Effects of Gundelia tournefortii L. on biochemical parameters, antioxidant activities and DNA damage in a rat model of experimental obesity

The present study was designed to investigate the effects of Gundelia tournefortii L. plant extract on different tissues in terms of DNA damage, biochemical and antioxidant parameter values in rats with high-calorie diets. With this aim, Wistar albino male rats were divided into 4 groups containing 6 rats each and the study was completed over 12 weeks duration. At the end of the implementation process over the 12 weeks, rats were sacrificed and blood and tissue samples were obtained. Analyses were performed on blood and tissue samples. According to results for DNA damage (8-OHdG), in brain tissue the OG2 group was significantly reduced compared to the NC group. For MDA results in liver tissue, OG1 and OG2 groups were determined to increase by a significant degree compared to the control group, while the OG2 group was also increased significantly compared to the obese group. In terms of the other parameters, comparison between the groups linked to consumption of a high calorie diet (HCD) and administration of Gundelia tournefortii L. in terms of antioxidant activities and serum samples obtained statistically significant results. Gundelia tournefortii L. plant extracts had effects that may be counted as positive on antioxidant parameter activity and were especially identified to improve DNA damage and MDA levels in brain tissues. Additionally, consumption of Gundelia tournefortii L. plant extract in the diet may have antiobesity effects; thus, it should be evaluated for use as an effective weight-loss method and as a new therapeutic agent targeting obesity.

Scale-up of prevention programmes: sustained state-wide use of programme delivery software is explained by normalised self-organised adoption and non-adoption

Background Population-level health promotion is often conceived as a tension between “top-down” and “bottom-up” strategy and action. We report behind-the-scenes insights from Australia’s largest ever investment in the “top-down” approach, the $45m state-wide scale-up of two childhood obesity programmes. We used Normalisation Process Theory (NPT) as a template to interpret the organisational embedding of the purpose-built software designed to facilitate the initiative. The use of the technology was mandatory for evaluation, i.e. for reporting the proportion of schools and childcare centres which complied with recommended health practices (the implementation targets). Additionally, the software was recommended as a device to guide the implementation process. We set out to study its use in practice. Methods Short-term, high-intensity ethnography with all 14 programme delivery teams across New South Wales was conducted, cross-sectionally, 4 years after scale-up began. The four key mechanisms of NPT (coherence/sensemaking, cognitive participation/engagement, collective action and reflexive monitoring) were used to describe the ways the technology had normalised (embedded). Results Some teams and practitioners embraced how the software offered a way of working systematically with sites to encourage uptake of recommended practices, while others rejected it as a form of “mechanisation”. Conscious choices had to be made at an individual and team level about the practice style offered by the technology—thus prompting personal sensemaking, re-organisation of work, awareness of choices by others and reflexivity about professional values. Local organisational arrangements allowed technology users to enter data and assist the work of non-users—collective action that legitimised opposite behaviours. Thus, the technology and the programme delivery style it represented were normalised by pathways of adoption and non-adoption. Normalised use and non-use were accepted and different choices made by local programme managers were respected. State-wide, implementation targets are being reported as met. Conclusion We observed a form of self-organisation where individual practitioners and teams are finding their own place in a new system, consistent with complexity-based understandings of fostering scale-up in health care. Self-organisation could be facilitated with further cross-team interaction to continuously renew and revise sensemaking processes and support diverse adoption choices across different contexts.

Impact of a high-risk multimorbidity integrated care implemented at the public health system in Chile

During recent years, multimorbidity has taken relevance because of the impact of causes in the system, people, and their families, which has been a priority in the health care plan. Interventions strategies and their implementation are still an emerging topic. In this context, Centro de Innovación en Salud ANCORA UC, together with Servicio de Salud Metropolitano Sur Oriente, implemented as a pilot study High-Risk Multimorbidity Integrated Care strategy. This study aimed to evaluate the impact of this strategy in terms of health services utilization and mortality. A cohort study was conducted with high-risk patients with multimorbidity, stratified by ACG®, intervened between April 2017 and December 2019. The studied population was 3,933 patients who belonged to similar size and location primary care centers. The impact analysis was performed used generalized linear models. Results showed that intervened patients had a significantly lower incidence in mortality (OR 0.56; 95% CI 0.40–0.77), hospital admissions, length of stay, and the number of hospital emergency consultancies. With the proper barriers and facilitators of a real context intervention, the implementation process allowed the systematization and consolidation of the intervention provided in this study. The training for new roles and the constant implementation support from the Centro de Innovación en Salud ANCORA UC team were essential in the progress and success of the intervention. A complete description of the high-risk intervention strategy is provided to contribute to this emerging topic and facilitate its scale-up. We can conclude that this complex intervention was feasible to be implemented in a real context. The Ministry of Health has taken the systematization and consolidation of the conditions for the national scale-up.

