Effectiveness of a Community-Based Health Promotion “Rethink Your Drink” on Reducing Sugary Beverage Consumption: A Case Study

Introduction: Obesity rates are rising throughout the United States. As a way to address obesity in a rural city in southwest Kentucky, researchers conducted a “Rethink Your Drink” challenge. The purpose of this study was to evaluate the effectiveness of a community health program in reducing the consumption of sugary beverages. Methods: Researchers conducted a “Rethink Your Drink” Challenge in a rural city in southwest Kentucky. Educational materials illustrated how beverages fell into red, yellow, or green light categories based on sugar content. Materials were provided to corporate sponsors throughout a rural city in southwest Kentucky. Community members (n=296) volunteered to track their beverage consumption over a 4-week period. Researchers collected data sheets at the end of the 4- weeks and analyzed change in beverage habits. Results: Researchers calculated weekly sugar intake as: [(red drinks * 3) + (yellow drinks * 2.25) + (green drinks * 0)]. Sugary beverage consumption decreased over the four weeks (t = 9.2, p \u3c 0.001). Conclusions: A community health program addressing sugary beverage consumption is an effective method to bring awareness to the hidden sugars and calories, which lead to obesity and obesity related diseases

Framing the detection of elder financial abuse as bystander intervention: Decision cues, pathways to detection and barriers to action

This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here (http://bura.brunel.ac.uk/handle/2438/8569). Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.This article has been made available through the Brunel Open Access Publishing Fund.Purpose – The purpose of this paper is to explore the detection and prevention of elder financial abuse through the lens of a “professional bystander intervention model”. The authors were interested in the decision cues that raise suspicions of financial abuse, how such abuse comes to the attention of professionals who do not have a statutory responsibility for safeguarding older adults, and the barriers to intervention. Design/methodology/approach – In-depth interviews were conducted using the critical incident technique. Thematic analysis was carried out on transcribed interviews. In total, 20 banking and 20 health professionals were recruited. Participants were asked to discuss real cases which they had dealt with personally. Findings – The cases described indicated that a variety of cues were used in coming to a decision that financial abuse was very likely taking place. Common to these cases was a discrepancy between what is normal and expected and what is abnormal or unexpected. There was a marked difference in the type of abuse noticed by banking and health professionals, drawing attention to the ways in which context influences the likelihood that financial abuse will be detected. The study revealed that even if professionals suspect abuse, there are barriers which prevent them acting. Originality/value – The originality of this study lies in its use of the bystander intervention model to study the decision-making processes of professionals who are not explicitly charged with adult safeguarding. The study was also unique because real cases were under consideration. Hence, what the professionals actually do, rather than what they might do, was under investigation.Economic and Social Research Counci

Impacto da mioterapia pós frenectomia na alteração de frênulo lingual

Objetivo: Verificar a evolução clínica de crianças com alteração de frênulo lingual que foram submetidas a frenectomia e a mioterapia. Métodos: Trata-se de um ensaio clínico randomizado cego. A amostra foi composta por 16 crianças entre cinco e 12 anos, com alteração de frênulo classificado como curto, curto-anteriorizado e anquiloglossia. O procedimento cirúrgico foi realizado com técnica padrão da instituição. Participaram sete indivíduos no grupo controle (GC) que realizaram a cirurgia e nove do grupo experimental (GE) que realizaram a cirurgia seguida de mioterapia. A avaliação fonoaudiológica foi conduzida pela mesma pesquisadora e realizada em três momentos: antes da cirurgia, 15 dias e 30 dias após. No 15º dia foram selecionadas aleatoriamente as crianças pertencentes ao GE que realizaram exercícios isotônicos de língua. Resultados: Todos sujeitos evoluíram nos aspectos de mobilidade e elevação de língua após a realização da frenectomia, porém a fala manteve a alteração fonética. Considerando a variável de realização de exercícios isotônicos, o GE teve uma melhora clínica nos escores do protocolo em relação ao GC, porém não houve significância estatística no presente estudo. Conclusão: Houve evolução clínica das crianças submetidas à frenectomia e mioterapia, apesar do desvio fonético persistir até a última avaliação.Purpose: To evaluate the clinical outcome of children with alteration on lingual frenulum who underwent frenectomy and myotherapy. Methods: This was a randomized blinded clinical trial. The sample consisted of 16 children between five and 12 years, with altered frenulum classified as short, short with anterior insertion and ankyloglossia. The surgical procedure was performed with standard technique of the institution. Seven subjects participated in the control group (CG) who underwent surgery and nine experimental group (EG) who underwent surgery plus myotherapy. The speech evaluation was conducted by the same researcher and performed three times: before surgery, 15 days and 30 days. On the 15th day were randomly selected children belonging to GE that made isotonic exercises tongue. Results: All subjects evolved in the aspects of mobility and elevation of tongue after perfomed frenectomy, but the speech remained with phonetic alteration. Considering the variable of performing isotonic exercises, the EG had a clinical improvement in the scores of the protocol compared to CG, however there was no statistical significance in this study. Conclusion: There was clinical evolution in children submitted to frenectomy and myotherapy, despite phonological deviation remain until last evaluation

