de salud del municipio de Camagüey, durante los meses enero-diciembre de 2022. La muestra quedó constituida por 25 familiares que cumplieron con los criterios de elegibilidad. Para evaluar los resultados de la intervención se aplicó un cuestionario antes y después de desarrollada la intervención. Resultados: existió predominio del sexo femenino 23 (92 %), un rango de edad de 30-39 años 11 (44 %) y un nivel escolar de bachiller 13 (52 %). Antes de la intervención fue insuficiente el nivel de conocimiento general sobre el trastorno del espectro autista en un 68 %. En lo referente a la competencia emocional, alcanzó el 84 %, el tratamiento indicado el 84 %, y los métodos educativos el 60 %. Posterior a la estrategia se logró elevar el nivel de conocimiento general en el 100 %, el 92 % alcanzó el objetivo de la competencia emocional, el 100 % logró suficiencia sobre el tratamiento indicado y en el 92 % obtuvo mejoría en el conocimiento sobre los estilos educativos. Conclusiones: se logró elevar el nivel de conocimientos generales sobre el trastorno del espectro autista, la competencia emocional, cumplimiento del tratamiento neurosensorial y estilos educativos.

Background: autism spectrum disorder" is an entity of neurobiological origin, characterized by a variety of signs and symptoms. Objective: raise the knowledge level in relatives of students with autism spectrum disorder. Methods: a quasi-experimental study of educational intervention was carried out in the nine Rehabilitation Services of the Camagüey municipality health areas, from January to December 2022. The sample consisted of 25 family members who met the eligibility criteria. To evaluate the results of the intervention, a questionnaire was applied before and after the intervention was developed. Results: there was a predominance of the female sex 23 (92%), an age range of 30-39 years 11 (44%) and a high school level 13 (52%). Before the intervention, the level of general knowledge about autism spectrum disorder was insufficient by 68%. Regarding emotional competence, it reached 84%, the indicated treatment 84%, and educational methods 60%. After the strategy, it was possible to raise the level of general knowledge by 100%, 92% achieved the objective of emotional competence, 100% achieved sufficiency regarding the indicated treatment and 92% obtained improvement in educational styles knowledge. Conclusions: it was possible to raise the level of general knowledge about autism spectrum disorder, emotional competence, compliance with neurosensory treatment and educational styles.

Impact of 4% Deltamethrin-Impregnated Dog Collars on the Incidence of Human Visceral Leishmaniasis: A Community Intervention Trial in Brazil.

BACKGROUND: In Brazil, human visceral leishmaniasis (HVL) is caused by the protozoan parasite Leishmania infantum, primarily transmitted by the sand fly Lutzomyia longipalpis, with dogs acting as the main urban reservoir. This study aims to evaluate the effectiveness of 4% deltamethrin-impregnated dog collars (DMC) on HVL incidence. METHODS: This is a community intervention study carried out from 2012 to 2015 in the municipalities of Araguaína, State of Tocantins, and Montes Claros, State of Minas Gerais, Brazil. Two areas in each were randomly allocated to either (1) culling seropositive dogs + residual insecticide spraying (control area-CA) or (2) culling seropositive dogs + residual insecticide spraying + DMC fitted to dogs every six months for two years (intervention area-IA). Cases of HVL (n = 1202) occurring from 2008 to 2020 were identified from the Brazilian Reportable Diseases Information System and georeferenced to the control and intervention areas. The HVL cases from 2008 to 2012 were considered as occurring in the "pre-intervention" period. Those cases from 2013 to 2016 and from 2017 to 2020 were regarded as occurring in the "intervention" and "post-intervention" periods, respectively. We used a mixed-effects Poisson regression model to estimate the effectiveness of the intervention, comparing the changes from the pre-intervention period to the intervention and post-intervention periods in the control and intervention areas. RESULTS: In Araguaína, there was a statistically significant reduction in the incidence of HVL in both the control and intervention areas, comparing both the intervention and post-intervention periods with the pre-intervention period. The intervention with DMC was significantly associated with a reduction in HVL when comparing the intervention and pre-intervention periods, yielding an effectiveness estimate of the DMC of 27% (IC95% 1-46%, p = 0.045). No differences were observed when comparing the pre- and post-intervention periods (p = 0.827). In Montes Claros, cases reduced in both the control and intervention areas from the pre-intervention period to the intervention period (p = 0.913). In the post-intervention period, the incidence increased in the control area, while cases continued to decrease in the DMC area (p = 0.188). CONCLUSIONS: The use of DMC was associated with a reduction of 27% in the incidence of HVL during the period of DMC delivery, indicating that DMC is effective as an additional strategy for controlling visceral leishmaniasis in Brazil. However, no significant reduction associated with DMC was detected after the intervention period, suggesting that a control program based on the large-scale deployment of DMC might have to be maintained for more extended periods without interruption.

