Specific Educational Interventions Research Articles

Perception of Health Workers on Preventing COVID-19 Transmission Behavior based on Work Area and Exposure

Coronavirus disease 2019 (COVID-19) emerged at the end of 2019 and spread worldwide, becoming a pandemic on March 11, 2020. Agents, hosts, and the environment influence disease transmission. Perception influences healthy behavior in preventing disease transmission. This study aims to determine differences in the perception of health care workers (HCWs) on COVID-19 prevention behavior based on the area of work and exposure. This study is a cross-sectional study with a survey method using the health belief model questionnaire with research subjects who were HCWs on duty during the COVID-19 pandemic from May to July 2021 in Dr. Hasan Sadikin General Hospital. Statistical tests used were chi-square and Kruskal-Walis tests. From 346 subjects, it was found that the perception of susceptibility and self-efficacy of HCW in the yellow and red zones was higher than in the green zone (p=0.002). In comparison, the perception of barriers in the yellow zone was higher than in the red area (p=0.014). Health care workers had relatively similar mean scores in terms of knowledge (median 7 of 9), perceived benefits (median 27 of 30), cues to action (median 20 of 20), and perceived severity (median 19 of 30). Based on the history of exposure, the parameter of cues to the action of HCWs exposed to COVID-19 was better than those never exposed (p=0.009). HCW of Dr. Hasan Sadikin General Hospital has good knowledge and perception of the prevention of COVID-19. Differences in the perception of HCW between the work area and exposure history require more targeted and specific educational interventions and actions.

Efficacy of a Robot-Assisted Intervention in Improving Learning Performance of Elementary School Children with Specific Learning Disorders.

(1) Background: There has been significant recent interest in the potential role of social robots (SRs) in special education. Specific Learning Disorders (SpLDs) have a high prevalence in the student population, and early intervention with personalized special educational programs is crucial for optimal academic achievement. (2) Methods: We designed an intense special education intervention for children in the third and fourth years of elementary school with a diagnosis of a SpLD. Following confirmation of eligibility and informed consent, the participants were prospectively and randomly allocated to two groups: (a) the SR group, for which the intervention was delivered by the humanoid robot NAO with the assistance of a special education teacher and (b) the control group, for which the intervention was delivered by the special educator. All participants underwent pre- and post-intervention evaluation for outcome measures. (3) Results: 40 children (NAO = 19, control = 21, similar baseline characteristics) were included. Pre- and post-intervention evaluation showed comparable improvements in both groups in cognition skills (decoding, phonological awareness and reading comprehension), while between-group changes favored the NAO group only for some phonological awareness exercises. In total, no significant changes were found in any of the groups regarding the emotional/behavioral secondary outcomes. (4) Conclusion: NAO was efficient as a tutor for a human-supported intervention when compared to the gold-standard intervention for elementary school students with SpLDs.

Accommodations, modifications, and special education interventions: influence on teacher expectations

ABSTRACT Students with special educational needs (SEN) are at risk of lower teacher expectations due to disability-related negative labelling effects. In most educational systems, students with SEN receive measures such as accommodations (adjustments of the learning/assessment conditions), curriculum modifications (adjustments of the learning objectives), or additional support from special education teachers to support inclusion in regular school. Here, we examine whether the receipt of such measures, even in the absence of a formally assessed SEN or disability diagnosis, is sufficient to evoke negative labelling effects. Using data from 110 lower secondary school classes in Switzerland, we show that students with reduced learning objectives or individual support by a special education teacher get systematically underestimated by their teachers regarding their cognitive abilities, although this is not the case for students receiving accommodations. These findings provide important implications for the application of such measures and the prevention of educational inequalities.

Gender differences in the association between biomarkers of environmental smoke exposure and developmental disorders in children and adolescents.

