Preliminary evaluation of a school-based resilience-promoting intervention in a high-risk population: Application of an exploratory two-cohort treatment/control design

Applying innovative methodology, we explored the efficacy of SPARK Resilience Programme––a new universal school-based resilience-promoting programme––regarding effects on depression symptoms and resilience in a high risk population in England. Quantitative and qualitative methods were combined in an exploratory two cohort treatment/control design with one cohort serving as the control group (single assessment) and a subsequent cohort as the treatment group (assessed before and immediately after treatment as well as 6 and 12 months after treatment ended), involving a total of 438 11–13 year old girls, According to analyses, depression symptoms were significantly lower directly after treatment and at 6 months but no longer at 12 months. Resilience scores, on the other hand, were significantly higher in the treatment cohort compared to the year-ahead control cohort at post-treatment and both follow-up assessments. Qualitative results demonstrated beneficial teacher experience overall. The current study provides first evidence for the efficacy of SPARK Resilience Programme. Furthermore, the applied two cohort treatment/control mixed methods design proved helpful for the preliminary testing of a school-based universal intervention programme efficacy in an authentic setting

Fatores de risco predisponente à persistência de abertura de incisão de esclerotomia pós vitrectomia posterior via Pars Plana 23 Gauge

Objetivo: Análise Multifatorial sobre a persistência de abertura de incisão de esclerotomia pós-cirurgia de Vitrectomia Posterior Via Pars Plana 23 GAUGE, após um período pós operatório de 30 e 60 dias. Métodos: Avaliação de 510 pacientes através de um estudo com desenho prospectivo, longitudinal e observacional, com critério de inclusão e exclusão. Após seleção, foi avaliada a persistência da abertura de eclerotomia 23 Gauge (presente ou ausente) com 30 e 60 dias de pós operatório de 455 pacientes; e a sua associação com as seguintes variáveis: sexo; faixa etária; lateralidade; etnia; alta miopia; presença de placa hialina degenerativa escleral; detalhes do procedimento cirúrgico de vitrectomia posterior, como: presença de elementos de introflexão escleral, uso de óleo de silicone intravítreo, gás expansor intravítreo, endofotocoagulação a laser ou medicamentos intravítreos no pré-operatório; intercorrência de hipertensão ocular no pós operatório; necessidade de reoperações de cirurgia de vitrectomia; método de contingência~da incisão de esclerotomia e tempo operatório. Resultados: A persistência da abertura da incisão de esclerotomia esteve presente em 49 pacientes (10,76% da amostra ) aos 30 dias e 14 pacientes (3,07% da amostra) aos 60 dias. As variáveis que apresentaram associação (p<0,05) com a persistência da abertura da esclerotomia, quando sob análise uni-variada, foram: hipertensão ocular no pós operatório (30 dias), presença de óleo de silicone (30 e 60 dias), presença de elementos de introflexão escleral (30 dias), reoperações de vitrectomia (30 e 60 dias) e tempo de cirurgia vítreo-retiniana (30 e 60 dias). Os sítios de esclerotomia com maior persistência de abertura foram temporal superior e nasal superior. Após a análise multivariada, as variáveis que apresentaram associação com a persistência da abertura de esclerotomia (p<0,05) foram: reoperações de vitrectomia e tempo operatório da cirurgia vítreo-retiniana.Conclusão: Houve correlação significativa entre a presença de hipertensão ocular no pós-operatório inicial de 30 dias, a presença de óleo de silicone com 30 e 60 dias, a presença de elementos de introflexão escleral com 30 dias, reoperações de vitrectomia com 30 e 60 dias e tempo de cirurgia vítreo-retiniana com 30 e 60 dias. Entretanto, sob análise multivariada, houve associação significativa (p<0,05) apenas com as variáveis de reoperações de vitrectomia e tempo de cirurgia vitreo-retiniana com 30 e 60 diasO presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Código de Financiamento 001Patients undergoing 23-gauge posterior pars plana vitrectomy surgery after postoperative periods of 30 and 60 days. Methods: The study evaluated 510 patients and had a prospective, longitudinal and observational design with inclusion and exclusion criteria. The persistent opening of 23-gauge sclerotomies (present or absent) was evaluated 30 and 60 days after surgery in 455 patients, along with its associations with the following variables: gender, age, laterality (right/left eye), ethnicity, high myopia, degenerative scleral hyaline plaque, intravitreal silicone oil, intravitreal gas injection, endolaser photocoagulation, scleral buckle elements, intraoperative use of intra vitreal drugs, postoperative ocular hypertension complication, vitrectomy reoperation, sclero tomy incision closing procedure, sclerotomy anatomical site morphology with leakage search and duration of vitre ctomy surgery. Results: Persistent opening of the sclerotomy incision was present in 49 patients (10.76% of the sample) at 30 days and in 14 patients (3.07% of the sample) 60 days after surgery. The variables showing significant correlations (univariate analysis) were postoperative ocular hypertension, presence of silicone oil, presence of scleral buckle elements, vitrectomy reoperations and duration of vitreoretinal surgery. The sclerotomy sites with the greatest amounts of persistent opening were the superior temporal and superior nasal sites. After multivariate analysis, the variables that were significantly associated with the persistence of sclerotomy opening (p<0.05) were vitrectomy surgery reoperations and duration of vitreoretinal surgery. Conclusions: Vitrectomy surgery reoperations and duration of vitreoretinal surgery were the most significant risk factors for persistent sclerotomy opening, even after an extended period (60 days). Factors such as the presence of scleral hyaline plaque were not correlated with persistent open sclerotomies. The presence of leakage at the sclerotomy sites was not statistically significant, as there were sclerotomies with open morphological aspects but without evidence of leakage53f

