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In a context where pessimistic survival perceptions have been widespread as a result of the HIV/AIDS epidemic (Fig. 1A), we study vaccine uptake and other health behaviors during the recent COVID-19 pandemic. Leveraging a longitudinal cohort study in rural Malawi that has been followed for up to 25 y, we document that a 2017 mortality risk information intervention designed to reduce pessimistic mortality perceptions (Fig. 1B) resulted in improved health behavior, including COVID-19 vaccine uptake (Fig. 1C). We also report indirect effects for siblings and household members. This was likely the result of a reinforcing process where the intervention triggered engagement with the healthcare system and stronger beliefs in the efficacy of modern biomedical treatments, which led to the adoption of health risk reduction behavior, including vaccine uptake. Our findings suggest that health information interventions focused on survival perceptions can be useful in promoting health behavior and participation in the formal healthcare system, even during health crises--such as the COVID-19 pandemic--that are unanticipated at the time of the intervention. We also note the importance of the intervention design, where establishing rapport, tailoring the content to the local context, and spending time with respondents to convey the information contributed to the salience of the message. [ABSTRACT FROM AUTHOR]

Background: Early Detection of Deterioration in Elderly Residents (EDDIE +) is a multi-modal intervention focused on empowering nursing and personal care workers to identify and proactively manage deterioration of residents living in residential aged care (RAC) homes. Building on successful pilot trials conducted between 2014 and 2017, the intervention was refined for implementation in a stepped-wedge cluster randomised trial in 12 RAC homes from March 2021 to May 2022. We report the process used to transition from a small-scale pilot intervention to a multi-site intervention, detailing the intervention to enable future replication. Methods: The EDDIE + intervention used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to guide the intervention development and refinement process. We conducted an environmental scan; multi-level context assessments; convened an intervention working group (IWG) to develop the program logic, conducted a sustainability assessment and deconstructed the intervention components into fixed and adaptable elements; and subsequently refined the intervention for trial. Results: The original EDDIE pilot intervention included four components: nurse and personal care worker education; decision support tools; diagnostic equipment; and facilitation and clinical support. Deconstructing the intervention into core components and what could be flexibly tailored to context was essential for refining the intervention and informing future implementation across multiple sites. Intervention elements considered unsustainable were updated and refined to enable their scalability. Refinements included: an enhanced educational component with a greater focus on personal care workers and interactive learning; decision support tools that were based on updated evidence; equipment that aligned with recipient needs and available organisational support; and updated facilitation model with local and external facilitation. Conclusion: By using the i-PARIHS framework in the scale-up process, the EDDIE + intervention was tailored to fit the needs of intended recipients and contexts, enabling flexibility for local adaptation. The process of transitioning from a pilot to larger scale implementation in practice is vastly underreported yet vital for better development and implementation of multi-component interventions across multiple sites. We provide an example using an implementation framework and show it can be advantageous to researchers and health practitioners from pilot stage to refinement, through to larger scale implementation. Trial registration: The trial was prospectively registered with the Australia New Zealand Clinical Trial Registry (ACTRN12620000507987, registered 23/04/2020). [ABSTRACT FROM AUTHOR]

Objective: To use evidence on addressing racism in social care intervention research to create a framework for advancing health equity for all populations with marginalized social identities (e.g., race, gender, and sexual orientation). Such groups have disproportionate social needs (e.g., food insecurity) and negative social determinants of health (SDOH; e.g., poverty). We recommend how the Agency for Healthcare Research and Quality (AHRQ) could advance health equity for marginalized populations through social care research and care delivery. Data Sources and Study Setting: This commentary is informed by a literature review of social care interventions that were affiliated with healthcare systems; input from health equity researchers, policymakers, and community leaders attending the AHRQ Health Equity Summit; and consensus of the authors. Principal Findings: We recommend that AHRQ: (1) create an ecosystem that values research on SDOH and the effectiveness and implementation of social care interventions in the healthcare sector; (2) work with other federal agencies to (a) develop position statements with actionable recommendations about racism and other systems that perpetuate marginalization based on social identity and (b) develop aligned, complementary approaches to research and care delivery that address social marginalization; (3) advance both inclusive care delivery and inclusive research teams; (4) advance understanding of racism as a social determinant of health and effective strategies to mitigate its adverse impact on health; (5) advance the creation and scaling of effective strategies for addressing SDOH in healthcare systems, particularly in co‐creation with community partners; and (6) require social care intervention researchers to use methods that advance our understanding of social health equity. Conclusions: AHRQ, as a federal agency, could help advance health equity using a range of strategies, including using the agency's levers to ensure AHRQ stakeholders examine and address the unique experiences of socially marginalized populations in SDOH and social care intervention research. [ABSTRACT FROM AUTHOR]

The effective detection and fast intervention of the psychomotor disorders form a truly relevant opportunity in order to benefit the complete development and health of preschool minors who are under hazardous Cognitive Content conditions due to their social and financial disadvantages. Recent literacy reports that such hazardous conditions are possible to reduce based on the intervention of diverse social and educational environments which are the outcome of implementing psychomotor programs. Indeed, the Program for Stimulation of Children Development living at Vulnerable Communities (PEDICV, for its Colombian acronym), was created, from the Universidad de Córdoba's Extension Department, as a strategy in order to benefit minors' neurological development in those socially vulnerable communities at the towns of Sahagún and Lorica, located on Colombia's North-Eastern Caribbean area whereas it is understood that such social networks are regarded as high risk because of their above-mentioned social and economic adverse conditions. The main purpose of this research was to analyze the PEDICV effectiveness on preschool children's neurological development located at Lorica, Córdoba, Colombia, in which 100 preschool minors whose ages ranged between 4 and 6 years old, at the beginning of the analysis (M = 4.51; SD = .59). In which, 46 % of the subjects are male and the remaining 54 % are female. And attending an urban educational institution in Northern Colombian area, took part of said study. Likewise, two comparative groups, for the baseline study, were discriminated as follows: The first one consisted of 51 preschool children (selected at random for participating in the intervention group) which received the psychomotor stimulation using the PEDICV, and the other control group had 49 preschool children who did not receive the PEDICV. The psychomotor abilities development analysis, before and after the PEDICV was carried-out with the Third Version of the Escala Abreviada del Desarrollo (EAD-3) (Abbreviated Development Scale), which is very frequently used to identify risks at different Colombian minor preschool children's development areas based upon four different domains such as: Fine motor skill adaptive (FMSA), gross motor skill (GMS), language audition (LA), and the social personal (SP) area. The findings in regards to the execution of the herein program suggest, as a preview manner that such performance showed positive effects within all analyzed variables (FMSA: d = .95, GMS: d = .87, LA: d = 1.35, SP: d = .77), and relevant differences which had benefits on those children who received the psychomotor stimulation (FMSA: p = .001, GMS: p = .001, LA: p = .001, SP: p = .001) with the PEDICV. Significant gender differences were not evident among the researched preschool children after carrying-out the PEDICV as findings of this study supported the significance of cognitive content stimulation on children's health and development, and it proves to be a very useful tool for intervening and promoting the preschool minor's neurological development within their socially vulnerable contexts. Furthermore, all the above considerations indicate that findings from this research are positive as carrying-out the PEDICV could be replicated within other contexts which show or do not have similar characteristics. Therefore, it is considered as very relevant to set future work lines with the purpose of analyzing the psychomotor performance of preschool minors based on social and economic variables and various cultural contexts. [ABSTRACT FROM AUTHOR]