Effects of environmental tobacco smoke (ETS) exposure on children and adolescent health outcomes have been attracted more and more attention. In the present study, we seek to examine the gender-specific difference association of environmental smoke exposure biomarkers and developmental disorders in children and adolescents aged 6-15 years. US nationally representative sample collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 was enrolled (N = 4428). Developmental disorders (DDs) are defined as a positive answer to the question, "Does your child receive special education or early intervention services?" Serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) were utilized as acute and chronic exposure biomarkers of ETS, respectively. Participants with serum cotinine >0.015 ng/mL were considered as with acute ETS exposure, and participants with creatinine-adjusted NNAL >0.0006 ng/mL were considered as with chronic ETS exposure. A survey logistic regression model was used to estimate the association between ETS exposure biomarkers and DDs. Additive interaction was utilized to examine the interaction of gender and biomarkers of ETS. Overall, approximately 9% of children were defined as DDs, and 65% of children had serum cotinine and urinary NNAL levels above the limit of detection. In the adjusted models, the association of ETS exposure biomarkers with DDs was only observed in girls. Girls with low cotinine levels and high urinary NNAL levels had 2.074 (95% CI: 1.012-4.247) and 1.851 (95% CI: 1.049-3.265) times higher odds of being DDs than those without ETS exposure, respectively. However, the effects of boys and NNAL exposure on DDs have additively interacted. Our findings first provided strong evidence for gender differences in the association between two tobacco metabolites and DDs in children, disclosing the public health implications and economic burdens of environmental tobacco smoke exposure.

Predictors of cervical cancer knowledge and attitude among Saudi women in Najran city: A cross-sectional study.

This study explores the predictors of cervical cancer (CC) knowledge and attitude among Saudi women in Najran city. A descriptive cross-sectional study was conducted in Najran/ KSA to recruit 1085 participants from June to September 2021. An online self-reported questionnaire was used for data collection; it consisted of basic data and health history, a CC knowledge quiz, and a CC attitude scale. Data analysis was performed using the Statistical IBM software, version 23 (IBM Corp., Armonk, N.Y., USA)'. The findings revealed that more than half of the participants (57.7%) had insufficient knowledge regarding CC. At the same time, 59.4% of them had a positive attitude toward CC screening. According to binary logistic regression analysis, University-educated participants had increased odds of sufficient knowledge (OR: 1.774, 95%CI1.101-2.856) and positive attitude (OR: 4.246, 95%CI 1.545-11.669) about CC compared to the participant with secondary education. Moreover, participants with no family history of CC were less likely to have sufficient knowledge (OR: 0.554, 95%CI 0.102-2.745) and positive attitude (OR: 0.867, 95%CI 0.776 - 0.968) about CC compared to participants with positive family history. Also, sufficient knowledge was statistically associated with a positive attitude (OR: 1.754, 95%CI 1.112-2.849). Among all basic variables, participants' educational qualifications and positive family history of CC are significant socio-demographic predictors of CC knowledge and attitude. Specific educational interventions to enhance women's knowledge and attitude toward CC screening should be developed and implemented in the community without delay, particularly for less-educated women.

Mucopolysaccharidosis Type I, Hematopoietic Cell Transplantation and Neurodevelopmental Profile: A Case Report

Type I mucopolysaccharidosis is caused by an alpha-L-iduronidase deficit and has three phenotypic expressions. Hurler syndrome includes dysmorphias, hirsutism, hepatosplenomegaly, hydrocephalus, skeletal deformities, recurrent infections, heart abnormalities, and global developmental delay. Hematopoietic cell transplantation provides a continuous source of alpha-L-iduronidase throughout the body, including the central nervous system and, currently, appears to be the gold-standard therapy for this pathology. We present the case of a six-years-old child with the diagnosis of Hurler syndrome, submitted to hematopoietic cell transplantation and integrated in a structured support plan with special education, speech therapy and early home intervention, who presents a trend of convergence with the normality in all the development areas, except for locomotor skills and eye-hand coordination. These findings highlight the positive impact of the hematopoietic cell transplantation together with the early and structured intervention of a multidisciplinary team in the neurodevelopmental profile of children affected by Hurler syndrome.

