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Multiple myeloma, the second most common hematologic malignancy worldwide, is an aggressive disease with high morbidity and mortality rates. Although myeloma remains incurable, new treatments have improved patients' life expectancy and quality of life. However, as these therapies are administered for prolonged and often indefinite periods, their success depends on high treatment adherence and significant patient engagement. This study aimed to evaluate the impact of a novel digital educational strategy on treatment adherence, quality of life, and the development of complications in patients with newly diagnosed myeloma. To this end, a two-arm, randomized, prospective, double-blind study was conducted to compare the conventional educational approach alone or combined with the novel digital strategy. This strategy was based on some principles of the Persuasive Systems Design model and incorporated the educational recommendations of patients and caregivers. Compared to the control group that only received information through the conventional educational approach, patients randomized to the digital strategy showed significantly higher treatment adherence and quality of life, associated with increased functionality and rapid reincorporation into daily routines. The digital strategy empowered patients and caregivers to understand the disease and therapeutic options and helped patients recall treatment information and implement healthy lifestyle habits. These results support that patient-targeted educational strategies can positively influence treatment adherence and thus improve their quality of life.

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PURPOSE: We aim to evaluate the effectiveness of a self-makeup program for Brazilian women with breast cancer by measuring different psychological variables and coping strategies. DESIGN: A quasi-experimental, longitudinal, within-group study. SAMPLE: One hundred fifty-two women undergoing treatment for breast cancer. METHODS: Indicators of anxiety, depression, self-esteem, body image, and coping strategies were evaluated before the workshop (baseline), immediately after the workshop (Time 1) and one month after the workshop (Time 2). FINDINGS: The self-makeup program was effective at Times 1 and 2. At Time 1, only a decrease in the anxiety score was observed (Cohen's d= -0.41; p < 0.001). At Time 2, the results were stronger and statistically significant (p ≤ 0.001), showing decreased anxiety (d = -0.62) and depression (d = -0.46) and improved self-esteem (d = 0.61) and satisfaction with the body (d = 0.46) and appearance (d = 0.48). No significant changes were observed in coping strategies, except for denial (d = -0.26). IMPLICATION FOR PSYCHOSOCIAL PROVIDERS OR POLICY: The self-makeup program effectively improved psychological variables, especially one month after the intervention. This program can be used as an adjuvant to treatment to promote mental health and humanize the hospital environment.

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Este artigo pretende refletir sobre a constituição de novos olhares sobre a cidade e o espaço urbano a partir de uma experiência educativa no âmbito do lazer e do turismo realizado por estudantes do curso técnico em Guia de Turismo do Instituto Federal do Espírito Santo (IFES) ­ campus Vitória, ofertado na modalidade de Educação de Jovens e Adultos (EJA). A partir de uma reflexão teórica sobre os limites e potencialidades do lazer, bem como sua importância para a concretização do direito à cidade, buscou-se demonstrar como uma experiência educativa relacionada à elaboração de roteiros turísticos urbanos contribuiu para que os estudantes, em sua maioria, de bairros de periferia, ressignificassem sua visão sobre a cidade, passando a valorizar sua identidade cultural, espaços de vivência e antigos espaços de lazer.

This article aims to reflect on the constitution of new views of the city, and the urban space from an educational experience in the field of leisure and tourism carried out by students of the technical course in Tourism Guide of the Federal Institute of Espírito Santo (Ifes) - Vitória campus, offered in the Education Program for Young People and Adults (EJA). From a theoretical reflection on the limits and potentialities of leisure, as well as its importance for the realization of the right to the city, we sought to demonstrate how an educational experience related to the elaboration of urban tourist itineraries helped students, most of whom from suburban neighborhoods, redefine their views of the city, valuing their cultural identity, living spaces, and former recreation areas.

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A noção de periculosidade da infância pobre vem sendo construída, desde as políticas higienistas do início do século passado, figurando a escola, muitas vezes, como solução para a desigualdade social. Tratou-se de pesquisa qualitativo-descritiva, a partir de entrevistas individuais com trabalhadores de um Núcleo de Educação de Tempo Integral, acerca das crianças e adolescentes em situação de risco e vulnerabilidade social, a partir da teoria das Representações Sociais. Os discursos dos entrevistados descrevem as crianças e adolescentes como vítimas tanto da rua como de suas próprias famílias, percebidas como perigosas e negligentes. Emerge a imagem de uma escola que não apenas instrui e ensina, mas cuida e protege os alunos de uma realidade dura e cruel, alunos cujas famílias não apresentam condições adequadas de exercer o cuidado necessário. Concluindo, tal proteção é descrita como importante para a defesa da sociedade, pois as crianças e adolescentes pobres aparecem não como estando em risco social, mas como sendo o próprio risco.

The notion of dangerousness of poor childhood has been constructed, since the hygienist policies of the beginning of the last century, with school as often a solution to social inequality. This was a qualitative-descriptive research, based on individual interviews with workers of a Center for Full-time Education for children and adolescents at risk and social vulnerability, based on the theory of Social Representations. The interviewees' speeches describe children and adolescents as victims of both, the street and their own families, perceived as dangerous and negligent. Emerges the image of a school that not only instructs and teaches but takes care of and protects students from a harsh and cruel reality, students whose families do not have adequate conditions to exercise the necessary care. Thus, such protection is described as important for the defense of society, since poor children and adolescents appear not as being at social risk, but as the risk themselves.