Use of behavior change techniques in physical activity programs and services for older adults: findings from a rapid review.

BACKGROUND: Understanding behavior change techniques (BCTs) used in randomized controlled trials (RCTs) of physical activity programs/services for older adults can help us to guide their implementation in real-world settings. PURPOSE: This study aims to: (a) identify the number and type of BCTs used in physical activity programs/services for older adults evaluated in large, good quality RCTs and (b) explore the impact of different BCTs on different outcome domains. METHODS: This is a secondary data analysis of a WHO-commissioned rapid review of physical activity programs/services for older adults. Fifty-six trials testing 70 interventions were coded for the type and number of BCTs present using a published BCT taxonomy. The proportion of positive effects found from physical activity interventions using the most common BCTs was calculated for the outcomes of physical activity, intrinsic capacity, functional ability, social domain, cognitive and emotional functioning, and well-being and quality of life. RESULTS: Thirty-nine of the 93 possible BCTs were identified in the included trials and 529 BCTs in total (mean 7.6, range 2-17). The most common BCTs were "action planning" (68/70 interventions), "instructions on how to perform a behavior" (60/70), "graded tasks" (53/70), "demonstration of behavior" (44/70), and "behavioral practice/rehearsal" (43/70). Interventions that used any of the most common BCTs showed overwhelmingly positive impacts on physical activity and social domain outcomes. CONCLUSION: Consideration of which BCTs are included in interventions and their impact on outcomes can improve the effectiveness and implementation of future interventions. To enable this, providers can design, implement, and evaluate interventions using a BCT taxonomy.

Interventions aimed at modifying health-related behaviors, such as physical activity, are often complex, with numerous components. To better understand interventions' "active ingredients," we conducted a secondary analysis of a World Health Organization (WHO)-commissioned rapid review, using a behavior change technique (BCT) taxonomy. We aimed to classify the number and types of BCTs in physical activity programs for older adults, as identified in randomized controlled trials (RCTs), and examine their impact on outcomes, including physical activity, intrinsic capacity, functional ability, social domain, cognitive and emotional functioning, and well-being. Examining 56 trials testing 70 interventions, we identified 39 out of 93 possible BCTs, totaling 529 instances across interventions. Common BCTs included "action planning," "instructions on how to perform a behavior," "graded tasks," "demonstration of behavior," and "behavioral practice/rehearsal." Interventions using the 10 most common BCTs demonstrated overwhelmingly positive impacts on physical activity and social domain outcomes. However, these BCTs were not consistently present in interventions yielding positive outcomes in other domains, with greater variation in effects. Our study highlights the significance of identifying both BCTs and desired outcomes when designing physical activity interventions. We advocate for the use of a taxonomy in designing and implementing future programs to maximize effectiveness.

One research question, two meta-analyses, three conclusions: Commentary on "A systematic review with meta-analysis of Cognitive Bias Modification interventions for anger and aggression".