Mental Health Literacy and Mental Health Information-Seeking Behavior in Iranian University Students.

Background:Inadequate Mental health literacy (MHL) is a problem worldwide. Research is limited in developing countries and about positive MHL. This study measured the disease-oriented MHL and positive MHL and investigated their association. In addition, this study explored the mental health information-seeking behavior among undergraduate students in Iran.MethodsThis study recruited undergraduate students of Tehran public universities through multistage stratified random sampling to undertake an analytical cross-sectional study. MHL was measured using Mental Health Literacy Scale (MHLS) and Mental Health Positive Knowledge (MHPK). Participants' most used mental health information sources and their trust in them were also inspected.ResultsA total of 543 students participated in this study. On average, the participants achieved about 65% of the total possible MHLS score, and 71% of participants showed sufficient MHPK score. The “internet” was the most used source for receiving and searching for mental health information. The most trusted source was “health care staff”. This study detected no correlation between disease-oriented MHL and positive MHL.ConclusionsMental health literacy of Iranian students still seems to be insufficient. As disease-oriented MHL and positive MHL were not correlated, specific educational interventions for each domain are needed. Although the internet is the main source of mental health knowledge, the trust of student in it is low. This issue should be taken into consideration in designing online educational interventions.

Predictors of Adjustment to Living with an Ostomy: Results of a Cross-sectional Study.

To describe predictors of adjustment to living with an ostomy among Italian adults with an enterostomy or a colostomy. A multicenter, cross-sectional design was performed, sampling 403 patients with an ostomy in three different outpatient clinics of northern Italy between April 2018 and December 2020. Data were collected by stoma therapists in ambulatory settings using the Italian version of the Ostomy Adjustment Inventory-23 and patient medical records. Acceptance was lower among women, patients who underwent emergency surgery, those with a urostomy, and those with a body mass index of less than or equal to 25 kg/m2. Negative feelings were associated with higher body mass index, colostomies, shorter length of time of living with an ostomy, and emergency ostomy creation. Being young and having a high level of education are protective against psychosocial problems and help promote acceptance and social engagement. The findings of this study help identify patients who are likely to be more vulnerable and need greater support through specific educational and motivational interventions.

Impact of a Family-Based Educational Intervention on Knowledge, Attitudes, and Burden of Alzheimer's Caregivers

Background: Family caregivers always encounter high levels of psychological distress and physical strain when caring for a person with dementia. Family-based intervention is an important option for providing effective and practical support. The study aimed to examine the effects of a specific educational intervention on improving Alzheimer's caregivers' knowledge and attitudes and explore how it reduces their subjective burdens. Material and Methods: A quasi-experimental research design was used with a purposive sample of 80 Alzheimer caregivers recruited conveniently from the Geriatric Society Association located at Almontazahat District, Jeddah, Saudi Arabia. To achieve the objectives of the current study 4 tools were used including demographic and personal data, Alzheimer's Disease Knowledge Scale (ADKS), The Dementia Attitudes Scale, and the burden scale of caregivers. Validity and reliability of the tools were confirmed and Cronbach's alpha of the Dementia Attitudes Scale was 0.87 and Cronbach's alpha of the burden scale of caregivers 0.941. Results: the age of the studied subjects ranged from 20 to 60 years with a mean of 35.6±12.2 years. the studied subject's knowledge level and attitudes were improved post-intervention than before. These differences were statistically significant (t: 108.008, P:<0.001). While, the studied subject's disease burden level was decreased post-intervention than before These differences were statistically significant (t: 8.378, P:<0.001). There is a weak positive significant relation between the studied subject's knowledge level and attitude regarding dementia (r:0.286, P:0.010). Whereas there is no correlation noted between knowledge level and caregiver burden with no statistical significance (r: -.048, P: 0.674). Conclusion and recommendation: the findings concluded that the studied subject's knowledge, attitude, and burden level were improved post-intervention than before with statistically significant differences. Therefore, it is recommended to develop a well-planned and structured educational program should be undertaken to improve the level of awareness and contribute to a better understanding of AD and dementia. Keywords: Alzheimer's burden, caregivers' attitudes, families, intervention, knowledge.