La noción de peligrosidad de la infancia pobre se ha construido a partir de las políticas higienistas del siglo pasado en los cuales se ubica la escuela, a menudo, como una solución a la desigualdad social. Este fue un estudio cualitativo-descriptivo, a partir de entrevistas individuales con los empleados de un Núcleo de Educación de tiempo integral, sobre los niños y adolescentes en situación de riesgo y vulnerabilidad social, a partir de la teoría de las representaciones sociales. Los discursos de los encuestados describen los niños y adolescentes como víctimas tanto de la calle como de sus propias familias, percibidas como peligrosas y negligentes. Emerge la imagen de una escuela que no sólo instruye y enseña, pero cuida y protege a los estudiantes de una realidad dura y cruel, alumnos cuyas familias no presentan condiciones adecuadas de ejercer el cuidado necesario. En conclusión, esta protección es descrita como importante para la defensa de la sociedad, porque los niños y adolescentes pobres no configuran como personas en situación de riesgo social, mas como sendo ellos el propio riesgo.

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OBJECTIVES: To describe the academic concerns and risk strata of children with sickle cell disease (SCD) as identified through a parent-directed screening tool and to compare the rates of these concerns with actual school service utilization in the clinic population. STUDY DESIGN: We completed a retrospective review of patients with SCD referred to the school intervention program during the 2017-2018 and 2018-2019 school years because of a school-related concern raised by parents or noted by the clinical team. All parents completed the Brief School Needs Inventory (BSNI), a validated parent-response tool used to stratify academic risk. Rates of special education services, grade retention, and results from neuropsychologic testing were captured. Clinical history, the use of disease-modifying therapy, and results from laboratory and neuroimaging studies were also obtained. Descriptive statistics were performed to examine demographic information, clinical history, and BSNI results. RESULTS: In total, 137 unique patients (age range, 14 months to 19 years) completed the BSNI during the study period, for 181 events. According to BSNI risk-stratification, 45% of patients were deemed low, 36% moderate, and 19% high academic risk. Over one-half of parents were concerned about their ability to advocate for their child's needs. Despite legal qualification for a Section 504 accommodation plan, only 20% had established plans. Academic concerns were common with 31% of children reporting an individualized education program and 20% with grade retention/remediation. CONCLUSIONS: Concerns for academic challenges remain high among parents of children with SCD; however, school service utilization remains disproportionately low attributable to numerous reasons.

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ABSTRACT Objective: to analyze the contribution of the Graduate Program in Nursing at Universidade Federal de Santa Catarina to the internationalization of Brazilian nursing. Method: this is a qualitative study of a social historical nature and with a political-documentary basis. The following were used as primary sources: 22 reports (from 1998 to 2020), available in the files of the aforementioned program and in the institutional website of the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, in addition to the five National Graduate Plans; and the secondary source was the article about the 30 years of the Program. The data were analyzed following the thematic content analysis steps, with the aid of the ATLAS.ti® software, version 9.1.5.0. The findings related to the internationalization initiatives carried out within the scope of the Program were interpreted in relation to the macro-policies of Brazilian graduate education. Results: the three analytical categories: Ground zero - The first steps of the Program towards internationalization (1976-1997), Consolidation milestone - Strengthening internationalization strategies (1998-2006), and Excellence milestone - The visibility of internationalization (2007-2020), show the internal and external movements that involved the Program's internationalization process. Conclusion: the contribution of the Graduate Program to the internationalization of Brazilian nursing was based on the commitment of its faculty and students to the profession and its challenges, as well as on a critical perspective at the legal parameters established. The 45-year trajectory, guided by the constitutional bases of international relations, in an original and pioneering way, fostered the development of partnerships, academic advisory and international solidarity. This entire movement exerted a positive impact on the strengthening of the nursing and health science in the world.

RESUMEN Objetivo: analizar la contribución del Programa de Posgrado en Enfermería de la Universidade Federal de Santa Catarina a la internacionalización de la enfermería brasileña. Método: estudio cualitativo de carácter histórico social y base político-documental. Se utilizaron como fuentes primarias: 22 informes (1998 a 2020), Disponíbles en los archivos del citado programa y sitio web institucional de la Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, y cinco Planes Nacionales de Posgrado; y como fuente secundaria el artículo sobre los 30 años del Programa. Los datos se analizaron siguiendo los pasos del análisis de contenido temático, utilizando el software ATLAS.ti versión 9.1.5.0®. Los hallazgos relacionados con las iniciativas de internacionalización llevadas a cabo en el ámbito del Programa se interpretaron en relación con las macropolíticas de los estudios de Posgrado brasileños. Resultados: las tres categorías analíticas: Marco Inicial - primeros pasos del Programa hacia la internacionalización (1976-1997), Marco de consolidación - fortalecimiento de las estrategias de internacionalización (1998-2006) y Marco de excelencia - visibilidad de la internacionalización (2007-2020) muestran los movimientos internos y externos que involucraron el proceso de internacionalización del Programa. Conclusión: la contribución del Programa de Posgrado a la internacionalización de la enfermería brasileña se basó en el compromiso de los docentes y estudiantes con la profesión y los desafíos, así como también en una mirada crítica a los parámetros legales establecidos. La trayectoria de 45 años, guiada por las bases constitucionales de las relaciones internacionales, de manera original y vanguardista, fomentó el desarrollo de asociaciones, asesorías y solidaridad internacional. Este movimiento tuvo un impacto positivo en el fortalecimiento de la enfermería y de las ciencias de la salud en el mundo.

