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1.  Destigmatizing Hepatitis B in the Asian American Community: Lessons Learned from the San Francisco Hep B Free Campaign 
Compared to any other racial/ethnic group, Asian Americans represent a population disproportionately affected by hepatitis B virus (HBV) infection, a leading cause of liver cancer. Since 2007, the San Francisco Hep B Free (SFHBF) Campaign has been actively creating awareness and education on the importance of screening, testing, and vaccination of HBV among Asian Americans. In order to understand what messages resonated with Asian Americans in San Francisco, key informant interviews with 23 (n=23) individuals involved in community outreach were conducted. A key finding was the ability of the SFHBF campaign to utilize unique health communication strategies to break the silence and normalize discussions of HBV. In addition, the campaign’s approach to using public disclosures and motivating action by emphasizing solutions towards ending HBV proved to resonate with Asian Americans. The findings and lessons learned have implications for not only HBV but other stigmatized health issues in the Asian American community.
doi:10.1007/s13187-011-0252-9
PMCID: PMC4537654  PMID: 21748476
Hep B; Asian American; San Francisco; Stigma; Health communication
2.  Assessment of HBV Preventive Services in a Medically Underserved Asian and Pacific Islander Population Using Provider and Patient Data 
ABSTRACT
Background
Hepatitis B (HBV) represents a significant health disparity among medically underserved Asian and Hawaiian/Pacific Islander (API) populations. Studies evaluating adherence to HBV screening and vaccination guidelines in this population are limited.
Objective
The purpose of this study was to evaluate HBV screening and vaccination practices using both provider self-report and patient records.
Design
Medical records for 20,574 API adults were reviewed retrospectively and primary care providers were surveyed to evaluate rates and adherence to HBV screening and vaccination guidelines.
Participants
The study included primary care providers and their adult API patients in the San Francisco safety-net healthcare system.
Main Measures
Patient, practice, and provider factors, as well as HBV screening and vaccination practices, were assessed using provider survey constructs and patient laboratory and clinical data. Generalized linear mixed models and multivariate logistic regression analyses were used to identify factors associated with recommended HBV screening and vaccination.
Key Results
The mean age of patients was 52 years, and 63.4 % of patients were female. Only 61.5 % underwent HBV testing, and 47.4 % of HBV-susceptible patients were vaccinated. Of 148 (44.8 %) responding providers, most were knowledgeable and had a favorable attitude towards screening, but 43.2 % were unfamiliar with HBV guidelines. HBV screening was positively associated with favorable provider attitude score (OR per unit 1.80, 95 % CI 1.18–2.74) and negatively associated with female patient sex (OR 0.82, 95 % CI 0.73–0.92), a higher number of clinic patients per week (OR per 20 patients 0.46, 95 % CI 0.28–0.76), and provider barrier score (OR per unit 0.45, 95 % CI 0.24–0.87). HBV vaccination was negatively associated with provider barrier score (OR per unit 0.48, 95 % CI 0.25–0.91).
Conclusions
Rates of HBV screening and vaccination of API patients in this safety-net system are suboptimal, and provider factors play a significant role. Efforts to cultivate positive attitudes among providers and expand healthcare system resources to reduce provider barriers to HBV care are warranted.
doi:10.1007/s11606-014-3057-9
PMCID: PMC4284271  PMID: 25324148
HBV screening; HBV vaccination; HBV prevention; Safety net; Asians
3.  Proceedings of the 3rd IPLeiria’s International Health Congress 
Tomás, Catarina Cardoso | Oliveira, Emanuel | Sousa, D. | Uba-Chupel, M. | Furtado, G. | Rocha, C. | Teixeira, A. | Ferreira, P. | Alves, Celeste | Gisin, Stefan | Catarino, Elisabete | Carvalho, Nelma | Coucelo, Tiago | Bonfim, Luís | Silva, Carina | Franco, Débora | González, Jesús Alcoba | Jardim, Helena G. | Silva, Rita | Baixinho, Cristina L. | Presado, Mª Helena | Marques, Mª Fátima | Cardoso, Mário E. | Cunha, Marina | Mendes, Joana | Xavier, Ana | Galhardo, Ana | Couto, Margarida | Frade, João G. | Nunes, Carla | Mesquita, João R. | Nascimento, Maria S. | Gonçalves, Guilherme | Castro, Conceição | Mártires, Alice | Monteiro, Mª João | Rainho, Conceição | Caballero, Francisco P. | Monago, Fatima M. | Guerrero, Jose T. | Monago, Rocio M. | Trigo, Africa P. | Gutierrez, Milagros L. | Milanés, Gemma M. | Reina, Mercedes G. | Villanueva, Ana G. | Piñero, Ana S. | Aliseda, Isabel R. | Ramirez, Francisco B. | Ribeiro, Andrea | Quelhas, Ana | Manso, Conceição | Caballero, Francisco P. | Guerrero, Jose T. | Monago, Fatima M. | Santos, Rafael B. | Jimenez, Nuria R. | Nuñez, Cristina G. | Gomez, Inmaculada R. | Fernandez, Mª Jose L. | Marquez, Laura A. | Moreno, Ana L. | Huertas, Mª Jesus Tena | Ramirez, Francisco B. | Seabra, Daniel | Salvador, Mª Céu | Braga, Luciene | Parreira, Pedro | Salgueiro-Oliveira, Anabela | Arreguy-Sena, Cristina | Oliveira, Bibiana F. | Henriques, Mª Adriana | Santos, Joana | Lebre, Sara | Marques, Alda | Festas, Clarinda | Rodrigues, Sandra | Ribeiro, Andrea | Lumini, José | Figueiredo, Ana G. | Hernandez-Martinez, Francisco J. | Campi, Liliana | Quintana-Montesdeoca, Mª Pino | Jimenez-Diaz, Juan F. | Rodriguez-De-Vera, Bienvenida C. | Parente, Alexandra | Mata, Mª Augusta | Pereira, Ana Mª | Fernandes, Adília | Brás, Manuel | Pinto, Mª Rosário | Parreira, Pedro | Basto, Marta L. | Rei, Ana C. | Mónico, Lisete M. | Sousa, Gilberta | Morna, Clementina | Freitas, Otília | Freitas, Gregório | Jardim, Ana | Vasconcelos, Rita | Horta, Lina G. | Rosa, Roger S. | Kranz, Luís F. | Nugem, Rita C. | Siqueira, Mariana S. | Bordin, Ronaldo | Kniess, Rosiane | Lacerda, Josimari T. | Guedes, Joana | Machado, Idalina | Almeida, Sidalina | Zilhão, Adriano | Alves, Helder | Ribeiro, Óscar | Amaral, Ana P. | Santos, Ana | Monteiro, Joana | Rocha, Mª Clara | Cruz, Rui | Amaral, Ana P. | Lourenço, Marina | Rocha, Mª Clara | Cruz, Rui | Antunes, Sandra | Mendonça, Verónica | Andrade, Isabel | Osório, Nádia | Valado, Ana | Caseiro, Armando | Gabriel, António | Martins, Anabela C. | Mendes, Fernando | Cabral, Lídia | Ferreira, Manuela | Gonçalves, Amadeu | Luz, Tatiana D. | Luz, Leonardo | Martins, Raul | Morgado, Alice | Vale-Dias, Maria L. | Porta-Nova, Rui | Fleig, Tânia C. | Reuter, Éboni M. | Froemming, Miriam B. | Guerreiro, Sabrina L. | Carvalho, Lisiane L. | Guedelha, Daniel | Coelho, P. | Pereira, A. | Calha, António | Cordeiro, Raul | Gonçalves, Ana | Certo, Ana | Galvão, Ana | Mata, Mª Augusta | Welter, Aline | Pereira, Elayne | Ribeiro, Sandra | Kretzer, Marcia | Jiménez-Díaz, Juan-Fernando | Jiménez-Rodríguez, Carla | Hernández-Martínez, Francisco-José | Rodríguez-De-Vera, Bienvenida-Del-Carmen | Marques-Rodrigues, Alexandre | Coelho, Patrícia | Bernardes, Tiago | Pereira, Alexandre | Sousa, Patrícia | Filho, João G. | Nazario, Nazare | Kretzer, Marcia | Amaral, Odete | Garrido, António | Veiga, Nélio | Nunes, Carla | Pedro, Ana R. | Pereira, Carlos | Almeia, António | Fernandes, Helder M. | Vasconcelos, Carlos | Sousa, Nelson | Reis, Victor M. | Monteiro, M. João | Mendes, Romeu | Pinto, Isabel C. | Pires, Tânia | Gama, João | Preto, Vera | Silva, Norberto | Magalhães, Carlos | Martins, Matilde | Duarte, Mafalda | Paúl, Constança | Martín, Ignácio | Pinheiro, Arminda A. | Xavier, Sandra | Azevedo, Julieta | Bento, Elisabete | Marques, Cristiana | Marques, Mariana | Macedo, António | Pereira, Ana T. | Almeida, José P. | Almeida, António | Alves, Josiane | Sousa, Nelson | Saavedra, Francisco | Mendes, Romeu | Maia, Ana S. | Oliveira, Michelle T. | Sousa, Anderson R. | Ferreira, Paulo P. | Lopes, Luci S. | Santiago, Eujcely C. | Monteiro, Sílvia | Jesus, Ângelo | Colaço, Armanda | Carvalho, António | Silva, Rita P. | Cruz, Agostinho | Ferreira, Ana | Marques, Catarina | Figueiredo, João P. | Paixão, Susana | Ferreira, Ana | Lopes, Carla | Moreira, Fernando | Figueiredo, João P. | Ferreira, Ana | Ribeiro, Diana | Moreira, Fernando | Figueiredo, João P. | Paixão, Susana | Fernandes, Telma | Amado, Diogo | Leal, Jéssica | Azevedo, Marcelo | Ramalho, Sónia | Mangas, Catarina | Ribeiro, Jaime | Gonçalves, Rita | Nunes, Amélia F | Tuna, Ana R. | Martins, Carlos R. | Forte, Henriqueta D. | Costa, Cláudia | Tenedório, José A. | Santana, Paula | Andrade, J. A. | Pinto, J. L. | Campofiorito, C. | Nunes, S. | Carmo, A. | Kaliniczenco, A. | Alves, B. | Mendes, F. | Jesus, C. | Fonseca, F. | Gehrke, F. | Albuquerque, Carlos | Batista, Rita | Cunha, Madalena | Madureira, António | Ribeiro, Olivério | Martins, Rosa | Madeira, Teresa | Peixoto-Plácido, Catarina | Santos, Nuno | Santos, Osvaldo | Bergland, Astrid | Bye, Asta | Lopes, Carla | Alarcão, Violeta | Goulão, Beatriz | Mendonça, Nuno | Nicola, Paulo | Clara, João G. | Gomes, João | Querido, Ana | Tomás, Catarina | Carvalho, Daniel | Cordeiro, Marina | Rosa, Marlene C. | Marques, Alda | Brandão, Daniela | Ribeiro, Óscar | Araújo, Lia | Paúl, Constança | Minghelli, Beatriz | Richaud, Sylvina | Mendes, Ana L. | Marta-Simões, Joana | Trindade, Inês A. | Ferreira, Cláudia | Carvalho, Teresa | Cunha, Marina | Pinto-Gouveia, José | Fernandes, Morgana C. | Rosa, Roger S. | Nugem, Rita C. | Kranz, Luís F. | Siqueira, Mariana S. | Bordin, Ronaldo | Martins, Anabela C. | Medeiros, Anabela | Pimentel, Rafaela | Fernandes, Andreia | Mendonça, Carlos | Andrade, Isabel | Andrade, Susana | Menezes, Ruth L. | Bravo, Rafael | Miranda, Marta | Ugartemendia, Lierni | Tena, José Mª | Pérez-Caballero, Francisco L. | Fuentes-Broto, Lorena | Rodríguez, Ana B. | Carmen, Barriga | Carneiro, M. A. | Domingues, J. N. | Paixão, S. | Figueiredo, J. | Nascimento, V. B. | Jesus, C. | Mendes, F | Gehrke, F. | Alves, B. | Azzalis, L. | Fonseca, F. | Martins, Ana R. | Nunes, Amélia | Jorge, Arminda | Veiga, Nélio | Amorim, Ana | Silva, André | Martinho, Liliana | Monteiro, Luís | Silva, Rafael | Coelho, Carina | Amaral, Odete | Coelho, Inês | Pereira, Carlos | Correia, André | Rodrigues, Diana | Marante, Nídia | Silva, Pedro | Carvalho, Sara | Araujo, André Rts | Ribeiro, Maximiano | Coutinho, Paula | Ventura, Sandra | Roque, Fátima | Calvo, Cristina | Reses, Manoela | Conde, Jorge | Ferreira, Ana | Figueiredo, João | Silva, David | Seiça, Luís | Soares, Raquel | Mourão, Ricardo | Kraus, Teresa | Abreu, Ana C. | Padilha, José M. | Alves, Júlia M. | Sousa, Paulino | Oliveira, Manuel | Sousa, Joana | Novais, Sónia | Mendes, Felismina | Pinto, Joana | Cruz, Joana | Marques, Alda | Duarte, Hugo | Dixe, Maria Dos Anjos | Sousa, Pedro | Cruz, Inês | Bastos, Fernanda | Pereira, Filipe | Carvalho, Francisco L. | Oliveira, Teresa T. | Raposo, Vítor R. | Rainho, Conceição | Ribeiro, José C. | Barroso, Isabel | Rodrigues, Vítor | Neves, Carmo | Oliveira, Teresa C. | Oliveira, Bárbara | Morais, Mª Carminda | Baylina, Pilar | Rodrigues, Rogério | Azeredo, Zaida | Vicente, Corália | Dias, Hélia | Sim-Sim, Margarida | Parreira, Pedro | Salgueiro-Oliveira, Anabela | Castilho, Amélia | Melo, Rosa | Graveto, João | Gomes, José | Vaquinhas, Marina | Carvalho, Carla | Mónico, Lisete | Brito, Nuno | Sarroeira, Cassilda | Amendoeira, José | Cunha, Fátima | Cândido, Anabela | Fernandes, Patrícia | Silva, Helena R. | Silva, Elsa | Barroso, Isabel | Lapa, Leila | Antunes, Cristina | Gonçalves, Ana | Galvão, Ana | Gomes, Mª José | Escanciano, Susana R. | Freitas, Maria | Parreira, Pedro | Marôco, João | Fernandes, Ana R. | Cabral, Cremilde | Alves, Samuel | Sousa, Pedro | Ferreira, António | Príncipe, Fernanda | Seppänen, Ulla-Maija | Ferreira, Margarida | Carvalhais, Maribel | Silva, Marilene | Ferreira, Manuela | Silva, Joana | Neves, Jéssica | Costa, Diana | Santos, Bruno | Duarte, Soraia | Marques, Sílvia | Ramalho, Sónia | Mendes, Isabel | Louro, Clarisse | Menino, Eva | Dixe, Maria | Dias, Sara S. | Cordeiro, Marina | Tomás, Catarina | Querido, Ana | Carvalho, Daniel | Gomes, João | Valim, Frederico C. | Costa, Joyce O. | Bernardes, Lúcia G. | Prebianchi, Helena | Rosa, Marlene Cristina | Gonçalves, Narcisa | Martins, Maria M. | Kurcgant, Paulina | Vieira, André | Bento, Sandrina | Deodato, Sérgio | Rabiais, Isabel | Reis, Laura | Torres, Ana | Soares, Sérgio | Ferreira, Margarida | Graça, Pedro | Leitão, Céu | Abreu, Renato | Bellém, Fernando | Almeida, Ana | Ribeiro-Varandas, Edna | Tavares, Ana | Frade, João G. | Henriques, Carolina | Menino, Eva | Louro, Clarisse | Jordão, Célia | Neco, Sofia | Morais, Carminda | Ferreira, Pedro | Silva, Carla R. | Brito, Alice | Silva, Antónia | Duarte, Hugo | Dixe, Maria Dos Anjos | Sousa, Pedro | Postolache, Gabriela | Oliveira, Raul | Moreira, Isabel | Pedro, Luísa | Vicente, Sónia | Domingos, Samuel | Postolache, Octavian | Silva, Darlen | Filho, João G. | Nazario, Nazare | Kretzer, Marcia | Schneider, Dulcineia | Marques, Fátima M. | Parreira, Pedro | Carvalho, Carla | Mónico, Lisete M. | Pinto, Carlos | Vicente, Sara | Breda, São João | Gomes, José H. | Melo, Rosa | Parreira, Pedro | Salgueiro, Anabela | Graveto, João | Vaquinhas, Marina | Castilho, Amélia | Jesus, Ângelo | Duarte, Nuno | Lopes, José C. | Nunes, Hélder | Cruz, Agostinho | Salgueiro-Oliveira, Anabela | Parreira, Pedro | Basto, Marta L. | Braga, Luciene M. | Ferreira, António | Araújo, Beatriz | Alves, José M. | Ferreira, Margarida | Carvalhais, Maribel | Silva, Marilene | Novais, Sónia | Sousa, Ana S. | Ferrito, Cândida | Ferreira, Pedro L. | Rodrigues, Alexandre | Ferreira, Margarida | Oliveira, Isabel | Ferreira, Manuela | Neves, Jéssica | Costa, Diana | Duarte, Soraia | Silva, Joana | Santos, Bruno | Martins, Cristina | Macedo, Ana P. | Araújo, Odete | Augusto, Cláudia | Braga, Fátima | Gomes, Lisa | Silva, Maria A. | Rosário, Rafaela | Pimenta, Luís | Carreira, Diana | Teles, Patrícia | Barros, Teresa | Tomás, Catarina | Querido, Ana | Carvalho, Daniel | Gomes, João | Cordeiro, Marina | Carvalho, Daniel | Querido, Ana | Tomás, Catarina | Gomes, João | Cordeiro, Marina | Jácome, Cristina | Marques, Alda | Capelas, Sylvie | Hall, Andreia | Alves, Dina | Lousada, Marisa | Loureiro, Mª Helena | Camarneiro, Ana | Silva, Margarida | Mendes, Aida | Pedreiro, Ana | G.Silva, Anne | Coelho, Elza S. | Melo, Flávio | Ribeiro, Fernando | Torres, Rui | Costa, Rui | Pinho, Tânia | Jácome, Cristina | Marques, Alda | Cruz, Bárbara | Seabra, Daniel | Carreiras, Diogo | Ventura, Maria | Cruz, x | Brooks, Dina | Marques, Alda | Pinto, M Rosário | Parreira, Pedro | Lima-Basto, Marta | Neves, Miguel | Mónico, Lisete M. | Bizarro, Carla | Cunha, Marina | Galhardo, Ana | Margarida, Couto | Amorim, Ana P. | Silva, Eduardo | Cruz, Susana | Padilha, José M. | Valente, Jorge | Guerrero, José T. | Caballero, Francisco P. | Santos, Rafael B. | Gonzalez, Estefania P. | Monago, Fátima M. | Ugalde, Lierni U. | Vélez, Marta M. | Tena, Maria J. | Guerrero, José T. | Bravo, Rafael | Pérez-Caballero, Francisco L. | Becerra, Isabel A. | Agudelo, Mª Elizabeth | Acedo, Guadalupe | Bajo, Roberto | Malheiro, Isabel | Gaspar, Filomena | Barros, Luísa | Furtado, Guilherme | Uba-Chupel, Mateus | Marques, Mariana | Rama, Luís | Braga, Margarida | Ferreira, José P. | Teixeira, Ana Mª | Cruz, João | Barbosa, Tiago | Simões, Ângela | Coelho, Luís | Rodrigues, Alexandre | Jiménez-Díaz, Juan-Fernando | Martinez-Hernandez, Francisco | Rodriguez-De-Vera, Bienvenida | Ferreira, Pedro | Rodrigues, Alexandrina | Ramalho, André | Petrica, João | Mendes, Pedro | Serrano, João | Santo, Inês | Rosado, António | Mendonça, Paula | Freitas, Kátia | Ferreira, Dora | Brito, António | Fernandes, Renato | Gomes, Sofia | Moreira, Fernando | Pinho, Cláudia | Oliveira, Rita | Oliveira, Ana I. | Mendonça, Paula | Casimiro, Ana P. | Martins, Patrícia | Silva, Iryna | Evangelista, Diana | Leitão, Catarina | Velosa, Fábia | Carecho, Nélio | Coelho, Luís | Menino, Eva | Dixe, Anjos | Catarino, Helena | Soares, Fátima | Gama, Ester | Gordo, Clementina | Moreira, Eliana | Midões, Cristiana | Santos, Marlene | Machado, Sara | Oliveira, Vânia P. | Santos, Marlene | Querido, Ana | Dixe, Anjos | Marques, Rita | Charepe, Zaida | Antunes, Ana | Santos, Sofia | Rosa, Marlene C. | Rosa, Marlene C. | Marques, Silvana F. | Minghelli, Beatriz | CaroMinghelli, Eulália | Luís, Mª José | Brandão, Teresa | Mendes, Pedro | Marinho, Daniel | Petrica, João | Monteiro, Diogo | Paulo, Rui | Serrano, João | Santo, Inês | Monteiro, Lina | Ramalho, Fátima | Santos-Rocha, Rita | Morgado, Sónia | Bento, Teresa | Sousa, Gilberta | Freitas, Otília | Silva, Isabel | Freitas, Gregório | Morna, Clementina | Vasconcelos, Rita | Azevedo, Tatiana | Soares, Salete | Pisco, Jacinta | Ferreira, Paulo P. | Olszewer, Efrain O. | Oliveira, Michelle T. | Sousa, Anderson R. | Maia, Ana S. | Oliveira, Sebastião T. | Santos, Erica | Oliveira, Ana I. | Maia, Carla | Moreira, Fernando | Santos, Joana | Mendes, Maria F. | Oliveira, Rita F. | Pinho, Cláudia | Barreira, Eduarda | Pereira, Ana | Vaz, Josiana A. | Novo, André | Silva, Luís D. | Maia, Bruno | Ferreira, Eduardo | Pires, Filipa | Andrade, Renato | Camarinha, Luís | Silva, Luís D. | Maia, Bruno | Ferreira, Eduardo | Pires, Filipa | Andrade, Renato | Camarinha, Luís | César, Ana F. | Poço, Mariana | Ventura, David | Loura, Raquel | Gomes, Pedro | Gomes, Catarina | Silva, Cláudia | Melo, Elsa | Lindo, João | Domingos, Joana | Mendes, Zaida | Poeta, Susana | Carvalho, Tiago | Tomás, Catarina | Catarino, Helena | Dixe, Mª Anjos | Ramalho, André | Rosado, António | Mendes, Pedro | Paulo, Rui | Garcia, Inês | Petrica, João | Rodrigues, Sandra | Meneses, Rui | Afonso, Carlos | Faria, Luís | Seixas, Adérito | Cordeiro, Marina | Granjo, Paulo | Gomes, José C. | Souza, Nelba R. | Furtado, Guilherme E. | Rocha, Saulo V. | Silva, Paula | Carvalho, Joana | Morais, Marina Ana | Santos, Sofia | Lebre, Paula | Antunes, Ana | Calha, António | Xavier, Ana | Cunha, Marina | Pinto-Gouveia, José | Alencar, Liana | Cunha, Madalena | Madureira, António | Cardoso, Ilda | Galhardo, Ana | Daniel, Fernanda | Rodrigues, Vítor | Luz, Leonardo | Luz, Tatiana | Ramos, Maurício R. | Medeiros, Dayse C. | Carmo, Bruno M. | Seabra, André | Padez, Cristina | Silva, Manuel C. | Rodrigues, António | Coelho, Patrícia | Coelho, Alexandre | Caminha, Madson | Matheus, Filipe | Mendes, Elenice | Correia, Jony | Kretzer, Marcia | Hernandez-Martinez, Francisco J. | Jimenez-Diaz, Juan F. | Rodriguez-De-Vera, Bienvendida C. | Jimenez-Rodriguez, Carla | Armas-Gonzalez, Yadira | Rodrigues, Cátia | Pedroso, Rosa | Apolinário-Hagen, Jennifer | Vehreschild, Viktor | Veloso, Milene | Magalhães, Celina | Cabral, Isabel | Ferraz, Maira | Nave, Filipe | Costa, Emília | Matos, Filomena | Pacheco, José | Dias, António | Pereira, Carlos | Duarte, João | Cunha, Madalena | Silva, Daniel | Mónico, Lisete M. | Alferes, Valentim R. | Brêda, Mª São João | Carvalho, Carla | Parreira, Pedro M. | Morais, Mª Carminda | Ferreira, Pedro | Pimenta, Rui | Boavida, José | Pinto, Isabel C. | Pires, Tânia | Silva, Catarina | Ribeiro, Maria | Viega-Branco, Maria | Pereira, Filomena | Pereira, Ana Mª | Almeida, Fabrícia M. | Estevez, Gustavo L. | Ribeiro, Sandra | Kretzer, Marcia R. | João, Paulo V. | Nogueira, Paulo | Novais, Sandra | Pereira, Ana | Carneiro, Lara | Mota, Maria | Cruz, Rui | Santiago, Luiz | Fontes-Ribeiro, Carlos | Furtado, Guilherme | Rocha, Saulo V. | Coutinho, André P. | Neto, João S. | Vasconcelos, Lélia R. | Souza, Nelba R. | Dantas, Estélio | Dinis, Alexandra | Carvalho, Sérgio | Castilho, Paula | Pinto-Gouveia, José | Sarreira-Santos, Alexandra | Figueiredo, Amélia | Medeiros-Garcia, Lurdes | Seabra, Paulo | Rodrigues, Rosa | Morais, Mª Carminda | Fernandes, Paula O. | Santiago, Conceição | Figueiredo, Mª Henriqueta | Basto, Marta L. | Guimarães, Teresa | Coelho, André | Graça, Anabela | Silva, Ana M. | Fonseca, Ana R. | Vale-Dias, Luz | Minas, Bárbara | Franco-Borges, Graciete | Simões, Cristina | Santos, Sofia | Serra, Ana | Matos, Maria | Jesus, Luís | Tavares, Ana S. | Almeida, Ana | Leitão, Céu | Varandas, Edna | Abreu, Renato | Bellém, Fernando | Trindade, Inês A. | Ferreira, Cláudia | Pinto-Gouveia, José | Marta-Simões, Joana | Amaral, Odete | Miranda, Cristiana | Guimarães, Pedro | Gonçalves, Rodrigo | Veiga, Nélio | Pereira, Carlos | Fleig, Tânia C. | San-Martin, Elisabete A. | Goulart, Cássia L. | Schneiders, Paloma B. | Miranda, Natacha F. | Carvalho, Lisiane L. | Silva, Andrea G. | Topa, Joana | Nogueira, Conceição | Neves, Sofia | Ventura, Rita | Nazaré, Cristina | Brandão, Daniela | Freitas, Alberto | Ribeiro, Óscar | Paúl, Constança | Mercê, Cristiana | Branco, Marco | Almeida, Pedro | Nascimento, Daniela | Pereira, Juliana | Catela, David | Rafael, Helga | Reis, Alcinda C. | Mendes, Ana | Valente, Ana R. | Lousada, Marisa | Sousa, Diana | Baltazar, Ana L. | Loureiro, Mª Helena | Oliveira, Ana | Aparício, José | Marques, Alda | Marques, Alda | Oliveira, Ana | Neves, Joana | Ayoub, Rodrigo | Sousa, Luís | Marques-Vieira, Cristina | Severino, Sandy | José, Helena | Cadorio, Inês | Lousada, Marisa | Cunha, Marina | Andrade, Diogo | Galhardo, Ana | Couto, Margarida | Mendes, Fernando | Domingues, Cátia | Schukg, Susann | Abrantes, Ana M. | Gonçalves, Ana C. | Sales, Tiago | Teixo, Ricardo | Silva, Rita | Estrela, Jéssica | Laranjo, Mafalda | Casalta-Lopes, João | Rocha, Clara | Simões, Paulo C. | Sarmento-Ribeiro, Ana B. | Botelho, Mª Filomena | Rosa, Manuel S. | Fonseca, Virgínia | Colaço, Diogo | Neves, Vanessa | Jesus, Carlos | Hesse, Camilla | Rocha, Clara | Osório, Nádia | Valado, Ana | Caseiro, Armando | Gabriel, António | Svensson, Lola | Mendes, Fernando | Siba, Wafa A. | Pereira, Cristina | Tomaz, Jorge | Carvalho, Teresa | Pinto-Gouveia, José | Cunha, Marina | Duarte, Diana | Lopes, Nuno V. | Fonseca-Pinto, Rui | Duarte, Diana | Lopes, Nuno V. | Fonseca-Pinto, Rui | Martins, Anabela C. | Brandão, Piedade | Martins, Laura | Cardoso, Margarida | Morais, Nuno | Cruz, Joana | Alves, Nuno | Faria, Paula | Mateus, Artur | Morouço, Pedro | Alves, Nuno | Ferreira, Nelson | Mateus, Artur | Faria, Paula | Morouço, Pedro | Malheiro, Isabel | Gaspar, Filomena | Barros, Luísa | Parreira, Pedro | Cardoso, Andreia | Mónico, Lisete | Carvalho, Carla | Lopes, Albino | Salgueiro-Oliveira, Anabela | Seixas, Adérito | Soares, Valter | Dias, Tiago | Vardasca, Ricardo | Gabriel, Joaquim | Rodrigues, Sandra | Paredes, Hugo | Reis, Arsénio | Marinho, Sara | Filipe, Vítor | Lains, Jorge | Barroso, João | Da Motta, Carolina | Carvalho, Célia B. | Pinto-Gouveia, José | Peixoto, Ermelindo | Gomes, Ana A. | Costa, Vanessa | Couto, Diana | Marques, Daniel R. | Leitão, José A. | Tavares, José | Azevedo, Maria H. | Silva, Carlos F. | Freitas, João | Parreira, Pedro | Marôco, João | Garcia-Gordillo, Miguel A. | Collado-Mateo, Daniel | Chen, Gang | Iezzi, Angelo | Sala, José A. | Parraça, José A. | Gusi, Narcis | Sousa, Jani | Marques, Mariana | Jardim, Jacinto | Pereira, Anabela | Simões, Sónia | Cunha, Marina | Sardo, Pedro | Guedes, Jenifer | Lindo, João | Machado, Paulo | Melo, Elsa | Carvalho, Célia B. | Benevides, Joana | Sousa, Marina | Cabral, Joana | Da Motta, Carolina | Pereira, Ana T. | Xavier, Sandra | Azevedo, Julieta | Bento, Elisabete | Marques, Cristiana | Carvalho, Rosa | Marques, Mariana | Macedo, António | Silva, Ana M. | Alves, Juliana | Gomes, Ana A. | Marques, Daniel R. | Azevedo, Mª Helena | Silva, Carlos | Mendes, Ana | Lee, Huei D. | Spolaôr, Newton | Oliva, Jefferson T. | Chung, Wu F. | Fonseca-Pinto, Rui | Bairros, Keila | Silva, Cláudia D. | Souza, Clóvis A. | Schroeder, Silvana S. | Araújo, Elsa | Monteiro, Helena | Costa, Ricardo | Dias, Sara S. | Torgal, Jorge | Henriques, Carolina G. | Santos, Luísa | Caceiro, Elisa F. | Ramalho, Sónia A. | Oliveira, Rita | Afreixo, Vera | Santos, João | Mota, Priscilla | Cruz, Agostinho | Pimentel, Francisco | Marques, Rita | Dixe, Mª Anjos | Querido, Ana | Sousa, Patrícia | Benevides, Joana | Da Motta, Carolina | Sousa, Marina | Caldeira, Suzana N. | Carvalho, Célia B. | Querido, Ana | Tomás, Catarina | Carvalho, Daniel | Gomes, João | Cordeiro, Marina | Costa, Joyce O. | Valim, Frederico C. | Ribeiro, Lígia C. | Charepe, Zaida | Querido, Ana | Figueiredo, Mª Henriqueta | Aquino, Priscila S. | Ribeiro, Samila G. | Pinheiro, Ana B. | Lessa, Paula A. | Oliveira, Mirna F. | Brito, Luísa S. | Pinto, Ítalo N. | Furtado, Alessandra S. | Castro, Régia B. | Aquino, Caroline Q. | Martins, Eveliny S. | Pinheiro, Ana B | Aquino, Priscila S. | Oliveira, Lara L. | Pinheiro, Patrícia C. | Sousa, Caroline R. | Freitas, Vívien A. | Silva, Tatiane M. | Lima, Adman S. | Aquino, Caroline Q. | Andrade, Karizia V. | Oliveira, Camila A. | Vidal, Eglidia F. | Ganho-Ávila, Ana | Moura-Ramos, Mariana | Gonçalves, Óscar | Almeida, Jorge | Silva, Armando | Brito, Irma | Amado, João | Rodrigo, António | Santos, Sofia | Gomes, Fernando | Rosa, Marlene C. | Marques, Silvana F. | Luís, Sara | Cavalheiro, Luís | Ferreira, Pedro | Gonçalves, Rui | Lopes, Rui S. | Cavalheiro, Luís | Ferreira, Pedro | Gonçalves, Rui | Fiorin, Bruno H. | Santos, Marina S. | Oliveira, Edmar S. | Moreira, Rita L. | Oliveira, Elizabete A. | Filho, Braulio L. | Palmeira, Lara | Garcia, Teresa | Pinto-Gouveia, José | Cunha, Marina | Cardoso, Sara | Palmeira, Lara | Cunha, Marina | Pinto-Gouveia, José | Marta-Simões, Joana | Mendes, Ana L. | Trindade, Inês A. | Oliveira, Sara | Ferreira, Cláudia | Mendes, Ana L. | Marta-Simões, Joana | Trindade, Inês A. | Ferreira, Cláudia | Nave, Filipe | Campos, Mariana | Gaudêncio, Iris | Martins, Fernando | Ferreira, Lino | Lopes, Nuno | Fonseca-Pinto, Rui | Rodrigues, Rogério | Azeredo, Zaida | Vicente, Corália | Silva, Joana | Sousa, Patrícia | Marques, Rita | Mendes, Isabel | Rodrigues, Rogério | Azeredo, Zaida | Vicente, Corália | Vardasca, Ricardo | Marques, Ana R. | Seixas, Adérito | Carvalho, Rui | Gabriel, Joaquim | Ferreira, Paulo P. | Oliveira, Michelle T. | Sousa, Anderson R. | Maia, Ana S. | Oliveira, Sebastião T. | Costa, Pablo O. | Silva, Maiza M. | Arreguy-Sena, Cristina | Alvarenga-Martins, Nathália | Pinto, Paulo F. | Oliveira, Denize C. | Parreira, Pedro D. | Gomes, Antônio T. | Braga, Luciene M. | Araújo, Odete | Lage, Isabel | Cabrita, José | Teixeira, Laetitia | Marques, Rita | Dixe, Mª Anjos | Querido, Ana | Sousa, Patrícia | Silva, Sara | Cordeiro, Eugénio | Pimentel, João | Ferro-Lebres, Vera | Souza, Juliana A. | Tavares, Mariline | Dixe, Mª Anjos | Sousa, Pedro | Passadouro, Rui | Peralta, Teresa | Ferreira, Carlos | Lourenço, Georgina | Serrano, João | Petrica, João | Paulo, Rui | Honório, Samuel | Mendes, Pedro | Simões, Alexandra | Carvalho, Lucinda | Pereira, Alexandre | Silva, Sara | Sousa, Paulino | Padilha, José M. | Figueiredo, Daniela | Valente, Carolina | Marques, Alda | Ribas, Patrícia | Sousa, Joana | Brandão, Frederico | Sousa, Cesar | Martins, Matilde | Sousa, Patrícia | Marques, Rita | Mendes, Francisco | Fernandes, Rosina | Martins, Emília | Magalhães, Cátia | Araújo, Patrícia | Grande, Carla | Mata, Mª Augusta | Vieitez, Juan G. | Bianchini, Bruna | Nazario, Nazare | Filho, João G. | Kretzer, Marcia | Costa, Tânia | Almeida, Armando | Baffour, Gabriel | Almeida, Armando | Costa, Tânia | Baffour, Gabriel | Azeredo, Zaida | Laranjeira, Carlos | Guerra, Magda | Barbeiro, Ana P. | Ferreira, Regina | Lopes, Sara | Nunes, Liliana | Mendes, Ana | Martins, Julian | Schneider, Dulcineia | Kretzer, Marcia | Magajewski, Flávio | Soares, Célia | Marques, António | Batista, Marco | Castuera, Ruth J. | Mesquita, Helena | Faustino, António | Santos, Jorge | Honório, Samuel | Vizzotto, Betina P. | Frigo, Leticia | Pivetta, Hedioneia F. | Sardo, Dolores | Martins, Cristina | Abreu, Wilson | Figueiredo, Mª Céu | Batista, Marco | Jimenez-Castuera, Ruth | Petrica, João | Serrano, João | Honório, Samuel | Paulo, Rui | Mendes, Pedro | Sousa, Patrícia | Marques, Rita | Faustino, António | Silveira, Paulo | Serrano, João | Paulo, Rui | Mendes, Pedro | Honório, Samuel | Oliveira, Catarina | Bastos, Fernanda | Cruz, Inês | Rodriguez, Cláudia K. | Kretzer, Márcia R. | Nazário, Nazaré O. | Cruz, Pedro | Vaz, Daniela C. | Ruben, Rui B. | Avelelas, Francisco | Silva, Susana | Campos, Mª Jorge | Almeida, Maria | Gonçalves, Liliana | Antunes, Lígia | Sardo, Pedro | Guedes, Jenifer | Simões, João | Machado, Paulo | Melo, Elsa | Cardoso, Susana | Santos, Osvaldo | Nunes, Carla | Loureiro, Isabel | Santos, Flávia | Alves, Gilberto | Soar, Cláudia | Marsi, Teresa O. | Silva, Ernestina | Pedrosa, Dora | Leça, Andrea | Silva, Daniel | Galvão, Ana | Gomes, Maria | Fernandes, Paula | Noné, Ana | Combadão, Jaime | Ramalhete, Cátia | Figueiredo, Paulo | Caeiro, Patrícia | Fontana, Karine C. | Lacerda, Josimari T. | Machado, Patrícia O. | Borges, Raphaelle | Barbosa, Flávio | Sá, Dayse | Brunhoso, Germana | Aparício, Graça | Carvalho, Amâncio | Garcia, Ana P. | Fernandes, Paula O. | Santos, Adriana | Veiga, Nélio | Brás, Carina | Carvalho, Inês | Batalha, Joana | Glória, Margarida | Bexiga, Filipa | Coelho, Inês | Amaral, Odete | Pereira, Carlos | Pinho, Cláudia | Paraíso, Nilson | Oliveira, Ana I. | Lima, Cristóvão F. | Dias, Alberto P. | Silva, Pedro | Espada, Mário | Marques, Mário | Pereira, Ana | Pereira, Ana Mª | Veiga-Branco, Mª | Pereira, Filomena | Ribeiro, Maria | Lima, Vera | Oliveira, Ana I. | Pinho, Cláudia | Cruz, Graça | Oliveira, Rita F. | Barreiros, Luísa | Moreira, Fernando | Camarneiro, Ana | Loureiro, Mª Helena | Silva, Margarida | Duarte, Catarina | Jesus, Ângelo | Cruz, Agostinho | Mota, Maria | Novais, Sandra | Nogueira, Paulo | Pereira, Ana | Carneiro, Lara | João, Paulo V. | Lima, Teresa Maneca | Salgueiro-Oliveira, Anabela | Vaquinhas, Marina | Parreira, Pedro | Melo, Rosa | Graveto, João | Castilho, Amélia | Gomes, José H. | Medina, María S. | Blanco, Valeriana G. | Santos, Osvaldo | Lopes, Elisa | Virgolino, Ana | Dinis, Alexandra | Ambrósio, Sara | Almeida, Inês | Marques, Tatiana | Heitor, Mª João | Garcia-Gordillo, Miguel A. | Collado-Mateo, Daniel | Olivares, Pedro R. | Parraça, José A. | Sala, José A. | Castilho, Amélia | Graveto, João | Parreira, Pedro | Oliveira, Anabela | Gomes, José H. | Melo, Rosa | Vaquinhas, Marina | Cheio, Mónica | Cruz, Agostinho | Pereira, Olívia R. | Pinto, Sara | Oliveira, Adriana | Manso, M. Conceição | Sousa, Carla | Vinha, Ana F. | Machado, Mª Manuela | Vieira, Margarida | Fernandes, Beatriz | Tomás, Teresa | Quirino, Diogo | Desouzart, Gustavo | Matos, Rui | Bordini, Magali | Mouroço, Pedro | Matos, Ana R. | Serapioni, Mauro | Guimarães, Teresa | Fonseca, Virgínia | Costa, André | Ribeiro, João | Lobato, João | Martin, Inmaculada Z. | Björklund, Anita | Tavares, Aida I. | Ferreira, Pedro | Passadouro, Rui | Morgado, Sónia | Tavares, Nuno | Valente, João | Martins, Anabela C. | Araújo, Patrícia | Fernandes, Rosina | Mendes, Francisco | Magalhães, Cátia | Martins, Emília | Mendes, Pedro | Paulo, Rui | Faustino, António | Mesquita, Helena | Honório, Samuel | Batista, Marco | Lacerda, Josimari T. | Ortiga, Angela B. | Calvo, Mª Cristina | Natal, Sônia | Pereira, Marta | Ferreira, Manuela | Prata, Ana R. | Nelas, Paula | Duarte, João | Carneiro, Juliana | Oliveira, Ana I. | Pinho, Cláudia | Couto, Cristina | Oliveira, Rita F. | Moreira, Fernando | Maia, Ana S. | Oliveira, Michelle T. | Sousa, Anderson R. | Ferreira, Paulo P. | Souza, Géssica M. | Almada, Lívia F. | Conceição, Milena A. | Santiago, Eujcely C. | Rodrigues, Sandra | Domingues, Gabriela | Ferreira, Irina | Faria, Luís | Seixas, Adérito | Costa, Ana R. | Jesus, Ângelo | Cardoso, Américo | Meireles, Alexandra | Colaço, Armanda | Cruz, Agostinho | Vieira, Viviane L. | Vincha, Kellem R. | Cervato-Mancuso, Ana Mª | Faria, Melissa | Reis, Cláudia | Cova, Marco P. | Ascenso, Rita T. | Almeida, Henrique A. | Oliveira, Eunice G. | Santana, Miguel | Pereira, Rafael | Oliveira, Eunice G. | Almeida, Henrique A. | Ascenso, Rita T. | Jesus, Rita | Tapadas, Rodrigo | Tim-Tim, Carolina | Cezanne, Catarina | Lagoa, Matilde | Dias, Sara S. | Torgal, Jorge | Lopes, João | Almeida, Henrique | Amado, Sandra | Carrão, Luís | Cunha, Madalena | Saboga-Nunes, Luís | Albuquerque, Carlos | Ribeiro, Olivério | Oliveira, Suzete | Morais, Mª Carminda | Martins, Emília | Mendes, Francisco | Fernandes, Rosina | Magalhães, Cátia | Araújo, Patrícia | Pedro, Ana R. | Amaral, Odete | Escoval, Ana | Assunção, Victor | Luís, Henrique | Luís, Luís | Apolinário-Hagen, Jennifer | Vehreschild, Viktor | Fotschl, Ulrike | Lirk, Gerald | Martins, Anabela C. | Andrade, Isabel | Mendes, Fernando | Mendonça, Verónica | Antunes, Sandra | Andrade, Isabel | Osório, Nádia | Valado, Ana | Caseiro, Armando | Gabriel, António | Martins, Anabela C. | Mendes, Fernando | Silva, Paula A. | Mónico, Lisete M. | Parreira, Pedro M. | Carvalho, Carla | Carvalho, Carla | Parreira, Pedro M. | Mónico, Lisete M. | Ruivo, Joana | Silva, Vânia | Sousa, Paulino | Padilha, José M. | Ferraz, Vera | Aparício, Graça | Duarte, João | Vasconcelos, Carlos | Almeida, António | Neves, Joel | Correia, Telma | Amorim, Helena | Mendes, Romeu | Saboga-Nunes, Luís | Cunha, Madalena | Albuquerque, Carlos | Pereira, Elsa S. | Santos, Leonino S. | Reis, Ana S. | Silva, Helena R. | Rombo, João | Fernandes, Jorge C. | Fernandes, Patrícia | Ribeiro, Jaime | Mangas, Catarina | Freire, Ana | Silva, Sara | Francisco, Irene | Oliveira, Ana | Catarino, Helena | Dixe, Mª Anjos | Louro, Mª Clarisse | Lopes, Saudade | Dixe, Anjos | Dixe, Mª Anjos | Menino, Eva | Catarino, Helena | Soares, Fátima | Oliveira, Ana P. | Gordo, Sara | Kraus, Teresa | Tomás, Catarina | Queirós, Paulo | Rodrigues, Teresa | Sousa, Pedro | Frade, João G. | Lobão, Catarina | Moura, Cynthia B. | Dreyer, Laysa C. | Meneghetti, Vanize | Cabral, Priscila P. | Pinto, Francisca | Sousa, Paulino | Esteves, Mª Raquel | Galvão, Sofia | Tytgat, Ite | Andrade, Isabel | Osório, Nádia | Valado, Ana | Caseiro, Armando | Gabriel, António | Martins, Anabela C. | Mendes, Fernando | Casas-Novas, Mónica | Bernardo, Helena | Andrade, Isabel | Sousa, Gracinda | Sousa, Ana P. | Rocha, Clara | Belo, Pedro | Osório, Nádia | Valado, Ana | Caseiro, Armando | Gabriel, António | Martins, Anabela C. | Mendes, Fernando | Martins, Fátima | Pulido-Fuentes, Montserrat | Barroso, Isabel | Cabral, Gil | Monteiro, M. João | Rainho, Conceição | Prado, Alessandro | Carvalho, Yara M. | Campos, Maria | Moreira, Liliana | Ferreira, José | Teixeira, Ana | Rama, Luís | Campos, Maria | Moreira, Liliana | Ferreira, José | Teixeira, Ana | Rama, Luís
BMC Health Services Research  2016;16(Suppl 3):200.
