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Abstract Objective: This study evaluated sociodemographic and radiographic features of patients with distal radial fractures treated at a trauma hospital in southern Brazil, comparing those treated by hand surgery specialists (group 1) and non-specialists (group 2). Methods: This study consists of a retrospective cohort of 200 patients treated in 2020. After reviewing medical records and radiographs, the following parameters were analyzed: age, gender, trauma mechanism, laterality, associated comorbidities and fractures, fracture classification (AO), radial height, radial inclination, and volar inclination. Comparison of the two groups used the Student t-test, chi-square test, or Fisher exact test. Results: Most subjects were women (54%), sustained low-energy traumas (58%), and were left-handed (53%). Group 1 had a lower mean age (50.2 years); most of their subjects sustained high-energy trauma (54%) and had type C fractures (73%); type A fractures prevailed in group 2 (72%). Radiographs showed a significant difference regarding the mean radial inclination (21.5° in group 1 and 16.5° in group 2 [p < 0.001] in women, and 21.3° in group 1 and 17° in group 2 [p < 0.001] in men) and volar inclination (10.1° and 12.8° in groups 1 and 2, respectively [p < 0.001]). In addition, the absolute number of cases with reestablished anatomical parameters per the three evaluated variables was also significantly different; all parameters were better in group 1. Conclusion: Hand surgeons treated the most severe fractures and had the best radiographic outcomes.

Resumo Objetivo: Avaliar as características sociodemográficas e radiográficas dos pacientes com fratura de rádio distal tratados em um hospital de trauma no sul do Brasil, comparando os casos tratados pelos especialistas em cirurgia da mão (grupo 1) com aqueles tratados por não especialistas (grupo 2). Métodos: Coorte retrospectiva realizada com 200 pacientes, no ano de 2020. Por meio da revisão de prontuários e radiografias, analisaram-se: idade, sexo, mecanismo de trauma, lateralidade, presença de comorbidades e fraturas associadas, classificação da fratura (AO), altura radial, inclinação radial e, inclinação volar. Comparou-se os dois grupos por meio do teste t de Student, qui-quadrado ou exato de Fisher. Resultados: A maioria era de pacientes do sexo feminino (54%), traumas de baixa energia (58%) e lateralidade esquerda (53%). O grupo 1 apresentou média de idade menor (50,2 anos), traumas de alta energia (54%), e fraturas tipo C (73%), enquanto no grupo 2 fraturas tipo A prevaleceram (72%). As radiografias apresentaram diferença significativa quanto à média de valores de inclinação radial (21,5° no grupo 1 e 16,5° no grupo 2 [p < 0,001] nas mulheres e, 21,3° no grupo 1 e 17° no grupo 2 [p < 0,001] nos homens) e inclinação volar (10,1° e 12,8° no grupo 1 e 2, respectivamente [p < 0,001]), bem como no número absoluto de casos que reestabeleceram os parâmetros anatômicos nas três variáveis avaliadas, sendo todos melhores no grupo 1. Conclusão: Os cirurgiões de mão trataram as fraturas mais graves e apresentaram os melhores resultados radiográficos.

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Assessing motor competence is essential for evaluating the effectiveness of physical activity interventions that aim to maintain or improve older adults' function. However, assessing motor competence in older adults who have difficulties walking or standing is challenging, because few instruments or guidelines are appropriate for these frail older adults. This article aims to describe challenges in evaluating motor function among frail older adults, discuss strategies for adapting motor function assessments to their home settings, and provide recommendations for future clinical trials so that older adults with ambulatory difficulties can benefit from motor function assessment and physical activity programs. Data came from the baseline assessment of 116 participants of an ongoing clinical trial, "Promoting Seniors' Health with Home Care Aides (Pro-Home)". Our results demonstrated that the Pro-Home study involved participants who would be typically excluded from clinical trials and that the two instruments selected or developed for Pro-Home (Short Physical Performance Battery, Pro-Home Ankle Range of Motion Measure) captured a wide range of lower extremity motor competence with no or few missing data. Recommendations for future studies include knowing the target population thoroughly, developing trust and rapport with all parties involved, and continuously collaborating with interviewers who conduct assessments.