RESUMO Objetivo: analisar a contribuição do Programa de Pós-Graduação em Enfermagem da Universidade Federal de Santa Catarina para a internacionalização da enfermagem brasileira. Método: trata-se de estudo qualitativo de cunho histórico social e de base político-documental. Foram utilizadas como fontes primárias: 22 relatórios (1998 a 2020), disponíveis nos arquivos do referido Programa e site institucional da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, além dos cinco Planos Nacionais de Pós-Graduação; como fonte secundária, o artigo acerca dos 30 anos do Programa. Os dados foram analisados seguindo os passos da análise de conteúdo temática, com o auxílio do software ATLAS.ti versão 9.1.5.0®. Os achados relativos às iniciativas de internacionalização realizadas no âmbito do Programa foram interpretados relacionando-os com as macropolíticas da Pós-Graduação brasileira. Resultados: as três categorias analíticas: Marco zero - os primeiros passos do Programa rumo à internacionalização (1976-1997), Marco da consolidação - fortalecendo estratégias de internacionalização (1998-2006) e Marco da excelência - a visibilidade da internacionalização (2007-2020) mostram os movimentos internos e externos que envolveram o processo de internacionalização do Programa. Conclusão: a contribuição do Programa de Pós-Graduação para a internacionalização da enfermagem brasileira pautou-se no compromisso do seu corpo docente e discente com a profissão e seus desafios, assim como no olhar crítico para os parâmetros legais instituídos. A trajetória, de 45 anos, norteada pelas bases constitucionais das relações internacionais, de modo original e desbravador, fomentou o desenvolvimento de parcerias, assessorias e solidariedade internacional. Todo esse movimento impactou positivamente no fortalecimento da ciência da enfermagem e saúde no mundo.

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Abstract The aim of this study was to assess the impact of a newly developed competency-based marital and relationship education (MRE) program for couples in Curaçao, Dutch Caribbean. In consideration to the 57% divorce rate in Curaçao, and the view that intuition or cohabitation are the sole alternatives to marriage preparation in the Dutch Caribbean, a new additional alternative that is both intellectually defensible and empirically based was proposed. This quasi-experimental study used a sample of 310 participants aged 19-63 years. Using the Solomon design and planned contrast for one-way ANOVA, we compared pre-, post-intervention and follow-up results after 2.5 years of couples in a distress and adjusted group. Statistically significantly increased scores were obtained for (1) marital satisfaction, with an effect size (Cohen's d) of 2.18 for the adjusted group and 4.44 for the distressed group; (2) commitment (adjusted group d = 1.98, distressed group d = 2.90); and (3) the 12 profiled relationship competencies for marital durability (adjusted group d = 1.62, distressed group d = 6.27). Follow-up measurements conducted 2.5 years upon MRE program completion indicated that its effects were durable. We concluded that participation in the Profile of Durable and Successful Couples (PDSC) program resulted in increased marital satisfaction, relationship commitment, and mastery of the 12 profiled family and relationship competencies, that contribute to relationship durability. This implicate that the PDSC program under study can be adopted to prevent relationship erosion, while also assisting those experiencing relationship distress in finding satisfactory solutions. The competency-based focus of the program could be considered the matrix in maximizing the sustainable success of MRE program.

Resumen El objetivo de este estudio es evaluar el impacto de un nuevo programa de educación marital o relacional basado en el desarrollo de competencias familiares para parejas en Curazao, Caribe Holandés. La tasa de divorcio del 57% y la opinión de que la intuición o la cohabitación son las únicas alternativas a la preparación para el matrimonio en el Caribe Holandés demandan una alternativa adicional que no solamente sea intelectualmente defendible, sino que además tenga base empírica. Por esta razón hemos realizado un estudio tipo cuasi experimental en el cual se usó una muestra de 310 individuos de 19 a 63 años. Además, se implementó el diseño de Solomon y el contraste planeado para el ANOVA de una vía, en el cual comparamos los resultados obtenidos de antes y después de una intervención (i.e. curso de educación de parejas). Posteriormente hemos comparado los resultados después de 2.5 años para evaluar el carácter permanente de los resultados en dos grupos de parejas, parejas ajustadas y parejas con dificultades relaciones/ angustiados. Los resultados obtenidos indican puntuaciones significativamente elevadas para la variable (1) de satisfacción marital, con un tamaño de efecto (d=Cohen) de 2.18 para el grupo ajustado y 4.44 para el grupo angustiado; (2) compromiso (d del grupo ajustado = 1.98, d del grupo angustiado 2,90); y (3) las 12 competencias perfiladas para la durabilidad marital (d del grupo ajustado = 1.62 y grupo angustiado = 6.27). Hemos concluido que el programa aumentó la satisfacción marital, el sentido de compromiso con la relación y el dominio de las 12 competencias perfiladas para la familia o relaciones duraderas. Este estudio tiene la siguiente implicación: la sensibilidad cultural y el enfoque basado en desarrollo de competencias pueden ser cruciales y la matriz en la maximación del éxito sostenible de programas de educación relacional y marital como herramienta de intervención preventiva y/o de tratamiento.