Associação entre aspiração no primeiro ano de vida e uso de sonda alimentar após os dois anos de idade

INTRODUÇÃO: Alterações da deglutição em lactentes são relativamente frequentes. Além da avaliação clínica pelo fonoaudiólogo, as disfagias infantis frequentemente são investigadas com exames objetivos. A videofluoroscopia da deglutição (VFD) é o exame mais utilizado como avaliação instrumental da deglutição, sendo os achados de penetração e aspiração considerados os mais importantes indicadores de alteração na deglutição. Poucos estudos avaliaram a relação entre alterações precoces na VFD e o desfecho de via alimentar em crianças a médio ou longo prazo. OBJETIVOS: Investigar a associação entre o achado de aspiração na VFD realizada em lactentes com até 12 meses de vida e o uso de sonda alimentar após 2 anos de idade. Secundariamente, identificar fatores clínicos associados ao uso de sonda em pacientes com risco ou suspeita de disfagia no primeiro ano de vida. MÉTODOS: Estudo de coorte retrospectivo, com dados de prontuário eletrônico dos pacientes. Foram analisados dados demográficos e clínicos referentes ao nascimento, período neonatal, comorbidades, dados da VFD, reinternações e consultas posteriores à alta para identificação do desfecho. O cálculo de risco relativo foi empregado como medida de associação e uma regressão de Poisson foi realizada para investigação de potenciais preditores do desfecho. RESULTADOS: Foram incluídos 164 pacientes, sendo que 112 (68%) contribuíram com informações para o desfecho de via alimentar aos 2 anos. A maioria eram prematuros (66%), com mediana de idade de 9,28 semanas (IQR 4,87-18,2) ao exame. Aspiração ocorreu em 33% da amostra, sem diferença entre pacientes a termo ou prematuros (p=0,173). O risco relativo do uso de sonda após 2 anos entre lactentes que aspiraram na VFD no primeiro ano de vida foi de 0,74 (IC 0,25-2,16, p=0,573), sendo maior para nascidos a termo. Na regressão de Poisson, número de reinternações (RR 1,04, IC1,01-1,07, p=0,005) e prematuridade <34 semanas (RR 0,266, IC0,07-0,089 p=0,032) estiveram associadas a um aumento do risco de uso de sonda. CONCLUSÃO: A VFD tem baixo valor preditivo em relação ao desfecho alimentar dos pacientes. A presença de aspiração na VFD deve ser considerada como informação complementar para decisão de condutas clínicas. Mesmo na suspeita precoce de disfagia, a via alimentar final depende de um conjunto de fatores, incluindo a presença e a gravidade de comorbidades clínicas, as intervenções e a assistência ao paciente e o desenvolvimento global da criança. Mais estudos são necessários para identificar fatores capazes de estimar com precisão o prognóstico da disfagia em lactentes.INTRODUCTION: Swallowing disorders are relatively frequent in infants. Infant dysphagia is often evaluated by means of instrumental evaluations, in addition to the clinical assessment performed by the speech and language therapist. Videofluoroscopic swallowing study (VFSS) is the most used test to assess swallowing in this population, and the findings of penetration and aspiration are considered the most important indicators of swallowing abnormalities. Few studies have evaluated the association between early changes in VFSS and infants’ feeding outcome. METHODS: Retrospective cohort study, with data obtained from the patients' electronic health records. Demographic and clinical information on birth, neonatal period, comorbidities, VFSS data and outpatient and inpatient visits following hospital discharge were analyzed. We calculated the relative risk for tube feeding and performed a Poisson regression to identify potential predictors. RESULTS: 164 patients were included, 112 (68%) of whom had information about feeding route at 2 years of age. Most patients were premature (66%), with a median age of 9.28 weeks (IQR 4.87-18.2). Aspiration occurred in 33% of VFSS exams, with no difference between term and preterm nfants (p=0.173). The relative risk of tube-feeding after 2 years of age among infants who aspirated in the VFSS in the first year of life was 0.74 (IC 0.25-2.16, p=0.573), being higher for term babies. Poisson regression analysis showed that number of readmissions (RR 1.04, CI 1.01-1.07, p=0.005) and prematurity <34 weeks (RR 0.266, CI 0.07-0.089, p = 0.032) were associated with increased risk of feeding tube use. CONCLUSION: VFSS has a low predictive value in relation to the patients' feeding route. The presence of aspiration in the VFSS should be considered as supplementary information for clinical management. Even in the early suspicion of dysphagia, feeding outcomes depend on numerous factors, including the presence and severity of clinical comorbidities, interventions and patient care, and child's global development. Further studies are needed to identify factors capable of accurately estimating the prognosis of dysphagia in infants