The importance of biopsychosocial factors in the genesis and maintenance of disease is increasingly being recognized. Most illnesses should be studied from a multifactorial perspective to facilitate understanding and treating them. Many psychopathological processes involve factors such as loneliness, hopelessness, and lack of social cohesion. As early as the nineteenth century, J.M. Charcot defined those illnesses in which no organic lesion was visible as functional disorders. Today, the anthropological view of illness known as the Heidelberg School provides us with a more global and comprehensible assessment of illness. The anthropological approach is complemented by a bioethical one, a bioethics of daily life which, as a practical science, studies and evaluates the living conditions of individuals, seeking practical solutions and contributing its reflections with deliberation and care. In this paper, we aim to highlight the most important factors that have an impact on illness by providing an anthropological view of illness and bringing bioethics closer to everyday life. [ABSTRACT FROM AUTHOR]

Background: World Health Organization (WHO) HEARTS packages are increasingly used to control hypertension. However, their feasibility in persons living with HIV (PLHIV) is unknown. We studied the effectiveness and implementation of a WHO HEARTS intervention to integrate the management of hypertension into HIV care. Methods: This was a mixed methods study at Uganda's largest HIV clinic. Components of the adapted WHO HEARTS intervention were lifestyle counseling, free hypertension medications, hypertension treatment protocol, task shifting, and monitoring tools. We determined the effectiveness of the intervention among PLHIV by comparing hypertension and HIV outcomes at baseline and 21 months. The RE-AIM framework was used to evaluate the implementation outcomes of the intervention at 21 months. We conducted four focus group discussions with PLHIV (n = 42), in-depth interviews with PLHIV (n = 9), healthcare providers (n = 15), and Ministry of Health (MoH) policymakers (n = 2). Results: Reach: Among the 15,953 adult PLHIV in the clinic, of whom 3892 (24%) had been diagnosed with hypertension, 1133(29%) initiated integrated hypertension-HIV treatment compared to 39 (1%) at baseline. Among the enrolled patients, the mean age was 51.5 ± 9.7 years and 679 (62.6%) were female. Effectiveness: Among the treated patients, hypertension control improved from 9 to 72% (p < 0.001), mean systolic blood pressure (BP) from 153.2 ± 21.4 to 129.2 ± 15.2 mmHg (p < 0.001), and mean diastolic BP from 98.5 ± 13.5 to 85.1 ± 9.7 mmHg (p < 0.001). Overall, 1087 (95.9%) of patients were retained by month 21. HIV viral suppression remained high, 99.3 to 99.5% (p = 0.694). Patients who received integrated hypertension-HIV care felt healthy and saved more money. Adoption: All 48 (100%) healthcare providers in the clinic were trained and adopted the intervention. Training healthcare providers on WHO HEARTS, task shifting, and synchronizing clinic appointments for hypertension and HIV promoted adoption. Implementation: WHO HEARTS intervention was feasible and implemented with fidelity. Maintenance: Leveraging HIV program resources and adopting WHO HEARTS protocols into national guidelines will promote sustainability. Conclusions: The WHO HEARTS intervention promoted the integration of hypertension management into HIV care in the real-world setting. It was acceptable, feasible, and effective in controlling hypertension and maintaining optimal viral suppression among PLHIV. Integrating this intervention into national guidelines will promote sustainability. [ABSTRACT FROM AUTHOR]

The generalized risk-adjusted cost-effectiveness (GRACE) analysis method modifies standard cost-effectiveness analysis (CEA), the primary method currently used worldwide to value health improvements arising from healthcare interventions. Generalizing standard CEA, GRACE allows for decreasing or even increasing returns to health. Previous presentations of GRACE have relied extensively on Taylor Series expansion methods to specify key model parameters, including those that properly adjust for illness severity and preexisting disability, consequences of uncertain treatment outcomes, and the marginal rate of substitution between life expectancy and health-related quality of life. Standard CEA cannot account for these sources of value or cost in its valuation of medical treatments. However, calculations of GRACE measures based on Taylor Series are approximations, which may be poorly behaved in some contexts. This paper provides a new approach for implementing GRACE, using exact utility functions instead of Taylor Series approximations. While any proper utility function will suffice, we illustrate with three well-known functions: constant relative risk aversion (CRRA) utility; hyperbolic absolute risk aversion (HARA) utility, of which CRRA is a special case; and expo-power (EP) utility, of which constant absolute risk aversion (CARA) is a special case. The analysis then extends from two-period to multiperiod models. We discuss methods to estimate parameters of HARA and EP functions using two different types of data, one from discrete choice experiments and the other from "happiness economics" methods. We conclude with some reflections on how this analysis might affect benefit-cost analysis studies of healthcare interventions. [ABSTRACT FROM AUTHOR]

Background: This study aimed at evaluating the effect of the "Walk," an 8-month physical activity (PA) program led by classroom and physical education teachers, on the motor competence (MC) and PA of 5- to 6-year-old children. Methods: A total of 143 children (mean age = 61.51 [1.85] mo) participated in the study and were randomly assigned to the experimental and control groups. Children's MC was assessed by the Körperkoordination Test für Kinder (KTK), and PA was objectively measured by Omron HJ-720IT-E2 pedometers. Measurements were performed at baseline, midintervention, and postintervention. A 1-sample t test computed at baseline step counts revealed that children presented significantly lower PA than recommended for their age (P <.001). To examine the effect of the intervention on children's MC and PA, several repeated-measures analyses of variance were utilized on (1) KTK item scores and (2) pedometer data. Results: The results revealed that the Walk project led to practically significant changes in the experimental group compared with the control group in both MC (P <.001, η2 >.14 for all KTK items) and PA (P <.001, η2 =.23). Conclusions: This study highlights the efficacy of a PA project, involving both classroom and physical education teachers, for the enhancement of children's MC and PA. [ABSTRACT FROM AUTHOR]

Background: The purpose of this systematic review was to evaluate the existing scientific literature on e- and mHealth interventions promoting physical activity (PA) among African American (AA) and Hispanic women. Methods: Using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, 5 electronic databases and gray literature sources were searched in August 2017. Inclusion criteria are published in English language peer-reviewed journals between 2000 and 2017, use of an e- or mHealth delivery strategy to promote PA, primary focus on AA or Hispanic women, and reported PA outcome data. Results: Ten articles met inclusion criteria for review, 6 studies focused on AA women and 4 studies on Hispanic women. The majority (n = 8) were pilot studies; only 2 studies were full-scale randomized controlled trials and both focused on Hispanic women. Six studies (60%) used websites as the primary method of intervention delivery, 3 studies (30%) used text messaging, and 1 study (10%) used the social networking website Facebook. In total, 70% of the studies (n = 7) reported significant within- or between-group differences for at least 1 PA outcome. Conclusions: Findings provide preliminary support for e- and mHealth PA interventions among AA and Hispanic women. However, future large-scale, rigorously designed, randomized controlled trials are needed to further explore their effectiveness among AA and Hispanic women. [ABSTRACT FROM AUTHOR]