Health Needs and Use of Services Among Children with Developmental Disabilities - United States, 2014-2018.

Developmental delays, disorders, or disabilities (DDs) manifest in infancy and childhood and can limit a person's function throughout life* (1-3). To guide strategies to optimize health for U.S. children with DDs, CDC analyzed data from 44,299 participants in the 2014-2018 National Health Interview Survey (NHIS). Parents reported on 10 DDs,† functional abilities, health needs, and use of services. Among the approximately one in six (17.3%) U.S. children and adolescents aged 3-17 years (hereafter children) with one or more DDs, 5.7% had limited ability to move or play, 4.7% needed help with personal care, 4.6% needed special equipment, and 2.4% received home health care, compared with ≤1% for each of these measures among children without DDs. Children with DDs were two to seven times as likely as those without DDs to have taken prescription medication for ≥3 months (41.6% versus 8.4%), seen a mental health professional (30.6% versus 4.5%), a medical specialist (26.0% versus 12.4%), or a special therapist, such as a physical, occupational, or speech therapist, (25.0% versus 4.5%) during the past year, and 18 times as likely to have received special education or early intervention services (EIS) (41.9% versus 2.4%). These percentages varied by type of disability and by sociodemographic subgroup. DDs are common, and children with DDs often need substantial health care and services. Policies and programs that promote early identification of children with developmental delays and facilitate increased access to intervention services can improve health and reduce the need for services later in life.§ Sociodemographic inequities merit further investigation to guide public health action and ensure early and equitable access to needed care and services.

EP089: 47, XXY: Mathematic capabilities and the impact of Hormonal Replacement Treatment (HRT)