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Intervention research and development for youth in the juvenile legal system (JLS) has often focused on recidivism as the primary outcome of interest. Although recidivism is an important outcome, it is ultimately a downstream marker of success and is affected by changes in other domains of youths' lives (e.g., family and peer relations, neighborhood safety, local and state-level policies). Thus, the present manuscript proposes the application of ecological systems theory to selecting outcomes to assess intervention effects in JLS intervention research to better capture proximal and distal influences on youth behavior. To that end, we first provide an overview of the strengths and limitations of using recidivism as an outcome measure. Next, the current application of social ecology theory to existing research on both risk and protective factors of JLS involvement is discussed, as well as existing work on assessing social-ecological domains within intervention studies. Then, a measurement framework is introduced for selecting pertinent domains of youths' social ecologies to assess as intervention outcomes, moderators, and mediators. To facilitate this, we provide examples of concrete constructs and measures that researchers may select. We conclude with potential new avenues of research to which our proposed framework could lead, as well as potential limitations of implementing our framework.

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Introducción: Los cuidados paliativos hacen referencia al tratamiento dirigido a la identificación precoz e impecable del dolor y otros problemas físicos, psicosociales y espirituales que limitan la calidad de vida de la persona, la familia y sus cuidadores. El objetivo de este artículo es identificar las intervenciones paliativas utilizadas para la valoración y el control de síntomas en personas con enfermedad de Parkinson (EP) avanzada. Materiales y métodos: Se desarrolló una revisión sistémica de la bibliografía aplicando los pasos propuestos por Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). La búsqueda se orientó a partir de una pregunta de revisión estructurada y se incluyeron estudios originales de pacientes con EP avanzada publicados en bases de datos como Medline y Google Scholar entre 2010 a 2021. Resultados: Se revisaron 31 estudios en texto completo y se excluyeron 12 estudios por no alcanzar los criterios de calidad. En total, se incluyeron 19 trabajos en esta revisión sistemática, identificando 10 herramientas clínicas para valorar las necesidades paliativas en EP avanzada, cuatro intervenciones farmacológicas, y tres intervenciones no farmacológicas centradas en disminuir síntomas motores, mejorar la calidad de vida y evitar el estado on/off. Un estudio notificó la derivación del paciente a terapias complementarias y asistidas por dispositivos. Conclusión: Como parte del abordaje paliativo se han descrito un conjunto de herramientas para identificar síntomas y valorar necesidades de atención paliativa. Las intervenciones en la EP avanzada se enfocan en el control de los síntomas motores y no motores para disminuir el impacto de la enfermedad sobre la calidad de vida.(AU)

Introduction: Palliative care refers to treatment aimed at the early and comprehensive identification of pain and other physical, psychosocial and spiritual problems that limit the quality of life of the person, their family and their caregivers. The aim of this article is to identify palliative interventions used for the assessment and control of symptoms in people with advanced Parkinson's disease (PD). Materials and methods: A systematic review of the literature was conducted following the steps proposed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was guided by a structured review question and included original studies of patients with advanced PD published in databases such as Medline and Google Scholar between 2010 and 2021. Results: Thirty-one full-text studies were reviewed and 12 were excluded due to not meeting quality criteria. A total of 19 papers were included in this systematic review, which identified 10 clinical tools to assess palliative needs in advanced PD, four pharmacological interventions, and three non-pharmacological interventions focused on reducing motor symptoms, improving quality of life and avoiding the on/off state. One study reported the referral of patients to complementary and device-assisted therapies. Conclusion: As part of the palliative approach, a set of tools for identifying symptoms and assessing palliative care needs have been described. Interventions in advanced PD focus on the control of motor and non-motor symptoms so as to reduce the impact of the disease on quality of life.(AU)

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BACKGROUND AND OBJECTIVES: The NET-Works trial (2012-2018) randomized 534 children ages 2-4 years at baseline and their caregivers to either a 3-year multicomponent obesity prevention intervention or a control group. This research examined treatment effects on body mass index and other outcomes at 66 months. METHODS: Parent-child dyads (n = 338) who agreed to participate in a 66 month measurement visit were measured for child BMI, physical activity, diet, and cardiometabolic risk factor variables. RESULTS: At 66 months, no significant treatment effects were observed on BMI (Effect = -0.38; 95% CI = -1.13, 0.37). Subgroup results were consistent with the NET-Works 36 month results. Children with overweight at baseline in the intervention group gained significantly less BMI versus children with overweight in the control group (Effect = -1.28; 95% CI = -2.48, -0.07). Among Hispanic children, those in the intervention gained significantly less BMI than those in the control group (Effect = -1.04; 95% CI = -1.97, -0.11). CONCLUSIONS: Evidence suggests that early intervention with children at highest risk for obesity, using community-based, multicomponent, multisetting interventions, may be effective in reducing excess weight gain and obesity among certain subgroups of children. The intervention appeared to be effective in slowing BMI gain 66 months after randomization among children who were already overweight at ages 2-4 years and among children of Hispanic ethnicity.