Background: During lactation, women may lose up to 10% of bone mineral density (BMD) at trabecular-rich sites. Previous studies show that resistance exercise may slow BMD; however, the long-term effects of exercise on BMD during lactation have not been reported. Objective: To evaluate the effect of two 16-week exercise interventions (4- to 20-wk postpartum) in lactating women at 1-year postpartum on lumbar spine, total body, and hip BMD. Methods: To increase sample size at 1-year postpartum, two 16-week exercise interventions were combined for analysis. At 4-week postpartum, 55 women were randomized to intervention group (weight bearing aerobic exercise and resistance exercise) or control group (no exercise) for 16-week, with a 1-year postpartum follow-up. BMD was measured by dual-energy X-ray absorptiometry. Repeated-measures analysis of covariance was used to test for time and group differences for BMD controlling for prolactin concentration and dietary calcium at 1-year postpartum. Results: Change in lumbar spine BMD was significantly different over time and between groups from 4-week to 1-year postpartum, when controlling for prolactin concentration and dietary calcium. There were no significant differences between groups in total body and hip BMD. Conclusion: These results suggest that resistance exercise may slow bone loss during lactation, resulting in higher BMD levels at 1-year postpartum. [ABSTRACT FROM AUTHOR]

Background: Facebook has over 1.8 billion users and offers unique opportunities for health intervention delivery due to its popularity, flexibility, high engagement, and social connectedness. Methods: This study aimed to determine the effectiveness of the Mums Step It Up (MSIU) Facebook app, a team-based, 50-day physical activity intervention for postpartum women. A total of 120 postpartum women were recruited and randomly allocated to 1 of 3 conditions: MSIU (n = 41), pedometer only (n = 39), and control (n = 40). Assessments were completed at baseline, 6 weeks, and 6 months. Primary outcomes were accelerometer moderate to vigorous physical activity and self-reported walking. Analyses were undertaken on an intention to treat basis using random effects mixed modeling (P ≤.05). Compliance and engagement with the MSIU app were analyzed, descriptively. Results: There were no significant differences in changes in moderate to vigorous physical activity (P =.81, 6 wk; P =.91, 6 mo) or self-reported walking (P =.55, 6 wk; P =.90, 6 mo) across the 3 conditions. High engagement with the MSIU app was evident, with participants on average visiting the app 26 times and logging steps for 48/50 days. Conclusion: Although engagement with the MSIU app was promising, the nonsignificant results suggest that further work needs to be done to enhance efficacy for postpartum women. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the multidisciplinary treatment intervention for patients with nonsyndromic oligodontia, focusing on both the preprosthodontic intervention and the type of prosthodontic and functional occlusal units at the end of treatment.Materials and Methods: A retrospective study on the multidisciplinary treatment of 24 patients with agenesis of 8 to 22 (median 15) permanent teeth was carried out by reviewing the patients' medical records, preprosthodontic surgical and orthodontic procedures, and the final dental and prosthodontic status.Results: A total of 23 patients underwent orthodontic treatment, and one-third of them had additional orthognathic surgery. Presurgical intervention involved bone augmentation in 20 patients and insertion of 2 to 16 implants per patient (median 8). The number of implants was positively correlated with the number of missing teeth (P = .004). At the end of treatment, the number of functional occlusal units ranged from 20 to 28 (median 24). A single-tooth crown was mounted on 167 implants, 32 implants were part of a fixed partial denture, and 29 fixed partial dentures were tooth-borne.Conclusion: The treatment of patients with severe oligodontia is comprehensive and complex. Irrespective of the number of congenitally missing teeth, the final functional occlusion consisted of a minimum of 20 units, which in addition to permanent teeth included preserved deciduous teeth, implants, and fixed partial dentures. [ABSTRACT FROM AUTHOR]

The position of the analyst in the direction of the cure, and in particular in the end of analysis, is central when conceptualizing professional practice. An axis of the research results is the comparison of the Lacanian and Freudian conceptualizations. In order to fulfill the objectives, a bibliographical review of selected works by the authors was carried out, specifying the theoretical-clinical categories enunciated. In the results obtained, the contrast between the perspective of both authors is found. The Freudian perspective in relation to the end of analysis revolves around the question of the possibility of reaching this stage in the analytic work, since it introduces the dimension of the traumatic factor, the drive intensity, among other dimensions. Lacan proposes a logical formulation regarding the end of analysis, the clinic, and the position of the analyst in his listening. Some of the results are: the relationship between the position of the analyst at the end of an analysis, with the psychoanalytic conceptualization of the cure, the analytic position and its relationship with the politics of psychoanalysis. For the revision of the conceptual-clinical categories, two Freudian histories were taken up: "On the psychogenesis of a case of female homosexuality" (1920), and "History of an infantile neurosis" (1917-1919), these allowed to account for The position of the analyst at the end of the treatment. The results allow establishing lines for the reading of the analyst's interventions at the end of a treatment, and contribute to the discussions within psychoanalysis. [ABSTRACT FROM AUTHOR]

High-quality health research is central to evidence-informed health care. Towards equitable health care access: community participatory research exploring unmet health care needs of homeless individuals. Such barriers are likely to be inherited by the health research environment where there is crossover between healthcare and research teams, and where recruitment and study procedures are carried out by clinical staff. [Extracted from the article]

We reflect on how qualitative research can be used to develop or refine theories about how the mechanisms triggered by intervention enactment might generate outcomes, referring to examples from a 'realist trial' of a whole-school health intervention. Qualitative research can explore mechanisms directly, by asking participants how they think interventions work, or indirectly, by exploring participant experiences of intervention-related actions to understand the conditions and consequences of these actions. Both of these approaches can inform theorisation of how mechanisms are triggered and generate outcomes, and how this is contingent on context. We discuss methods for sampling, data collection and data analysis, and recommend dimensional analysis as a means to analyse qualitative data on mechanisms. We then consider how to draw on qualitative research to inform hypotheses to be tested statistically. [ABSTRACT FROM AUTHOR]

Background: The activity-stat theory infers that total physical activity (PA) in children is constant, independent of environmental interventions. Methods: We conducted a 3-year prospective population-based controlled PA intervention study including, at baseline, 7- to 9-year-old children (66 boys, 40 girls in the intervention and 50 boys, 38 girls in the control group). PA was increased in the intervention group from 60 to 200 minutes/week, while the controls maintained 60 minutes/week. We registered weekly duration of total PA and leisure-time PA and daily duration of sedentary activities, through questionnaires at baseline and 2 and 3 years after baseline. Results: Between intervention and control groups PA was similar before intervention start. After intervention start, total PA in both genders was increased during the entire period (P-values adjusted for age and Tanner stage at follow-up between 0.001 and 0.002). Duration of sedentary activities was unchanged with no group differences. Children in the intervention group changed their behavior so that they also achieved more leisure-time PA. Conclusion: A 3-year school-based PA intervention program in prepubertal children increases the duration of total PA without increasing the duration of sedentary activities, and the program seems to initiate more PA during leisure-time. Our results refute the activity-stat theory. [ABSTRACT FROM AUTHOR]