47,XXY, also known as Klinefelter syndrome, is the most frequently occurring sex chromosome aneuploidy with an incidence of approximately 1:600 live male births. It is medically characterized by hypogonadism, azoospermia, micropenis, and tall stature. The neurodevelopmental phenotype includes speech and motor delay, language-based learning disabilities, executive dysfunction, reduced expressive language, and increased risk for anxiety. Academic achievement for reading and writing has been shown to be largely impacted in school-aged males with 47,XXY. For example, an early study reported an increased risk for dyslexia due to challenges in processing speed, language, and memory despite intact intelligence quotients (IQ). Further, a more recent study revealed mastering school curricula often requires special education intervention. Math-related achievement, however, is a component of the 47,XXY neurodevelopmental profile that has been largely overlooked. There are a few studies that have indirectly demonstrated reduced arithmetic capabilities in 47,XXY compared to neurotypical controls, but none have delineated the specific mathematical skillsets that are impacted by a supernumerary X. Thus, we aimed to expand on this paucity of literature by comprehensively examining mathematical skills in school-aged males with 47,XXY. Further, though consistent in symptomatology, the phenotype is widely variable in severity depending on factors such as timing of diagnosis, family learning disability (FLD), and access to treatment. The potential profound benefits of Hormonal Replacement Therapy (HRT), or the administration of testosterone enanthate, on neurodevelopmental challenges in males with 47,XXY have been well-documented. In school-aged males specifically, HRT has been associated with increased expressive ability, working memory, and executive function. Therefore, we also explored the potential effect of HRT on mathematical achievement in our cohort. Our cohort consisted of 111 prenatally diagnosed school-aged males with 47,XXY (CA: 133 months). Those who were postnatally diagnosed, presented with mosaicism or other copy number variants (CNVs), or had a positive family history of learning disabilities were excluded from this study. An in-depth history was recorded in which HRT statuses were obtained. All participants were assessed by their respective pediatric endocrinologists who determined HRT administration. Study participants completed the KeyMath-3 and Wechsler Intelligence Scale for Children, 4th or 5th Edition (WISC-IV/V). For the purpose of this study, only the Arithmetic subtest was used. To investigate the potential effect of HRT on mathematical skills, participants were bifurcated into untreated (No-T, N=22) and treated (T, N=89) groups. A two-tailed t-test determined statistically significant group differences on each assessment, if any. Participants showed no significant differences on any demographic scales including maternal and paternal age (p=0.97 and p=0.19, respectively), birthweight (p=0.90), delivery method (p=0.79), race (p=0.55), or socioeconomic status (p=0.88). Significant effect of treatment was observed on several mathematical subtests of the KeyMath-3 including Numeration (p=0.005), Algebra (p=0.03), Geometry (p=0.03), Mental Computation and Estimation (p=0.005), Multiplication and Division (p=0.03), and Foundations of Problem Solving (p=0.05). The T group also demonstrated significantly increased scores on the Operations (M=115.28, p=0.004) and Total Test (M=116.38, p=0.01) areas compared to the No-T group (M=103.65 and M=106.62, respectively). Additionally, while not statistically significant, the T group exhibited higher average scores on the rest of the subtests and areas including Measurement (M=12.88), Data Analysis (M=12.40), Basic Concepts (M=117.03), Addition and Subtraction (M=12.55), Applied Problem Solving (M=12.21), and Applications (M=112.61) compared to the No-T group (M=11.95, M=11.55, M=110.90, M=11.11, M=11.18, and M=106.29, respectively). On the WISC-IV/V Arithmetic subtest, the T group (M=115.28, SD=2.72) did demonstrate a higher mean with less variability than the No-T group (M=115.28, SD=3.67), though not quite statistically significant (p=0.06). Our findings are the first to shed light on the mathematical profile of treated and untreated school-aged males with 47,XXY. Our observations of reduced scores in the untreated group corroborates a past study describing a proposed susceptibility to mathematics disability in this population. Other previous studies have documented the similar cognitive mechanisms shared between math disability and reading disability, as well as the increased risk of comorbidity. However, the neurodevelopmental profile for males with 47,XXY is usually restricted to only include language-based learning disability. Our findings suggest the phenotype may be expanded to include all learning disabilities, including those math-related.

Abstract P4-10-12: The relevance of chemobrain in breast cancer survivors: An Italian exploratory study to measure incidence and psycho-social impact