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Resumo O objetivo foi analisar as experiências vivenciadas pelos acadêmicos ingressantes de cursos de Licenciatura em Educação Física do Estado o Paraná com a ginástica de competição na Educação Básica. A pesquisa caracterizou-se como descritiva, com abordagem qualitativa e quantitativa. Participaram 168 estudantes ingressantes no ano de 2017 no curso de Educação Física Licenciatura de quatro universidades públicas do Paraná. Foi utilizado um questionário com informações sócio demográficas e questões abertas e fechadas sobre a experiência do conteúdo 'ginásticas de competição no contexto escolar'. Foi utilizada a análise de conteúdo para as questões abertas e a estatística descritiva para a análise das informações sócio demográficas e questões fechadas. Evidenciou-se escassa experiência por parte dos estudantes com as modalidades de ginástica de competição e a falta de oportunidade destes alunos de vivenciar e refletir sobre a ginástica na Educação Física escolar.

Abstract The aim of this paper was to analyze the experiences of freshman students of the Physical Education Program in the State of Paraná (Brazil) regarding competitive gymnastics during their Primary and Secondary Education. The research was descriptive with a qualitative and quantitative approach. Participants included 168 students who entered the Physical Education Program in four public universities in Paraná in 2017. The questionnaire used included socio- demographic information, with open and closed questions about the participants' previous experience in competitive gymnastics in school. Open questions were analyzed by content analysis, while socio-demographic information and close questions were analyzed by descriptive statistics. Results evidenced that students had little experience in competitive gymnastics and lacked opportunities to experience and reflect on gymnastics in school Physical Education.

Resumen El objetivo fue analizar las experiencias vivenciadas por los estudiantes que ingresaron a cursos de Licenciatura en Educación Física en el Estado de Paraná (Brasil) con la gimnasia de competición durante la Educación Primaria y Secundaria. La investigación se caracterizó como descriptiva con abordaje cualitativo y cuantitativo. Participaron 168 estudiantes que ingresaron en el año 2017 en cursos de Educación Física Licenciatura de cuatro universidades públicas de Paraná. Fue utilizado un cuestionario con información sociodemográfica, preguntas abiertas y cerradas sobre la experiencia del contenido de gimnasia de competición en el contexto escolar. Para analizar las preguntas abiertas fue utilizado el análisis de contenido. En el análisis de información sociodemográfica y preguntas cerradas se usó estadística descriptiva. Se evidenció escasa experiencia por parte de los estudiantes con las modalidades de gimnasia de competición y falta de oportunidad de estos alumnos de vivenciar y reflexionar sobre la gimnasia en la Educación Física escolar.

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BACKGROUND: Multidisciplinary interventions may be useful for children and adolescents with diabetes mellitus (DM), especially in areas where new blood glucose monitoring and control technologies are difficult to access. METHODS: PAANDA, a care program for adolescents and children with diabetes, was implemented in patients aged 0 to 18 years and 11 months. The effect of the intervention was determined by self-blood glucose monitoring (SBGM) and glycosylated hemoglobin (HbA1C ) levels at start and after 6 months. RESULTS: A total of 121 patients with DM were evaluated, mean age of 14.27 years (SD: 4.60 years). Blood glucose measurements in range (70-120 mg/dL pre-prandial or 70-180 mg/dL post-prandial) increased by 20.67% before breakfast, 8.14% after breakfast (both P-value <.001), 5.02% before lunch (P-value = .02), 8.66% after lunch (P-value <.001), 11.50% before dinner (P-value <.001), 11.87% after dinner (P-value <.001), and 8.00% at dawn (P-value = .001). This change was accompanied by fewer values in the hyperglycemic category (-19.49% before breakfast, -7.73% after breakfast, both P-value <.001) and hypoglycemia (-1.18%). HbA1C levels decreased significantly 1.8% (P-value = .018). Multivariate logistic regression analysis showed an increase in glycemic control associated with each month after the intervention time in the PAANDA program (P-value <.001 for all the time points evaluated) and a significant decrease in glycemic variability. CONCLUSIONS: The multidisciplinary PAANDA intervention had a beneficial effect on glycemic control, with an improved time in range in a population of children and adolescents with DM.