Recently two independent meta-analyses on the efficacy of Cognitive Bias Modification of Interpretation (CBM-I) to reduce aggressive behavior came to different conclusions: Ciesinski et al. (2023) concluded that "CBM demonstrates efficacy for the treatment of aggressive behavior" (Abstract), whereas our research team concluded that "findings show limited support for the efficacy of CBM-I to reduce aggressive behavior" (AlMoghrabi et al., 2023, Discussion). How can similar meta-analyses reach such different conclusions? In this commentary, we raise awareness concerning how 1) seemingly identical research questions can be based on meaningfully different definitions of the intervention and outcomes; 2) intervention efficacy conclusions can depend on outcome assessment type; and 3) the interpretation of underpowered moderator analyses should not depend on statistical significance. We end our commentary with a third, more nuanced conclusion that can reconcile the two disparate conclusions: that current CBM-I is an effective experimental manipulation to modify interpretation biases, but not an effective stand-alone treatment to reduce aggressive behavior.

Features of Studies on Transition Interventions for Childhood Cancer Survivors: A Scoping Review.

PURPOSE: in this scoping review, previously reported data were described and synthesized to document transition interventions in CCSs, and the features of intervention components of the current transition studies for CCSs were summarized. METHODS: A literature search was conducted in PubMed, Web of Science, EMBASE, PsycINFO, CINAHL, Ovid, and the Cochrane Library following the PRISMA-ScR statement. All original studies (n = 9) investigating transition interventions in CCSs were included. RESULTS: The current studies identified essential elements for transition programs, such as delivering knowledge, developing skills for coordination of care, and addressing psychosocial needs. However, the current transition interventions were generally in their infancy, and major deficits were found, including poorly reported intervention components and procedures, a limited number of relevant validated outcomes, and a failure to incorporate conceptual frameworks and international consensus statements. CONCLUSIONS: This scoping review mapped current evidence of transition interventions for CCSs and highlighted the paucity of data in this area. More high-quality and well-reported randomized controlled trials are needed for the enrichment and standardization of future transition interventions.

The Delivery of Person-Centered Care for People Living With Dementia in Residential Aged Care: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Person-centered care is the gold standard of care for people living with dementia, yet few systematic reviews have detailed how it is delivered in practice. This mixed-methods review aimed to examine the delivery of person-centered care, and its effectiveness, for people living with dementia in residential aged care. RESEARCH DESIGN AND METHODS: A systematic review and meta-analysis. Eligible studies were identified across 4 databases. Quantitative and qualitative studies containing data on person-centered care delivered to people with dementia living in residential aged care were included. Meta-analysis using a random-effects model was conducted where more than 3 studies measured the same outcome. A narrative meta-synthesis approach was undertaken to categorize verbatim participant quotes into representative themes. Risk of bias was undertaken using quality appraisal tools from the Joanna Briggs Institute. RESULTS: 41 studies were identified for inclusion. There were 34 person-centered care initiatives delivered, targeting 14 person-centered care outcomes. 3 outcomes could be pooled. Meta-analyses demonstrated no reduction in agitation (standardized mean difference -0.27, 95% confidence interval [CI], -0.58, 0.03), improvement in quality of life (standardized mean difference -0.63, 95% CI: -1.95, 0.70), or reduced neuropsychiatric symptoms (mean difference -1.06, 95% CI: -2.16, 0.05). Narrative meta-synthesis revealed barriers (e.g., time constraints) and enablers (e.g., staff collaboration) to providing person-centered care from a staff perspective. DISCUSSION AND IMPLICATIONS: The effectiveness of person-centered care initiatives delivered to people with dementia in residential aged care is conflicting. Further high-quality research over an extended time is required to identify how person-centered care can be best implemented to improve resident outcomes.

Development and evaluation of a concise nurse-driven non-pharmacological delirium reduction workflow for hospitalized patients: An interrupted time series study.

We created a concise nurse-driven delirium reduction workflow with the aim of reducing delirium rates and length of stay for hospitalized adults. Our nurse-driven workflow included five evidence-based daytime "sunrise" interventions (patient room lights on, blinds up, mobilization/out-of-bed, water within patient's reach and patient awake) and five nighttime "turndown" interventions (patient room lights off, blinds down, television off, noise reduction and pre-set bedtime). Interventions were also chosen because fidelity could be quickly monitored twice daily without patient interruption from outside the room. To evaluate the workflow, we used an interrupted time series study design between 06/01/17 and 05/30/22 to determine if the workflow significantly reduced the unit's delirium rate and average length of stay. Our workflow is feasible to implement and monitor and initially significantly reduced delirium rates but not length of stay. However, the reduction in delirium rates were not sustained following the emergence of the COVID-19 pandemic.

