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Introduction/Purpose: Observational research suggests that consistent exercise timing could be leveraged to promote moderate-to-vigorous physical activity (MVPA) among adults with obesity. However, the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting is unknown. The purpose of this study was to assess the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting among inactive adults with obesity (primary) and to compare MVPA timing prescriptions and characterize exercise barriers/facilitators (secondary). Methods: Using a within-subjects design, inactive adults with obesity (n=15) were randomized in counterbalanced order to three 3-wk exercise timing conditions separated by 2-wk washout periods: 1) consistent morning, 2) consistent evening, and 3) choice timing (control). Feasibility was assessed using prespecified benchmarks. Acceptability and preferred timing were assessed with questionnaires post-intervention. Secondarily, exercise timing and MVPA were assessed via accelerometry and nightly surveys and barriers/facilitators were assessed with nightly surveys. Results: All feasibility benchmarks were achieved (e.g., timing adherence = 69.9% via accelerometry and 87.4% via self-report (target: ≥60%)). Consistent exercise timing was acceptable (mean rating = 3.7 of 5 (target: ≥3.5)). Choice was the most popular prescription. There were medium- to large-sized effects (partial η2 of 0.09-0.16) of condition on MVPA; MVPA was higher during the morning and evening conditions versus choice condition. Facilitators were similar across conditions, while some barriers were time specific. Conclusion: Prescribed exercise timing in a free-living setting appears feasible and acceptable. While choice timing was most preferred, consistent timing appeared most effective for increasing MVPA. Data warrant larger trials to test the efficacy and mechanisms of consistent exercise timing as a translational strategy for promoting MVPA. Pending findings from a fully powered randomized trial, practitioners interested in promoting MVPA among their patients or clients could consider encouraging exercise at a consistent time day-to-day.

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

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

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INTRODUCTION: Few community-based interventions addressing the transmission control and clinical management of COVID-19 cases have been reported, especially in poor urban communities from low-income and middle-income countries. Here, we analyse the impact of a multicomponent intervention that combines community engagement, mobile surveillance, massive testing and telehealth on COVID-19 cases detection and mortality rates in a large vulnerable community (Complexo da Maré) in Rio de Janeiro, Brazil. METHODS: We performed a difference-in-differences (DID) analysis to estimate the impact of the multicomponent intervention in Maré, before (March-August 2020) and after the intervention (September 2020 to April 2021), compared with equivalent local vulnerable communities. We applied a negative binomial regression model to estimate the intervention effect in weekly cases and mortality rates in Maré. RESULTS: Before the intervention, Maré presented lower rates of reported COVID-19 cases compared with the control group (1373 vs 1579 cases/100 000 population), comparable mortality rates (309 vs 287 deaths/100 000 population) and higher case fatality rates (13.7% vs 12.2%). After the intervention, Maré displayed a 154% (95% CI 138.6% to 170.4%) relative increase in reported case rates. Relative changes in reported death rates were -60% (95% CI -69.0% to -47.9%) in Maré and -28% (95% CI -42.0% to -9.8%) in the control group. The case fatality rate was reduced by 77% (95% CI -93.1% to -21.1%) in Maré and 52% (95% CI -81.8% to -29.4%) in the control group. The DID showed a reduction of 46% (95% CI 17% to 65%) of weekly reported deaths and an increased 23% (95% CI 5% to 44%) of reported cases in Maré after intervention onset. CONCLUSION: An integrated intervention combining communication, surveillance and telehealth, with a strong community engagement component, could reduce COVID-19 mortality and increase case detection in a large vulnerable community in Rio de Janeiro. These findings show that investment in community-based interventions may reduce mortality and improve pandemic control in poor communities from low-income and middle-income countries.