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This study aimed to investigate the effect of a caregiver intensive education program (CIEP) on anxiety, depression, and quality of life (QOL) in patients with drug-resistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) who underwent cortico-amygdalohippocampectomy (CAH). Ninety patients with drug-resistant TLE-MTS who underwent CAH and their caregivers were recruited and randomly allocated to the CIEP group or control group as 1:1 ratio. Caregivers received the CIEP program or routine guidance/education (control group). Anxiety/depression and QOL in patients at month (M)0, M1, M3, and M6 were assessed by the Hospital Anxiety and Depression Scale (HADS) scale and the QOL in Epilepsy Inventory-31 (QOLIE-31), respectively. Treatment efficacy at M6 was assessed by Engel classification. The HADS-anxiety score at M3 (P=0.049) and M6 (P=0.028), HADS-anxiety score change (M6-M0) (P=0.001), percentage of anxiety patients at M6 (P=0.025), and anxiety severity at M6 (P=0.011) were all decreased in the CIEP group compared with the control group. The HADS-depression score at M6 (P=0.033) and HADS-depression score change (M6-M0) (P=0.022) were reduced, while percentage of depression patients at M6 (P=0.099) and depression severity at M6 (P=0.553) showed no difference in the CIEP group compared with the control group. The QOLIE-31 score at M6 (P=0.043) and QOLIE-31 score change (M6-M0) (P=0.010) were both elevated in the CIEP group compared with the control group. In conclusion, CIEP for caregivers contributed to the recovery of anxiety and depression as well as the improvement of QOL in patients with drug-resistant TLE-MTS who underwent CAH.

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RESUMO Objetiva compreender a configuração e os impactos do Programa de Educação Tutorial Educação Física do/no Cefd/Ufes, entre os anos de 1994 a 2018. Buscamos entender qua(is) proposta(s) formativa(s) se constituíram em diferentes momentos no programa. Como fontes, faz uso do acervo de materiais localizados no arquivo do PET EF e no Cefd/Ufes, das produções do grupo, dos documentos externos de regulamentação e legislação do programa. Percebemos que o grupo realizou atividades que englobaram ensino, pesquisa e extensão e sofreu diversas mudanças, passando de Programa Especial de Treinamento à Programa de Educação Tutorial. Além disso, o PET EF se desenvolveu em meio às lutas de representação e resistiu taticamente em frente às estratégias impostas.

ABSTRACT Devoted to understanding the configuration and impacts of the Cefd/Ufes Physical Education Tutorial Education Program between 1994 and 2018. We sought to understand what formative proposal (s) were constituted at different times in the program. As sources, it makes use of the collection of materials located in the PET EF archive and Cefd / Ufes, the group's productions, the external regulatory documents and the program's legislation. We realized that the group carried out activities that included teaching, research and extension and underwent several changes, going from Special Training Program to the Tutorial Education Program. PET EF developed in the midst of the representation struggles and resisted tactically in front of the imposed strategies.

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Objective: Improve knowledge, attitudes and reproductive behaviours through an educational intervention aimed at reproductive health in two groups of Mexican women. Materials and methods: We carried out an education program targeting two segments, indigenous women and marginalised adolescents, with a pre-test, immediate post-test and post-test six months after it was carried out. Instruments used: a reproductive health history was established (pre-test and post-test six months) and a questionnaire of knowledge, attitude and conduct related to reproductive health and condom use (pre-test, immediate post-test and post-test six months). Results: Improved test scores in reproductive health and condom use - knowledge, attitude and conduct, were notable in the group of indigenous women (p < .05). However, in the group of adolescents there was a significant increase (p < .05) only in reproductive health - knowledge and attitude; in condom usage, increase was only noted in knowledge and conduct, not in attitude (pre-test vs immediate post-test). Six months after post-test results there was a decrease in test scores in comparison with the immediate post-test results. They were however, higher than the pre-test scores. Conclusions: Both groups significantly increased short-term knowledge, attitude and conduct related to reproductive health and condom use through the implementation of an education program. Results show that this education program can contribute to the development of an effective education program.

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RESUMEN Fundamento: El insuficiente nivel de conocimiento sobre salud bucal, la presencia de factores de riesgos y las características propias de la juventud, son elementos determinantes que favorecen el desarrollo y aplicación de programas educativos. Objetivo: Evaluar la efectividad del Programa Educativo de salud bucodental en reclusos del Centro de Atención al Joven de la provincia Sancti Spíritus durante el período de enero a julio del 2017. Metodología: Se realizó un estudio cuasiexperimental de intervención comunitaria con diseño antes y después en un ambiente no controlado en una muestra de 42 reclusos de 18 a 25 años. El nivel de conocimiento se identificó a través de una encuesta, las prácticas a través de una entrevista estructurada y la eficiencia del cepillado bucodental mediante el control de placa dentobacteriana. Resultados: Se observó un cambio de 9.5 % a un 71.4 % del nivel de conocimiento bueno, al igual que en las prácticas y en la eficiencia del cepillado de un 31.0 % a un 83.3 %. Conclusiones: El Programa Educativo demostró su efectividad al obtener resultados satisfactorios en cuanto a la modificación de los conocimientos y prácticas sobre salud bucodental en los reclusos.

ABSTRACT Background: The insufficient level of knowledge about oral health, the presence of risk factors and the characteristics of youth, are determining elements that favor the development and application of educational programs. Objective: To evaluate the effectiveness of the Oral Health Education Program in inmates of the Youth Care Center in Sancti Spiritus province from January to July 2017. Methodology: A quasi-experimental study of community intervention with former and later design in an uncontrolled environment was designed, sample of 42 inmates aged 18 to 25. The level of knowledge was identified through a survey, practices through a structured interview and the efficiency of oral brushing through the control of dentobacterial plaque. Results: A change from 9.5 % to 71.4 % of good knowledge level was observed, as well as practices and brushing efficiency from 31.0 % to 83.3 %. Conclusions: The Education Program demonstrated its effectiveness by obtaining satisfactory results regarding the modification of knowledge and practices on oral health in inmates.