Effectiveness of comprehensive sexuality education curriculum on improving hostile and benevolent sexism among university students / 中国学校卫生

Objective@#To explore the effectiveness of a comprehensive sexuality education (CSE) curriculum on university students hostile and benevolent sexism, so as to provide a reference for evaluating the effects of CSE on reducing ambivalent sexism.@*Methods@#From September 2018 to January 2019, 165 university students from a university in Beijing were recruited using convenience sampling for a 5 month of CSE curriculum (36 sessions, 2 sessions per week, 45 min per session), including CSE and gender studies, sexual physiology and health, gender and gender roles, gender bias, intimate relationships and gender bias, gender based violence and gender bias, culture and gender bias, and gender and power. Students who took CSE curriculum were included in the intervention group ( n =97) and students from the same university who had not taken CSE curriculum were included in the control group ( n =68). Using the Ambivalent Sexism Inventory, both groups of university students were surveyed before and after the curriculum to analyze the effectiveness of the CSE curriculum. Chi -square test, ANOVA，cluster analysis and Kruskal Wallis test were used for statistical analysis.@*Results@#After the CSE curriculum, both hostile and benevolent sexism scores were lower in the intervention group (2.21±0.76, 2.36±0.68) than in the control group (2.81±0.61, 3.03±0.60) ( F =17.24, 33.26), and pre test scores were higher in the intervention group (2.64±0.67, 2.88±0.68) ( F =45.62, 66.93) ( P <0.01). On both hostile and benevolent sexism, female students scores (2.46±0.72, 2.65±0.70) were lower than male students scores (2.86±0.59, 3.09± 0.69 ) ( F=11.02, 14.20, P <0.01). Comparison of the curriculum effectiveness of hostile and benevolent sexism among clustered groups showed that the difference in hostile sexism scores was higher in the inconsistent type [0.63(0.25, 1.25)]than in the more consistent type [0.38(-0.16, 0.88)] and the lower consistent type [0.38(0.06, 0.63)] ( H=8.71, P <0.05); and the difference in benevolent sexism scores was higher in the more consistent type [0.75(0.53, 1.22)] than in the less consistent type [0.38(0.09, 0.88 )] and inconsistent type [0.38(-0.13,0.63)] ( H=10.82, P <0.05).@*Conclusions@#CSE can improve hostile and benevolent sexism in university students with sex and type differences. Attention should be paid to CSE curriculum to improve ambivalent sexism among university students with a view to fostering their awareness of gender equality.

Intervention effects of moderate and high intensities of classroom physical activity on cardiorespiratory fitness and executive function among junior grade one students in Tibetan / 中国学校卫生

Objective@#To explore the intervention effect of different intensity of classroom physical exercise on cardiorespiratory fitness and executive function of Tibetan first grade students at high altitude, so as to provide reference for improving the level of cardiorespiratory fitness and executive function of Tibetan adolescents.@*Methods@#From September to December 2020, 184 Tibetan students from five first grade classes in a middle school in Lhasa, Tibet, were randomly assigned into a control group (81 students in two classes) and an intervention group (103 students in three classes). Both groups followed the same teaching programme, but the intervention group received 36 sessions of moderate to high intensity classroom physical activity, one session per day, Monday,Wednesday and Friday, for 12 weeks. Before and after the intervention, cardiorespiratory fitness and executive function were tested by 20m round trip running and Flanker s experimental paradigm, 2-back s experimental paradigm, and More odd shifting experimental paradigm for inhibitory control, refreshing memory, and switching flexibility, and the results were analysed by analysis of covariance (ANCOVA) to compare the results of the pre and post intervention periods.@*Results@#The maximum oxygen uptake (VO 2max ) of Tibetan first grade students in the intervention group increased by 2.25 mL/(kg〖WW）〗·〖WW(〗min) compared with the control group after the intervention ( t =-3.89, P <0.01); the response time of the inhibitory function was reduced by 4.40 ms, that of the refreshing function by 196.06 ms, and that of the switching function by 92.72 ms in the intervention group compared with the control group ( t =2.98, 4.82 ,3.21, P <0.05).@*Conclusion@#The 12 week moderate to high intensity classroom physical activity intervention has different degrees of improvement effects on cardiorespiratory fitness and executive function in Tibetan adolescents.