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ABSTRACTEvidence supporting the direct therapeutic benefits of neuropsychological assessment (NPA) feedback relies mostly upon post-feedback consumer surveys. This randomized-controlled trial with cross-over investigated the benefits of NPA feedback in multiple sclerosis (MS). Seventy-one participants were randomly allocated to NPA with feedback or a "delayed-treatment" control group. The primary hypotheses were that NPA feedback would lead to improved knowledge of cognitive functioning and improved coping. Outcome instruments were administered by a research assistant blinded to group allocation. At 1-week post-NPA feedback there were no significant group-by-time interaction effects, indicating no improvement. But nor was there any significant deterioration in psychological wellbeing, despite most participants receiving "bad news" confirming cognitive impairment. At 1-month follow-up, within-subjects' analyses not only found no evidence of any delayed deterioration, but showed clinically significant improvement (small-medium effects) in perceived everyday cognitive functioning, MS self-efficacy, stress and depression. Despite lack of improvement in the RCT component at 1-week post-NPA feedback, the absence of deterioration at this time, in addition to significant improvements in perceived cognitive functioning, self-efficacy and mood at follow-up, together with high satisfaction ratings, all support NPA feedback as a safe psycho-educational intervention that is followed by improved psychological wellbeing over time.Trial registration: Uniform Trial Number identifier: U1111-1127-1585.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12612000161820.

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Percutaneous coronary intervention (PCI) is increasingly performed for symptom relief and survival benefit, particularly in patients presenting with acute coronary syndromes. It remains controversial whether prior PCI, and specifically when index PCI is performed on previously treated lesion(s), affects peri-procedural and in-hospital mortality. We queried an institutional PCI registry for all unique patients undergoing PCI during a 4-year period and classified them as having had or not prior PCI. If prior PCI had occurred, we further defined index PCI as a target lesion (TLR) PCI or non-TLR PCI, according to lesion(s) treated during the prior PCI. Multivariable analysis was performed to identify predictors of in-hospital mortality. Prior PCI was an independent predictor of in-hospital survival or lower mortality (HR 0.41 [0.22-0.76], P = 0.004), together with lower age (per 5 years, HR 0.73 [0.66-0.82], P < 0.001) and elective PCI (HR 0.63 [0.58-0.70], P < 0.0001). Among prior PCI patients, TLR PCI was associated with higher mortality (HR 3.03 [1.05-8.33]. P = 0.045), while elective PCI status was associated with lower mortality (HR 0.10 [0.01-0.80], P = 0.03). This excess mortality was only present in non-elective PCI cases (PINT = 0.02). We conclude that PCI mortality risk is decreased in patients with prior PCI, particularly when index PCI is performed electively on a lesion not previously treated.

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BACKGROUND: Data integrity is a priority in any internet research study; it should be maintained to protect the safety and privacy of human participants and to maintain the validity and reliability of research findings. However, one noteworthy risk of web-based research is fraudulent respondent activity. When investigators must utilize anonymous web-based recruitment techniques to reach hidden and expanded populations, steps should be taken to safeguard the integrity of data collected. OBJECTIVE: The purpose of this paper is to present a novel protocol in the form of an anonymous web-based research data integrity plan (DIP) protocol that outlines steps for securing data integrity while conducting anonymous web-based data collection. METHODS: In this paper, we discuss a protocol regarding the development and implementation of a specific DIP in response to fraudulent activity in an original large-scale mixed methods study launched in April 2021. Four primary steps, each with a set of affiliated procedures, are presented: (1) defining the risks, (2) planning research protocols, (3) securing data collection and recruitment, and (4) determining enrollment. RESULTS: Following the relaunch of a large-scale original study and implementation of the DIP protocol, preliminary analyses demonstrated no fraudulent activity. A pre-post analysis is underway to evaluate the effectiveness of the DIP strategies from February 2022 through May 2023. CONCLUSIONS: Implementing the DIP protocol could save valuable research time, provides a process to examine data critically, and enables the contribution of rigorous findings to various health fields. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38550.