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BACKGROUND: Effective education is considered essential for people with type 1 diabetes mellitus (T1DM) to adhere to a complex and long-term medical regimen and to delay or prevent the onset of diabetes-related complications. OBJECTIVE: We compared the effect of a compact, cost-effective, education program (CEPT1) vs a long-term program on the metabolic control of children and adolescents with T1DM. METHODS: Young people aged 8 to 21 years with T1DM were randomized to a short-term (experimental) or an extensive education program (control). The experimental group participated in three sessions of 90 minutes, with one session per week, containing five short videos. The control group attended an extended program delivered through 45-minute PowerPoint lectures, with one class every 3 months. The primary outcome was change in glycated hemoglobin A1c (HbA1c) levels from baseline to endpoint (baseline, 3, 6, 9, and 12 months). RESULTS: In total, 62 patients were randomized to the experimental (CEPT1) (n = 32) or control (n = 30) groups. Both groups showed comparable improvement in HbA1c levels at the end of 12 months (P = .183). In a per-protocol analysis, the mean HbA1c level reduction was -2.3% (-2.6, -2.0) in the experimental group and - 1.8% (-2.0, -1.5) in the control group (P = .008). CONCLUSION: CEPT1 was comparable with an extensive education program in reducing HbA1c levels. In a per-protocol analysis, the CEPT1 was more effective than the control program in reducing HbA1c levels. CEPT1 is a simple and cost-effective tool that can equally be used in settings with limited resources and specialized centers.

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El proyecto desarrollado en la Institución Educativa de Machado, municipio de Arroyohondo en el departamento de Bolívar, Colombia, tuvo como objetivo generar un aprendizaje ambiental significativo en niños y adolescentes; de forma tal que se modifiquen actitudes y comportamientos frente a situaciones que contribuyen al deterioro y contaminación del ambiente. Los conocimientos adquiridos y los cambios actitudinales y participativos que presentaron los niños y jóvenes, mostraron los resultados positivos de trabajar educación ambiental de manera transversal en el Proyecto Educativo Institucional, encaminado a la conservación de los recursos y a la formación de sujetos más comprometidos y responsables con el ambiente. La metodología participativa incluyó una etapa de planificación, implementación, verificación y mejora continua del proceso, donde a partir de la identificación de las condiciones ambientales existentes, se establecen los lineamientos necesarios para generar un Programa de Educación Ambiental. Como resultado se obtiene la línea base ambiental y la estructuración de cuatro programas sobre los cuales debe trabajar la institución educativa en formación ambiental.

The project developed in the educational institution in Machado, Municipality of Arroyohondo in the Department of Bolivar, Colombia aimed to generate a significant environmental learning in children and adolescents in such a way that attitudes and behaviors are modified in situations that contribute to the deterioration and contamination of the environment. The knowledge acquired and the attitudinal and participatory changes displayed by the children and youngsters showed the positive results of working environmental education in a cross-curricular way in the Institutional Educational Project (PEI in Spanish), aimed at the conservation of resources and the training of people more committed and responsible with the environment. The participatory methodology included a planning, implementation, verification and continuous improvement process where, from the identification of the existing environmental conditions, the necessary guidelines to generate an environmental education program are established. As a result, the environmental baseline and the structuring of four programs on which the educational institution must work in environmental training are obtained.

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This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method. In the ICEP group, the caregivers received ICEP, while in the Control group caregivers received usual education and guidance. All patients received conventional rehabilitation treatment. Cognitive impairment (assessed by Mini Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score), anxiety (assessed by Hospital Anxiety and Depression Scale (HADS)-A score and Self-rating Anxiety Scale (SAS) score), and depression (assessed by HADS-D score and Self-rating Depression Scale (SDS) score) were assessed at baseline (M0), 3 months (M3), 6 months (M6), and 12 months (M12). Cognitive impairment score at M12 and cognitive impairment score change (M12-M0) were increased, while cognitive impairment rate at M12 was reduced in the ICEP group compared with the Control group. Anxiety score change (M12-M0), anxiety score at M12, and anxiety rate at M12 were decreased in the ICEP group compared with the Control group. Depression score change (M12-M0), depression score at M12, and depression rate at M12 were lower in the ICEP group compared with the Control group. Further subgroup analysis based on baseline features also provided similar results. In conclusion, ICEP effectively reduced cognitive impairment, anxiety, and depression in AIS patients.