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Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determined. Methods: This non-randomized company-based trial evaluated 6- and 12-months effects of a WHP intervention on BP among 2,002 participating workers from seven Mexican companies. Intervention and control groups were assigned at the company level. The intervention included nutrition counseling, physical exercise, and stress management components. Mixed models assessed differences in BP change between intervention and control companies in intent-to-treat (ITT), per-protocol (PerP), and as-treated (AsTr) analyses, and also within-group changes stratified by company, intervention component, and baseline cardiovascular risk factor levels. All analyses were adjusted for potential confounders. We accounted for missing data and loss to follow-up using inverse probability of censoring weighting. Results: ITT analyses revealed mean BP change differences of -1.1 mmHg at 12 months (95% CI: -2.9; 0.6) in intervention companies relative to control companies. PerP and AsTr analyses confirmed this finding. Within-group analyses showed consistent BP reductions at both 6 and 12 months. Substantial differences in BP changes ranging from diastolic -6.1 mmHg, (95% CI: -11.2; -1.2) to systolic -13.0 mmHg (95% CI: -16.0; -10.1) were found among individuals with diabetes at baseline in intervention companies relative to control companies. Conclusion: After 1 year, WHP was associated with modest but uncertain BP reductions. Substantial reductions were mainly observed among diabetic workers.

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OBJETIVO: analisar a percepção de enfermeiras e agentes comunitários de saúde em relação ao suicídio antes e após uma intervenção educativa. MÉTODO: estudo quase experimental, do tipo antes e depois, de abordagem qualitativa, baseado no referencial teórico da Transferência de Conhecimento. Participaram do estudo duas enfermeiras e dez agentes comunitários de saúde de uma unidade básica de saúde de Campo Grande, do estado de Mato Grosso do Sul. Foi utilizada a técnica de grupo focal, para a coleta de dados, antes e após a intervenção educativa. A análise dos dados foi realizada por meio da técnica de Triangulação de Métodos. RESULTADOS: emergiram duas categorias da análise dos dados, "a percepção do suicídio nos seus diferentes aspectos", que traz percepções, compreensões e conceitos relacionados ao suicídio e "o contexto da assistência à saúde no comportamento suicida", que mostra como o suicídio é vivenciado pelos profissionais de saúde nos espaços de cuidado. CONCLUSÃO: a intervenção educativa favoreceu mudanças na percepção dos participantes referentes à identificação e abordagem do comportamento suicida, indicando a importância de ações dessa natureza para abordagens inerentes à prevenção do suicídio.

OBJECTIVE: to analyze the perception of nurses and community health agents in relation to suicide before and after an educational intervention. METHOD: a quasi-experimental research, of the before and after study type and with a qualitative approach, based on the theoretical framework of Knowledge Transfer. Two nurses and ten community health agents from a basic health unit in Campo Grande, state of Mato Grosso do Sul, participated in the study. The focus group technique was used for data collection before and after the educational intervention. Data analysis was performed using the technique of Triangulation of Methods. RESULTS: two categories of data analysis emerged: "the perception of suicide in its different aspects", which brings perceptions, understandings, and concepts related to suicide; and "the context of health care in suicidal behavior", which is characterized by how suicide is experienced by the health professionals in care contexts. CONCLUSION: the educational intervention fostered changes in the participants' perception regarding the identification and approach of suicidal behavior, indicating the importance of actions of this nature for approaches concerning suicide prevention.

OBJETIVO: analizar la percepción de enfermeras y agentes comunitarios de salud en relación con el suicidio, antes y después de una intervención educativa. MÉTODO: estudio cuasi experimental, del tipo antes y después, con enfoque cualitativo, basado en el marco teórico de la Transferencia de Conocimiento. Los participantes del estudio fueron dos enfermeras y diez agentes comunitarios de salud de una unidad básica de salud de Campo Grande en el estado de Mato Grosso do Sul. Se utilizó la técnica del grupo focal se utilizó para recopilar datos antes y después de la intervención educativa. El análisis de los datos se realizó mediante la técnica del Método de Triangulación. RESULTADOS: surgieron dos categorías de análisis de datos, "la percepción del suicidio en sus diferentes aspectos", que trae percepciones, entendimientos y conceptos relacionados con el suicidio y "el contexto de la atención en salud en el comportamiento suicida", que muestra cómo los profesionales de la salud experimentan el suicidio en los espacios de atención. CONCLUSIÓN: la intervención educativa favoreció cambios en la percepción de los participantes con respecto a la identificación y el enfoque del comportamiento suicida, lo que indica la importancia de acciones de esta naturaleza para abordajes inherentes a la prevención del suicidio.