The impact of misinformation about vapes' relative harms compared with smoking may lead to increased tobacco-related burden of disease and youth vaping. Unfortunately, vaping misinformation has proliferated. Despite growing attempts to mitigate vaping misinformation, there is still considerable ambiguity regarding the ability to effectively curb the negative impact of misinformation. To address this gap, we use a meta-analysis to evaluate the relative impact of interventions designed to mitigate vaping-related misinformation. We searched (from January 2020 till August 2021) various databases and gray literature. Only English language, original studies that employed experimental designs where participants were randomly assigned either to receive mitigating information or to a no-mitigation condition (either misinformation-only or neutral control) were included. Meta-analysis was conducted for the four eligible studies. The mean effect size of attempts to mitigate vaping misinformation was positive but not statistically significant (d = 0.383, 95% CI [−0.029, 0.796], p =.061, k = 5) with lack of evidence for publication bias. Given limited studies included, we were unable to determine factors affecting the efficacy of interventions. The limited focus on non-US studies and youth populations is concerning given the popularity of vaping in low- to middle-income countries (LMICs) and among youth. The findings of this meta-analysis describe the current state of the literature and prescribe specific recommendations to better address the proliferation of vaping misinformation, providing insights helpful in limiting the tobacco mortality burden and curtailing youth vaping. [ABSTRACT FROM AUTHOR]

Ensuring people have access to their preferred method of contraception can be key for meeting their reproductive goals. A growing number of mHealth interventions show promise for improving access to contraception, but no literature review has identified the effects of mHealth interventions among both adolescents and adults in the United States. The purpose of this systematic review was to describe the format, theoretical basis, and impact of mHealth interventions for contraceptive behavior change (contraceptive initiation and continuation) among people of all ages in the US. A systematic review of the literature was conducted using six electronic databases guided by Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Data on study design, frequency, duration, mHealth modality, contraceptive method, behavior change theory, and behavioral outcome were extracted to facilitate comparison. Eighteen studies met eligibility criteria. The majority (11; 61%) used SMS (short message service). Twelve studies focused on contraceptive initiation, most (n = 8) of which also measured continued use over time. The remaining six interventions focused on continuation alone, generally through appointment reminders. Very little contraceptive behavior change was identified across studies. Current mHealth interventions may hold promise for some health areas but there is little evidence that they change contraceptive behavior. Future mHealth interventions should focus on assessing person-centered outcomes, including satisfaction, side effects, and reasons for discontinuation, to best support people to use their preferred contraceptive method. [ABSTRACT FROM AUTHOR]

Background: With the ever-increasing demand on acute healthcare, the hospital discharge process and delayed discharges are considered relevant in achieving optimal performance in clinical settings. The purpose of this paper is to review the literature to identify conceptual and operational definitions of delayed discharges, identify causes and effects of delayed discharges, and also to explore the literature for interventions aimed at decreasing the impact (in terms of reducing the number/rate of delays) of delayed discharges in acute healthcare settings. Methods: An extensive literature search yielded a total of 26 248 records. Sixty-four research articles were included in the scoping review after considering inclusion/exclusion criteria and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) search strategy. The following databases were utilized: Cochrane, EBSCO, PubMed, PubMed Central, Medline, and Web of Science. The search was carried out between January 2017 and March 2020 and covered literature ranging from 1990 to 2019. Results were reviewed by authors for duplicates and filtered using the inclusion/ exclusion criteria. Tables were created to classify the chosen articles (n = 64), allowing us to organise findings and results. Results: Conceptual and operational definitions were analysed. In turn, causes and effects of delayed discharges were extracted and represented in diagrammatic format, together with specific interventions used in acute healthcare settings to lessen the effect of delayed discharges. Operational definitions of delayed discharges were found to be more difficult to establish, particularly in the light of the vast number of different scenarios and workplace interventions uncovered in the literature. The main causes of delayed discharges were faulty organisational management, inadequate discharge planning, transfer of care problems, and age. The main effects were bed-blocking, A&E (Accident & Emergency) overcrowding, and financial implications. The main interventions included 'discharge before noon' initiative, 'discharge facilitation tools,' 'discharge delay tracking' mechanisms, and the role of general practitioners and social care staff. Conclusion: This paper fills a gap in the fragmented literature on delayed inpatient discharges by providing a researchbased perspective on conceptual and operational definitions, causes and effects, as well as interventions to minimize their impact. The findings and definitions are intended as points of reference for future research. [ABSTRACT FROM AUTHOR]

The objective is to analyze the scope of the National Civil Protection System (SINAPROC) and the National Health System (SNS), and its relationship to the attention of the COVID-19 pandemic. The study is within the approach to disaster risk, considering how the concretion of a threat, exposition and vulnerability can affect society. The first part makes a diagnosis of the impact of disasters associated with natural phenomena, as well as the evolution of the Covid-19. Subsequently, the legal framework underpinning both systems is discussed, considering their structure and components for identifying possible mechanisms of collaboration. Among the conclusions is that, despite being two vertical models of intervention, the legislation incorporates both health and disaster risk, which could complement each other. At the end of the pandemic, the strategy to strengthen the health risk management model should be evaluated from the disaster risk approach. [ABSTRACT FROM AUTHOR]

This article describes facilitators and recommendations of health care providers in HIV clinics for the implementation of pre-exposure prophylaxis (PrEP) in Colombia. A qualitative study was conducted using semi-structured interviews with twenty health care providers in nine clinics. In addition, the "Consolidated Framework for Implementation Research" was used to guide data collection and the analysis. Results are as follow: 1. Characteristics of the intervention : providers recognize PrEP as an innovative therapy with proven effectiveness; they recommend that it should be implemented by national regulations of the Ministry of Health and Social Protection with centralized purchase of medicines and adaptations to regional diversities. To assemble PrEP in clinics, they recommend linking it to preventive Sexual Health Programs, guided by trained interdisciplinary teams. 2. External environment : it was recommended to strengthen networking with the Secretaries of Health, Profamilia and LGTBI organizations; change contracting conditions with Health Promoting Entities to include PrEP aimed at partners of patients with HIV, and finance people who cannot pay for it with public resources. 3. Internal environment : climate and availability of implementation perceived as favorable for the adoption of PrEP. In order to reduce organizational tensions due to change, expanding training plans are recommended. 4. Implementation process : the design of national, local and institutional plans is recommended, as well as the attraction of key internal and external leaders. It is concluded that health providers in the HIV clinics in Colombia perceive a favorable environment for the adoption of PrEP in the country. [ABSTRACT FROM AUTHOR]