Abstract Breast Cancer is the most frequently diagnosed cancer among women. Despite the decreasing death-rate, a large portion of patients experience long-term side effects. One of the most common is “chemobrain”: a series of subtle but persistent cognitive deficits that affect attention, memory, and speed of processing. There is a lack of consensus regarding the exact rate of “chemobrain” incidence(from 12% to 86% of patients complaining cognitive sequelae after adjuvant-therapies) primarily due to the heterogeneity of assessment measures used to quantify it. Our first aim was to estimate the prevalence of perceived cognitive deficits in breast cancer-survivors, and to address the relevance of psycho-social factors that might affect perceived cognitive functioning. The second aim was to better understand the specific impact on patients comparing possible differences in perceived cognitive functioning between a cohort of breast cancer-survivors and an age-matched group of women without oncologic diagnosis. A total of 216 subjects submitted an anonymous online questionnaire that included FACTCog v.3and 41 items investigating clinical history, cognitive reserve, sleep quality, dietary and health habits. Inclusion criteria were being female, aged between 25 and 75, lack of known psychiatric or neurological diseases. The study was approved by the Ethical Committee of University of Trieste. The study sample comprised 90 oncological patients, recruited through clinical oncology practices between Trieste - ASU GI and Cremona - ASST Breast Cancer Units, and 126 age-matched controls enrolled through LILT (Lega Italiana Lotta Tumori) - Trieste (Italy). To perform within and between groups comparisons, both populations (Breast-cancer patients’ and age-matched controls’) were subdivided in two subgroups each, based on FACTCog PCI18 score according to Van Dyk et al.(2020), cutpoints: Subjective Cognitive Complaints - SCC (PCI18<54) and No Subjective Cognitive Complaints - NSCC (PCI18 ≥54).Statistical analysis revealed that 36% of breast-cancer patients reported perceived cognitive deficits, while only for 18% of the age-matched control group this was the case (p<.001). We found a significant difference in perceived cognitive abilities (CogPCA p<.001), quality of life (CogQOL p<.001) and frequency of aerobic activity (moderate physical activity p<.01) between SCC versus NSCC patients with the former group showing worse scores in all reported measures. Between group analysis performed on breast-cancer group versus age-matched control group revealed a significant interaction of oncological diagnosis and SCC on measures of perceived cognitive abilities (CogPCA p<.001) and quality of life (CogQOL p<.001), indicating that SCC patients had worse scores on these measures. On the other hand, NSCC patients had higher scores on measures regarding how others (e.g., family members or close friends) perceived their cognitive abilities (p<.05).A significant effect of oncological diagnosis but not of SCC (or interaction between the two) was found on measures concerning sleep (Sleep quality index p<.05), indicating a strong effect of cancer diagnosis on sleep quality. Conversely when comparing the effect of cancer diagnosis on measures of physical activity no significant effect was found, instead a strong effect of SCC emerged (Physical activity index p<.01). Subjective perceived cognitive deficit affects the quality of life of breast cancer survivors, thus suggesting the usefulness of specific educational interventions to prevent stress-related effects. Citation Format: Thomas West, Bruna Scaggiante, Rita Ceccherini, Silva Foladore, Daniele Generali, Francesco Versace, Corrado Cavallero. The relevance of chemobrain in breast cancer survivors: An Italian exploratory study to measure incidence and psycho-social impact [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-12.

Early Intervention in Early Childhood Special Education According to Parents: A Qualitative Study

Early intervention practices have an important place in early childhood special education practices as in every period. This study aims to examine the early intervention process of parents who have children with special needs during early childhood, the problems they experience and the solution suggestions to these problems. The study was conducted in qualitative research design. 53 parents participated in the research. As a result of the analysis of the opinions obtained with the semi-structured interview form, 6 themes and categories that were related to these themes were determined. When the special need of the child was found, it was seen that more opinions were expressed in the categories of "hospital/doctor" regarding the first person and/or institution theme. The other category in terms of the meaning of early intervention was "starting treatment/education early for the existing situation/problem”. In addition, the category of “leaving it to time and helping with one's own competence” for the theme of struggling with the difficulties experienced also emphasizes how guidance is necessary and important. It was suggested that early intervention and pregnancy screening and the next process should be carried out with guidance.

A Proposed Multi-Criteria Optimization Approach to Enhance Clinical Outcomes Evaluation for Diabetes Care: A Commentary.

There are several challenges in diabetes care management including optimizing the currently used therapies, educating patients on selfmanagement, and improving patient lifestyle and systematic healthcare barriers. The purpose of performing a systems approach to implementation science aided by artificial intelligence techniques in diabetes care is two-fold: 1) to explicate the systems approach to formulate predictive analytics that will simultaneously consider multiple input and output variables to generate an ideal decision-making solution for an optimal outcome; and 2) to incorporate contextual and ecological variations in practicing diabetes care coupled with specific health educational interventions as exogenous variables in prediction. A similar taxonomy of modeling approaches proposed by Brennon et al (2006) is formulated to examining the determinants of diabetes care outcomes in program evaluation. The discipline-free methods used in implementation science research, applied to efficiency and quality-of-care analysis are presented. Finally, we illustrate a logically formulated predictive analytics with efficiency and quality criteria included for evaluation of behavioralchange intervention programs, with the time effect included, in diabetes care and research.

Religiously Conditioned Health Behaviors within Selected Religious Traditions.