Table of contents
S1 Health literacy and health education in adolescence
Catarina Cardoso Tomás
S2 The effect of a walking program on the quality of life and well-being of people with schizophrenia
Emanuel Oliveira, D. Sousa, M. Uba-Chupel, G. Furtado, C. Rocha, A. Teixeira, P. Ferreira
S3 Diagnosis and innovative treatments - the way to a better medical practice
Celeste Alves
S4 Simulation-based learning and how it is a high contribution
Stefan Gisin
S5 Formative research about acceptability, utilization and promotion of a home fortification programme with micronutrient powders (MNP) in the Autonomous Region of Príncipe, São Tomé and Príncipe
Elisabete Catarino, Nelma Carvalho, Tiago Coucelo, Luís Bonfim, Carina Silva
S6 Safety culture of the patient: a reflexion about the therapeutic approach on the patient with vocal pathology
Débora Franco
S7 About wine, fortune cookies and patient experience
Jesús Alcoba González
O1 The psychological impact on the emergency crews after the disaster event on February 20, 2010
Helena G. Jardim, Rita Silva
O2 Musculoskeletal disorders in midwives
Cristina L. Baixinho, Mª Helena Presado, Mª Fátima Marques, Mário E. Cardoso
O3 Negative childhood experiences and fears of compassion: Implications for psychological difficulties in adolescence
Marina Cunha, Joana Mendes, Ana Xavier, Ana Galhardo, Margarida Couto
O4 Optimal age to give the first dose of measles vaccine in Portugal
João G. Frade, Carla Nunes, João R. Mesquita, Maria S. Nascimento, Guilherme Gonçalves
O5 Functional assessment of elderly in primary care
Conceição Castro, Alice Mártires, Mª João Monteiro, Conceição Rainho
O6 Smoking and coronary events in a population of Spanish health-care centre: An observational study
Francisco P. Caballero, Fatima M. Monago, Jose T. Guerrero, Rocio M. Monago, Africa P. Trigo, Milagros L. Gutierrez, Gemma M. Milanés, Mercedes G. Reina, Ana G. Villanueva, Ana S. Piñero, Isabel R. Aliseda, Francisco B. Ramirez
O7 Prevalence of musculoskeletal injuries in Portuguese musicians
Andrea Ribeiro, Ana Quelhas, Conceição Manso
O8 Hip fractures, psychotropic drug consumption and comorbidity in patients of a primary care practice in Spain
Francisco P. Caballero, Jose T. Guerrero, Fatima M. Monago, Rafael B. Santos, Nuria R. Jimenez, Cristina G. Nuñez, Inmaculada R. Gomez, Mª Jose L. Fernandez, Laura A. Marquez, Ana L. Moreno, Mª Jesus Tena Huertas, Francisco B. Ramirez
O9 The role of self-criticism and shame in social anxiety in a clinical SAD sample
Daniel Seabra, Mª Céu Salvador
O10 Obstruction and infiltration: a proposal of a quality indicator
Luciene Braga, Pedro Parreira, Anabela Salgueiro-Oliveira, Cristina Arreguy-Sena, Bibiana F. Oliveira, Mª Adriana Henriques
O11 Balance and anxiety and depression symptoms in old age people
Joana Santos, Sara Lebre, Alda Marques
O12 Prevalence of postural changes and risk factors in school children and adolescents in a northern region (Porto)
Clarinda Festas, Sandra Rodrigues, Andrea Ribeiro, José Lumini
O13 Ischemic stroke vs. haemorrhagic stroke survival rate
Ana G. Figueiredo
O14 Chronobiological factors as responsible for the appearance of locomotor pathology in adolescents
Francisco J. Hernandez-Martinez, Liliana Campi, Mª Pino Quintana-Montesdeoca, Juan F. Jimenez-Diaz, Bienvenida C. Rodriguez-De-Vera
O15 Risk of malnutrition in the elderly of Bragança
Alexandra Parente, Mª Augusta Mata, Ana Mª Pereira, Adília Fernandes, Manuel Brás
O16 A Lifestyle Educational Programme for primary care diabetic patients: the design of a complex nursing intervention
Mª Rosário Pinto, Pedro Parreira, Marta L. Basto, Ana C. Rei, Lisete M. Mónico
O17 Medication adherence in elderly people
Gilberta Sousa, Clementina Morna, Otília Freitas, Gregório Freitas, Ana Jardim, Rita Vasconcelos
O18 Hospitalization for cervical cancer of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014
Lina G. Horta, Roger S. Rosa, Luís F. Kranz, Rita C. Nugem, Mariana S. Siqueira, Ronaldo Bordin
O19 Oncologic assistance of high complexity: evaluation of regulating accesses
Rosiane Kniess, Josimari T. Lacerda
O20 Perceived barriers for using health care services by the older population as seen by the social sector: findings from the Vila Nova de Gaia Gerontological Plan
Joana Guedes, Idalina Machado, Sidalina Almeida, Adriano Zilhão, Helder Alves, Óscar Ribeiro
O21 Sleep difficulties and depressive symptoms in college students
Ana P. Amaral, Ana Santos, Joana Monteiro, Mª Clara Rocha, Rui Cruz
O22 Psychopathological symptoms and medication use in higher education
Ana P. Amaral, Marina Lourenço, Mª Clara Rocha, Rui Cruz
O23 Sexually transmitted diseases in higher education institutions
Sandra Antunes, Verónica Mendonça, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes
O24 Alcohol consumption and suicide ideation in higher education students
Lídia Cabral, Manuela Ferreira, Amadeu Gonçalves
O25 Quality of life in university students
Tatiana D. Luz, Leonardo Luz, Raul Martins
O26 Male and female adolescent antisocial behaviour: characterizing vulnerabilities in a Portuguese sample
Alice Morgado, Maria L. Vale-Dias
O27 Risk factors for mental health in higher education students of health sciences
Rui Porta-Nova
O28 International classification of functioning disability and health as reflexive reasoning in primary attention in health
Tânia C. Fleig, Éboni M. Reuter, Miriam B. Froemming, Sabrina L. Guerreiro, Lisiane L. Carvalho
O29 Risk factors and cardiovascular disease in Portalegre
Daniel Guedelha, P. Coelho, A. Pereira
O30 Health status of the elderly population living in Portalegre historic city centre: A longitudinal study
António Calha, Raul Cordeiro
O31 Student’s sleep in higher education: sleep quality among students of the IPB
Ana Gonçalves, Ana Certo, Ana Galvão, Mª Augusta Mata
O32 Trend in mortality from cervical cancer in the metropolitan area of Florianópolis, state of Santa Catarina, Brazil, 2000 to 2013
Aline Welter, Elayne Pereira, Sandra Ribeiro, Marcia Kretzer
O33 Adherence to treatment in the elderly in an urban environment in Spain
Juan-Fernando Jiménez-Díaz, Carla Jiménez-Rodríguez, Francisco-José Hernández-Martínez, Bienvenida-Del-Carmen Rodríguez-De-Vera, Alexandre Marques-Rodrigues
O34 Beira Baixa Blood Pressure Study (Study PABB)
Patrícia Coelho, Tiago Bernardes, Alexandre Pereira
O35 Trends in cervical cancer mortality statistics in Santa Catarina State, Brazil, by age group and macro-region, from 2000 to 2013
Patrícia Sousa, João G. Filho, Nazare Nazario, Marcia Kretzer
O36 Sleep problems among Portuguese adolescents: a public health issue
Odete Amaral, António Garrido, Nélio Veiga, Carla Nunes, Ana R. Pedro, Carlos Pereira
O37 Association between body fat and health-related quality of life in patients with type 2 diabetes
António Almeia, Helder M. Fernandes, Carlos Vasconcelos, Nelson Sousa, Victor M. Reis, M. João Monteiro, Romeu Mendes
O38 Therapy adherence and polypharmacy in non-institutionalized elderly from Amares county, Portugal
Isabel C. Pinto, Tânia Pires, João Gama
O39 Prevalence of surgical site infection in adults at a hospital unit in the North of Portugal
Vera Preto, Norberto Silva, Carlos Magalhães, Matilde Martins
O40 Frailty phenotype in old age: implications to intervention
Mafalda Duarte, Constança Paúl, Ignácio Martín
O41 Portuguese women: sexual symptoms in perimenopause
Arminda A. Pinheiro
O42 Predictive ability of the Perinatal Depression Screening and Prevention Tool – preliminary results of the categorical approach
Sandra Xavier, Julieta Azevedo, Elisabete Bento, Cristiana Marques, Mariana Marques, António Macedo, Ana T. Pereira
O43 Aging and muscle strength in patients with type 2 diabetes: cross sectional analysis
José P. Almeida, António Almeida, Josiane Alves, Nelson Sousa, Francisco Saavedra, Romeu Mendes
O44 Accessibility of the elderly in the prevention of hypertension in a family health unit
Ana S. Maia, Michelle T. Oliveira, Anderson R. Sousa, Paulo P. Ferreira, Luci S. Lopes, Eujcely C. Santiago
O45 Community Health screenings and self-reported chronic diseases
Sílvia Monteiro, Ângelo Jesus, Armanda Colaço, António Carvalho, Rita P. Silva, Agostinho Cruz
O46 Evaluation of indoor air quality in Kindergartens
Ana Ferreira, Catarina Marques, João P. Figueiredo, Susana Paixão
O47 Atmospheric exposure to chemical agents under the occupational activity of pathology technicians
Ana Ferreira, Carla Lopes, Fernando Moreira, João P. Figueiredo
O48 Occupational exposure to air pollutants in night entertainment venues workers
Ana Ferreira, Diana Ribeiro, Fernando Moreira, João P. Figueiredo, Susana Paixão
O49 Beliefs and attitudes of young people towards breastfeeding
Telma Fernandes, Diogo Amado, Jéssica Leal, Marcelo Azevedo, Sónia Ramalho
O50 Profiling informal caregivers: surveying needs in the care of the elderly
Catarina Mangas, Jaime Ribeiro, Rita Gonçalves
O51 Visual health in teenagers
Amélia F Nunes, Ana R. Tuna, Carlos R. Martins, Henriqueta D. Forte
O52 Amenable mortality and the geographic accessibility to healthcare in Portugal
Cláudia Costa, José A. Tenedório, Paula Santana
O53 Bacterial contamination of door handles in a São Paulo See Metropolitan Cathedral public restrooms in Brazil
J. A. Andrade, J. L. Pinto, C. Campofiorito, S. Nunes, A. Carmo, A. Kaliniczenco, B. Alves, F. Mendes, C. Jesus, F. Fonseca, F. Gehrke
O54 Adherence of patients to rehabilitation programmes
Carlos Albuquerque, Rita Batista, Madalena Cunha, António Madureira, Olivério Ribeiro, Rosa Martins
O55 Prevalence of malnutrition among Portuguese elderly living in nursing homes: preliminary results of the PEN-3S project
Teresa Madeira, Catarina Peixoto-Plácido, Nuno Santos, Osvaldo Santos, Astrid Bergland, Asta Bye, Carla Lopes, Violeta Alarcão, Beatriz Goulão, Nuno Mendonça, Paulo Nicola, João G. Clara
O56 Relation between emotional intelligence and mental illness in health students
João Gomes, Ana Querido, Catarina Tomás, Daniel Carvalho, Marina Cordeiro
P1 Fall risk factors in people older than 50 years old – a pilot report
Marlene C. Rosa, Alda Marques
P2 What about the Portuguese oldest old? A global overview using census data
Daniela Brandão, Óscar Ribeiro, Lia Araújo, Constança Paúl
P3 Prevalence of injuries in senior amateur volleyball athletes in Alentejo and Algarve clubs, Portugal: factors associated
Beatriz Minghelli, Sylvina Richaud
P4 Shame feelings and quality of life: the role of acceptance and decentring
Ana L. Mendes, Joana Marta-Simões, Inês A. Trindade, Cláudia Ferreira
P5 Assessment of social support during deployment in portuguese colonial war veterans
Teresa Carvalho, Marina Cunha, José Pinto-Gouveia
P6 Hospitalization for acute viral bronchiolitis of residents in the metropolitan region of Porto Alegre, Southern Brazil, 2012 to 2014
Morgana C. Fernandes, Roger S. Rosa, Rita C. Nugem, Luís F. Kranz, Mariana S. Siqueira, Ronaldo Bordin
P7 Falls-risk screening – an opportunity for preventing falls in the elderly from Nordeste
Anabela C. Martins, Anabela Medeiros, Rafaela Pimentel, Andreia Fernandes, Carlos Mendonça, Isabel Andrade, Susana Andrade, Ruth L. Menezes
P8 Aging provokes chronodisruption in mature people in temperature circadian rhythm
Rafael Bravo, Marta Miranda, Lierni Ugartemendia, José Mª Tena, Francisco L. Pérez-Caballero, Lorena Fuentes-Broto, Ana B. Rodríguez, Barriga Carmen
P9 The influence of climate and pollution factors in dengue cases of great ABC region, São Paulo
M. A. Carneiro, J. N. Domingues, S. Paixão, J. Figueiredo, V. B. Nascimento, C. Jesus, F Mendes, F. Gehrke, B. Alves, L. Azzalis, F. Fonseca
P10 Visual function and impact of visual therapy in children with learning disabilities: a pilot study
Ana R. Martins, Amélia Nunes, Arminda Jorge
P11 Edentulism and the need of oral rehabilitation among institutionalized elderly
Nélio Veiga, Ana Amorim, André Silva, Liliana Martinho, Luís Monteiro, Rafael Silva, Carina Coelho, Odete Amaral, Inês Coelho, Carlos Pereira, André Correia
P12 Therapy adherence of outpatients in the pharmacy services of a hospital unit
Diana Rodrigues, Nídia Marante, Pedro Silva, Sara Carvalho, André Rts Araujo, Maximiano Ribeiro, Paula Coutinho, Sandra Ventura, Fátima Roque
P13 Universal access and comprehensive care of oral health: an availability study
Cristina Calvo, Manoela Reses
P14 Is the respiratory function of children a predictor of air quality? Coimbra as a case study
Jorge Conde, Ana Ferreira, João Figueiredo
P15 Meaning-in-life of college students
David Silva, Luís Seiça, Raquel Soares, Ricardo Mourão, Teresa Kraus
O57 Training needs for nurses in palliative care
Ana C. Abreu, José M. Padilha, Júlia M. Alves
O58 Impact of computerized information systems in the global nurses’ workload: nurses’ perceptions and real-time
Paulino Sousa, Manuel Oliveira, Joana Sousa
O59 The perspective of health care professionals on self-care in hereditary neurodegenerative disease: a qualitative study
Sónia Novais, Felismina Mendes
O60 Contribution for health-related physical fitness reference values in healthy adolescents
Joana Pinto, Joana Cruz, Alda Marques
School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
O61 Perception of learning, satisfaction and self-efficacy of nursing students about High-Fidelity Simulation
Hugo Duarte, Maria Dos Anjos Dixe, Pedro Sousa
O62 Analysis of statements of diagnosis about health deviation in self-care requisites customized in a Nursing Practice Support System (SAPE®): Management of therapeutic regimen
Inês Cruz, Fernanda Bastos, Filipe Pereira
O63 Hybrid management and hospital governance: doctors and nurses as managers
Francisco L. Carvalho, Teresa T. Oliveira, Vítor R. Raposo
O64 Time management in health professionals
Conceição Rainho, José C. Ribeiro, Isabel Barroso, Vítor Rodrigues
O65 Financial rewards and wellbeing in primary health care
Carmo Neves, Teresa C. Oliveira
O66 Patient safety promotion in the operating room
Bárbara Oliveira, Mª Carminda Morais, Pilar Baylina
O67 Difficulties and needs of pre-graduate nursing students in the area of Geriatrics/Gerontology
Rogério Rodrigues, Zaida Azeredo, Corália Vicente
O68 Teaching and learning sexuality in nursing education
Hélia Dias, Margarida Sim-Sim
O69 Entrepreneurial Motivations Questionnaire: AFC and CFA in academy
Pedro Parreira, Anabela Salgueiro-Oliveira, Amélia Castilho, Rosa Melo, João Graveto, José Gomes, Marina Vaquinhas, Carla Carvalho, Lisete Mónico, Nuno Brito
O70 Nursing intervention to patient with Permanent Pacemakers and Implantable Cardioverter Defibrillators: a qualitative analysis
Cassilda Sarroeira, José Amendoeira, Fátima Cunha, Anabela Cândido, Patrícia Fernandes, Helena R. Silva, Elsa Silva
O71 Alcohol consumption among nursing students: where does education fail?