Introduction: South Africa is an upper middle-income country with wide wealth inequality. It faces a quadruple burden of disease and poor health outcomes, with access to appropriate and adequate health care a challenge for millions of South Africans. The introduction of large-scale, comprehensive community health worker (CHW) programs in the country, within the context of implementing universal health coverage, was anticipated to improve population health outcomes. However, there is inadequate local (or global) evidence on whether such programs are effective, especially in urban settings.Methods: This study is part of a multi-method, quasi-experimental intervention study measuring effectiveness of a large-scale CHW program in a health district in an urban province of South Africa, where CHWs now support approximately one million people in 280,000 households. Using interviewer administered questionnaires, a 2019 cross-sectional survey of 417 vulnerable households with long-term CHW support (intervention households) are compared to 417 households with no CHW support (control households). Households were selected from similar vulnerable areas from all sub-levels of the Ekurhuleni health district.Results: The 417 intervention and control households each had good health knowledge. Compared to controls, intervention households with long-term comprehensive CHW support were more likely to access early care, get diagnosed for a chronic condition, be put on treatment and be well controlled on chronic treatment. They were also more likely to receive a social grant, and have a birth certificate or identity document. The differences were statistically significant for social support, health seeking behavior, and health outcomes for maternal, child health and chronic care.Conclusion: A large-scale and sustained comprehensive CHW program in an urban setting improved access to social support, chronic and minor acute health services at household and population level through better health-seeking behavior and adherence to treatment. Direct evidence from households illustrated that such community health worker programs are therefore effective and should be part of health systems in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To systematically evaluate the effects of mobile health care management on medication compliance of patients with hypertension. METHODS: PubMed, CNKI and Wanfang Data were retrieved to collect the randomized controlled trials of effects of mobile health care management on medication compliance of patients with hypertension (the control group was treated with conventional medication treatment + nursing care management, while the study group received intervention of mobile health care management on the basis of routine management of the control group) . After literature screening according to the research objectives, literature quality was evaluated, and Meta-analysis was performed by using RevMan 5. 3 software. RESULTS: Totally 12 articles were enrolled, including2 371 patients (1 184 patients in the study group and 1 187 patients in the control group) . Meta-analysis showed that compared with the conventional management, after the application of mobile health care management methods, the medication compliance scores of patients with hypertension were significantly improved, and the difference was statistically significant (SMD = 0. 76, 95% CI = 0. 51-1. 00, P < 0. 000 01) . Compared with the conventional management, the application of mobile health care management could effectively improve the medication compliance scores for 3 months (SMD = 0. 94, 95% CI = 0. 19-1. 68, P = 0. 01), and the medication compliance scores remained at the high level for 12 months (SMD = 0. 96, 95% CI = 0. 40-1. 51, P = 0. 000 7), the differences were statistically significant. The most significant reduction in systolic pressure was observed at 3 months of mobile health care management application[MD =-7. 63 mm Hg (1 mm Hg = 0. 133 kPa), 95% CI =-12. 39--2. 86, P = 0. 002], and the patients still had significantly lower systolic pressure at 6 months (MD =-5. 55 mm Hg, 95% CI =-7. 68--3. 42, P < 0. 000 01) (but the magnitude was less than at 3 months), the differences were statistically significant compared with the conventional management. Patients showed the most significant reduction in diastolic pressure at 6 months of mobile health care management application, with statistically significant difference compared with the conventional management (MD =-3. 36 mm Hg, 95% CI =-5. 11--1. 62, P = 0. 000 2) . And the downward trend of blood pressure continued to 12 months. CONCLUSIONS: Mobile health care has natural advantages in the treatment and management of chronic diseases such as hypertension, and could play an important role in medical services in the future. [ABSTRACT FROM AUTHOR]

Background: To determine the health system costs and health-related benefits of interventions for the prevention and control of non-communicable diseases (NCDs), including mental health disorders, for the purpose of identifying the most cost-effective intervention options in support of global normative guidance on the best-buy interventions for NCDs. In addition, tools are developed to allow country contextualisation of the analyses to support local priority setting exercises. Methods: This analysis follows the standard WHO-CHOICE (World Health Organization-Choosing Interventions that are Cost-Effective) approach to generalized cost-effectiveness analysis applied to two regions, Eastern sub-Saharan Africa and South-East Asia. The scope of the analysis is all NCD and mental health interventions included in WHO guidelines or guidance documents for which the health impact of the intervention is able to be identified and attributed. Costs are measured in 2010 international dollars, and benefits modelled beginning in 2010, both for a period of 100 years. Results: There are many interventions for NCD prevention and management that are highly cost-effective, generating one year of healthy life for less than Int. $100. These interventions include tobacco and alcohol control policies such as taxation, voluntary and legislative actions to reduce sodium intake, mass media campaigns for reducing physical activity, and treatment options for cardiovascular disease (CVD), cervical cancer and epilepsy. In addition a number of interventions fall just outside this range, including breast cancer, depression and chronic lung disease treatment. Conclusion: Interventions that represent good value for money, are technically feasible and are delivered for a low per-capita cost, are available to address the rapid rise in NCDs in low- and middle-income countries. This paper also describes a tool to support countries in developing NCD action plans. [ABSTRACT FROM AUTHOR]

Background: Information on cost-effectiveness allows policy-makers to evaluate if they are using currently available resources effectively and efficiently. Our objective is to examine the cost-effectiveness of health interventions to improve maternal, newborn and child health (MNCH) outcomes, to provide global evidence relative to the context of two geographic regions. Methods: We consider interventions across the life course from adolescence to pregnancy and for children up to 5 years old. Interventions included are those that fall within the areas of immunization, child healthcare, nutrition, reproductive health, and maternal/newborn health, and for which it possible to model impact on MNCH mortality outcomes using the Lives Saved Tool (LiST). Generalized cost-effectiveness analysis (GCEA) was used to derive average cost-effectiveness ratios (ACERs) for individual interventions and combinations (packages). Costs were assessed from the health system perspective and reported in international dollars. Health outcomes were estimated and reported as the gain in healthy life years (HLYs) due to the specific intervention or combination. The model was run for 2 regions: Eastern sub-Saharan Africa (SSA-E) and South-East Asia (SEA). Results: The World Health Organization (WHO) recommended interventions to improve MNCH are generally considered cost-effective, with the majority of interventions demonstrating ACERs below I$100/HLY saved in the chosen settings (lowand middle-income countries [LMICs]). Best performing interventions are consistent across the two regions, and include family planning, neonatal resuscitation, management of pneumonia and neonatal infection, vitamin A supplementation, and measles vaccine. ACERs below I$100 can be found across all delivery platforms, from community to hospital level. The combination of interventions into packages (such as antenatal care) produces favorable ACERs. Conclusion: Within each region there are interventions which represent very good value for money. There are opportunities to gear investments towards high-impact interventions and packages for MNCH outcomes. Cost-effectiveness tools can be used at national level to inform investment cases and overall priority setting processes. [ABSTRACT FROM AUTHOR]