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Introducción: La atención estomatológica integral a la población presenta un amplio marco en el desarrollo de la atención primaria de salud, ya que el estomatólogo está íntimamente relacionado con el médico de la familia. Objetivos: Identificar factores de riesgos en mujeres embarazadas del Área Centro, Sancti Spíritus y diseñar un programa educativo que ayude a disminuirlos. Método: Se utilizó el método descriptivo. El universo estuvo constituido por 100 gestantes. Los datos fueron reunidos mediante la aplicación de un cuestionario diseñado por los autores. El análisis de la información se realizó con el sistema estadístico Stadistica, Package, Scentific, Social (SPSS), a partir de la utilización del método Delphi y de la proyección en tablas de distribución de frecuencias absolutas y relativas. Resultados: El mayor porciento de gestantes que asistieron a la consulta fue el 66 por ciento, perteneciente al área urbana. En cuanto al perfil profesional, predominaron las ocupaciones técnicas (7 por ciento), con un rango de edad comprendido entre los 20 y 24 años (10 por ciento). El nivel preuniversitario fue el más representativo (39 por ciento). Entre los factores de riesgo biológico el que más se presentó fue el antecedente de caries con 67 por ciento y los factores de riesgo por hábitos, en los que predominó la deficiente higiene bucal en 63 por ciento. Se diseñó un programa educativo. Conclusión: El área urbana fue la más representativa en las consultas de gestantes. El nivel técnico fue el que más predominó en el aspecto ocupacional y el nivel educacional en el preuniversitario. Los factores de riesgos presentes fueron la deficiente higiene bucal y la dieta cariogénica. El programa educativo diseñado debe lograr el abandono de los factores de riesgos(AU)

Introduction: Dentist care for the population presents a broad framework at primary health care, since the dentist associates much closely to the family doctor. Objective: To identify risk factors in pregnant women in Área Centro, Sancti Spíritus and to design and educational program. Method: A descriptive cross-sectional study was carried out. One hundred pregnant women formed the universe. Data were collected in a form designed by the authors. The information analysis was expressed in Stadistica, Package, Scentific, and Social (SPSS) in charts of absolute y relative distribution of frequency. Results: The largest number of pregnant women who attended the consultation was 66 percent from the urban area. Seven percent had technical education. Age ranged 0 to 24 years (10.0 percent). 39.0 percent had pre-university education level, which was the most representative. The most frequent risk factors were history of cavities (67.0 percent), and poor oral hygiene habits (63.0 percent). An educational program was designed. Conclusion: The urban area was the most representative in consultations of pregnant women, the technical level was the majority in the occupational level, educational level was high school, and poor oral hygiene and cariogenic diet were the risk factors present. The educational program designed for improving the quality of health in pregnant women should eliminate these risk factors(AU)

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Resumen Objetivo: Este artículo analiza dos campañas orientadas a prevenir el embarazo en adolescentes, con el fin de elucidar la incorporación de elementos procedentes de disciplinas como el mercadeo, y cómo estos pudieron incidir en los logros de las mismas, a la luz del modelo de "la rueda de mercadeo social". Metodología: Se revisaron informes de estudios cualitativos y cuantitativos sobre las campañas "Sexo a lo Bien" y "Parents Speak Up!", realizadas en dos contextos sociales diferentes: una en Colombia y la otra en Estados Unidos. El procedimiento de análisis fue el rastreo de elementos de mercadeo implícitos en ambas campañas, a partir de los archivos identificados sobre las mismas. Resultados: Se evidencia que la falta de coherencia entre la definición del problema, la estrategia usada y la ejecución de la misma afecta los resultados esperados en una de las campañas. La campaña "Parents Speak Up!" presenta logros importantes, porque se basó en un buen respaldo teórico, articulado con una ejecución bien definida frente a distintos públicos focalizados. La menor efectividad de resultados en la campaña "Sexo a lo Bien" se debe a la ambiciosa propuesta, así como en la falta de coherencia entre la concepción del problema que se enfrenta y la poca claridad en definición de públicos de interés y en el contenido de los mensajes. Conclusiones: Para el logro efectivo de resultados en campañas educativas sobre prevención de embarazo en adolescentes, el mercadeo social puede aportar elementos en cuanto a incorporar el proceso de planeación, ejecución y evaluación respecto del tipo de producto, el público y el contenido de los mensajes.

Abstract Objective: this article analyses two campaigns designed to prevent adolescent pregnancy. The authors aim to clarify the implementation of elements coming from other disciplines such as marketing, and the possible effects in the campaigns' results, in light of "the social marketing wheel" model. Methodology: reports of qualitative and quantitative studies on the campaigns "Sexo a lo Bien" and "Parents Speak Up!" were studied. Those campaigns were originally implemented in different contexts: one in Colombia and one in the United States. The analysis was carried out by tracking implicit marketing elements in both campaigns, from existing records about them. Results: a lack of coherence between the problems' definition, the chosen strategy and its execution was evident and affected the expected outcomes in one of the campaigns. The "Parents Speak Up!" campaign achieved important results, because it had a strong theoretical basis, articulated with a well-defined execution for different target focused audiences. The "Sexo a lo Bien" campaign had less effective results. It was too ambitious; it lacked coherence between the aimed problem, an unclear definition of target audience and the content of the messages. Conclusions: Social marketing can offer valuable elements for and educational campaign on adolescent pregnancy to achieve effective results, such as planning, execution and evaluation of the type of product, the target audience and the content of the message.