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Objective: Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers. Methods: The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services' needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions. Results: HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions. Conclusion: Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step. Clinical trial registration: NCT00881699

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OBJECTIVE: To evaluate the effects of moderate-term açaí and juçara juice intake on fasting glucose, lipid profile, and oxidative stress biomarkers in healthy subjects. METHODS: A randomized cross-over study was performed with 30 healthy adults. The subjects were assigned to drink 200 mL/day of açaí or juçara juice for four weeks with a 4-week washout period. Before and after each nutritional intervention, blood samples were obtained to evaluate the outcomes: fasting glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), small, dense LDL-c (sd-LDL-c), total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), uric acid, and activity of the enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). RESULTS: After four weeks, açaí and juçara juices increased the concentrations of HDL-c by 7.7% and 11.4%, respectively (P < 0.05). In addition, açaí juice intake promoted significant increases in TAC (66.7%), CAT (275.1%), GPx (15.3%), and a decrease in OSI (55.7%) compared to baseline (P < 0.05 for all). Juçara juice intake significantly increased CAT activity (~15.0%) in relation to baseline. No significant intergroup differences were observed for any outcomes (P > 0.05). CONCLUSION: The results indicated a positive impact of regular consumption of açaí and juçara juices on the HDL-c levels, as well as on the antioxidant enzyme activities, which may contribute to cardiovascular health.

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Objective: To evaluate the impact of multidimensional interventions on quality of life (QoL) and depressive symptoms in Brazilian older adults living in the community. Methods: Longitudinal, quasi-experimental study of older adults receiving conventional primary health care (PHC). The interventions were designed in response to a first round of data collection and validated through pilot testing in groups of older adults from another community. The validated interventions were then applied to an intervention group (IG). To measure their effect, we used the Medical Outcomes Short-Form Health Survey (SF-36) quality of life scale and the Geriatric Depression Scale (GDS-30). Results: The sample comprised 118 participants. IG participants exhibited significant improvement in several QoL domains (SF-36): mental health (p = 0.010), general health perceptions (p = 0.016), and physical functioning (p = 0.045). No such improvement occurred in controls (p > 0.050). The prevalence of depression (GDS-30) fell from 36.7 to 23.3% in the IG, despite no significant difference (p = 0.272). Controls also reported a reduction in depressive symptoms, but only from 44.8 to 41.4% (p = 0.112). Conclusions: This multidimensional intervention was associated with significant improvement in mental health, general health perceptions, and physical functioning in a sample of Brazilian older adults. Clinical trial registration: RBR-92dbtx.

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ABSTRACT Objective Evaluate the effectiveness of mHealth strategy on sodium consumption markers. Methods Intervention study carried out with 175 adults (20-59 years), from an educational institution of Vitória, Espírito Santo State. Participants were made aware through posters, oral approach and electronic media. Anthropometric, hemodynamic, socioeconomic, health, and dietary practices data was collected in two stages. After the first assessment, participants were randomized into two groups: Intervention Group and Control Group. The Intervention Group included 21 electronic messages and 3 videos on healthy eating focusing on the goal to reduce sodium intake for 3 months. Behavioral changes were assessed using the Generalized Estimation Equation (p-value <0.05). Results At baseline, no significant differences in socioeconomic, anthropometric and health variables, and eating practices between groups were observed. The stock broth cube was the most used ready processed seasoning. After the intervention, a reduction in the use of stock broth was observed only in the intervention group (β=0.615; p=0.016). In addition, 73% of the intervention group participants reported that the messages were clear, 67% reported that they were useful, and 48% stated they followed the guidelines. Conclusion There was a reduction in the frequency of use of stock broth cubes, demonstrating the potential effect of the m-Health strategy on sodium consumption markers in individuals without a hypertension medical diagnosis.