Isabel Barroso, Leila Lapa, Cristina Antunes
O72 Labour stress in nursing
Ana Gonçalves, Ana Galvão, Mª José Gomes, Susana R. Escanciano
O73 The influence of safe staff nursing in patient satisfaction with nursing care
Maria Freitas, Pedro Parreira, João Marôco
O74 Intention to use eHealth strategies with nursing students
Ana R. Fernandes, Cremilde Cabral, Samuel Alves, Pedro Sousa
O75 Community Based Mental Health: contributions of an interdisciplinary international program for students in higher health education
António Ferreira, Fernanda Príncipe, Ulla-Maija Seppänen, Margarida Ferreira, Maribel Carvalhais, Marilene Silva
O76 Study of satisfaction at work of graduates in nursing: 2002-2014
Manuela Ferreira, Joana Silva, Jéssica Neves, Diana Costa, Bruno Santos, Soraia Duarte
O77 Health professionals’ attitudes towards breastfeeding
Sílvia Marques, Sónia Ramalho, Isabel Mendes
O78 Continuity of nursing care to person with type 2 diabetes
Clarisse Louro, Eva Menino, Maria Dixe, Sara S. Dias
O79 Stigma toward mental illness among future health professionals
Marina Cordeiro, Catarina Tomás, Ana Querido, Daniel Carvalho, João Gomes
O80 Working with fears and anxieties of medical students in search of a humanized care
Frederico C. Valim, Joyce O. Costa, Lúcia G. Bernardes
P16 Surgical paediatrics patients’ psycho prophylaxis at a teaching hospital
Helena Prebianchi
P17 Patient-perceived outcomes in physiotherapy – a pilot study
Marlene Cristina Rosa
P18 Building competencies for managers in nursing
Narcisa Gonçalves, Maria M. Martins, Paulina Kurcgant
P19 Theoretical basis underlying physiotherapy practice in stroke rehabilitation
André Vieira
P20 When the life-cycle ends: the nurse’s confrontation with death
Sandrina Bento, Sérgio Deodato, Isabel Rabiais
P21 Nursing students’ opinion about the supervision relationship during their first clinical experience
Laura Reis
P22 Nursing Relational Laboratory: Pedagogical, dialogic and critical project
Ana Torres, Sérgio Soares, Margarida Ferreira, Pedro Graça
P23 Job satisfaction of bioscientists at a Lisbon hospital
Céu Leitão, Renato Abreu, Fernando Bellém, Ana Almeida, Edna Ribeiro-Varandas, Ana Tavares
P24 Sociodemographic and professional profile of nurses and its relation with the importance of family in nursing practices
João G. Frade, Carolina Henriques, Eva Menino, Clarisse Louro, Célia Jordão
P25 Professional satisfaction of rehabilitation nurses
Sofia Neco, Carminda Morais, Pedro Ferreira
P26 The person living with a stoma: the formalization of knowledge in nursing
Carla R. Silva, Alice Brito, Antónia Silva
P27 Validation of the Portuguese versions of the nursing students’ perceptions of learning and learner satisfaction with simulation tool
Hugo Duarte, Maria Dos Anjos Dixe, Pedro Sousa
P28 Physiotherapists’ perceived knowledge on technologies for electronic health records for physiotherapy
Gabriela Postolache, Raul Oliveira, Isabel Moreira, Luísa Pedro, Sónia Vicente, Samuel Domingos, Octavian Postolache
P29 Quality of life and physical activity of medicine undergraduate students in the University of Southern Santa Catarina, Brazil
Darlen Silva, João G. Filho, Nazare Nazario, Marcia Kretzer, Dulcineia Schneider
P30 The curricular skills for decision making education in a Nursing Degree
Fátima M. Marques
P31 Effect of nurses’ mobilization in satisfaction at work and turnover: An empirical study in the hospital setting
Pedro Parreira, Carla Carvalho, Lisete M. Mónico, Carlos Pinto, Sara Vicente, São João Breda
P32 Entrepreneurial skills of students of polytechnic higher education in Portugal: Business influences
José H. Gomes, Rosa Melo, Pedro Parreira, Anabela Salgueiro, João Graveto, Marina Vaquinhas, Amélia Castilho
P33 Design and assessment of e-learning modules for Pharmacology
Ângelo Jesus, Nuno Duarte, José C. Lopes, Hélder Nunes, Agostinho Cruz
P34 Perspective of nurses involved in an action-research study on the changes observed in care provision: results from a focus group
Anabela Salgueiro-Oliveira, Pedro Parreira, Marta L. Basto, Luciene M. Braga
P35 Use of peer feedback by nursing students during clinical training: teacher’s perception
António Ferreira, Beatriz Araújo, José M. Alves, Margarida Ferreira, Maribel Carvalhais, Marilene Silva, Sónia Novais
P36 What’s new on endotracheal suctioning recommendations
Ana S. Sousa, Cândida Ferrito
P37 Assessment of the nurses satisfaction on the Central Region of Portugal
Pedro L. Ferreira, Alexandre Rodrigues, Margarida Ferreira, Isabel Oliveira
P38 Study of graduate’s satisfaction with the school of nursing
Manuela Ferreira, Jéssica Neves, Diana Costa, Soraia Duarte, Joana Silva, Bruno Santos
P39 Partnership between the school of nursing and the hospital: Supervisors´ perspectives
Cristina Martins, Ana P. Macedo, Odete Araújo, Cláudia Augusto, Fátima Braga, Lisa Gomes, Maria A. Silva, Rafaela Rosário
P40 Coping strategies of college students
Luís Pimenta, Diana Carreira, Patrícia Teles, Teresa Barros
P41 Emotional intelligence and mental health stigma in health students
Catarina Tomás, Ana Querido, Daniel Carvalho, João Gomes, Marina Cordeiro
P42 Stigma of mental health assessment: Comparison between health courses
Daniel Carvalho, Ana Querido, Catarina Tomás, João Gomes, Marina Cordeiro
O81 Short- and long-term effects of pulmonary rehabilitation in mild COPD
Cristina Jácome, Alda Marques
O82 Phonological awareness programme for preschool children
Sylvie Capelas, Andreia Hall, Dina Alves, Marisa Lousada
O83 REforma ATIVA: An efficient health promotion program to be implemented during retirement
Mª Helena Loureiro, Ana Camarneiro, Margarida Silva, Aida Mendes, Ana Pedreiro
O84 Intervention for men who batter women, a case report
Anne G.Silva, Elza S. Coelho
O85 Immediate effects of Bowen Therapy on muscle tone and flexibility
Flávio Melo, Fernando Ribeiro, Rui Torres, Rui Costa
O86 Predictive equation for incremental shuttle walk test in adolescents
Tânia Pinho, Cristina Jácome, Alda Marques
O87 Life satisfaction and psychopathology in institutionalized elderly people: The results of an adapted Mindfulness-Based Stress Reduction program
Bárbara Cruz, Daniel Seabra, Diogo Carreira, Maria Ventura
O88 Outcome changes in COPD rehabilitation: exploring the relationship between physical activity and health-related outcomes
Joana Cruz, Dina Brooks, Alda Marques
O89 Assessing the effectiveness of a Complex Nursing Intervention
M Rosário Pinto, Pedro Parreira, Marta Lima-Basto, Miguel Neves, Lisete M. Mónico
O90 Psychotherapeutic intervention in addiction disorders: Change in psychopathological symptoms and emotional states
Carla Bizarro, Marina Cunha, Ana Galhardo, Couto Margarida, Ana P. Amorim, Eduardo Silva
O91 Economic impact of a nursing intervention program to promote self-management in COPD
Susana Cruz, José M. Padilha, Jorge Valente
O92 Multimodal acute pain management during uterine artery embolization in treatment of uterine myomas
José T. Guerrero, Francisco P. Caballero, Rafael B. Santos, Estefania P. Gonzalez, Fátima M. Monago, Lierni U. Ugalde, Marta M. Vélez, Maria J. Tena
O93 Fluid administration strategies in major surgery: Goal-directed therapy
José T. Guerrero, Rafael Bravo, Francisco L. Pérez-Caballero, Isabel A. Becerra, Mª Elizabeth Agudelo, Guadalupe Acedo, Roberto Bajo
O94 Development and implementation of a self-management educational programme using lay-led’s in adolescents Spina Bifida: A pilot study
Isabel Malheiro, Filomena Gaspar, Luísa Barros
O95 Influence of chair-based yoga exercises on salivary anti-microbial proteins in institutionalized frail-elderly women: a preliminary study
Guilherme Furtado, Mateus Uba-Chupel, Mariana Marques, Luís Rama, Margarida Braga, José P. Ferreira, Ana Mª Teixeira
O96 High intensity interval training vs moderate intensity continuous training impact on diabetes 2
João Cruz, Tiago Barbosa, Ângela Simões, Luís Coelho
O97 Family caregiver of people with pressure ulcer: Nursing intervention plan
Alexandre Rodrigues, Juan-Fernando Jiménez-Díaz, Francisco Martinez-Hernández, Bienvenida Rodriguez-De-Vera, Pedro Ferreira, Alexandrina Rodrigues
O98 Chronic effects of exercise on motor memory consolidation in elderly people
André Ramalho, João Petrica, Pedro Mendes, João Serrano, Inês Santo, António Rosado
O99 Impression cytology of the ocular surface: Collection technique and sample processing
Paula Mendonça, Kátia Freitas
O100 Does sport practice affect the reaction time in neuromuscular activity?
Dora Ferreira, António Brito, Renato Fernandes
O101 Efficiency of the enteral administration of fibbers in the treatment of chronic obstipation
Sofia Gomes, Fernando Moreira, Cláudia Pinho, Rita Oliveira, Ana I. Oliveira
O102 Fast decalcifier in compact bone and spongy bone
Paula Mendonça, Ana P. Casimiro, Patrícia Martins, Iryna Silva
O103 Health promotion in the elderly – Intervention project in dementia
Diana Evangelista
O104 Prevention of musculoskeletal disorders through an exercise protocol held in labour context
Catarina Leitão, Fábia Velosa, Nélio Carecho, Luís Coelho
O105 Knowledge of teachers and other education agents on diabetes type 1: Effectiveness of an intervention program
Eva Menino, Anjos Dixe, Helena Catarino, Fátima Soares, Ester Gama, Clementina Gordo
O106 Treatment of diabetic peripheral neuropathic pain: a systematic review of clinical trials of phase II and III
Eliana Moreira, Cristiana Midões, Marlene Santos
O107 New drugs for osteoporosis treatment: Systematic review of clinical trials of phase II and III
Sara Machado, Vânia P. Oliveira, Marlene Santos
O108 Promoting hope at the end of life: Effectiveness of an Intervention Programme
Ana Querido, Anjos Dixe, Rita Marques, Zaida Charepe
P43 Psychomotor therapy effects on adaptive behaviour and motor proficiency of adults with intellectual disability
Ana Antunes, Sofia Santos
P44 The effect of exercise therapy in multiple sclerosis – a single study case
Marlene C. Rosa
P45 Physical condition and self-efficacy in people with fall risk – a preliminary study
Marlene C. Rosa, Silvana F. Marques
P46 Shock waves: their effectiveness in improving the symptoms of calcifying tendinitis of the shoulder
Beatriz Minghelli, Eulália Caro
P47 Pacifier – construction and pilot application of a parenting intervention for parents of babies until six months in primary health care
Mª José Luís, Teresa Brandão
P48 The influence of Motor Imagery in fine motor skills of individuals with disabilities
Pedro Mendes, Daniel Marinho, João Petrica, Diogo Monteiro, Rui Paulo, João Serrano, Inês Santo
P49 Evaluation of the effects of a walking programme on the fall risk factors in older people – a longitudinal pilot study
Lina Monteiro, Fátima Ramalho, Rita Santos-Rocha, Sónia Morgado, Teresa Bento
P50 Nursing intervention programme in lifestyles of adolescents
Gilberta Sousa, Otília Freitas, Isabel Silva, Gregório Freitas, Clementina Morna, Rita Vasconcelos
P51 The person submitted to hip replacement rehabilitation, at home
Tatiana Azevedo, Salete Soares, Jacinta Pisco
P52 Effects of Melatonin use in the treatment of neurovegetative diseases
Paulo P. Ferreira, Efrain O. Olszewer, Michelle T. Oliveira, Anderson R. Sousa, Ana S. Maia, Sebastião T. Oliveira
P53 Review of Phytotherapy and other natural substances in alcohol abuse and alcoholism
Erica Santos, Ana I. Oliveira, Carla Maia, Fernando Moreira, Joana Santos, Maria F. Mendes, Rita F. Oliveira, Cláudia Pinho
P54 Dietary programme impact on biochemical markers in diabetics: systematic review
Eduarda Barreira, Ana Pereira, Josiana A. Vaz, André Novo
P55 Biological approaches to knee osteoarthritis: platelet-rich plasma and hyaluronic acid
Luís D. Silva, Bruno Maia, Eduardo Ferreira, Filipa Pires, Renato Andrade, Luís Camarinha
P56 Platelet-rich plasma and hyaluronic acid intra-articular injections for the treatment of ankle osteoarthritis
Luís D. Silva, Bruno Maia, Eduardo Ferreira, Filipa Pires, Renato Andrade, Luís Camarinha
P57 The impact of preventive measures in the incidence of diabetic foot ulcers: a systematic review
Ana F. César, Mariana Poço, David Ventura, Raquel Loura, Pedro Gomes, Catarina Gomes, Cláudia Silva, Elsa Melo, João Lindo
P58 Dating violence among young adolescents
Joana Domingos, Zaida Mendes, Susana Poeta, Tiago Carvalho, Catarina Tomás, Helena Catarino, Mª Anjos Dixe
P59 Physical activity and motor memory in pedal dexterity
André Ramalho, António Rosado, Pedro Mendes, Rui Paulo, Inês Garcia, João Petrica
P60 The effects of whole body vibration on the electromyographic activity of thigh muscles
Sandra Rodrigues, Rui Meneses, Carlos Afonso, Luís Faria, Adérito Seixas
P61 Mental health promotion in the workplace
Marina Cordeiro, Paulo Granjo, José C. Gomes
P62 Influence of physical exercise on the self-perception of body image in elderly women: A systematic review of qualitative studies
Nelba R. Souza, Guilherme E. Furtado, Saulo V. Rocha, Paula Silva, Joana Carvalho
O109 Psychometric properties of the Portuguese version of the Éxamen Geronto-Psychomoteur (P-EGP)
Marina Ana Morais, Sofia Santos, Paula Lebre, Ana Antunes
O110 Symptoms of depression in the elderly population of Portugal, Spain and Italy
António Calha
O111 Emotion regulation strategies and psychopathology symptoms: A comparison between adolescents with and without deliberate self-harm
Ana Xavier, Marina Cunha, José Pinto-Gouveia
O112 Prevalence of physical disability in people with leprosy
Liana Alencar, Madalena Cunha, António Madureira
O113 Quality of life and self-esteem in type 1 and type 2 diabetes mellitus patients
Ilda Cardoso, Ana Galhardo, Fernanda Daniel, Vítor Rodrigues
O114 Cross-cultural comparison of gross motor coordination in children from Brazil and Portugal
Leonardo Luz, Tatiana Luz, Maurício R. Ramos, Dayse C. Medeiros, Bruno M. Carmo, André Seabra, Cristina Padez, Manuel C. Silva
O115 Electrocardiographic differences between African and Caucasian people
António Rodrigues, Patrícia Coelho, Alexandre Coelho
O116 Factors associated with domestic, sexual and other types of violence in the city of Palhoça - Brazil
Madson Caminha, Filipe Matheus, Elenice Mendes, Jony Correia, Marcia Kretzer
O117 Tinnitus prevalence study of users of a hospital of public management - Spain
Francisco J. Hernandez-Martinez, Juan F. Jimenez-Diaz, Bienvendida C. Rodriguez-De-Vera, Carla Jimenez-Rodriguez, Yadira Armas-Gonzalez
O118 Difficulties experienced by parents of children with diabetes mellitus of preschool age in therapeutic and nutritional management
Cátia Rodrigues, Rosa Pedroso
O119 E-mental health - “nice to have” or “must have”? Exploring the attitudes towards e-mental health in the general population
Jennifer Apolinário-Hagen, Viktor Vehreschild
O120 Violence against children and adolescents and the role of health professionals: Knowing how to identify and care
Milene Veloso, Celina Magalhães, Isabel Cabral, Maira Ferraz
O121 Marital violence. A study in the Algarve population
Filipe Nave, Emília Costa, Filomena Matos, José Pacheco
O122 Clinical factors and adherence to treatment in ischemic heart disease
António Dias, Carlos Pereira, João Duarte, Madalena Cunha, Daniel Silva
O123 Can religiosity improve optimism in participants in states of illness, when controlling for life satisfaction?