Background: Health is a value of paramount importance for human existence. It has a special place in every religious system, both on the doctrinal and practical levels. Most religions view health as a priority value to be cared for, and require followers of individual religious groups to take care of their physical and mental health, and to maintain a balance between body and spirit. The aim of the study was to verify whether the level of religious commitment significantly influences health behaviors and whether in selected religions the faithful have a different approach to health behaviors. Methods: This cross-sectional study was conducted on a group of 296 people—118 Seventh-day Adventists (SDA), 134 Catholics, and 14 Jews living in southern Poland, and 31 Muslims living in southern and north-eastern Poland. The following research tools were used as part of the diagnostic survey method: a questionnaire survey designed by us; the International Physical Activity Questionnaire (IPAQ); the Inventory of Health Behaviours (IHB); the Perceived Stress Scale (PSS 10) and anthropometric measurements, physical examination, laboratory tests. Results: Only 75% of Catholics who participated in the study declared a high level of religious commitment. On the other hand, all (100%) of SDA, Jews, and Muslim respondents declared their religious commitment at a high level. SDA were characterized by the most desirable health behaviors on the IHB (high and average levels), especially eating habits. They did not consume alcohol, did not smoke cigarettes. The physical activity of most ADS was high and moderate. Most of the SDA subjects were characterized by an average and low level of stress intensity. The most common correct scores for homocysteine, triglycerides, and CRP were SDA, cholesterol by Jews, glucose by Muslims, and HDL by Catholics. The most common negative results were: homocysteine, glucose and triglycerides among Jews, cholesterol and CRP among Catholics, HDL among Muslims. Optimal blood pressure was most common among Catholics, and hypertension was most often diagnosed among Jews. Most often, Muslims had the correct body weight, and at the same time it was the group of respondents most often diagnosed with obesity. In contrast, underweight was observed only among Catholics. The SDA subjects were most often overweight. Conclusions: The results suggest that public health professionals and nurses should develop culturally specific educational interventions, especially among Catholics.

ENFERMAGEM E CONTROLE DE INFECÇÕES EM MEDICAÇÕES INJETÁVEIS: ELABORAÇÃO E VALIDAÇÃO DE INSTRUMENTO

Objective: to develop and validate an instrument for measuring the knowledge of nursing professionals about SafeInjecting practices for the prevention of infection in injectable medications. Method: methodological study, carried out in a city in the interior of São Paulo, between March 2018 and December 2019, according to stages: establishment of the conceptual structure, construction and validation of the instrument, by experts, through the agreement rate and content validity index. After the validation process, the instrument was applied with a target audience. The result: an instrument composed of 27 items was constructed, including: preparation of the environment, preparation and administration of injectable medications and disposal of sharp materials. There was a high rate of agreement among the ten specialists and semantic refinement after a response from 34 participants from the target audience. Conclusion: a tool capable of measuring knowledge on the subject in a standardized way was consolidated, allowing the development of specific educational interventions, according to the situational diagnosis performed.

Educational Insights into Dyslexia

Dyslexia is a specific learning disorder characterized by difficulties in reading, writing, and spelling due to compromised phonological processing skills. Treatment of dyslexia solely with medical support is far-fetched. However, it can be surmounted by the combination of special education interventions and supportive psychosocial care. Suitable approaches coupled with beneficial learning strategies enable dyslexic learners with consummate linguistic achievement. Although dyslexia research offers an increased understanding from a biological standpoint, the knowledge gap on the educational front is unfortunately persistent. To this end, this paper revisits the teaching-learning aspects of dyslexia. Teaching principles and approaches, strategies to support learning, and personalized educational plans are discussed in detail. Acknowledging the difficulty, familiarizing with the approaches, and attaining successful outcomes via essential practices emphasize the inclusiveness of dyslexic learners in the curriculum. We contend that the educational insights into dyslexia will provide informed teaching and learning solutions.