Papilopatia diabética e triamcinolona intravítrea Diabetic papillopathy and intravitreal triamcinolone

Os autores descrevem um caso de papilopatia diabética em paciente diabética insulino-dependente no qual se utilizou o acetonido de triancinolona com injeção intravítrea como opção de tratamento.<br>The authors describe one case of diabetic papillopathy. They used an intravitreal triamcinolone as an option of treatment

Retinal microvascular abnormalities, cotton wool-like lesions, and macular edema following COVID-19 in a patient previously vaccinated with AstraZeneca and idiopathic myopathy

In this case study, the authors describe peculiar bilateral cotton wool-like retinal lesions associated with macular edema in a patient with COVID-19 who was vaccinated with a single dose of AstraZeneca one month earlier. This patient had no pulmonary or systemic cardiovascular complications from COVID-19, as reported in other papers that found retinal lesions. However, the patient was diagnosed with idiopathic myopathy when discovering the SARS-CoV-2 infection. The patient was a 22-year-old white female with no previous history of morbidity, complaining of blurred vision in both eyes seven days after testing positive for SARS-CoV-2 by PCR (using nasal and oral swab) and confirmed through ELISA blood test (IgM positive). There was no ancillary test revealing diabetes mellitus. The patient presented with scattered whitish cotton wool-like lesions and a few hemorrhages on the posterior pole in fundus examination. On spectral domain optical coherence tomography (SD-OCT), there were hyperreflective lesions in the nerve fiber layer, ganglion cell layer, inner nuclear layer, and inner and outer plexiform layers at the site corresponding to the whitish cotton wool-like lesions in the posterior fundus photos. Moreover, the macula of both eyes had intraretinal and subretinal fluid, reversible with corticosteroid therapy. In conclusion, COVID-19 has been associated with capillary disorders at different target sites such as retina, lungs, and central nervous system. Similarly, vaccination against SARS-CoV-2 has been linked to retinal complications in the literature; however, cotton wool-like lesions have not yet been reported. There are many questions yet to be answered about the implications of COVID-19 infection and its vaccines

Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

Item does not contain fulltextBACKGROUND: The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. RESULTS: Meta-analyses and systematic reviews have indicated that the high effectiveness of ART sealants using high-viscosity glass ionomers in carious lesion development prevention is not different from that of resin fissure sealants. ART using high-viscosity glass ionomer can safely be used to restore single-surface cavities both in primary and in permanent posterior teeth, but its quality in restoring multiple surfaces in primary posterior teeth cavities needs to be improved. Insufficient information is available regarding the quality of ART restorations in multiple surfaces in permanent anterior and posterior teeth. There appears to be no difference in the survival of single-surface high-viscosity glass-ionomer ART restorations and amalgam restorations. DISCUSSION: The use of ART results in smaller cavities and in high acceptance of preventive and restorative care by children. Because local anaesthesia is seldom needed and only hand instruments are used, ART is considered to be a promising approach for treating children suffering from early childhood caries. ART has been implemented in the public oral health services of a number of countries, and clearly, proper implementation requires the availability of sufficient stocks of good high-viscosity glass ionomers and sets of ART instruments right from the start. Textbooks including chapters on ART are available, and the concept is being included in graduate courses at dental schools in a number of countries. Recent development and testing of e-learning modules for distance learning has increasingly facilitated the distribution of ART information amongst professionals, thus enabling more people to benefit from ART. However, this development and further research require adequate funding, which is not always easily obtainable. The next major challenge is the continuation of care to the frail elderly, in which ART may play a part. CONCLUSION: ART, as part of the Basic Package of Oral Care, is an important cornerstone for the development of global oral health and alleviating inequality in oral care