Student retention is a key outcome measure for post-secondary education, but data show relatively stagnant retention rates over the past decade. Longstanding interventions such as counseling, academic advising, and mentoring provide crucial student services, but little change in retention rates suggest there is still need for additional student supports. Within the landscape of higher education, academic coaching is a relatively new, yet burgeoning intervention designed to increase student retention and success. Despite rapid growth of the intervention, little empirical work has been done to systematically describe and evaluate such programs. In this study, we provide a rich description of one academic coaching program and use a quasi-experimental design to evaluate the program's effects on student outcomes. We investigate two research questions: 1) how does academic coaching influence key student outcomes? and 2) to what extent do these effects vary by amount of coaching received? On average, we found that students with prior semester grade point averages from 1.0—2.0 who participate in the academic coaching program earn grade point averages about 0.4 points higher during the coaching semester, are about 10% more likely to enroll in the semester following coaching, and earn about two more credits in the semester following coaching than students who choose not participate in the program. Outcomes varied minimally based on the number of coaching appointments students attended. [ABSTRACT FROM AUTHOR]

We develop a model to formulate the mutual referral process in a health care system involving a city hospital and a community hospital, and derive the optimal mutual referral strategy between them in the subordination situation as a benchmark. We also concentrate on the subcontracting situation, where the city hospital plays a dominating role, offering contracts to induce the community hospital to follow the optimal mutual referral strategy. We introduce two complex contracts: fee-for-service via cost sharing (FFS-CS) and pay-for-performance via cost sharing (P4P-CS) to coordinate, and find that both contracts coordinate effectively, regardless of the scale of the system. In addition, we discuss four extreme cases: fee-for-service via no cost sharing (FFS-NCS), fee-for-service via total cost sharing (FFS-TCS), pay-for-performance via no cost sharing (P4P-NCS), and pay-for-performance via total cost sharing (P4P-TCS) and find that some can coordinate the health care system under certain circumstances, whereas others cannot. Through the numerical examples we discuss the applicability of the coordinating contracts and further find that FFS-CS outperforms P4P-CS in terms of applicability. [ABSTRACT FROM PUBLISHER]

Una intervención sanitaria en una crisis compleja como la de Cabo Delgado (Mozambique) solo puede tener éxito si la comunidad se compromete de forma efectiva y participa activamente en la respuesta. [ABSTRACT FROM AUTHOR]

Reddit is an anonymous social media platform that allows users to create, modify, share, and discuss content. While this platform is widely used by mainstream audiences, little research exists on how Redditors respond to health information when it appears in general, non-health specific forums called subreddits. Guided by media system dependency theory, the purpose of this study was to anonymously intervene on college subreddits to explore how Redditors interacted with messages about smoke-free policy compliance. Two messages were posted two weeks apart on ten college subreddits, yielding 370 comments (per thread range = 66-0) and 552 Karma points (per thread range = 123-0). A content analytic approach was employed, identifying eight content themes, and classifying message tone. The most popular themes were general smoking [n = 85], animosity toward smoke-free policies/compliance [n = 68], and smoke-free policy/compliance support [n = 65]). Most comments expressed a neutral tone [n = 196]. Data suggest that Redditors are willing to interact with health content on their college subreddits to varying degrees, especially if this content conforms to norms of the subreddit and/or platform. Implications from the findings suggest important considerations for use of Reddit as a future site for health interventions. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, there has been a global surge in the development and implementation of digital interventions to diagnose, track, prevent and mitigate the spread of the SARS-CoV-2 coronavirus. To date, however, there has been little research to characterise the vast scope and scale of these novel, ad hoc and widely varied digital tools. This paper helps fill this gap by providing a descriptive summary of the digital response to COVID-19. The research finds that the digital response can be broken into four main categories: 1) tracking the spread of the virus (contact tracing); 2) controlling social behaviour during the outbreak (social behaviour monitoring); 3) information gathering and dissemination about the virus (one-way and two-way public communications); and 4) diagnosis and treatment (remote diagnostics and treatment). This paper describes the four response categories and provides examples of the digital technologies being developed and implemented for these purposes. This descriptive understanding provides a contextual foundation for subsequent research to analyse the opportunities and challenges associated with the development, implementation and uptake of digital interventions, alongside the development of analytical frameworks and guidance. [ABSTRACT FROM AUTHOR]

Copyright of KONTAKT - Journal of Nursing & Social Sciences related to Health & Illness is the property of University of South Bohemia in Ceske Budejovice, Faculty of Health & Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The friction cost approach (FCA) is one way to estimate lost productivity, which considers the time taken to replace an employee, known as the friction period. The friction period may be influenced by local labour market conditions, limiting the relevance of international FCA estimates. The objective was to estimate the time and costs of replacing an employee in Australia. Methods: Staff responsible for recruitment in businesses across Australia were surveyed about the last management and non-management employee hired, workforce composition, friction period time and costs, and team dynamic effects. Primary analyses were conducted on respondents that recruited in the past 12 months. The friction period was decomposed into three periods: recruitment decision, recruitment period, and training period. Descriptive statistics of the friction period time and costs, and team dynamic effects were calculated. Results: The sample consisted of Australian businesses (N = 274), primarily micro-organisations (2–4 employees, 44%) in urban locations (75%). The time (12.3 weeks; SD 15.1) and costs ($6230; SD $17,502) to replace a manager were higher than those to replace non-managers (10.0 weeks, SD 13.01; $2666, sd $7849). The training period represented the longest time component in replacing an employee (38–40% of the total friction period). There was an increasing impact on other employees' productivity, particularly for absent managers as time off work increased. Conclusions: The friction period in Australia was similar to international estimates. Interestingly, the friction period mainly consisted of time outside the recruitment period; the decision to recruit and the training period. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to provide an updated systematic review of randomized controlled trials that studied the effectiveness of pharmacological and nonpharmacological interventions to prevent aspiration pneumonia in older adults at risk for aspiration. Method: The search was conducted in MEDLINE (PubMed), Scopus, and Web of Science databases and the Cochrane Central Register of Controlled Trials, using a protocol registered on PROSPERO (CRD42019139973). Randomized controlled trials of interventions to reduce the incidence of aspiration pneumonia in individuals older than 65 years at risk for aspiration, published between January 2002 and July 2019 and written in English, were included. Two reviewers independently evaluated the methodological quality of studies using the revised Cochrane risk-of-bias tool. Results: Thirteen out of 703 articles identified met the eligibility criteria and were included. Six studies focused on pharmacological interventions, three studies focused on dietary interventions and compensatory strategies, one study focused on oral care, two studies focused on multidisciplinary interventions, and one study assessed a screening method. Four studies showed positive and statistically significant effect in reducing aspiration pneumonia but were considered to have unclear or high risk of bias. Three studies showed promising results on the preventive effect of pharmacological interventions. Conclusions: The most recent evidence on the prevention of aspiration pneumonia in older adults revealed modest to poor methodological quality. Given the burden of aspiration pneumonia on patients and on the health care systems, the development of larger well-designed trials on this topic is of undoubted importance. [ABSTRACT FROM AUTHOR]