Intervention effect of 12 week spinal health gymnastics on high and low shoulder exercise in adolescents / 中国学校卫生

Objective@#To explore the intervention effect of 12 week spinal health exercise on adolescents high and low shoulders, in order to provide empirical evidence for exploring simple and feasible measures to intervene.@*Methods@#In February 2023, 60 high and low shoulder students from a vocational high school in a certain county of Luzhou City were randomly selected as the research subjects by convenient sampling method. Paired sampling was used to randomly divide participants into an intervention group and a control group with 30 students each group. The intervention group received spinal health gymnastics intervention during 12 weeks of morning exercises and large break exercises for twice a day, with two groups each time; the control group maintained their previous morning exercises and large break exercises. A follow up study was conducted on the height difference between the left and right shoulder peaks of the intervention group and the control group students before intervention, after 12 weeks intervention, at 4 weeks post intervention. The t-test was used to analyze the changes in shoulder peak height difference between the intervention group and the control group.@*Results@#Before intervention, there was no statistically significant difference in the height of the left and right shoulder peaks between the intervention group [(2.50±1.19)cm] and the control group [(2.49±1.20)cm] adolescents ( t=0.05, P > 0.05). After 12 weeks of intervention, the difference in shoulder height between the left and right sides of adolescents in the intervention group decreased, compared to that before intervention [(1.43±1.15, 2.50±1.19)cm], while the control group increased compared to that before intervention [(2.58±1.19, 2.49±1.20) cm], and the differences were both statistically significant ( t= -78.17 , 20.15, P <0.05). At 4 weeks post intervention, there was no statistically significant difference in the height of the left and right shoulder peaks between the intervention group [(1.44±1.15)cm] and the control group [(2.59±1.18)cm] compared to 12 weeks after the intervention ( t=1.80, 1.05, P >0.05). The intervention group [(2.49±1.26, 2.52±1.16) (1.43±1.21, 1.44±1.13) (1.44±1.21, 1.45±1.14)cm] and the control group [(2.45±1.24, 2.52±1.20) (2.55±1.24, 2.61±1.18) (2.55±1.22, 2.62±1.18)cm] showed no statistically significant difference in the height of the left and right shoulder peaks between males and females before intervention, after 12 weeks of intervention, and after stopping intervention for 4 weeks ( t =-0.08, -0.03, -0.02; -0.15, -0.12, -0.15, P >0.05).@*Conclusions@#Spinal health gymnastics has a good effect on correcting high and low shoulders in adolescents. Spinal health gymnastics should be promoted on campus to promote adolescent posture health.

Effects of comprehensive intervention on 24 h activity behavior among obese students in vocational colleges / 中国学校卫生