Lisete M. Mónico, Valentim R. Alferes, Mª São João Brêda, Carla Carvalho, Pedro M. Parreira
O124 Empowerment, knowledge and quality of life of people with diabetes type 2 in the Alto Minho Health Local Unit
Mª Carminda Morais, Pedro Ferreira, Rui Pimenta, José Boavida
O125 Antihypertensive therapy adherence among hypertensive patients from Bragança county, Portugal
Isabel C. Pinto, Tânia Pires, Catarina Silva
O126 Subjective perception of sexual achievement - An exploratory study on people with overweight
Maria Ribeiro, Maria Viega-Branco, Filomena Pereira, Ana Mª Pereira
O127 Physical activity level and associated factors in hypertensive individuals registered in the family health strategy of a basic health unit from the city of Palhoça, Santa Catarina, Brazil
Fabrícia M. Almeida, Gustavo L. Estevez, Sandra Ribeiro, Marcia R. Kretzer
O128 Perception of functional fitness and health in non-institutionalised elderly from rural areas
Paulo V. João, Paulo Nogueira, Sandra Novais, Ana Pereira, Lara Carneiro, Maria Mota
O129 Medication adherence in patients with type 2 diabetes mellitus treated at primary health care in Coimbra
Rui Cruz, Luiz Santiago, Carlos Fontes-Ribeiro
O130 Multivariate association between body mass index and multi-comorbidities in elderly people living in low socio-economic status context
Guilherme Furtado, Saulo V. Rocha, André P. Coutinho, João S. Neto, Lélia R. Vasconcelos, Nelba R. Souza, Estélio Dantas
O131 Metacognition, rumination and experiential avoidance in Borderline Personality Disorder
Alexandra Dinis, Sérgio Carvalho, Paula Castilho, José Pinto-Gouveia
O132 Health issues in a vulnerable population: nursing consultation in a public bathhouse in Lisbon
Alexandra Sarreira-Santos, Amélia Figueiredo, Lurdes Medeiros-Garcia, Paulo Seabra
O133 The perception of quality of life in people with multiple sclerosis accompanied in External Consultation of the Local Health Unit of Alto Minho
Rosa Rodrigues, Mª Carminda Morais, Paula O. Fernandes
O134 Representation of interaction established between immigrant women and nurse during pregnancy to postpartum, from the perspective of immigrant women
Conceição Santiago, Mª Henriqueta Figueiredo, Marta L. Basto
O135 Illness perceptions and medication adherence in hypertension
Teresa Guimarães, André Coelho, Anabela Graça, Ana M. Silva, Ana R. Fonseca
O136 A Portuguese study on adults’ intimate partner violence, interpersonal trust and hope
Luz Vale-Dias, Bárbara Minas, Graciete Franco-Borges
P63 QOL’ predictors of people with intellectual disability and general population
Cristina Simões, Sofia Santos
P64 Content validation of the Communication Disability Profile (CDP) - Portuguese Version
Ana Serra, Maria Matos, Luís Jesus
P65 Study of biochemical and haematological changes in football players
Ana S. Tavares, Ana Almeida, Céu Leitão, Edna Varandas, Renato Abreu, Fernando Bellém
P66 Body image dissatisfaction in inflammatory bowel disease: exploring the role of chronic illness-related shame
Inês A. Trindade, Cláudia Ferreira, José Pinto-Gouveia, Joana Marta-Simões
P67 Obesity and sleep in the adult population - a systematic review
Odete Amaral, Cristiana Miranda, Pedro Guimarães, Rodrigo Gonçalves, Nélio Veiga, Carlos Pereira
P68 Frequency of daytime sleepiness and obstructive sleep apnea risk in COPD patients
Tânia C. Fleig, Elisabete A. San-Martin, Cássia L. Goulart, Paloma B. Schneiders, Natacha F. Miranda, Lisiane L. Carvalho, Andrea G. Silva
P69 Working with immigrant-origin clients: discourses and practices of health professionals
Joana Topa, Conceição Nogueira, Sofia Neves
P70 Systemic Lupus Erythematosus – what are audiovestibular changes?
Rita Ventura, Cristina Nazaré
P71 Mental disorders in the oldest old: findings from the Portuguese national hospitalization database
Daniela Brandão, Alberto Freitas, Óscar Ribeiro, Constança Paúl
P72 Recurrence analysis in postural control in children with cerebral palsy
Cristiana Mercê, Marco Branco, Pedro Almeida, Daniela Nascimento, Juliana Pereira, David Catela
P73 The experience of self-care in the elderly with COPD: contributions to reflect proximity care
Helga Rafael
P74 Culturally competent nurses: managing unpredictability in clinical practice with immigrants
Alcinda C. Reis
O137 Paediatric speech and language screening: An instrument for health professionals
Ana Mendes, Ana R. Valente, Marisa Lousada
O138 Anthropometric and nutritional assessment in bodybuilders
Diana Sousa, Ana L. Baltazar, Mª Helena Loureiro
O139 Computerized adventitious respiratory sounds in children with lower respiratory tract infections
Ana Oliveira, José Aparício, Alda Marques
O140 Role of computerized respiratory sounds as a marker in LRTI
Alda Marques, Ana Oliveira, Joana Neves, Rodrigo Ayoub
O141 Confirmatory factor analysis of the Personal Wellbeing Index in people with chronic kidney disease
Luís Sousa, Cristina Marques-Vieira, Sandy Severino, Helena José
O142 Phonological awareness skills in school aged children
Inês Cadorio, Marisa Lousada
O143 Assessment of early memories of warmth and safeness in interaction with peers: its relationship with psychopathology in adolescence
Marina Cunha, Diogo Andrade, Ana Galhardo, Margarida Couto
O144 The molecular effects induced by single shot irradiation on a diffuse large B cell lymphoma cell line
Fernando Mendes, Cátia Domingues, Susann Schukg, Ana M. Abrantes, Ana C. Gonçalves, Tiago Sales, Ricardo Teixo, Rita Silva, Jéssica Estrela, Mafalda Laranjo, João Casalta-Lopes, Clara Rocha, Paulo C. Simões, Ana B. Sarmento-Ribeiro, Mª Filomena Botelho, Manuel S. Rosa
O145 Morpho-functional characterization of cardiac chambers by Transthoracic Echocardiography, in young athletes of gymnastics competition
Virgínia Fonseca, Diogo Colaço, Vanessa Neves
O146 Prevalence of the antibodies of the new histo-blood system – FORS system
Carlos Jesus, Camilla Hesse, Clara Rocha, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Lola Svensson, Fernando Mendes, Wafa A. Siba, Cristina Pereira, Jorge Tomaz
O147 Assessment of the war-related perceived threat in Portuguese Colonial War Veterans
Teresa Carvalho, José Pinto-Gouveia, Marina Cunha
O148 Pulse transit time estimation for continuous blood pressure measurement: A comparative study
Diana Duarte, Nuno V. Lopes, Rui Fonseca-Pinto
O149 Blood pressure assessment during standard clinical manoeuvres: A non-invasive PPT based approach
Diana Duarte, Nuno V. Lopes, Rui Fonseca-Pinto
O150 Development and initial validation of the Activities and Participation Profile related to Mobility (APPM)
Anabela C. Martins
O151 MEASYCare-2010 Standard–A geriatric evaluation system in primary health care: Reliability and validity of the latest version in Portugal
Piedade Brandão, Laura Martins, Margarida Cardoso
O152 Interrater and intrarater reliability and agreement of the range of shoulder flexion in the standing upright position through photographic assessment
Nuno Morais, Joana Cruz
O153 Three-dimensional biofabrication techniques for tissue regeneration
Nuno Alves, Paula Faria, Artur Mateus, Pedro Morouço
O154 A new computer tool for biofabrication applied to tissue engineering
Nuno Alves, Nelson Ferreira, Artur Mateus, Paula Faria, Pedro Morouço
O155 Development and psychometric qualities of a scale to measure the functional independence of adolescents with motor impairment
Isabel Malheiro, Filomena Gaspar, Luísa Barros
O156 Organizational Trust in Health services: Exploratory and Confirmatory factor analysis of the Organizational Trust Inventory- Short Form (OTI-SF)
Pedro Parreira, Andreia Cardoso, Lisete Mónico, Carla Carvalho, Albino Lopes, Anabela Salgueiro-Oliveira
O157 Thermal symmetry: An indicator of occupational task asymmetries in physiotherapy
Adérito Seixas, Valter Soares, Tiago Dias, Ricardo Vardasca, Joaquim Gabriel, Sandra Rodrigues
O158 A study of ICT active monitoring adoption in stroke rehabilitation
Hugo Paredes, Arsénio Reis, Sara Marinho, Vítor Filipe, João Barroso
O159 Paranoia Checklist (Portuguese Version): Preliminary studies in a mixed sample of patients and healthy controls
Carolina Da Motta, Célia B. Carvalho, José Pinto-Gouveia, Ermelindo Peixoto
O160 Reliability and validity of the Composite Scale on Morningness: European Portuguese version, in adolescents and young adults
Ana A. Gomes, Vanessa Costa, Diana Couto, Daniel R. Marques, José A. Leitão, José Tavares, Maria H. Azevedo, Carlos F. Silva
O161 Evaluation scale of patient satisfaction with nursing care: Psychometric properties evaluation
João Freitas, Pedro Parreira, João Marôco
O162 Impact of fibromyalgia on quality of life: Comparing results from generic instruments and FIQR
Miguel A. Garcia-Gordillo, Daniel Collado-Mateo, Gang Chen, Angelo Iezzi, José A. Sala, José A. Parraça, Narcis Gusi
O163 Preliminary study of the adaptation and validation of the Rating Scale of Resilient Self: Resilience, self-harm and suicidal ideation in adolescents
Jani Sousa, Mariana Marques, Jacinto Jardim, Anabela Pereira, Sónia Simões, Marina Cunha
O164 Development of the first pressure ulcer in inpatient setting: Focus on length of stay
Pedro Sardo, Jenifer Guedes, João Lindo, Paulo Machado, Elsa Melo
O165 Forms of Self-Criticizing and Self-Reassuring Scale: Adaptation and early findings in a sample of Portuguese children
Célia B. Carvalho, Joana Benevides, Marina Sousa, Joana Cabral, Carolina Da Motta
O166 Predictive ability of the Perinatal Depression Screening and Prevention Tool – Preliminary results of the dimensional approach
Ana T. Pereira, Sandra Xavier, Julieta Azevedo, Elisabete Bento, Cristiana Marques, Rosa Carvalho, Mariana Marques, António Macedo
O167 Psychometric properties of the BaSIQS-Basic Scale on insomnia symptoms and quality of sleep, in adults and in the elderly
Ana M. Silva, Juliana Alves, Ana A. Gomes, Daniel R. Marques, Mª Helena Azevedo, Carlos Silva
O168 Enlightening the human decision in health: The skin melanocytic classification challenge
Ana Mendes, Huei D. Lee, Newton Spolaôr, Jefferson T. Oliva, Wu F. Chung, Rui Fonseca-Pinto
O169 Test-retest reliability household life study and health questionnaire Pomerode (SHIP-BRAZIL)
Keila Bairros, Cláudia D. Silva, Clóvis A. Souza, Silvana S. Schroeder
O170 Characterization of sun exposure behaviours among medical students from Nova Medical School
Elsa Araújo, Helena Monteiro, Ricardo Costa, Sara S. Dias, Jorge Torgal
O171 Spirituality in pregnant women
Carolina G. Henriques, Luísa Santos, Elisa F. Caceiro, Sónia A. Ramalho
O172 Polypharmacy in older patients with cancer
Rita Oliveira, Vera Afreixo, João Santos, Priscilla Mota, Agostinho Cruz, Francisco Pimentel
O173 Quality of life of caregivers of people with advanced chronic disease: Translation and validation of the quality of life in life threatening illness - family carer version (QOLLTI-C-PT)
Rita Marques, Mª Anjos Dixe, Ana Querido, Patrícia Sousa
O174 The psychometric properties of the brief Other as Shamer Scale for Children (OAS-C): preliminary validation studies in a sample of Portuguese children
Joana Benevides, Carolina Da Motta, Marina Sousa, Suzana N. Caldeira, Célia B. Carvalho
O175 Measuring emotional intelligence in health care students – Revalidation of WLEIS-P
Ana Querido, Catarina Tomás, Daniel Carvalho, João Gomes, Marina Cordeiro
O176 Health indicators in prenatal assistance: The impact of computerization and of under-production in basic health centres
Joyce O. Costa, Frederico C. Valim, Lígia C. Ribeiro
O177 Hope genogram: Assessment of resources and interaction patterns in the family of the child with cerebral palsy
Zaida Charepe, Ana Querido, Mª Henriqueta Figueiredo
O178 The influence of childbirth type in postpartum quality of life
Priscila S. Aquino, Samila G. Ribeiro, Ana B. Pinheiro, Paula A. Lessa, Mirna F. Oliveira, Luísa S. Brito, Ítalo N. Pinto, Alessandra S. Furtado, Régia B. Castro, Caroline Q. Aquino, Eveliny S. Martins
O179 Women’s beliefs about pap smear test and cervical cancer: influence of social determinants
Ana B Pinheiro, Priscila S. Aquino, Lara L. Oliveira, Patrícia C. Pinheiro, Caroline R. Sousa, Vívien A. Freitas, Tatiane M. Silva, Adman S. Lima, Caroline Q. Aquino, Karizia V. Andrade, Camila A. Oliveira, Eglidia F. Vidal
O180 Validity of the Portuguese version of the ASI-3: Is anxiety sensitivity a unidimensional or multidimensional construct?
Ana Ganho-Ávila, Mariana Moura-Ramos, Óscar Gonçalves, Jorge Almeida
O181 Lifestyles of higher education students: the influence of self-esteem and psychological well-being
Armando Silva, Irma Brito, João Amado
P75 Assessing the quality of life of persons with significant intellectual disability: Portuguese version of Escala de San Martín
António Rodrigo, Sofia Santos, Fernando Gomes
P76 Childhood obesity and breastfeeding - A systematic review
Marlene C. Rosa, Silvana F. Marques
P77 Cross-cultural adaptation of the Foot and Ankle Ability Measure (FAAM) for the Portuguese population
Sara Luís, Luís Cavalheiro, Pedro Ferreira, Rui Gonçalves
P78 Cross-cultural adaptation of the Patient-Rated Wrist Evaluation score (PRWE) for the Portuguese population
Rui S. Lopes, Luís Cavalheiro, Pedro Ferreira, Rui Gonçalves
P79 Cross-cultural adaptation of the Myocardial Infraction Dimensional Assessment Scale (MIDAS) for Brazilian Portuguese language
Bruno H. Fiorin, Marina S. Santos, Edmar S. Oliveira, Rita L. Moreira, Elizabete A. Oliveira, Braulio L. Filho
P80 The revised Portuguese version of the Three-Factor Eating Questionnaire: A confirmatory factor analysis
Lara Palmeira, Teresa Garcia, José Pinto-Gouveia, Marina Cunha
P81 Assessing weight-related psychological inflexibility: An exploratory factor analysis of the AAQW’s Portuguese version
Sara Cardoso, Lara Palmeira, Marina Cunha; José Pinto-Gouveia
P82 Validation of the Body Appreciation Scale-2 for Portuguese women
Joana Marta-Simões, Ana L. Mendes, Inês A. Trindade, Sara Oliveira, Cláudia Ferreira
P83 The Portuguese validation of the Dietary Intent Scale
Ana L. Mendes, Joana Marta-Simões, Inês A. Trindade, Cláudia Ferreira
P84 Construction and validation of the Inventory of Marital Violence (IVC)
Filipe Nave
P85 Portable continuous blood pressure monitor system
Mariana Campos, Iris Gaudêncio, Fernando Martins, Lino Ferreira, Nuno Lopes, Rui Fonseca-Pinto
P86 Construction and validation of the Scale of Perception of the Difficulties in Caring for the Elderly (SPDCE)
Rogério Rodrigues, Zaida Azeredo, Corália Vicente
P87 Development and validation of a comfort rating scale for the elderly hospitalized with chronic illness
Joana Silva, Patrícia Sousa, Rita Marques
P88 Construction and validation of the Postpartum Paternal Quality of Life Questionnaire (PP-QOL)
Isabel Mendes, Rogério Rodrigues, Zaida Azeredo, Corália Vicente
P89 Infrared thermal imaging: A tool for assessing diabetic foot ulcers
Ricardo Vardasca, Ana R. Marques, Adérito Seixas, Rui Carvalho, Joaquim Gabriel
P90 Pressure ulcers in an intensive care unit: An experience report
Paulo P. Ferreira, Michelle T. Oliveira, Anderson R. Sousa, Ana S. Maia, Sebastião T. Oliveira, Pablo O. Costa, Maiza M. Silva
P91 Validation of figures used in evocations: instrument to capture representations
Cristina Arreguy-Sena, Nathália Alvarenga-Martins, Paulo F. Pinto, Denize C. Oliveira, Pedro D. Parreira, Antônio T. Gomes, Luciene M. Braga
P92 Telephone assistance to decrease burden in informal caregivers of stroke older people: Monitoring and diagnostic evaluation
Odete Araújo, Isabel Lage, José Cabrita, Laetitia Teixeira
P93 Hope of informal caregivers of people with chronic and advanced disease
Rita Marques, Mª Anjos Dixe, Ana Querido, Patrícia Sousa
P94 Functionality and quality information from the Portuguese National Epidemiological Surveillance System
Sara Silva, Eugénio Cordeiro, João Pimentel
P95 Resting metabolic rate objectively measured vs. Harris and Benedict formula
Vera Ferro-Lebres, Juliana A. Souza, Mariline Tavares
O182 Characteristics of non-urgent patients: Cross-sectional study of an emergency department
Mª Anjos Dixe, Pedro Sousa, Rui Passadouro, Teresa Peralta, Carlos Ferreira, Georgina Lourenço
O183 Physical fitness and health in children of the 1st Cycle of Education
João Serrano, João Petrica, Rui Paulo, Samuel Honório, Pedro Mendes
O184 The impact of physical activity on sleep quality, in children
Alexandra Simões, Lucinda Carvalho, Alexandre Pereira
O185 What is the potential for using Information and Communication Technologies in Arterial Hypertension self-management?
