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La teoría del cambio: una herramienta para la planificación y la evaluación participativa en salud comunitaria
2020
Resumen: Existe un creciente interés por encontrar respuestas innovadoras para evaluar intervenciones complejas en salud pública. En esta nota metodológica, se presenta la teoría del cambio como una herramienta útil para facilitar tanto la planificación como la evaluación de intervenciones en promoción de la salud comunitaria. Una teoría del cambio es una representación visual de cómo funciona un programa o una intervención, en la que se identifican sus diferentes componentes y cómo cada elemento se vincula con otro: cuáles son sus objetivos, los resultados esperados y a través de qué acciones se pretenden alcanzar. Es una herramienta de investigación aplicada a la práctica que se desarroll…
Acceptability, reach and implementation of a training to enhance teachers’ skills in physical activity promotion
2020
This is a pre-print of a published study: Renko, E., Knittle, K., Palsola, M. et al. Acceptability, reach and implementation of a training to enhance teachers’ skills in physical activity promotion. BMC Public Health 20, 1568 (2020). https://doi.org/10.1186/s12889-020-09653-x Background: In order to achieve real-world impacts, successful behavior change interventions need to be scaled up and broadly implemented. Implementation is challenging however, and the factors influencing successful implementation are not fully understood. This study describes the nationwide implementation of a complex theory-based program to promote physical activity and reduce sedentary behavior in vocational school…
Obere gastrointestinale Blutung mit hämorrhagischem Schock am Ende einer Urlaubsreise: Präklinische und innerklinische Versorgung eines gastrointesti…
2014
ZusammenfassungNach der Rückkehr aus dem Urlaub wurde ein 55-jähriger Patient mit Teerstuhl und hämorrhagischem Schock im Zugabteil eines InterCity der Deutschen Bahn notfallmedizinisch versorgt und in ein Krankenhaus der Maximalversorgung eingeliefert. Hier erfolgte zunächst die weitere notfallmedizinische Behandlung, in deren Rahmen in der internistischen Notaufnahme in interdisziplinärer Zusammenarbeit eine Stabilisierung der Hämodynamik sowie die Sicherung der Atemwege und Atemfunktion erfolgten. Anschließend wurde eine Notfall-Endoskopie des oberen Gastrointestinaltrakts durchgeführt. Ursächlich für das hämorrhagische Schockgeschehen war eine arteriell spritzende, endoskopisch nicht zu…
Specialized Management of Oral Anticoagulation Therapy Improves Outcome in Patients with Chronic Renal Insufficiency
2020
Oral anticoagulation (OAC) is effective at preventing and treating thromboses and thromboembolism in patients with normal renal function. We aimed to research the impact of severe renal failure (RF) on patient outcome and to determine the potential benefit of caring for these patients in a specialized coagulation service (CS). A total of 1516 usual medical care patients and 756 CS-managed patients of the thrombEVAL multicenter (21 centers), prospective, cohort study (NCT01809015) were analyzed in a 3-year follow-up. Patients with RF (serum creatinine >
Impact of a physician-targeted letter on opioid prescribing.
2020
We study the effect of a physician-targeted nudge letter on opioid prescribing. In May 2017, the Social Insurance Institution of Finland sent a personal information letter to all physicians who had issued a prescription containing at least 100 tablets of paracetamol-codeine combination to a new patient. The aim of the letter was to draw the physicians’ attention to their prescribing practices and to decrease the size of the first codeine prescription. Using individual level register data and a difference-in-differences strategy, we estimate that the letter decreased the average number of tablets purchased by new patients by 12.5 percent and the probability of a first purchase being at least…
Understanding the risks for post-disaster infectious disease outbreaks: a systematic review protocol
2020
Introduction Disasters have many forms, including those related to natural hazards and armed conflict. Human-induced global change, such as climate change, may alter hazard parameters of these disasters. These alterations can have serious consequences for vulnerable populations, which often experience post-disaster infectious disease outbreaks, leading to morbidity and mortality. The risks and drivers for these outbreaks and their ability to form cascades, are somewhat contested. Despite evidence for post-disaster outbreaks, reviews quantifying them have been on short time scales, specific geographic areas or specific hazards. This review aims to fill this gap and gain a greater understandi…
Radiation-induced changes in levels of selected proteins in peripheral blood serum of breast cancer patients as a potential triage biodosimeter for l…
2014
The threat of a large scale radiological emergency, where thousands of people may require fast biological dosimetry for the purpose of triage, makes it necessary to search for new, high throughput biological dosimeters. The authors tested an assay based on the quantitative analysis of selected proteins in peripheral blood serum. They were particularly interested in testing proteins that are specific to irradiation of skin, as these can be used in cases of partial body exposure. Candidate proteins were identified in an earlier study with mice, where skin of the animals was exposed to different doses of radiation and global expression of serum proteins was analyzed. Eight proteins were found,…
Repetition without Repetition or Differential Learning of Multiple Techniques in Volleyball?
2021
A variety of approaches have been proposed for teaching several volleyball techniques to beginners, ranging from general ball familiarization to model-oriented repetition to highly variable learning. This study compared the effects of acquiring three volleyball techniques in parallel with three approaches. Female secondary school students (N = 42
Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons: Randomized Controlled Trial.
2021
Objectives: Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored. Design: Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization. Setting and Participants: A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: >65 years, meeti…