Assessing the Role of Collective Efficacy Beliefs During Participative Occupational Health Interventions

Background: For group-based participatory interventions in the context of occupational health, no questionnaires exist to assess the participants' active engagement in the interventions. On the basis of the construct of collective efficacy beliefs, this study has developed a questionnaire with which the group-related efficacy beliefs can be assessed as a precondition for participants actively engaging in participative interventions.Methods: Participants were drawn from a two-arm cluster-randomized intervention study to fill out the questionnaire. A Factor analysis and an initial psychometric calibration were performed. In a second step, the group-related properties of the questionnaire were validated using a Multilevel analysis.Results: The factorial structure of the questionnaire is consistent with the theory of efficacy beliefs according to A. Bandura. Furthermore, the collective efficacy expectations of the interventions' participants are lowered in the absence of appreciation and support in the psychosocial environment of the worksite.Conclusions: Assessing participant's quality of interventional activity in participatory interventions by collective efficacy can be valuable in understanding the amount of interventional activity. In addition, it is recommended to consider the influence of the worksite's psychosocial environment on collective efficacy beliefs when implementing participatory interventions.Clinical Trial Registration: Registration trial DRKS00021138 on the German Registry of Clinical Studies (DRKS), retrospectively registered on 25 March, 2020.

Rationale and design of reGional network for Acute Myocardial Infarction (GAMI): protocol for a Prospective Cluster-randomized Intervention study of STEMI management

BackgroundTimely revascularization is essential for ST-segment elevation myocardial infarction (STEMI) patients to reduced mortality rate. However, it's seldom achieved due to patient and medical system-level barriers in China, especially in the rural area. It's needed to establish a regionally coordinated network to promote the early revascularization rate for STEMI patients.MethodsRegional network for Acute Myocardial Infarction (GAMI) is a multi-center, prospective, intervention study with regional intervention. It was carried out in 8 centers by 1:1 cluster randomization in south China with diverse economic and medical levels since 2016. The regional intervention were carried out in the intervention centers, which consisted of intensive public education and regional network construction for STEMI treatment, including community and online propaganda to raised patients' awareness of the treatment for STEMI and establishment of regional clinic-EMS-PCI transfer network for timely primary revascularization. Consecutive acute STEMI patients were enrolled for assessment of regional intervention according to the key performance indicators. The primary study endpoint was reperfusion rate, and secondary endpoints included change of pre-hospital delay, changes of in-hospital delay time and in-hospital outcomes. All patients were followed up for more than 1 year.DiscussionThe GAMI study is a prospective cluster-randomized intervention study, which would provide helpful evaluation of the effectiveness of enhanced public education and regional network construction on regional STEMI treatmentTrial registration: Clinical Trials, NCT03928119. Registered , 25 April, 2019， https://clinicaltrials.gov/ct2/show/NCT03928119?id=NCT03928119&draw=2&rank=1

Pro-vegetarian food patterns and cardiometabolic risk in the PREDIMED-Plus study: a cross-sectional baseline analysis

Purpose We explored the cross-sectional association between the adherence to three different provegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), and the cardiometabolic risk in adults with metabolic syndrome (MetS) of the PREDIMED-Plus randomized intervention study. Methods We performed a cross-sectional analysis of baseline data from 6439 participants of the PREDIMED-Plus randomized intervention study. The gPVG food pattern was built by positively scoring plant foods (vegetables/fruits/legumes/grains/potatoes/nuts/olive oil) and negatively scoring, animal foods (meat and meat products/animal fats/eggs/fish and seafood/dairy products). The hPVG and uPVG were generated from the gPVG by adding four new food groups (tea and coffee/fruit juices/sugar-sweetened beverages/sweets and desserts), splitting grains and potatoes and scoring them differently. Multivariable-adjusted robust linear regression using MM-type estimator was used to assess the association between PVG food patterns and the standardized Metabolic Syndrome score (MetS z-score), a composed index that has been previously used to ascertain the cardiometabolic risk, adjusting for potential confounders. Results A higher adherence to the gPVG and hPVG was associated with lower cardiometabolic risk in multivariable models. The regression coefficients for 5th vs. 1st quintile were − 0.16 (95% CI: − 0.33 to 0.01) for gPVG (p trend: 0.015), and − 0.23 (95% CI: − 0.41 to − 0.05) for hPVG (p trend: 0.016). In contrast, a higher adherence to the uPVG was associated with higher cardiometabolic risk, 0.21 (95% CI: 0.04 to 0.38) (p trend: 0.019). Conclusion Higher adherence to gPVG and hPVG food patterns was generally associated with lower cardiovascular risk, whereas higher adherence to uPVG was associated to higher cardiovascular risk.

Comparing the Effects of Rose Essential Oil and Benson Relaxation Technique on Preoperative Anxiety and Hemodynamic Status and Postoperative Complications in Rhinoplasty Candidates

Objective: Rhinoplasty is a stressful and challenging procedure for plastic surgeries. Researchers are looking for appropriate methods of traditional and complementary medicine to control anxiety before rhinoplasty. This study aims to compare the effects of Benson Relaxation Technique (BRT) and Rose essential oil on preoperative anxiety and hemodynamics and postoperative complications in rhinoplasty candidates. Methods: In this randomized intervention study, participants were 68 candidates for rhinoplasty referred to Zare Hospital in Sari, Iran who were randomly divided into BRT (n=34) and aromatherapy (n=34) groups. Anxiety was assessed before and after the intervention by Spielberger’s State-Trait Anxiety Inventory. Hemodynamic status, intraoperative bleeding, nausea and vomiting were assessed 24 hours after surgery. Results: The two groups were homogenous in terms of demographic characteristics. The level of overt anxiety decreased by 27.5% in the aromatherapy group and by 20.4% in the BRT group. The level of covert anxiety decreased by 27.2% in the aromatherapy group and by 20.8% in the BRT group. Systolic and diastolic blood pressure levels decreased more in the aromatherapy group than in the BRT group. There was a significant difference in the number of pulses between the two groups after the intervention (P= 0.038). The mean amount of intraoperative bleeding was 18.6±2.4 mL in the BRT group and 18.2±3.8 mL in the aromatherapy group (P= 0.626). Nausea, vomiting and surgeon satisfaction levels during the surgery were similar in the two groups Conclusion: Rose essential oil and BRT are recommended for patients before rhinoplasty due to reducing their preoperative anxiety and stabilizing their hemodynamic status.