Resumo Objetivo: este artigo analisa duas campanhas encaminhadas a prevenir a gravidez na adolescência, visando esclarecer a incorporação de elementos originários de disciplinas como o marketing, e seus possíveis efeitos nos resultados das campanhas, utilizando o modelo de "a roda de marketing social". Metodologia: revisaram-se relatórios de estudos qualitativos e quantitativos sobre as campanhas "Sexo a lo Bien" e "Parents Speak Up!", realizadas em dois contextos sociais diferentes: uma foi feita na Colômbia e a outra nos Estados Unidos. A análise foi mediante rastreio de elementos de marketing implícitos nas duas campanhas, com arquivos identificados sobre elas. Resultados: a falta de coerência entre a definição do problema, a estratégia utilizada e a sua execução foi evidente, afetando os resultados esperados em uma das campanhas. A campanha "Parents Speak Up!" obteve resultados importantes, porque teve uma forte base teórica, articulada com uma execução bem definida para diferentes públicos focalizados. A campanha "Sexo a lo Bien" teve resultados menos efetivos por ser uma proposta muito ambiciosa, e por falta de coerência entre a concepção do problema objetivo, uma definição difusa de públicos de interesse e o conteúdo das mensagens. Conclusões: para conseguir resultados efetivos nas campanhas educativas sobre a prevenção da gravidez na adolescência o marketing social pode fornecer elementos relacionado com o processo de planejamento, execução e avaliação do tipo de produto, do público alvo e do conteúdo das mensagens.

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BACKGROUND: Fibromyalgia (FM) is a syndrome characterized by widespread chronic pain associated to other symptoms, such as: fatigue, anxiety, depression and sleep disorders. Health education programs (HEP) have emerged as good non-pharmacological strategies to treat it. However, it is still not clear if the benefits are only subjective, or it has also objective impacts on immune and or neuroendocrine systems. METHODS: Fifty-eight fibromyalgia women were randomly allocated in experimental group (n = 27) or control group (n = 31). The experimental group was submitted to HEP treatment for 11 weeks, while control group did not receive intervention at the same period. All data were collected at zero and 11th week by a blinded researcher. The statistical analysis were made in GraphPad Prism software (version 5.0) with significant level adjusted for α = 0.05. RESULTS: Forty-four patients concluded the full study, 21 in the experimental group and 23 in the control group. Intragroup and intergroup analysis revealed that treatment induced significant increases of IL-4 plasma levels, anti-inflammatory cytokine/inflammatory cytokine ratio (AC/IC ratio), salivary cortisol levels, in addition to significant decreases on FIQ scores. Intergroup variation analyses revealed also significant increases of IL-10 plasma levels. CONCLUSION: The results presented suggest that this kind of HEP could induce subjective and objective changes (immune and neuroendocrine), that could explain, at least in part the improvement of fibromyalgia patient's health status. (Clinical Trial Registration Number - ReBEC - RBR-5tdnbr).

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The proposal of the Educational Program for Health Work (EPW - Health) provides opportunities for higher education institutions to train health professionals with a profile appropriate for social needs, based on skills and ability to work in teams, giving full attention to health, to interdisciplinarity and to humanistic aspects, besides favoring the implementation of health services that are more resolvable and adequate to the needs of the population. Against this background, the aim was to delineate social representations of "Being a SUS Professional" from the perspective of Health Sciences undergraduates. Secondary data were obtained from 234 candidates who entered the EPW-Health, the third time it was offered in the institution, from a free recall projective test through the inducing term "Being a SUS professional", applied by mentors of the Program. The EVOC® software was used for analysis, and the products were organized according to previous experience in the program. Between those people with previous experience (n=98) representational components aligned in the SUS, such as "Multi-professional service", "Universality", "Integrality" and "Humanization" were found. From the perspective of another group there was no direct allusion to the guidelines and principles of the SUS as the core elements of social representations. These results indicate that the experience in EPWHealth can contribute greatly for training of health professionals aware of the social demands of SUS

A proposta do Programa de Educação pelo Trabalho para a Saúde (PET - Saúde) vem oportunizar às instituições de ensino superior a formação de profissionais de saúde com perfil adequado às necessidades sociais, pautada em competências e habilidade para o trabalho em equipe, para a atenção integral à saúde, para a interdisciplinaridade e para os aspectos humanísticos, além de favorecer a efetivação de serviços de saúde mais resolutivos e adequados às necessidades da população. Em face desse cenário, objetivou-se delinear representações sociais sobre "Ser profissional do SUS" na perspectiva de graduandos de 12 cursos de Ciências da Saúde de uma Universidade Federal. Foram obtidos dados secundários de 234 candidatos à terceira oferta do PET-Saúde na instituição, a partir do teste projetivo de evocação livre por meio do termo indutor "Ser profissional do SUS", aplicado por professores tutores do Programa. O software EVOC® foi utilizado para as análises das representações sociais, sendo os produtos organizados conforme a vivência prévia no referido programa. Verificou-se dentre aqueles com experiência anterior no PET-Saúde (n=98) componentes representacionais pautados na proposta do SUS tais como "Atendimento multiprofissional", "Universalidade", "Integralidade" e "Humanização". Já na perspectiva do outro grupo, não houve alusão direta às diretrizes e princípios dos SUS como elementos do núcleo central das representações sociais. Esses resultados apontam que a experiência no PET-Saúde pode contribuir fortemente para a formação de profissionais de saúde atentos às demandas sociais do SUS.

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