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BACKGROUND: While interventions have been developed and tested to help youth who have become disconnected from work and school, there is a paucity of research on young people's intervention preferences. This study aims to understand young people's preferred intervention outcomes and approaches for youth who are out of work and school. METHODS: Thirty youth participated in virtual focus groups. Transcripts were analyzed using thematic analysis. RESULTS: Youth want interventions and approaches that support them in (1) vocational readiness, (2) securing a job, and (3) mental health and well-being, while providing them with (4) high-contact, individualized, and integrated support. CONCLUSIONS: Young people want interventions to be individualized and integrated, providing a high level of support for their educational and employment pursuits as well as their mental health and well-being. Incorporating youth's perspectives when designing interventions can increase intervention relevance and potentially service uptake, helping youth continue to pursue their educational and vocational goals.

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Students with neurodevelopmental disorders [Specific Learning Disorders (SLD), Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD)] often experience learning challenges due to underlying weaknesses in cognitive processes. As these are some of the most common conditions to impact functioning, the development of effective treatments is a priority for neuropsychologists. However, the task of designing effective cognitive interventions has proven one of the most difficult challenges for our field. The Arrowsmith Program uses a novel approach compared to other cognitive intervention programs. We hypothesized that intensive practice of one aspect of this program would lead to improved cognitive functions in students with neurodevelopmental disorders. Twenty-seven students with neurodevelopmental disorders (ages 9.4-18.4 years) were recruited from Arrowsmith schools. Cognitive baseline and post-intervention data were gathered using components of the Woodcock-Johnson IV Tests of Cognitive Abilities. The intervention consisted of 6 weeks of intensive practice of the Symbol Relations Task. W-scores were used in a paired sample t-test analysis to determine if cognitive skill improvement occurred. Significant improvements were found in several measures of neuropsychological assessment, in particular in the Cattell-Horn-Carroll broad abilities These results provide a foundation for further work examining the utility of this novel approach to cognitive intervention.

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Contingency management (CM) interventions are based on operant principles and are effective in promoting health behaviors. Despite their success, a common criticism of CM is that its effects to not persist after the intervention is withdrawn. Many CM studies evaluate posttreatment effects, but few investigate procedures for promoting maintenance. Token economy interventions and CM interventions are procedurally and conceptually similar. The token economy literature includes many studies in which procedures for promoting postintervention maintenance are evaluated. A systematic literature review was conducted to synthesize the literature on treatment maintenance in token economies. Search procedures yielded 697 articles, and application of inclusion/exclusion criteria resulted in 37 articles for review. The most successful strategy is to combine procedures. In most cases, thinning or fading was combined with programmed transfer of control via social reinforcement or self-management. Social reinforcement and self-monitoring procedures appear to be especially important, and were included in 70% of studies involving combined approaches. Thus, our primary recommendation is to incorporate multiple maintenance strategies, at least one of which should facilitate transfer of control of the target behavior to other reinforcers. In addition, graded removal of the intervention, which has also been evaluated to a limited extent in CM, is a reasonable candidate for further development and evaluation. Direct comparisons of maintenance procedures are lacking, and should be considered a research priority in both domains. Researchers and clinicians interested in either type of intervention will likely benefit from ongoing attention to developments in both areas.

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OBJECTIVE: The objective of this study was to determine the prevalence, risk factors, and audiological characteristics of auditory neuropathy spectrum disorder (ANSD) in the pediatric population. DESIGN: A retrospective review of medical charts was conducted for children visiting two hospitals in Saudi Arabia. STUDY SAMPLE: Medical records of 1025 patients with sensorineural hearing loss (SNHL) were reviewed. We analyzed the databases for results of audiological examinations, risk factors, and outcomes of intervention including hearing aid (HA) and cochlear implantation (CI). RESULTS: Out of 1025 children with SNHL, 101 patients (9.85%) were identified to have ANSD. Audiological characteristics of the ANSD group revealed a severe-to-profound degree of hearing loss, all showed type A tympanogram and absent reflexes, absent auditory brainstem response (ABR) findings with present cochlear microphonic while otoacoustic emissions were absent in 54.5% of patients. The most prevalent risk factors for ANSD in this group were family history of hearing loss, consanguinity, hyperbilirubinemia, and low birth weight. Pure tone and speech detection thresholds improved significantly with CI compared to HA use in this sample of patients with ANSD. CONCLUSION: This study shows that ANSD is not extremely rare among Saudi children with severe to profound hearing loss, with a prevalence of 9.85%.