The CADI-study: Compression after device implantation - To examine the effect of a compressive dressing after device implantation or replacement focusing on the patient"s bleeding, hematomas and pain

Funding Acknowledgements University Hospital Rigshospitalet, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Denmark Background Bleeding and pocket hematomas are a known complication in pacemaker or implantable cardioverter defibrillator (ICD) implantations. Hematomas are associated with increased risk of infection and pain. Purpose To investigate whether a compressive dressing applied for three hours can prevent bleeding, pocket hematomas and pain. Method The study was a pseudo-randomized intervention study including patients scheduled for implantation or box change of a pacemaker or an ICD. In alternating months patients either received a compressive dressing (intervention group) or not (control group). Patients were excluded by the implanting physician if there was a clinical indication for a compressive dressing due to seeping bleeding. Patients were followed at the catheterization lab, for three hours at the ward and until the first outpatient control visit (1-3 months). The outcomes were: Bleeding, pocket hematomas and pain. The bleedings were graded as active bleeding or seeping bleeding or hematomas. Hematomas were measured by degree 1 to 3 (3 largest) and size (in cm). Pain was rated by the patient by numerical rank scale (NRS) from 0 to 10 (10 worst). Descriptive statistics were used. Results A total of 191 patients were included, 95 patients in the intervention group. After inclusion 24 patients of the 96 patients in the control group were excluded by the implanting physician on clinical indication for a compressive dressing. Before the intervention there were significantly more patients with bleeding (graded as: Seeping bleeding) in the intervention group (n = 25, (26.9%)) compared to the control group (n = 4, (5.6%), p <0.001). No patients had developed pocket hematomas at the end of the procedure. Furthermore, the pain score was low in both groups (Total n = 19, NRS score ≤ 2.5). Over the next three hours in the ward, there was no significant difference in the bleeding (graded as: Seeping bleeding) in the groups (intervention: n = 8 vs. control: n = 3, p = 0.55). Two patients in each group had developed a pocket hematoma after three hours (p = 0.36) and the intervention group experienced more pain (intervention: 1.7 (±2.4) vs. control: 1.1(±1.7), p= 0.02). At the outpatient control 1-3 months after implantation, there was no significant difference between the groups related to bleeding, pocket hematomas and pain. Conclusion Compressive dressing did not significantly reduce bleeding or the number of pocket hematomas after pacemaker or ICD implantation. In addition patients reported a slight increase in pain scores related to the compressive dressing. The results question routine compression after procedure, but should be validated in larger studies.

Beyond Ramen: Investigating Methods to Improve Food Agency among College Students

Many college students struggle to cook frequently, which has implications for their diet quality and health. Students’ ability to plan, procure, and prepare food (food agency) may be an important target for shifting the college student diet away from instant and inexpensive staples like packaged ramen. The randomized intervention study included two sequential cooking interventions: (1) six weeks of cooking classes based in food agency pedagogy held once per week, and (2) six weekly home delivered meal kits (3 meals per kit) to improve food agency, diet quality, and at home cooking frequency of college students. Based on availability and subsequent randomization, participants were assigned to one of four conditions that included active cooking classes, meal kit provision, or no intervention. Participants who took part in the cooking intervention had significant improvement in food agency immediately following the intervention period. Participants who did not participate in cooking classes and only received meal kits experienced significant, though less pronounced, improvement in food agency scores following the meal kit provision. Neither intervention improved diet quality or routinely improved cooking frequency. Active cooking classes may improve food agency of college students, though further research is needed to determine how this may translate into improved diet quality and increased cooking frequency.

Knowledge and attitudes in dementia held by general practitioners in the primary care setting of Botucatu, São Paulo, Brazil

ABSTRACT Background: Alzheimer's disease (AD) is the leading cause of dementia worldwide. Despite alarming evidence on dementia prevalence, the condition is still underdiagnosed by general practitioners (GPs) in primary care. Early detection of the disease is beneficial for patients and relatives, who should be provided comprehensive guidance on dealing with dementia complications, covering medical, family and social aspects, thereby providing an opportunity to plan for the future. Objective: The objective of this study was to assess the knowledge of and attitudes toward dementia held by GPs from a city in the interior of São Paulo State, Brazil. Methods: A non-randomized intervention study was conducted involving six lectures about dementia. Before and after the intervention, the participating physicians completed two quizzes about knowledge of and attitudes towards dementia. The study was carried out in the primary care services of the town and a total of 34 GPs participated in the study. Results: The mean age of the sample was 33.9 (±10.2) years and the majority (76.5%) of the sample had not undertaken medical residency training. The mean number of correct answers on the Knowledge Quiz about dementia before and after the training intervention was 59.6 and 71.2% (p<0.001), respectively. The comparison of the mean responses on the Attitude Quiz revealed no statistically significant difference between the two applications of the instrument, before and after intervention (p=0.059). Conclusions: More training for GPs on dementia should be provided.