Direito autoral e mídias digitais: o direito de autor na era do streaming

O presente trabalho faz uma análise do direito autoral aplicado aos conteúdos fonográficos, estudando os direitos de autor e conexos, em suas vertentes morais e patrimoniais, demonstrando, ainda, os reflexos jurídicos e práticos causados pelo surgimento e desenvolvimento das mídias digitais e novas tecnologias na indústria musical, expondo a necessidade do Direito em acompanhar tais transformações

Enhanced referral prioritisation for acute adult dietetic services: A randomised control trial to test a web-based decision training tool

BACKGROUND & AIMS: Dietitians in acute adult services need to prioritise dietetic referrals in order to manage their daily workload and ensure effective treatment of patients. Newly qualified dietitians do not usually receive specific training on prioritisation and could be helped with an evidence-based, effective, decision-training tool that is based on the practice of experienced dietitians. We developed an internationally available web-based decision-training tool designed to improve novice dietitians' ability to make dietetic prioritisation decisions. The training tool comprised of a pre-training task, a post-training task and training materials. The aim of this study was to test the effectiveness of the training tool on novices' ability for dietetic prioritisation. METHODS: Pre-registration dietitians and recent graduates (one-year) from across the UK were invited to participate in this randomised controlled trial (RCT). Each participant made prioritisation decisions on a set of dietetic referral scenarios: 53 scenarios at pre-training and 27 at post-training. After pre-training the intervention group was presented with the training materials, whereas the control group was told to carry on with the post-training task. Participants did not know which group they had been randomly allocated to. We calculated i) level of agreement between decisions made by each novice and experts' consensus using Pearson correlation, intra-class correlation (ICC(2,1)); ii) intra-rater consistency using ICC(1,1) and iii) intra-group consistency using ICC (2,1). We compared group means at pre-training and post-training; estimated effect size using the degree of change from pre- to post-training, and 2-factor mixed ANOVA to assess overall effect of the training across the groups and time-points. RESULTS: 151 participants (69 in control and 82 in intervention) completed the trial. The groups did not differ in demographic characteristics. Both Pearson and ICC(2,1) correlations increased with training intervention; a moderate effect of training was found for both metrics, d = 0.69 (r = 0.32) for the former and d = 0.54 (r = 0.26) for the latter. Intra-rater consistency improved with training but with a small effect size, d = 0.32 (r = 0.16). The intra-group consistency also improved with training: ICC = 0.48 pre-training to 0.61 post-training. CONCLUSIONS: The training tool was found to be effective in improving the novice dietitian's ability to prioritise referrals in the acute adult setting. The training tool is freely available at www.dietitianreferral.org for use by all student or early career dietitians internationally

The woman's life after mastectomy in the light of Roy Adaptive theory

Objective: check the adaptation methods of mastectomies women; raise the presence of changes in the habits of life of women after mastectomy; correlate the adaptive process outlined by the woman with the theory presented by Roy and investigate the care provided by nurses to women with mastectomies. Method: For carrying out the survey was used to type descriptive qualitative approach. Results: The role of nursing in the care the woman, who had been subjected to breast surgery, encompasses care for maintenance of their bodily functions as well as support to those who are involved in the process, the individual as a whole and family. Conclusion: Roy's theory is the bases for hypotheses that can be tested

Permanência e deriva: o cais de Martinho de Haro

O presente artigo aborda uma série de cinco pinturas de Martinho de Haro produzidas em momentos distintos e figuram a imagem de um mesmo porto localizado na Ilha de Santa Catarina. A questão da série é pensada a partir de uma compreensão do próprio procedimento pictórico como operação de semelhança e repetição, considerando o que há de desviante no gesto do retorno. São feitas relações com obras de Paul Cézanne e Giorgio Morandi, nas quais são pensadas noções operatórias que comparecem em séries destes ar- tistas e reverberam neste recorte da obra de Martinho de Haro