Multimedia As a New Approach for Learning in Physical Education

Aim: To present the relevant research results that enhance the possibilities presented today with the use of multimedia applications. An attempt was made to explain its importance in the learning process in general and motor skills in particular. At the same time, we try to define the implementation process and the flags that need attention for the best possible results. Nowadays the use of digital technology has reached very high levels. Especially in the last two years with the COVID-19 pandemic, where distance learning was most used. Teachers have learned to use these digital tools to create attractive lessons for their students, who are already introduced to digital technology in their lives. The use of multimedia in education, as many research suggests, is a modern learning tool in the classroom, but recently they have been used in both physical education and sport. The effectiveness of multimedia use is based on the theory of visualization of information that helps the student store this information in their memory for subsequent recall, make the course more attractive/pleasant, so students are motivated to learn. In PA and sports it is used as a helpful tool, since the master of learning is practice. The means used to present multimedia in the classroom can be tablets, mobile phones, a laptop with a large screen view at the same time.

Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED – The meaningful occupational engagement intervention for people with dementia

Introduction Engagement in meaningful everyday life occupations is linked to well-being. However, people with dementia are often deprived of engagement. As a response, a Danish Dementia Town was established with the intention of transforming care services to improve opportunities for meaningful engagement. The evidence-based The meaningful occupational engagement intervention for people with dementia (MOED) intervention was developed and implemented in dementia town to enhance meaningful occupational engagement. The purpose of this paper is to evaluate the content, impact and implementation process of MOED. Method To evaluate MOED, we applied a program theory-based qualitative approach, building on participant observations and informal conversations with people with dementia ( n = 7) and staff ( n = 9). Data were analysed from a hermeneutic approach to gain an in-depth understanding of how MOED influenced meaningful occupational engagement and to evaluate the implementation process. Findings The main theme ‘Engagement in meaningful occupations – a conditional and fragile process’ emerged along with three subthemes: ‘Creating an everyday space of meaning: Conditions of the intervention’, ‘Occupational engagement as an opportunity to blossom: Impact of the intervention’ and ‘Professional identity, culture and reflections: Contextual barriers to changes to working practice’. Together, the subthemes illustrate how engagement in meaningful occupations arose. However, opportunities to engage in meaningful occupations were fragile, as they depended on various factors within the context. Conclusion Engagement in meaningful occupations emerged when MOED was applied in accordance with the program theory, as it seemed to create spaces where people with dementia could engage in meaningful occupations and they could blossom over time. However, MOED was only partially implemented in accordance with the developed program theory, as several contextual barriers influenced the sustainability of the intervention. MOED showed potential to support improvement in dementia care activity programmes to enhance opportunities to engage in meaningful occupations in everyday life for people living with dementia.

Implementation of Evidence-Based Patient Safety Practices: 4-Years’ Follow-up of a Nationwide Regulatory Intervention in Brazilian Hospitals

Background: Regulatory interventions are widely recommended to improve the quality of health services, but there are few studies on the possible models and their effects. The aim of this study is to describe the implementation process and analyse the results of a nationwide regulatory intervention for the implementation of patient safety practices.Methods: Four nationwide annual cross-sectional assessments were conducted in Brazilian hospitals with Intensive Care Unit beds. The participants involved all facilities operating during 2016-2019 (average N=1,989). The regulatory intervention theory aimed to increase adherence to safe evidence-based practices through national annual assessment involving a set of 21 validated structure and process indicators related to patient safety practices. At moment 1(Risk assessment), data were collected to classify hospitals according to the risk. In the sequence, the Sanitary Surveillance Centers (VISAS) carried out the analysis of the information sent by the hospitals. VISAS classified services into three groups according to compliance with the composite adherence indicator: High (67-100%); Medium (34-66%); and Low Compliance (0-33%). Moment 2 (Risk management) used responsive actions according to the hospital’s classification. Results: The intervention resulted in six annual cyclic stages and, between 2016-2019, 782 (40.1%), 980 (49.0%), 1,093 (54.3%) and 1,255 (61.8%) hospitals participated, respectively. 17 of the 20 indicators with at least two measurements had a significant improvement after national interventions (p<0.05). The overall percentage of compliance increased from 70.7 to 84.1 (p<0.001) and the percentage of hospitals with high compliance increased from 59.1 to 83.0 (p<0.001).Conclusion: The regulatory intervention used was a good tool to strengthen the information system and government actions to promote patient safety. The set of low-cost interventions seems to be useful to prioritise hospitals at higher risk and to induce responsive measures to implement patient safety practices in the evaluated context, promoting the efficiency of the regulatory process.

