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There are only a small number of reported intervention studies to improve health literacy among older populations. This paper reports on a study designed to investigate the feasibility and potential impact on health literacy and health practices of embedding an intervention programme to improve health literacy with older people through established primary health care units (PHCUs) in a disadvantaged urban community in Brazil. This investigation utilized a quasi-experimental design, with 42 participants recruited for the intervention group and comparison group. The Alfa-Health Program was offered by a nurse in a PHCU as part of the public universal health system over a period of 5 months, and was compared for its impact on a range of health literacy and self-reported health outcomes with routine health care available for older people. The intervention achieved relatively high levels of participation, and positive feedback from participants. Some improvements in vaccination rates, health literacy and reported health behaviours related to food choices and physical activity were observed. The intervention made good use of existing facilities; the content and methods were well received by the participants. However, there were some difficulties in recruitment and in retention of participants. The study has demonstrated the practical feasibility of delivering a comprehensive health education programme designed to improve health literacy in a PHCU in Brazil. [ABSTRACT FROM AUTHOR]

Purpose: Child participation in type 1 diabetes (T1D) self‐care is needed in developing countries due to a lack of resources, especially during the school day. This pilot study evaluated the feasibility of a therapeutic play intervention (ITP) versus standard education (SE) on the ability of children with T1D to correctly perform insulin injection technique. Design and Methods: Children with T1D (7–12 years) were recruited at two diabetes clinics in Brazil and randomized to ITP or SE. Registered nurses received protocol training to deliver the intervention and perform data collection. ITP group received an education that included a story about a child with T1D who self‐injects insulin at school; SE group received routine clinic‐based education. Preintervention, children were video‐recorded giving insulin injections to a doll; postintervention, children were rerecorded giving the doll an injection. The research team reviewed the videos and assessed the injection technique using validated checklists. Parents reported children's self‐injection practices at baseline and 30 days. Results: Children (N = 20, 40% male) were 9.6 ± 1.3 years old and had T1D for 3.6 ± 2.3 years; HbA1c was 9.1 ± 2.0%; 20% of ITP and 50% of SE children used syringes (vs. pens) for injections. At baseline, 80% of both groups knew how to self‐inject; most were taught by a parent/relative. Injection technique scores were low in both groups; ITP group increased their scores significantly postintervention. Practices of self‐injection did not change in either group after 30 days. Practice Implications: The play‐based intervention appeared to improve the injection technique in the short‐term. Pilot findings support the development of a larger trial to evaluate the effectiveness of ITP on educating children on insulin injections. [ABSTRACT FROM AUTHOR]

Background Oral diseases can negatively influence the quality of life causing harm in the development of routine activities, child development and their well-being. Aim To investigate the impact of dental caries, malocclusion and developmental defects of enamel ( DDE) on the oral health-related quality of life of preschool children and their parents. Design A cross-sectional study was carried out with 646 children aged 2-6 years in Diamantina, Brazil. Calibrated dental examiners performed the oral examinations. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale ( B- ECOHIS) and a questionnaire on socio-economic indicators. Statistical analyses involved the chi-square test and Poisson regression. Results Malocclusion and DDE did not cause a negative impact on the children's quality of life. Children with dental caries ( PR: 1.92; 95% CI: 1.56-2.35) and those aged 5 ( PR: 1.51; 95% CI: 1.13-2.02) and 6 years ( PR: 1.51; 95% CI: 1.02-2.23) were more likely to have a negative quality of life impact on the total B- ECOHIS. Conclusions Dental caries was associated with a negative impact on the quality of life of children. Malocclusion and DDE did not cause a negative impact on the children's quality of life. Older children had higher frequency of negative impact on OHRQo L. [ABSTRACT FROM AUTHOR]

Background and Objective The evidence of effectiveness of metronidazole ( Mtz) as an adjunct therapy to periodontal procedure in the treatment of patients with chronic periodontitis is not conclusive. The aim of this study was to compare the effect of Mtz (delivered locally as a gel or systemically as a tablet) as an adjunctive therapy with full mouth periodontal debridement (1 h of ultrasonic calculus/plaque removal) in smokers with chronic periodontitis. Material and Methods This pilot study involved 30 smokers with at least six teeth with a clinical attachment loss of ≥ 5 mm and probing pocket depth ( PPD) of ≥ 5 mm. They were randomly assigned into one of three groups ( n = 10): (i) 3 g daily of placebo gel applied topically (using a dental tray with the gel overnight) + periodontal debridement; (ii) 3 g daily of a 15% Mtz benzoate gel applied topically (using a dental tray with the gel overnight) + periodontal debridement; and (iii) a daily single dose of 750 mg Mtz (Flagyl®) + periodontal debridement. Clinical parameters (visible plaque index, gingival bleeding index [ GBI], relative attachment level and PPD) and quantitative analysis (by real-time polymerase chain reaction) of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia were assessed at baseline and at 1, 3 and 6 mo after periodontal debridement. Results There was no statistically significant difference in the average GBI and visible plaque index values at baseline between the groups ( p ≥ 0.05). There was no significant difference between groups in all parameters evaluated ( p ≥ 0.05). Significant reductions in GBI at 3 and 6 mo were observed in all groups ( p < 0.05). Significant reductions in both PPD and relative attachment level at 1, 3 and 6 mo were observed in all groups ( p < 0.05). Significant reductions in bacterial levels at 7 and 30 d were observed in all groups ( p < 0.05). Conclusion Adjunctive use of Mtz (gel or tablet) to periodontal debridement had similar clinical and microbiological improvement compared to treatment with placebo + periodontal debridement in smokers with chronic periodontitis up to 6 mo post-treatment. Further studies are necessary to confirm the clinical relevance of these findings. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of electroacupuncture on stress-related symptoms.sleep disorders, anxiety, depression and burnout.in medical students, and provide data to inform a power analysis to determinate numbers for future trials. Methods: Twenty-five students were randomly assigned to an electroacupuncture (n=12) group or control group (n=13) that did not receive treatment. Electroacupuncture was applied at a continuous frequency 2 Hz for 20 min once a week for 8 weeks at sites on the extremities, face, ear and scalp. The outcomes of the students treated with electroacupuncture were compared with those of the control group at the endpoint, controlling the influence of baseline scores. The instruments used were self-administered questionnaires that comprised the validated Portuguese version of the mini-sleep questionnaire (MSQ), the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Beck depression inventory (BDI), the Beck anxiety inventory, the Maslach burnout inventory-student survey (MBI-SS), and World Health Organization quality of life assessment -- abbreviated version (WHOQOL-bref). Results: The medical students treated with electroacupuncture showed a significant decrease compared with the control group for MSQ scores (p=0.04) and PSQI (p=0.006). After treatment, 75% students in the electroacupuncture group presented a good sleep quality, compared with 23.1% of the students in the control group. No significant difference on daytime sleepiness was shown by the ESS. The electroacupuncture group showed significant improvement on depressive symptoms (BDI), the emotional exhaustion and cynicism dimensions of burnout (MBI-SS) and physical health (WHOQOL-bref). Conclusions: Electroacupuncture was associated with a significant reduction of stress-related symptoms, but because of the study design the authors cannot say what proportion of the reduction was due to needle stimulation. [ABSTRACT FROM AUTHOR]