Objective@#To explore the effects of comprehensive intervention measures targeting physical activity, sedentary, sleep and other behaviors on 24 h activity behavior of obese students in vocational colleges, so as to provide a more tailored empirical basis for intervening obese students in vocational colleges.@*Methods@#A quasi experimental design using parallel controlled, randomized grouping was conducted from January to March 2023. A total of 79 first year obese students from a vocational college in Wuxi City were selected as the intervention group (41 students) and the control group (38 students). From April to June, 2023, the control group received no intervention, while the intervention group adopted an information based and behavioral intervention approach to comprehensively intervene in 24 h physical activity, sedentary, sleep and other behaviors (120 minutes each day for 8 weeks).Wherein, information based intervention mainly used paper leaflets and social and learning software to accurately push intervention information, and behavioral intervention mainly concentrated 1 hour of physical exercise and multiple activity behavior requirements every day with the triaxial accelerometer to feedback the objective data of physical activity. Subsequently, from June to July, 2023, a one week post test and follow up survey were conducted respectively.Bouchard diary in physical activity, Weekly questionnaire and triaxial accelerometer were used to record the 24 h activity behavior of both groups of students. T-test and repeated measurement analysis of variance were used to compare the differences of 24 h activity component index time between two groups before and after intervention and examine the changes within each group.@*Results@#Before and after intervention, there was no significant difference in the time of each component index of 24 h activity behavior in the control group. However, repeated measures analysis of variance between the intervention group and the control group revealed statistically significant interaction differences in physical activity, sedentary behavior, sleep and other index time were statistically significant(pre-test and post test: F =6.45, 4.66 ,7.21,7.88; pre-test,post-test and follow up test: F =5.37,5.12,5.43,5.29; P <0.01). During the followup period, compared with the post-test data [(313.25±54.15, 601.88±65.47, 462.83±42.86, 61.92±18.53)min/d], the time of each component (physical activity, sedentary behavior, sleep, other) of the 24 h activity behavior of students in the intervention group rebounded [(298.52± 60.27 , 613.69±68.55, 442.33±45.26, 85.28±20.57)min/d], but it was better than the pre-test data [(230.45±67.42, 720.32±105.63, 369.78±32.31, 119.29±22.17)min/d], and the difference was statistically significant( F =42.46,39.45,33.41,59.43, P <0.01). During the intervention period, the physical activity, sedentary and sleep duration indicators of the intervention group students showed fluctuating patterns in the 4th and 5th weeks.@*Conclusions@#The comprehensive intervention on 24 h activity behavior among obese students in vocational colleges shows significant effectiveness, but its sustainability is insufficient. Considering the characteristics of obese students in vocational colleges, personalized intervention measures should be provided to increase physical activity and sleep time and reduce static activity time, in order to promote students to develop a healthy lifestyle.

Effects of group sports game intervention on social skills and quality of life in children with austism spectrum disorders / 中国学校卫生

Objective@#To explore the effects of group sports game intervention on social ability and quality of life of children with austism spectrum disorders (ASD),so as to provide reference for rehabilitation intervention of social and quality of life of children with ASD.@*Methods@#From September 2021 to January 2022, 72 children with ASD aged 4-6 in the children s rehabilitation department of Xiangyang Central Hospital were selected to participate in the study, and were randomly divided into experimental group ( n =36) and control group ( n =36). The control group received routine rehabilitation training (including individual sports game training), and the experimental group replaced individual sports game training with group sports game training on the basis of routine rehabilitation.The course content mainly included three parts: warm up before class, group sports games and relaxation after class. The course combined social skills with sports games, and was carried out in a group form (divided into 12 groups with 3 people in each group), and was trained five times a week for 60 minutes, for a total of 12 weeks. The scores of Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC), Social Responsiveness Scale (SRS) and Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) were observed before and after treatment. t-test and χ 2 test were used for statistical analysis.@*Results@#There was no significant difference in SRS scores between the experimental group and the control group before intervention ( t =-0.63, P >0.05). After the intervention, the total response rate in the experimental group was 83.33 %, higher than 41.67% in the control group χ 2=13.33, P <0.05),and the SRS scores decreased in the experimental group and control group ( t =17.75,8.71, P <0.05). The SRS scale score of the experimental group Social perception (17.67±4.12) , social cognition (30.33±4.99) , social communication (50.33±9.39) , social motivation (24.25±6.78) scores and total scores ( 152.67± 25.82) were lower than those of the control group(22.17±5.34，36.00±4.13，62.58±11.07，34.42±7.13，186.33±29.03)( t = -4.88，-2.03，-2.13，-3.58，-3.01， P ＜0.05).After the intervention, the scores of social function (53.33±18.01) and total score (283.83±51.83) on PedsQL 4.0 scale in experimental group were higher than those in control group(23.33±15.13，218.00±39.01) ( t =4.42，3.52， P ＜0.05). After the intervention, Autism Treatment Evaluation Scale (ATEC) scores of experimental groups(44.33±14.72) was lower than that in control group ( 59.33±16.95)( t =-2.32, P ＜0.05).@*Conclusion@#The intervention of group sports game has a significant effect on improving social ability and life quality of children with ASD.