EFEKTIVITAS PROGRAM KELUARGA HARAPAN DALAM RANGKA PENANGGULANGAN KEMISKINAN DI KECAMATAN RENGASDENGKLOK

Asically, poor people are people who are weak in the ability to fulfill their basic needs such as clothing, food and shelter and also do not have the ability to do business because everything they have is so limited that they are unable to participate in a decent social life. One of the special programs issued by the government is the Family Hope Program as an effort to build a social protection system for the poor in order to maintain and improve the social welfare of the poor as well as an effort to break the chain of poverty. In this study, researchers used a descriptive method with a qualitative research approach. The data collection technique is done by literature study, observation, interview, documentation and triangulation. Data is determined from sources based on nonprobability sampling techniques. The informants in this study were 6 informants consisting of Social Service employees as key informants. PKH Coordinator and PKH Facilitator as secondary informants. And the community, especially the community members of the Family Hope Program as informants. This research uses Edy Sutrisno's theory of effectiveness which consists of understanding the program, being on target, on time, achieving goals and real change. The results of this study indicate that the Harapan Family Program has not been running effectively where there are still obstacles in the implementation process.

Risk Factor Identification Occupational Health and Safety Medical Record Officer Filing Section in Hospital (Literature Review)

Background: Filing service is one of the medical record work units that responsible for the storage and maintenance of medical record files. Filing is one of the work units in medical records that are responsible for the storage and maintenance of medical record files. The work implementation process has risks that can threaten the safety and health of officers. Therefore, it can result in low quality of work. An attempt that can be performed to decrease the risk of accident is the implementation of good Occupational Health and Safety. Through several studies related to Occupational Health and Safety in Filing Unit, some of the factors causing work accidents are physical, chemical, biological, biomechanical factors related to ergonomics, individuals, and psychosocial, which causes the officers to feel unsafe and uncomfortable at work. Therefore, this study aims to identify what are the risk factors for occupational health and safety to medical record officers in the filing section at the hospital.Methods: The research method was qualitative research. The data collection used a literature study. The subjects of the study were medical record officers in the filing section, while the object of the study was occupational health and safety.Results: The results of the study, according to 10 journals reviewed, show that factors that become the risk to occupational health and safety of medical record officers in the filling section are lighting, air temperature, smells caused by old medical record files, virus exposure, medical record storage rack, awareness of using PPE, and work relationship between officers.Conclusions: It is expected that the hospital can improve work facilities and infrastructures, and the self-awareness of medical record officers to maintain safety and comfort at work is required so that a good and optimal working atmosphere can be created.

Awareness and product knowledge of service stakeholders involved in the importation and distribution of HCFC-22 in Botswana

Environmental problems such as global warming, ozone depletion and climate change remain universal subjects of concern, with baneful effects on both the environment and human health. The consumption and venting of ozone depleting substances (ODS) into the atmosphere are the chief anthropogenic cause of ozone depletion. One such manmade ODS with high global warming potential Chlorodifluoromethane (HCFC-22). The MP targeted to phase-out HCFC-22 with obligatory cut-off timelines for its use by 2040 for developing nations. To comply with the HCFC-22 phase-out timelines, meant at embarking on national communications to disseminate information on HCFC-22 phase-out through key stakeholders’ involvement. The achievement of HCFC-22 phase-out strategy depends on participation of key stakeholders in the implementation process. the level of awareness and product knowledge of service stakeholders in the importation and distribution of HCFC-22 in Botswana. customs officers, officers and industrial consumers. Questionnaires and interviews were used to solicit key stakeholders’ views, opinions and perceptions on HCFC-22 phase-out awareness and product knowledge. Results revealed that 87% of the stakeholders are learned and knowledgeable in ODS related service provision. The level of HCFC-22 knowledge and awareness among stakeholders is moderate with distinguished inter-group differences. In particular, industrial consumers had the highest median level of HCFC-22 awareness than other stakeholders, indicating gaps in HCFC-22 phase-out awareness raising and training. About 67% of respondents had low levels of awareness of the HPMP and alternative technologies to HCFC-22. This proposes gaps in information dissemination to key stakeholders and this remains a crucial disparity between the country’s HPMP success lead and lag indicators. There is need to carefully select communication media used in line with the media consumption habits of target markets. Use of popular and commonly accessed social-media platforms would ensure that the HCFC-22 phase-out messages have high chance of reaching targeted stakeholders and the general population.