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Children with autism spectrum disorder (ASD) show difficulties in social communication behaviors, emotion regulation and daily living skills, and they frequently present with challenging behaviors. In parents of children with ASD, higher rates of stress and mental health problems have been reported than in parents of either typically developing children or children with other conditions. In this study, we tested whether maternal well-being changes with improved social communicative behaviors of children with ASD receiving early intervention. We examined developmental changes in 72 pre-schoolers and stress levels in their mothers (measured by the Parental Stress Inventory) before and after a 12-month community-based intervention program based on the Early Start Denver Model, a naturalistic developmental behavioral intervention targeting social communication. Multiple regression analyses showed that maternal child-related stress was predicted by changes in children's social communication behaviors (measured with the Pervasive Developmental Disorder Behavior Inventory). Gains in the early social communication behavior domain were the strongest predictor of post-intervention child-related maternal stress, surpassing adaptive behavior, language and non-verbal cognitive gains, and reduction in challenging behavior. These findings support the hypothesis that, in children with ASD, the acquisition of social communication behaviors contribute to improvements in maternal well-being.

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BACKGROUND: This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). MATERIALS AND METHODS: Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. RESULTS: 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. CONCLUSIONS: In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.

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INTRODUCTION: Early intervention is crucial for the optimal speech and language development of children with impaired hearing. Underwater vibrostimulation could help develop behavioural reactions to low-frequency stimuli immediately after diagnosis and facilitate aural rehabilitation after hearing aid (HA) or cochlear implant (CI) activation. GOALS: To determine the limits of underwater vibrotactile stimuli perception and to measure the effect of vibrostimulation training on the aural rehabilitation of young children. METHODS: Two adults and three children with congenital hearing loss participated in the first part of the study. Pure tones between 100 and 4000 Hz and natural broadband sounds were delivered under water while the participants were sitting in a pool. The lower thresholds of perception and the maximum comfortable levels were measured and the subjective sensations were recorded. In the second part of the study, 15 children <3 years old were presented with the same stimuli until they developed stable conditioned reactions to the stimuli. The time until the development of "hearing behaviour" and the number of fitting sessions after HA or CI activation were compared between the vibrostimulation group and a control group who did not receive such training. RESULTS: In the first part of the study, participants were most sensitive to 100-400 Hz stimuli, while the stimuli >1000 Hz did not evoke any sensations. The vibrations were felt across all body parts and produced hearing-like sensations in the ear. In the second part of the study, children in the vibrostimulation group required fewer fitting sessions and developed "hearing behaviour" sooner than the control group. CONCLUSIONS: Underwater vibrostimulation is a promising new method of early aural rehabilitation that could be recommended for implementation in paediatric audiology centres.

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Preventive intervention research dictates that new techniques are needed to elucidate what types of interventions work best for whom to prevent behavioral problems. The current investigation applies a latent class modeling structure to identify the constellation of characteristics-or profile-in urban male adolescents (n = 125, aged 15) that interrelatedly predict responses to a brief administration of an evidence-based program, Positive Adolescent Choices Training (PACT). Individual-level characteristics were selected as predictors on the basis of their association with risk behaviors and their implication in intervention outcomes (e.g., mental health, stress exposure, temperament, cognitive function, stress reactivity and emotion perception). Outcome measures included virtual reality vignettes and questionnaire-style role play scenarios to gauge orientations around aggressive conflict resolution, communication, emotional control, beliefs supporting aggression and hostility. A three-class model was found to best fit the data: "NORMative" (NORM), with relatively low symptomatology; "Mental Health" problems (MH-I) with elevated internalizing symptoms; and "Mental Health-E + Cognitive Deficit" (MH-E + Cog) with elevated mental health symptoms paired with cognitive decrements. The NORM class had positive PACT effects for communication, conflict resolution, and aggressive beliefs. Moderation was evidenced by lack of positive PACT effects for the MH-I and MH-E + Cog groups. Also, PACT classes with MH issues showed marginally significant worsening of aggressive beliefs compared to control students in the same class. Results suggest that a latent class model may identify "signatures" or profiles of traits, experiences and other influences that collectively-and more realistically-predict variable intervention outcomes with implications for more effectively targeting interventions than singular factors.

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LAY ABSTRACT: After a diagnosis of autism, it is an important first step to give families information about autism and skills to help them support their child. These interventions are called Parent Education and Training programmes. Little is known about these programmes or if they can make a difference to families, particularly in countries with few autism resources. In this study, we compared two Parent Education and Training programmes in South Africa. EarlyBird/EarlyBird Plus was developed in the United Kingdom, and Autism Cares in South Africa. We wanted to know if parents found the programmes useful, and if any changes were required. We collected information from parents through questionnaires and interviews before and after the group. We also asked a panel of experts (including parents) to compare the programmes. In total, 18 parents attended the EarlyBird/EarlyBird Plus group and 11 attended the Autism Cares group. Parents found both programmes helpful and made suggestions for improvements. Parents showed less stress, more knowledge of autism, and saw improvements in their children. The expert panel rated EarlyBird/EarlyBird Plus as better because it was more supportive of parents and was seen as easier to run in the country. Our study showed that Parent Education and Training programmes are important, but that researchers must study not only the outcomes but also the implementation needs of these programmes.