Influence of group psychological counseling on mental health of children with authoritarian mothers / 中国学校卫生

Objective@#To explore the influence of group psychological counseling on the mental health of children with mother s authoritarian parenting.@*Methods@#From November 2022 to February 2023, 76 students from grades 4 to 6 whose mother showed authoritarian parenting style, while fathers adopted no authoritative, authoritarian or democratic parenting style and who scored ≥65 on the total MHT were selected using the Parenting Style Questionnaire (PBI) and the Mental Health Diagnostic Test (MHT). All the participants and their mothers were randomly assigned to the intervention and control groups. Before and after the intervention, participants filled out questionnaires on parental bonding instrument and mental health test. Control group: regular delivery of mental health education information, 2 times per week, for 8 weeks, without any other intervention. Intervention group: group counseling activities were conducted once a week. Each intervention lasted 1.5-2 hours and lasts for 8 weeks. Before and after the intervention, participants filled in the family parenting style and mental health screening questionnaires.@*Results@#After the intervention, compared with the control group, students in the intervention group showed a significant decrease in the total scale score of the MHT, learning anxiety, social anxiety, allergic tendency, physical symptoms, fear tendency, and impulsive tendency ( t=-0.43, -1.04 , -0.81, P >0.05). After intervention, the intervention group students showed a significant decrease in psychological diagnosis test scores, learning anxiety, anxiety towards others, allergic tendencies, physical symptoms, phobic tendencies, and impulsive tendencies compared to the control group students ( t=-20.00, -5.06, -2.09, -3.36, -6.15, -4.76, -5.15, P <0.05).@*Conclusion@#Rregular group psychological counseling can effectively improve the academic anxiety, social anxiety, allergic tendencies, physical symptoms, fearful and impulsive tendencies of students whose mothers with authoritarian parenting style, and greatly improve their mental health.

"Tus pies te llaman": Impacto de una intervención para mejorar autocuidado de pies en diabetes / "Your feet call you": Impact of an intervention to improve self-care of feet in diabetes

Resumen Objetivo: Evaluar el impacto de una intervención educativa individualizada en los conocimientos, autocuidado de los pies, control glucémico, riesgo de ulceración e incidencia de úlceras en pacientes con diabetes tipo 2. Material y Métodos: Estudio de intervención realizado en 65 pacientes ambulatorios, mayores de 35 años, con diabetes tipo 2, distribuidos aleatoriamente en dos grupos: grupo control (35) quien recibió un manual de cuidado de los pies, y grupo intervención (30) quien recibió la intervención, un kit de cuidado de los pies y un manual. El seguimiento se realizó a los tres y seis meses después de la intervención. El análisis estadístico incluyó la prueba de Chi-cuadrado, prueba de Wilcoxon y prueba ANOVA de mediciones repetidas. Resultados: La intervención mejoró los conocimientos y el autocuidado de pies en el grupo de intervención, con diferencias significativas entre grupos (p=.001), pero no mejoró el control glucémico ni el riesgo de ulceración. Conclusiones: El programa "tus pies te llaman" fue efectivo parcialmente, este estudio puede ser replicado en instituciones de primer nivel de forma ordinaria para mejorar el autocuidado y prevenir la ulceración del pie a mediano plazo.

Abstract Objective: To evaluate the impact of an individualized educational intervention on knowledge, self-care of the feet, glycemic control, risk of ulceration and incidence of ulcers in patients with type 2 diabetes. Material and Methods: The intervention study, was carried out on 65 outpatients, over 35 years of age, with type 2 diabetes, patients were randomly distributed into two groups: the control group (35), who received a manual on foot care, and the intervention group (30), who received the intervention, a foot care kit, and manual. Follow-up was done at three and six months after the intervention. Statistical analysis included the Chi-square test, Wilcoxon test and the ANOVA test of repeated measures. Results: The intervention improved knowledge and foot self-care in the intervention group with significant differences between groups (p=.001), but not the glycemic control or the ulceration risk. Conclusions: The program "Your Feet Call You" was partially effective, and this study can be ordinarily replicated in first-level institutions to improve self-care and prevent foot ulceration in the medium term.