Special Education Services and School-Related Quality of Life in Children With Learning Disorders and Their Families: A One-Year Follow-Up Study

Learning disorders can have adverse impacts on children and families extending beyond the academic skills deficits. The goal of the present study was to assess the impact of the school’s response, following an independent evaluation, for child and family school-related quality of life (QOL). We hypothesized that a positive school response would be associated with improved QOL. Parents completed the LDQOL/15, a brief measure of school-related QOL, at the time that their child received an independent evaluation and again a year later (N = 155). At follow-up, parents reported the tenor of the school’s response to the evaluation and whether special education services had changed. QOL problems were very high in this referred population, with 66% of respondents rating a level of problems in the clinical range at baseline. Predicted interactions between time of assessment (baseline/follow-up) and the school’s response to the evaluation were confirmed for all outcome variables; a positive school response was associated with improved QOL. Nevertheless, the overall prevalence of school-related QOL problems remained high a year after the evaluation. These findings indicate that special education interventions can mitigate learning disabilities’ impacts, but even with these services, many children with learning disorders and their families continue to be significantly affected.

Effect of the fourth generation multi-theory model intervention on the quality of life in Iranian postmenopausal women: A randomized controlled trial.

Menopause is a natural part of women's lives and is associated with a series of complications that can impair their quality of life. This study was conducted to determine the effect of specific educational interventions on the quality of life among postmenopausal women. This randomized controlled trial was conducted on 80 menopausal women who met the inclusion and exclusion criteria and were selected through the multi-stage stratified random sampling method. The participants were randomly allocated to either the control or intervention group (40 per group). The intervention comprised 5 × 45-min educational sessions based on the Multi-Theory Model on the predetermined days of the week. The scores of the quality of life level were collected at baseline, immediately, and 3months after the intervention using the Menopause-Specific Quality of Life questionnaire (MENQOL). The control group received a health advice. Analysis of variance of repeated measures showed a significant interaction between time and intervention. The comparison between the mean score of quality of life of the "before," "immediately after intervention," and "3months after the intervention" showed a significant difference between the two groups. The intervention group quality of life improved significantly as the intervention went on compared to the control group. Structured simple educational programs based on the Multi-Theory Model could be used as a simple and noninvasive intervention that help menopausal women improve their quality of life through menopausal symptoms relief. Further interventions with larger trials may be required to confirm these findings.

The diagnostic odyssey of autism: a cross-sectional study of 3 age cohorts of children from the 2016\u20132018 National Survey of Children\u2019s Health

BackgroundAutism prevalence has increased rapidly in recent years, however, nationally representative estimates on the ages of first identification and intervention are out of date. Objectives: (1) To estimate the ages at which children with autism receive their first diagnosis, intervention plan, and developmental services; and (2) To evaluate differences in ages at events by birth cohort and sociodemographic characteristics.MethodsUsing cross-sectional data from the 2016–2018 National Survey of Children’s Health (NSCH), we examined associations via linear regression among a sample of 2303 children aged 2–17 years old, who had ever been diagnosed with autism and either (1) ever had a plan for special education or early intervention, or (2) ever received special services to meet developmental needs. Exposures included age cohort, child, household and healthcare provider characteristics.ResultsMost children in the study sample (n = 2303) were over age 6 years, male, of non-Hispanic white race/ethnicity and had mild/moderate autism. Mean ages (years) at first diagnosis was 4.56 (SE = 0.13); first plan was 4.43 (SE = 0.11); and first services was 4.10 (SE = 0.11). After adjustment for exposures and survey year, the middle childhood cohort was 18 months older at first intervention (β = 1.49, 95% CI, 1.18–1.81), and adolescents were 38 months older at first diagnosis (β = 3.16, 95% CI, 2.72–3.60) compared to those in early childhood. Younger ages at events were observed among: Hispanic/Latinx as compared to white children, those with moderate or severe symptoms as compared to mild symptoms, and children who received their diagnosis from a specialist as compared to psychologists or psychiatrists.ConclusionsChildren with autism receive their first diagnosis, intervention plans and developmental services at younger ages than they had in the past. Future research is needed to identify the mechanisms for these improvements in early identification and intervention to accelerate additional progress.