Clinicians have seen a continually increasing rise in the number of children and adolescents presenting with gender dysphoria. Many are requesting gender-affirming medical interventions before they possess the legal authority to give consent. Since only legal caregivers can provide informed permission for transgender-specific medical treatment for minors, therapists who see these youths need an approach mindful of the distress inherent to the lived experience of transgender minors and respectful of the fear and hesitation most guardians of trans youth experience. Due to the partial or fully irreversible nature of medical treatment for transgender minors, parents tend to be cautious about what they may view as extreme treatments. Sometimes well-meaning parents functionally "filibuster" their adolescent's transition which can cause a harmful delay in necessary treatment. Utilizing a Bowen family systems framework, this article employs a case study to demonstrate creative strategies clinicians can apply to help families through the transition process. Although, transgender minors may bring the family to initial therapeutic encounter, they are not "holding" family dysfunction. Their distress is due to their dysphoria which is outside their control. At the same time, the family system may experience increased levels of stress resulting from an inability to support a transgender child within a cisnormative world. Successful work with these families will create a new homeostasis. Therapists must earn the trust of both the youth and parents. [ABSTRACT FROM AUTHOR]

Multicomponent positive psychology interventions are increasing in the general population but the study of its effectiveness in adolescents is still scarce, especially in the school context. Previous meta-analyses have reported that multicomponent positive psychology interventions increase well-being and reduce distress outcomes. However, the results on these outcomes limit their samples to adult populations. The aim of the current systematic review and meta-analysis is to evaluate and compare the immediate but also long-lasting effects of school-based multicomponent positive psychology interventions aimed at increasing well-being indicators of mental health (i.e., subjective and psychological well-being) and reducing the most common psychological distress indicators (i.e., depression, anxiety, and stress) in adolescents. A total of 9 randomized and non-randomized controlled trials from the searched literature met inclusion criteria for the meta-analysis. The results showed small effects for subjective well-being (g = 0.24), psychological well-being (g = 0.25), and depression symptoms (g = 0.28). Removing low-quality studies led to a slight decrease in the effect sizes for subjective well-being and a considerable increase for psychological well-being and depression symptoms. The relevant moderation analyses had an effect on subjective well-being and depression symptoms. The present systematic review and meta-analysis found evidence for the efficacy of school-based multicomponent positive psychology interventions in improving mental health in the short and long-term. Small effects for subjective well-being, psychological well-being, and depression symptoms were identified. Effects for psychological well-being and depression symptoms remained significant over time. In light of our results, education policy-makers and practitioners are encouraged to include positive practices within the schools' curriculum as effective and easily implemented tools that help to enhance adolescents' mental health. Further research is needed in order to strengthen the findings about school-based multicomponent positive psychology interventions in adolescents. [ABSTRACT FROM AUTHOR]

Objectives: To present the characteristics and level of evidence (LOE) of clinical studies published in leading oral implantology journals during 2008–2018 and to explore whether the LOE of a study is associated with its scientific and social impact. Materials and methods: Clinical studies with direct relevance to the evaluation of healthcare interventions published in 2008, 2013, and 2018 in six oral implantology journals were identified via hand searches. A modified 4‐level Oxford 2011 LOE tool was used to assess the LOE of all eligible studies. The citation count and Altmetric Attention Score (AAS) of each study were extracted from Web of Science and Altmetric Explorer, respectively. Thereafter, multivariable generalized estimation equation analyses were used to investigate the association between LOE, citation counts, and AAS, adjusting for potential confounding factors and clustering effects. Results: A total of 763 clinical studies were included, among which the proportion of level‐1, level‐2, level‐3, and level‐4 studies was 2.4%, 30.4%, 40.2%, and 27.0%, respectively. During 2008–2018, the proportion of high LOE studies (level‐1 and level‐2) increased substantially from 24.6% to 43.1%, although the number of systematic reviews that only include randomized controlled trials has remained limited. According to multivariable analyses, the citation count (p =.002) and AAS (p =.005) of high LOE studies were both significantly greater than those of low LOE studies. Conclusions: During the past decade, the proportion of high LOE studies has increased substantially in the field of oral implantology. Clinical studies with higher LOE tend to have greater scientific and social impact. [ABSTRACT FROM AUTHOR]

Despite the increasing amount of research investigating health interventions that applies to interactive computer technology, the effect sizes in Cohen's d obtained across these studies range from −0.32 to 1.74. The lack of systematic review of interactive health interventions leaves their overall effectiveness unknown. To address this, a meta-analysis of 67 studies examining the effects of web-based interactive health interventions was conducted. Results indicated that web-based interactive health interventions were effective in general, but the effects were moderated by health topic, theoretical framework, and design of treatment and control groups. The unique advantage of interactivity was small but significant when comparing to health interventions with comparable information in non-interactive version. Theoretical and practical implications of findings were discussed. [ABSTRACT FROM AUTHOR]

This research was carried out to determine the effect of individual counseling intervention on health practices in pregnancy. This research is a single-blind randomized controlled experimental and follow-up design. Population of the research consisted of 126 pregnant women in total, with 64 of them being in the training group and 64 being in the control group. The research data were collected by using a 'Pregnant Identifying Information Form' and 'Health Practices in Pregnancy Questionnaire (HPQ)'. In this research, it was found that there was no significant difference in total score average of the HPQ before the individual counseling training between the pregnant women in the training and control groups (P  > 0.05). It was also determined that there was a statistically significant difference in total score average of the HPQ after the individual counseling training during the second trimester between the two groups (P  < 0.05). It was determined that there was a statistically significant difference in total score average of the HPQ during the third trimester between two groups (P  < 0.05). It has been determined that the training provided with individual counseling to pregnant women is an effective initiative in increasing the health practices of pregnant women. [ABSTRACT FROM AUTHOR]

Effective obesity interventions in adolescent populations have been identified as an immediate priority action to stem the increasing prevalence of adult obesity. The purpose of this meta-analysis was to make a quantitative analysis of the impact of school-based interventions on body mass index during adolescence. Studies were retrieved from PubMed, Scopus, Science Direct and Web of Science databases. Results were pooled using a random-effects model with 95% confidence interval considered statistically significant. Of the 18 798 possible relevant articles identified, 12 articles were included in this meta-analysis. The global result showed a low magnitude effect, though it was statistically significant (N  = 14 428), global e.s. = −0.055, P  =   0.004 (95% CI = −0.092, −0.017). Heterogeneity was low among the studies (I 2 = 9.017%). The funnel plot showed no evidence of publication bias. The rank-correlation test of Begg (P  =   0.45641) and Egger's regression (P  =   0.19459) confirmed the absence of bias. This meta-analysis reported a significant effect favoring the interventions; however, future research are needed since the reported the evidence was of low magnitude, with the studies following a substantial range of approaches and mostly had a modest methodological quality. [ABSTRACT FROM AUTHOR]

This paper explains the failure of an obesity intervention funded by a Carol M. White U.S. Department of Education grant which created a three way partnership between middle schools in a poor largely Latino school district, the local University, and local after-school care providers. This paper assesses the project and situates it theoretically using Foucault's microphysics of power and Bourdieu's concepts of capital to analyze the refusal of most students and teachers to engage in the program and the standardized testing required by the state. We further articulate a new form of Bourdieu's concept of symbolic violence based on position in the consumer hierarchy. We conclude with a critique of grant mechanisms as a means of addressing health issues, and situate the obesity epidemic as a social construction that perpetuates inequality and discourses of power. [ABSTRACT FROM AUTHOR]