Sara Silva, Paulino Sousa, José M. Padilha
O186 Exploring psychosocial factors associated with risk of falling in older patients undergoing haemodialysis
Daniela Figueiredo, Carolina Valente, Alda Marques
O187 Development of pressure ulcers on the face in patients undergoing non-invasive ventilation
Patrícia Ribas, Joana Sousa, Frederico Brandão, Cesar Sousa, Matilde Martins
O188 The elder hospitalized: Limiting factors of comfort
Patrícia Sousa, Rita Marques
O189 Physical activity and health state self-perception by Portuguese adults
Francisco Mendes, Rosina Fernandes, Emília Martins, Cátia Magalhães, Patrícia Araújo
O190 Satisfaction with social support in the elderly of the district of Bragança
Carla Grande, Mª Augusta Mata, Juan G. Vieitez
O191 Prevalence of death by traumatic brain injury and associated factors in intensive care unit of a general hospital, Brazil
Bruna Bianchini, Nazare Nazario, João G. Filho, Marcia Kretzer
O192 Relation between family caregivers burden and health status of elderly dependents
Tânia Costa, Armando Almeida, Gabriel Baffour
O193 Phenomena sensitive to nursing care in day centre
Armando Almeida, Tânia Costa, Gabriel Baffour
O194 Frailty: what do the elderly think?
Zaida Azeredo, Carlos Laranjeira, Magda Guerra, Ana P. Barbeiro
O195 The therapeutic self-care as a nursing-sensitive outcome: A correlational study
Regina Ferreira
O196 Phonetic-phonological acquisition for the European Portuguese from 18 months to 6 years and 12 months
Sara Lopes, Liliana Nunes, Ana Mendes
O197 Quality of life of patients undergoing liver transplant surgery
Julian Martins, Dulcineia Schneider, Marcia Kretzer, Flávio Magajewski
O198 Professional competences in health: views of older people from different European Countries
Célia Soares, António Marques
O199 Life satisfaction of working adults due to the number of hours of weekly exercise
Marco Batista, Ruth J. Castuera, Helena Mesquita, António Faustino, Jorge Santos, Samuel Honório
O200 Therapeutic itinerary of women with breast cancer in Santa Maria City/RS
Betina P. Vizzotto, Leticia Frigo, Hedioneia F. Pivetta
O201 The breastfeeding prevalence at 4 months: Maternal experience as a determining factor
Dolores Sardo
O202 The impact of the transition to parenthood in health and well-being
Cristina Martins, Wilson Abreu, Mª Céu Figueiredo
P96 Self-determined motivation and well-being in Portuguese active adults of both genders
Marco Batista, Ruth Jimenez-Castuera, João Petrica, João Serrano, Samuel Honório, Rui Paulo, Pedro Mendes
P97 The geriatric care: ways and means of comforting
Patrícia Sousa, Rita Marques
P98 The influence of relative age, subcutaneous adiposity and physical growth on Castelo Branco under-15 soccer players 2015
António Faustino, Paulo Silveira, João Serrano, Rui Paulo, Pedro Mendes, Samuel Honório
P99 Data for the diagnostic process focused on self-care – managing medication regime: An integrative literature review
Catarina Oliveira, Fernanda Bastos, Inês Cruz
P100 Art therapy as mental health promotion for children
Cláudia K. Rodriguez, Márcia R. Kretzer, Nazaré O. Nazário
P101 Chemical characterization of fungal chitosan for industrial applications
Pedro Cruz, Daniela C. Vaz, Rui B. Ruben, Francisco Avelelas, Susana Silva, Mª Jorge Campos
P102 The impact of caring older people at home
Maria Almeida, Liliana Gonçalves, Lígia Antunes
P103 Development of the first pressure ulcer in an inpatient setting: Focus on patients’ characteristics
Pedro Sardo, Jenifer Guedes, João Simões, Paulo Machado, Elsa Melo
P104 Association between General Self-efficacy and Physical Activity among Adolescents
Susana Cardoso, Osvaldo Santos, Carla Nunes, Isabel Loureiro
O203 Characterization of the habits of online acquisition of medicinal products in Portugal
Flávia Santos, Gilberto Alves
O204 Waiting room – A space for health education
Cláudia Soar, Teresa O. Marsi
O205 Safey culture evaluation in hospitalized children
Ernestina Silva, Dora Pedrosa, Andrea Leça, Daniel Silva
O206 Sexual Self-awareness and Body Image
Ana Galvão, Maria Gomes, Paula Fernandes, Ana Noné
O207 Perception of a Portuguese population regarding the acquisition and consumption of functional foods
Jaime Combadão, Cátia Ramalhete, Paulo Figueiredo, Patrícia Caeiro
O208 The work process in primary health care: evaluation in municipalities of southern Brazil
Karine C. Fontana, Josimari T. Lacerda, Patrícia O. Machado
O209 Exploration and evaluation of potential probiotic lactic acid bacteria isolated from Amazon buffalo milk
Raphaelle Borges, Flávio Barbosa, Dayse Sá
O210 Road safety for children: Using children’s observation, as a passenger
Germana Brunhoso, Graça Aparício, Amâncio Carvalho
O211 Perception and application of quality-by-design by the Pharmaceutical industry in Portugal
Ana P. Garcia, Paula O. Fernandes, Adriana Santos
O212 Oral health among Portuguese children and adolescents: a public health issue
Nélio Veiga, Carina Brás, Inês Carvalho, Joana Batalha, Margarida Glória, Filipa Bexiga, Inês Coelho, Odete Amaral, Carlos Pereira
O213 Plant species as a medicinal resource in Igatu-Chapada Diamantina (Bahia, Brazil)
Cláudia Pinho, Nilson Paraíso, Ana I. Oliveira, Cristóvão F. Lima, Alberto P. Dias
O214 Characterization of cognitive and functional performance in everyday tasks: Implications for health in institutionalised older adults
Pedro Silva, Mário Espada, Mário Marques, Ana Pereira
O215 BMI and the perception of the importance given to sexuality in obese and overweight people
Ana Mª Pereira, Mª Veiga-Branco, Filomena Pereira, Maria Ribeiro
O216 Analysis and comparison of microbiological contaminations of two different composition pacifiers
Vera Lima, Ana I. Oliveira, Cláudia Pinho, Graça Cruz, Rita F. Oliveira, Luísa Barreiros, Fernando Moreira
O217 Experiences of couple relationships in the transition to retirement
Ana Camarneiro, Mª Helena Loureiro, Margarida Silva
O218 Preventive and corrective treatment of drug-induced calcium deficiency: an analysis in a community pharmacy setting
Catarina Duarte, Ângelo Jesus, Agostinho Cruz
O219 Profile of mood states in physically active elderly subjects: Is there a relation with health perception?
Maria Mota, Sandra Novais, Paulo Nogueira, Ana Pereira, Lara Carneiro, Paulo V. João
O220 (Un)Safety behaviour at work: the role of education towards a health and safety culture
Teresa Maneca Lima
O221 Analysis of the entrepreneurial profile of students attending higher education in Portugal: the Carland Entrepreneurship Index application
Anabela Salgueiro-Oliveira, Marina Vaquinhas, Pedro Parreira, Rosa Melo, João Graveto, Amélia Castilho, José H. Gomes
O222 Evaluation of welfare and quality of life of pregnant working women regarding the age of the pregnant
María S. Medina, Valeriana G. Blanco
O223 Psychological wellbeing protection among unemployed and temporary workers: Uncovering effective community-based interventions with a Delphi panel
Osvaldo Santos, Elisa Lopes, Ana Virgolino, Alexandra Dinis, Sara Ambrósio, Inês Almeida, Tatiana Marques, Mª João Heitor
O224 Chilean population norms derived from the Health-related quality of life SF-6D
Miguel A. Garcia-Gordillo, Daniel Collado-Mateo, Pedro R. Olivares, José A. Parraça, José A. Sala
O225 Motivation of college students toward Entrepreneurship: The influence of social and economic instability
Amélia Castilho, João Graveto, Pedro Parreira, Anabela Oliveira, José H. Gomes, Rosa Melo, Marina Vaquinhas
O226 Use of aromatic and medicinal plants, drugs and herbal products in Bragança city
Mónia Cheio, Agostinho Cruz, Olívia R. Pereira
O227 Edible flowers as new novel foods concept for health promotion
Sara Pinto, Adriana Oliveira, M. Conceição Manso, Carla Sousa, Ana F. Vinha
O228 The influence of leisure activities on the health and welfare of older people living in nursing homes
Mª Manuela Machado, Margarida Vieira
O229 Risk of falling, fear of falling and functionality in community-dwelling older adults
Beatriz Fernandes, Teresa Tomás, Diogo Quirino
O230 Musculoskeletal pain and postural habits in children and teenage students
Gustavo Desouzart, Rui Matos, Magali Bordini, Pedro Mouroço
O231 What's different in Southern Europe? The question of citizens’ participation in health systems
Ana R. Matos, Mauro Serapioni
O232 Occupational stress in Portuguese police officers
Teresa Guimarães, Virgínia Fonseca, André Costa, João Ribeiro, João Lobato
O233 Is occupational therapy culturally relevant to promote mental health in Burkina Faso?
Inmaculada Z. Martin, Anita Björklund
P105 Pay-for-performance satisfaction and quality in primary care
Aida I. Tavares, Pedro Ferreira, Rui Passadouro
P106 Economic development through life expectancy lenses
Sónia Morgado
P107 What is the effectiveness of exercise on smoking cessation to prevent clinical complications of smoking?
Nuno Tavares, João Valente, Anabela C. Martins
P108 A systematic review of the effects of yoga on mental health
Patrícia Araújo, Rosina Fernandes, Francisco Mendes, Cátia Magalhães, Emília Martins
P109 Healthy lifestyle: comparison between higher education students that lived until adult age in rural and urban environment
Pedro Mendes, Rui Paulo, António Faustino, Helena Mesquita, Samuel Honório, Marco Batista
P110 Evaluation of the Mobile Emergency Care Service (SAMU) in Brazil
Josimari T. Lacerda, Angela B. Ortiga, Mª Cristina Calvo, Sônia Natal
P111 Bioactive compounds - antioxidant activity of tropical fruits
Marta Pereira
P112 Use of non-pharmacological methods to relieve pain in labour
Manuela Ferreira, Ana R. Prata, Paula Nelas, João Duarte
P113 Mechanical safety of pacifiers sold in Portuguese pharmacies and childcare stores
Juliana Carneiro, Ana I. Oliveira, Cláudia Pinho, Cristina Couto, Rita F. Oliveira, Fernando Moreira
P114 The importance of prenatal consultation: Information to pregnant women given on a unit of primary care
Ana S. Maia, Michelle T. Oliveira, Anderson R. Sousa, Paulo P. Ferreira, Géssica M. Souza, Lívia F. Almada, Milena A. Conceição, Eujcely C. Santiago
P115 Influence of different backpack loading conditions on neck and lumbar muscles activity of elementary school children
Sandra Rodrigues, Gabriela Domingues, Irina Ferreira, Luís Faria, Adérito Seixas
P116 Efficacy and safety of dry extract Hedera helix in the treatment of productive cough
Ana R. Costa, Ângelo Jesus, Américo Cardoso, Alexandra Meireles, Armanda Colaço, Agostinho Cruz
P117 A portrait of the evaluation processes of education groups in primary health care
Viviane L. Vieira, Kellem R. Vincha, Ana Mª Cervato-Mancuso
P118 Benefits of vitamins C and E in sensorineural hearing loss: a review
Melissa Faria, Cláudia Reis
P119 BODY SNAPSHOT – a web-integrated anthropometric evaluation system
Marco P. Cova, Rita T. Ascenso, Henrique A. Almeida, Eunice G. Oliveira
P120 Anthropometric evaluation and variation during pregnancy
Miguel Santana, Rafael Pereira, Eunice G. Oliveira, Henrique A. Almeida, Rita T. Ascenso
P121 Knowledge of college students on the amendments of their eating habits and physical activity index in the transition to higher education
Rita Jesus, Rodrigo Tapadas, Carolina Tim-Tim, Catarina Cezanne, Matilde Lagoa, Sara S. Dias, Jorge Torgal
P122 Muscular activity of a rally race car driver
João Lopes, Henrique Almeida, Sandra Amado, Luís Carrão
O234 Literacy and results in health
Madalena Cunha, Luís Saboga-Nunes, Carlos Albuquerque, Olivério Ribeiro
O235 Literacy promotion and empowerment of type 2 diabetics elderly in four family health units of the group of health centers of Dão Lafões
Suzete Oliveira, Mª Carminda Morais
O236 Mediterranean diet, health and life quality among Portuguese children
Emília Martins, Francisco Mendes, Rosina Fernandes, Cátia Magalhães, Patrícia Araújo
O237 Health literacy, from data to action - translation, validation and application of the European Health Literacy Survey in Portugal (HLS-EU-PT)
Ana R. Pedro, Odete Amaral, Ana Escoval
O238 Oral health literacy evaluation in a Portuguese military population
Victor Assunção, Henrique Luís, Luís Luís
O239 Preferences to Internet-based cognitive behavioural therapy – do attachment orientations matter?
Jennifer Apolinário-Hagen, Viktor Vehreschild
O240 A comparative transnational study in health literacy between Austria and Portugal
Ulrike Fotschl, Gerald Lirk, Anabela C. Martins, Isabel Andrade, Fernando Mendes
O241 Health literacy and social behaviours: relationship with sexually transmitted diseases?
Verónica Mendonça, Sandra Antunes, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes
O242 Parenting styles and attachment to parents: what relationships?
Paula A. Silva, Lisete M. Mónico, Pedro M. Parreira, Carla Carvalho
O243 Work-life balance in health professionals and professors: comparative study of workers with shift work and fixed schedule
Carla Carvalho, Pedro M. Parreira, Lisete M. Mónico, Joana Ruivo
O244 Technology literacy in self-management of diabetes
Vânia Silva, Paulino Sousa, José M. Padilha
O245 Satisfaction with therapeutic education and its relationship with clinical variables in children with type 1 diabetes
Vera Ferraz, Graça Aparício, João Duarte
O246 Nutrition-related knowledge in middle-age and older patients with type 2 diabetes
Carlos Vasconcelos, António Almeida, Joel Neves, Telma Correia, Helena Amorim, Romeu Mendes
O247 Validating the HLS-EU-(PT) questionnaire to measure health literacy in adolescents (CrAdLiSa project: HLS-EU-PT)
Luís Saboga-Nunes, Madalena Cunha, Carlos Albuquerque
O248 Health education in people with coronary heart disease: Experience of the cardiology department of a hospital on the outskirts of Lisbon
Elsa S. Pereira, Leonino S. Santos, Ana S. Reis, Helena R. Silva, João Rombo, Jorge C. Fernandes, Patrícia Fernandes
O249 Information and training needs of informal caregivers of individuals with stroke sequelae: a qualitative survey
Jaime Ribeiro, Catarina Mangas, Ana Freire
O250 Prevention of psychoactive substances consumption in students from 6th grade of Albergaria-a-Velha´s School Group
Sara Silva, Irene Francisco, Ana Oliveira
O251 Promoting healthy sexuality: shared responsibility for family, youth and educators
Helena Catarino, Mª Anjos Dixe, Mª Clarisse Louro
O252 Sexual risk behaviour in adolescents and young people
Saudade Lopes, Anjos Dixe
O253 Knowledge of school staff on type 1 diabetes
Mª Anjos Dixe, Eva Menino, Helena Catarino, Fátima Soares, Ana P. Oliveira, Sara Gordo, Teresa Kraus
O254 Sexual health in adolescents: the impact of information search in literacy
Catarina Tomás, Paulo Queirós, Teresa Rodrigues
P123 Improving basic life support skills in adolescents through a training programme
Pedro Sousa, João G. Frade, Catarina Lobão
P124 Difficulties in sexual education reported by basic education teachers in the city of Foz do Iguaçu - Brazil
Cynthia B. Moura, Laysa C. Dreyer, Vanize Meneghetti, Priscila P. Cabral
P125 Breast cancer survivors: subjects and resources for information. A qualitative systematic review
Francisca Pinto, Paulino Sousa, Mª Raquel Esteves
P126 Relationship between health literacy and prevalence of STI in Biomedical Laboratory Science students
Sofia Galvão, Ite Tytgat, Isabel Andrade, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes
P127 Health literacy, risk behaviours and sexually transmitted diseases among blood donors
Mónica Casas-Novas, Helena Bernardo, Isabel Andrade, Gracinda Sousa, Ana P. Sousa, Clara Rocha, Pedro Belo, Nádia Osório, Ana Valado, Armando Caseiro, António Gabriel, Anabela C. Martins, Fernando Mendes
P128 Promoting literacy in pregnancy health-care
Fátima Martins, Montserrat Pulido-Fuentes
P129 The lifestyles of the operating assistants of education
Isabel Barroso, Gil Cabral, M. João Monteiro, Conceição Rainho
P130 Experiences of service-learning health and the literary art: reflections about the health education
Alessandro Prado, Yara M. Carvalho
P131 Life long swimming – a European Erasmus + project
Maria Campos, Liliana Moreira, José Ferreira, Ana Teixeira, Luís Rama
doi:10.1186/s12913-016-1423-5
PMCID: PMC4943498  PMID: 27409075
4.  Reinterpreting Ethnic Patterns among White and African American Men Who Inject Heroin: A Social Science of Medicine Approach 
PLoS Medicine  2006;3(10):e452.