RESUMO Objetivo Avaliar a efetividade da estratégia mHealth sobre marcadores do consumo de sódio. Métodos Estudo de intervenção realizado com 175 adultos (20-59 anos), vinculados a uma instituição de ensino de Vitória, no Estado do Espirito Santo. Os participantes foram contatados por através da exposição a de um pôster, de abordagem oral e mídia eletrônica. Dados antropométricos, hemodinâmicos, socioeconômicos, de saúde e práticas alimentares foram coletados em dois momentos. Os participantes foram randomizados em dois grupos: Grupo de Intervenção e Grupo de Controle. Durante a intervenção, que durou três meses, os participantes receberam 21 mensagens eletrônicas e assistiram a três vídeos sobre alimentação saudável, com foco na redução do consumo de sódio. Mudanças foram avaliadas por Equação de Estimativa Generalizada e adoção de valor de p<0,05. Resultados Na linha de base, não foram observadas diferenças significativas em relação às variáveis antropométricas, socioeconômicas, de saúde e práticas alimentares entre os grupos. Caldo pronto foi o condimento industrializado mais utilizado pelos participantes durante o estudo. Foi observada uma redução do uso de caldo pronto apenas no Grupo de Intervenção (β=0,615; p=0,016). Além disso, 73% do Gruo de Intervenção relataram que as mensagens foram claras; 67% afirmaram que as mensagens foram úteis e 48% disseram que seguiram as orientações. Conclusão Foi observada uma redução da frequência do uso de caldo pronto, demonstrando potencial da estratégia m-Health sobre marcadores do consumo de sódio em participantes sem diagnóstico de hipertensão.

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RESUMO Objetivo: Elaborar um programa de remediação com a nomeação rápida e leitura, bem como verificar a significância clínica da aplicação do programa elaborado em escolares com dislexia. Método: Participaram cinco sujeitos do terceiro ao quinto ano do ensino fundamental, com idade de 8 a 11 anos, de ambos os sexos, com diagnóstico interdisciplinar de dislexia. Todos os escolares foram submetidos na pré e pós-testagem à aplicação das provas de habilidades metalinguísticas e de leitura, compreensão de leitura e da prova de nomeação automática rápida. Resultados: A análise foi realizada pelo Método JT, que permitiu verificar se houve mudança positiva ou negativa e significância clínica na pós-testagem. Os resultados mostraram ter havido significância clínica nas provas de identificação; adição e combinação de sílaba, de fonema final e medial, além de repetição de não palavras, leitura de palavras reais e pseudopalavras, compreensão leitora, além de nomeação automática rápida quando comparada a pré com a pós-testagem. Conclusão: O programa elaborado mostrou-se eficaz e com aplicabilidade, podendo ser utilizado instrumento de intervenção baseada em evidência científica para escolares com dislexia, pois ocorreu significância clínica para o desempenho em leitura.

ABSTRACT Purpose: Elaborate a remediation program with rapid automatized naming and reading, as well as to verify the clinical significance of the elaborated program for students with dyslexia. Method: The study involved five students from 3rd to the 5th grade of elementary school, aged 8 to 12 years, of both genders, with an interdisciplinary diagnosis of dyslexia. All students were submitted to pre- and post-test application of metalinguistic skills and reading test, reading comprehension and rapid automatized naming test. Results: The analysis was performed using the JT method that allowed to verify positive or negative change and clinical significance in the post-testing. The results showed clinical significance in the tests of identification, syllable addition and combination, final and medial phoneme; in addition to nonwords repetition, real words and pseudowords reading, reading comprehension and rapid automatized naming test when comparing the pre- and post-testing. Conclusion: The elaborated program was efficient and applicable as an intervention instrument based on scientific evidence for students with dyslexia since it showed clinical significance for reading performance.

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