Introduction. The disorders of the schizophrenia spectrum present emotional, cognitive and/or behavioural alterations, related to daily functioning, therefore it is necessary to develop intervention programmes focused on the improvement of these constructs. The objective of this work is to analyze the effect on cognitive functioning, symptomatological perception and psychosocial functioning of the Trisquel intervention program. Methodology. An experimental design was carried out with a total of 24 people with a diagnosis of schizophrenia spectrum disorder who were randomly assigned to the experimental group Trisquel and the control group. The Trisquel group conducted two structured weekly sessions for three months, while the control group conducted cognitive stimulation sessions with the same frequency and intensity. Neuropsychological, clinical and functional tests were administered before and after the intervention. Results. After the intervention program in the Trisquel group, statistically significant improvements were found in the subtest of letters and numbers (p = 0,029), in the working memory index (p = 0,020) WAIS-III, in interpersonal sensitivity (p = 0,015) and paranoid ideation (p = 0,049) SCL-90-R and in psychosocial functioning EEAG (p = 0,020). And in the control group, in processing speed (p = 0,034) WAIS-III and health perception SF-36 (p = 0,017). Conclusions. The results of this study suggest that «Trisquel» may be an effective intervention program to induce improvements in the functioning of working memory, in the symptomatic dimensions of interpersonal sensitivity and paranoid ideation, and in psychosocial functioning in people with a diagnosis of schizophrenia spectrum disorder. [ABSTRACT FROM AUTHOR]

Couple therapy is too complex, and too important, to be undertaken under the sway of doctrinal orthodoxy. Integrating various schools of thought enlarges our toolkit and optimizes our efforts. In their excellent paper, "Couple Impasses: Three Therapeutic Approaches, Siegel, Goldman, and Fishbane provide three contemporary examples of such integration. In this commentary, I will note some commonalities in their work, highlight some singularly useful ideas from each author's section, and conclude with some of my own thoughts about integrating and sequencing interventions in couple therapy. [ABSTRACT FROM AUTHOR]

We argue for the importance of multitheoretical integrative clinical intervention and training. Mental health professionals, including clinical social workers, are frequently primarily committed to a single dominant therapeutic theory, perhaps one that was favored by a school, fieldwork agency, inspiring teacher, or influential supervisor. However, each such theory tends to target just one aspect of the extraordinarily complex human meaning system that scientific research has shown to operate at biological, neuroscientific, behavioral, cognitive, unconscious, family-systems, and cultural levels in complexly interacting ways. We know that any monotheoretic intervention approach likely fails to help a substantial number of clients, implying an ethical imperative not to equate failure to respond to monotheoretical treatment with clinical failure. Thus, there are persuasive scientific and ethical arguments supporting the move toward psychotherapy integration in which multiple theories and their associated techniques are seen as part of a larger theoretical and interventive metasystem. Such integration is especially urgent in clinical social work with its diverse and often multi-problem clients. In this article, we consider the reasons for integration, review the levels of the human meaning system that interact in normal and abnormal functioning and thus justify a multitheoretical approach, examine recent research in support of integrationist practices, and offer the example of the natural conceptual convergence occurring between cognitive and psychodynamic approaches to illustrate how, as theories mature, they tend to converge and recognize the same reality of the human meaning system. [ABSTRACT FROM AUTHOR]

Focusing on affect and the expression of emotion has long been a key feature of psychodynamic psychotherapies. While psychodynamically-oriented therapists have always paid attention to the emotional life of their clients, they usually do not focus on accessing and processing emotions in the manner and to the degree that emotion-focused therapists do. By recognizing the power of emotion as a fundamental change mechanism, an increasing number of therapists who previously defined themselves a classically psychodynamic (e.g., fostering insight through interpretation) are now placing themselves in the "experiential camp." Developed in the 1980′s, Time-Limited Dynamic Psychotherapy (TLDP) has undergone several changes. One of these is to emphasize experiential learning as a main therapeutic change agent. In this updated version of TLDP, there is a focus on accessing feelings in the here–and-now that are seen as altering and even transforming old dysfunctional patterns of relating to self and others. To provide examples of what such interventions might look like in an integrative psychodynamically-oriented therapy, excerpts from transcripts of actual TLDP sessions will be provided. In particular, vignettes will illustrate accessing and processing emotion relevant for understanding and shifting a client's cyclical maladaptive pattern and "working through." [ABSTRACT FROM AUTHOR]

In December 2019, an outbreak of a novel zoonotic coronavirus began, called SARS-CoV-2 or COVID-19, which reached pandemic dimensions on March 11, 2020. By March 3, it had already entered República Argentina, while on March 9 the first case occurred in the Province of Rio Negro. In this province, 823 cases were identified with 41 deaths and 602 recovered cases by June 30, giving rise to successive intervention strategies to prevent its arrival in some places without viral circulation, to control outbreaks occurred and, when this objective was achieved, to avoid reintroduction. Among all measures, those related to non-pharmaceutical Interventions or NFI based on Primary Health Care and One Health with integrated participation among health agents of the First Level of Care, veterinary public health and medical areas of the Departments of Activities for the Area and Its Primary Health Care Centers and epidemiology services are a central, highly effective and essential strategy to cut the transmission chain and decrease the agent's reproductive capacity (R0) to a value <1. The activities carried out from the appearance of cases were described in the towns of El Bolsón, San Carlos de Bariloche, General Roca and Choele Choel in the Province of Rio Negro during 110 days of the pandemic. [ABSTRACT FROM AUTHOR]

Objectives. To examine effects of unmet social needs on adherence to pediatric weight management intervention (PWMI). Methods. We examined individual associations of positive screens for parental stress, parental depression, food insecurity, and housing insecurity with intervention adherence, and associations of 0, 1 or 2, and 3 or 4 unmet social needs with adherence, among children enrolled in a 2017–2019 comparative effectiveness trial for 2 high-intensity PWMIs in Massachusetts. Models were adjusted for child age, body mass index (BMI), parent BMI, and intervention arm. Results. Families with versus without housing insecurity received a mean of 5.3 (SD = 8.0) versus 8.3 (SD = 10.9) contact hours (P <.01). There were no statistically significant differences in adherence for families reporting other unmet social needs. Children with 3 to 4 unmet social needs versus without received a mean of 5.2 (SD = 8.1) versus 9.2 (SD = 11.8) contact hours (P <.01). In fully adjusted models, those with housing insecurity attended a mean difference of −3.14 (95% confidence interval [CI] = −5.41, −0.88) hours versus those without. Those with 3 or 4 unmet social needs attended −3.74 (95% CI = –6.64, −0.84) hours less than those with none. Conclusions. Adherence to PWMIs was lower among children with housing insecurity and in families with 3 or 4 unmet social needs. Addressing social needs should be a priority of PWMIs to improve intervention adherence and reduce disparities in childhood obesity. Trial Registration: ClinicalTrials.gov identifier: NCT03012126. [ABSTRACT FROM AUTHOR]