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There is general consensus that alcohol abuse is a risk factor to be considered in batterer intervention programs. Intimate partner violence perpetrators with alcohol abuse problems are more likely to dropout of batterer intervention programs. However, there is little research on intimate partner violence perpetrators with alcohol abuse problems completing batterer intervention programs. In this study, we analyze drop-out rates among perpetrators with alcohol abuse problems and explore whether perpetrators with alcohol abuse problems completing a batterer intervention program differ from those who do not have alcohol abuse problems in a number of outcomes. The sample was 286 males convicted for intimate partner violence against women, attending a community-based batterer intervention program. Final (i.e., recidivism) and proximal (i.e., risk of recidivism, responsibility attributions, attitudes toward violence, sexism, psychological adjustment, and social integration) intervention outcomes were analyzed. Chi-square test, binary logistic regression, and one-way ANOVA were conducted. Results confirmed higher dropout rates among perpetrators with alcohol abuse problems. Results also showed a reduction in alcohol abuse among perpetrators with alcohol abuse problems completing the batterer intervention program. Finally, results showed that, regardless of alcohol abuse problems, perpetrators who completed the batterer intervention program showed improvements in all intervention outcomes analyzed. Perpetrators both with and without alcohol abuse problems can show positive changes after completing an intervention program and, in this regard, the present study highlights the need to design more effective adherence strategies for intimate partner violence perpetrators, especially for those with alcohol abuse problems.

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BACKGROUND: Childhood obesity among Hispanic children is a public health concern in the United States and Mexico. Although experiences from school-based intervention programs aimed at influencing obesity-related behaviors have been positive, the understanding of those framework elements that are associated with successful outcomes is limited. The purpose of this study was to examine the frameworks used within school-based intervention programs in the United States and Mexico that showed improvements in obesity-related outcomes among Hispanic children. METHODS: A systematic review of the literature was conducted using 4 electronic databases. Inclusion criteria included: incorporating a framework or aspects of frameworks within an intervention, more than 50% of Hispanic children used in the study and obesity-related outcomes (eg, dietary behaviors and anthropometric measurements). Data extraction and evaluation were completed using the Academy of Nutrition and Dietetics Evidence Analysis Manual. RESULTS: Ten articles (United States = 4; Mexico = 6) meeting inclusion criteria were evaluated. Eight studies that included a community-based framework, intensive nutrition education, and continuous communication among stakeholders resulted in improvements in dietary behaviors and anthropometric measurements among children compared to control groups. CONCLUSIONS: Incorporating community-based frameworks may increase the efficacy of school-based intervention programs to reduce obesity-related outcomes among Hispanic children.

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AIM: To evaluate the effectiveness of a structured teaching program (STP) on: a) improving knowledge of female hospital housekeeping personnel regarding harmful impact of tobacco chewing and how to quit, and b) fostering an unfavorable attitude toward tobacco chewing. METHODS: The STP focused on adverse health effects of tobacco chewing, myths and facts, and tobacco cessation. It was administered in regional language to female hospital housekeeping personnel (N=35) over three days. Post-assessments were conducted at 4 weeks following the last session of the STP. RESULTS: Current tobacco use was reported by 26% of the sample. Tobacco chewers (vs. non-chewers) were more likely to be significantly older, have elementary education, belong to nuclear family, have lesser knowledge regarding harmful effects, and have a more favorable attitude toward the practice of tobacco chewing. At the end of 4 weeks following the STP, participants significantly improved their knowledge regarding the harmful health impact of tobacco chewing and how to quit (p=0.001), and showed a significantly less favorable attitude toward tobacco chewing (p=0.001). Change in participants' knowledge scores was found to be negatively correlated with change in attitude scores, implying that increase in knowledge was associated with less favorable attitude toward tobacco chewing (r=-0.427, p=0.011). CONCLUSION: Findings provide preliminary evidence for the effectiveness of health education on harmful impact of tobacco chewing and how to quit, delivered through a STP, in improving knowledge and fostering an unfavorable attitude toward tobacco chewing, among female hospital housekeeping personnel.

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