Background
Street-based heroin injectors represent an especially vulnerable population group subject to negative health outcomes and social stigma. Effective clinical treatment and public health intervention for this population requires an understanding of their cultural environment and experiences. Social science theory and methods offer tools to understand the reasons for economic and ethnic disparities that cause individual suffering and stress at the institutional level.
Methods and Findings
We used a cross-methodological approach that incorporated quantitative, clinical, and ethnographic data collected by two contemporaneous long-term San Francisco studies, one epidemiological and one ethnographic, to explore the impact of ethnicity on street-based heroin-injecting men 45 years of age or older who were self-identified as either African American or white. We triangulated our ethnographic findings by statistically examining 14 relevant epidemiological variables stratified by median age and ethnicity. We observed significant differences in social practices between self-identified African Americans and whites in our ethnographic social network sample with respect to patterns of (1) drug consumption; (2) income generation; (3) social and institutional relationships; and (4) personal health and hygiene. African Americans and whites tended to experience different structural relationships to their shared condition of addiction and poverty. Specifically, this generation of San Francisco injectors grew up as the children of poor rural to urban immigrants in an era (the late 1960s through 1970s) when industrial jobs disappeared and heroin became fashionable. This was also when violent segregated inner city youth gangs proliferated and the federal government initiated its “War on Drugs.” African Americans had earlier and more negative contact with law enforcement but maintained long-term ties with their extended families. Most of the whites were expelled from their families when they began engaging in drug-related crime. These historical-structural conditions generated distinct presentations of self. Whites styled themselves as outcasts, defeated by addiction. They professed to be injecting heroin to stave off “dopesickness” rather than to seek pleasure. African Americans, in contrast, cast their physical addiction as an oppositional pursuit of autonomy and pleasure. They considered themselves to be professional outlaws and rejected any appearance of abjection. Many, but not all, of these ethnographic findings were corroborated by our epidemiological data, highlighting the variability of behaviors within ethnic categories.
Conclusions
Bringing quantitative and qualitative methodologies and perspectives into a collaborative dialog among cross-disciplinary researchers highlights the fact that clinical practice must go beyond simple racial or cultural categories. A clinical social science approach provides insights into how sociocultural processes are mediated by historically rooted and institutionally enforced power relations. Recognizing the logical underpinnings of ethnically specific behavioral patterns of street-based injectors is the foundation for cultural competence and for successful clinical relationships. It reduces the risk of suboptimal medical care for an exceptionally vulnerable and challenging patient population. Social science approaches can also help explain larger-scale patterns of health disparities; inform new approaches to structural and institutional-level public health initiatives; and enable clinicians to take more leadership in changing public policies that have negative health consequences.
Bourgois and colleagues found that the African American and white men in their study had a different pattern of drug use and risk behaviors, adopted different strategies for survival, and had different personal histories.
Editors' Summary
Background.
There are stark differences in the health of different ethnic groups in America. For example, the life expectancy for white men is 75.4 years, but it is only 69.2 years for African-American men. The reasons behind these disparities are unclear, though there are several possible explanations. Perhaps, for example, different ethnic groups are treated differently by health professionals (with some groups receiving poorer quality health care). Or maybe the health disparities are due to differences across ethnic groups in income level (we know that richer people are healthier). These disparities are likely to persist unless we gain a better understanding of how they arise.
Why Was This Study Done?
The researchers wanted to study the health of a very vulnerable community of people: heroin users living on the streets in the San Francisco Bay Area. The health status of this community is extremely poor, and its members are highly stigmatized—including by health professionals themselves. The researchers wanted to know whether African American men and white men who live on the streets have a different pattern of drug use, whether they adopt varying strategies for survival, and whether they have different personal histories. Knowledge of such differences would help the health community to provide more tailored and culturally appropriate interventions. Physicians, nurses, and social workers often treat street-based drug users, especially in emergency rooms and free clinics. These health professionals regularly report that their interactions with street-based drug users are frustrating and confrontational. The researchers hoped that their study would help these professionals to have a better understanding of the cultural backgrounds and motivations of their drug-using patients.
What Did the Researchers Do and Find?
Over the course of six years, the researchers directly observed about 70 men living on the streets who injected heroin as they went about their usual lives (this type of research is called “participant observation”). The researchers specifically looked to see whether there were differences between the white and African American men. All the men gave their consent to be studied in this way and to be photographed. The researchers also studied a database of interviews with almost 7,000 injection drug users conducted over five years, drawing out the data on differences between white and African men. The researchers found that the white men were more likely to supplement their heroin use with inexpensive fortified wine, while African American men were more likely to supplement heroin with crack. Most of the white men were expelled from their families when they began engaging in drug-related crime, and these men tended to consider themselves as destitute outcasts. African American men had earlier and more negative contact with law enforcement but maintained long-term ties with their extended families, and these men tended to consider themselves as professional outlaws. The white men persevered less in attempting to find a vein in which to inject heroin, and so were more likely to inject the drug directly under the skin—this meant that they were more likely to suffer from skin abscesses. The white men generated most of their income from panhandling (begging for money), while the African American men generated most of their income through petty crime and/or through offering services such as washing car windows at gas stations.
What Do These Findings Mean?
Among street-based heroin users, there are important differences between white men and African American men in the type of drugs used, the method of drug use, their social backgrounds, the way in which they identify themselves, and the health risks that they take. By understanding these differences, health professionals should be better placed to provide tailored and appropriate care when these men present to clinics and emergency rooms. As the researchers say, “understanding of different ethnic populations of drug injectors may reduce difficult clinical interactions and resultant physician frustration while improving patient access and adherence to care.” One limitation of this study is that the researchers studied one specific community in one particular area of the US—so we should not assume that their findings would apply to street-based heroin users elsewhere.
Additional Information.
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0030452.
The US Centers for Disease Control (CDC) has a web page on HIV prevention among injection drug users
The World Health Organization has collected documents on reducing the risk of HIV in injection drug users and on harm reduction approaches
The International Harm Reduction Association has information relevant to a global audience on reducing drug-related harm among individuals and communities
US-focused information on harm reduction is available via the websites of the Harm Reduction Coalition and the Chicago Recovery Alliance
Canada-focused information can be found at the Street Works Web site
The Harm Reduction Journal publishes open-access articles
The CDC has a web page on eliminating racial and ethnic health disparities
The Drug Policy Alliance has a web page on drug policy in the United States
doi:10.1371/journal.pmed.0030452
PMCID: PMC1621100  PMID: 17076569
5.  Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation 
Chambers, David | Simpson, Lisa | Hill-Briggs, Felicia | Neta, Gila | Vinson, Cynthia | Chambers, David | Beidas, Rinad | Marcus, Steven | Aarons, Gregory | Hoagwood, Kimberly | Schoenwald, Sonja | Evans, Arthur | Hurford, Matthew | Rubin, Ronnie | Hadley, Trevor | Barg, Frances | Walsh, Lucia | Adams, Danielle | Mandell, David | Martin, Lindsey | Mignogna, Joseph | Mott, Juliette | Hundt, Natalie | Kauth, Michael | Kunik, Mark | Naik, Aanand | Cully, Jeffrey | McGuire, Alan | White, Dominique | Bartholomew, Tom | McGrew, John | Luther, Lauren | Rollins, Angie | Salyers, Michelle | Cooper, Brittany | Funaiole, Angie | Richards, Julie | Lee, Amy | Lapham, Gwen | Caldeiro, Ryan | Lozano, Paula | Gildred, Tory | Achtmeyer, Carol | Ludman, Evette | Addis, Megan | Marx, Larry | Bradley, Katharine | VanDeinse, Tonya | Wilson, Amy Blank | Stacey, Burgin | Powell, Byron | Bunger, Alicia | Cuddeback, Gary | Barnett, Miya | Stadnick, Nicole | Brookman-Frazee, Lauren | Lau, Anna | Dorsey, Shannon | Pullmann, Michael | Mitchell, Shannon | Schwartz, Robert | Kirk, Arethusa | Dusek, Kristi | Oros, Marla | Hosler, Colleen | Gryczynski, Jan | Barbosa, Carolina | Dunlap, Laura | Lounsbury, David | O’Grady, Kevin | Brown, Barry | Damschroder, Laura | Waltz, Thomas | Powell, Byron | Ritchie, Mona | Waltz, Thomas | Atkins, David | Imel, Zac E. | Xiao, Bo | Can, Doğan | Georgiou, Panayiotis | Narayanan, Shrikanth | Berkel, Cady | Gallo, Carlos | Sandler, Irwin | Brown, C. Hendricks | Wolchik, Sharlene | Mauricio, Anne Marie | Gallo, Carlos | Brown, C. Hendricks | Mehrotra, Sanjay | Chandurkar, Dharmendra | Bora, Siddhartha | Das, Arup | Tripathi, Anand | Saggurti, Niranjan | Raj, Anita | Hughes, Eric | Jacobs, Brian | Kirkendall, Eric | Loeb, Danielle | Trinkley, Katy | Yang, Michael | Sprowell, Andrew | Nease, Donald | Lyon, Aaron | Lewis, Cara | Boyd, Meredith | Melvin, Abigail | Nicodimos, Semret | Liu, Freda | Jungbluth, Nathanial | Lyon, Aaron | Lewis, Cara | Boyd, Meredith | Melvin, Abigail | Nicodimos, Semret | Liu, Freda | Jungbluth, Nathanial | Flynn, Allen | Landis-Lewis, Zach | Sales, Anne | Baloh, Jure | Ward, Marcia | Zhu, Xi | Bennett, Ian | Unutzer, Jurgen | Mao, Johnny | Proctor, Enola | Vredevoogd, Mindy | Chan, Ya-Fen | Williams, Nathaniel | Green, Phillip | Bernstein, Steven | Rosner, June-Marie | DeWitt, Michelle | Tetrault, Jeanette | Dziura, James | Hsiao, Allen | Sussman, Scott | O’Connor, Patrick | Toll, Benjamin | Jones, Michael | Gassaway, Julie | Tobin, Jonathan | Zatzick, Douglas | Bradbury, Angela R. | Patrick-Miller, Linda | Egleston, Brian | Olopade, Olufunmilayo I. | Hall, Michael J. | Daly, Mary B. | Fleisher, Linda | Grana, Generosa | Ganschow, Pamela | Fetzer, Dominique | Brandt, Amanda | Farengo-Clark, Dana | Forman, Andrea | Gaber, Rikki S. | Gulden, Cassandra | Horte, Janice | Long, Jessica | Chambers, Rachelle Lorenz | Lucas, Terra | Madaan, Shreshtha | Mattie, Kristin | McKenna, Danielle | Montgomery, Susan | Nielsen, Sarah | Powers, Jacquelyn | Rainey, Kim | Rybak, Christina | Savage, Michelle | Seelaus, Christina | Stoll, Jessica | Stopfer, Jill | Yao, Shirley | Domchek, Susan | Hahn, Erin | Munoz-Plaza, Corrine | Wang, Jianjin | Delgadillo, Jazmine Garcia | Mittman, Brian | Gould, Michael | Liang, Shuting (Lily) | Kegler, Michelle C. | Cotter, Megan | Phillips, Emily | Hermstad, April | Morton, Rentonia | Beasley, Derrick | Martinez, Jeremy | Riehman, Kara | Gustafson, David | Marsch, Lisa | Mares, Louise | Quanbeck, Andrew | McTavish, Fiona | McDowell, Helene | Brown, Randall | Thomas, Chantelle | Glass, Joseph | Isham, Joseph | Shah, Dhavan | Liebschutz, Jane | Lasser, Karen | Watkins, Katherine | Ober, Allison | Hunter, Sarah | Lamp, Karen | Ewing, Brett | Iwelunmor, Juliet | Gyamfi, Joyce | Blackstone, Sarah | Quakyi, Nana Kofi | Plange-Rhule, Jacob | Ogedegbe, Gbenga | Kumar, Pritika | Van Devanter, Nancy | Nguyen, Nam | Nguyen, Linh | Nguyen, Trang | Phuong, Nguyet | Shelley, Donna | Rudge, Sian | Langlois, Etienne | Tricco, Andrea | Ball, Sherry | Lambert-Kerzner, Anne | Sulc, Christine | Simmons, Carol | Shell-Boyd, Jeneen | Oestreich, Taryn | O’Connor, Ashley | Neely, Emily | McCreight, Marina | Labebue, Amy | DiFiore, Doreen | Brostow, Diana | Ho, P. Michael | Aron, David | Harvey, Jillian | McHugh, Megan | Scanlon, Dennis | Lee, Rebecca | Soltero, Erica | Parker, Nathan | McNeill, Lorna | Ledoux, Tracey | McIsaac, Jessie-Lee | MacLeod, Kate | Ata, Nicole | Jarvis, Sherry | Kirk, Sara | Purtle, Jonathan | Dodson, Elizabeth | Brownson, Ross | Mittman, Brian | Curran, Geoffrey | Curran, Geoffrey | Pyne, Jeffrey | Aarons, Gregory | Ehrhart, Mark | Torres, Elisa | Miech, Edward | Miech, Edward | Stevens, Kathleen | Hamilton, Alison | Cohen, Deborah | Padgett, Deborah | Morshed, Alexandra | Patel, Rupa | Prusaczyk, Beth | Aron, David C. | Gupta, Divya | Ball, Sherry | Hand, Rosa | Abram, Jenica | Wolfram, Taylor | Hastings, Molly | Moreland-Russell, Sarah | Tabak, Rachel | Ramsey, Alex | Baumann, Ana | Kryzer, Emily | Montgomery, Katherine | Lewis, Ericka | Padek, Margaret | Powell, Byron | Brownson, Ross | Mamaril, Cezar Brian | Mays, Glen | Branham, Keith | Timsina, Lava | Mays, Glen | Hogg, Rachel | Fagan, Abigail | Shapiro, Valerie | Brown, Eric | Haggerty, Kevin | Hawkins, David | Oesterle, Sabrina | Hawkins, David | Catalano, Richard | McKay, Virginia | Dolcini, M. Margaret | Hoffer, Lee | Moin, Tannaz | Li, Jinnan | Duru, O. Kenrik | Ettner, Susan | Turk, Norman | Chan, Charles | Keckhafer, Abigail | Luchs, Robert | Ho, Sam | Mangione, Carol | Selby, Peter | Zawertailo, Laurie | Minian, Nadia | Balliunas, Dolly | Dragonetti, Rosa | Hussain, Sarwar | Lecce, Julia | Chinman, Matthew | Acosta, Joie | Ebener, Patricia | Malone, Patrick S. | Slaughter, Mary | Freedman, Darcy | Flocke, Susan | Lee, Eunlye | Matlack, Kristen | Trapl, Erika | Ohri-Vachaspati, Punam | Taggart, Morgan | Borawski, Elaine | Parrish, Amanda | Harris, Jeffrey | Kohn, Marlana | Hammerback, Kristen | McMillan, Becca | Hannon, Peggy | Swindle, Taren | Curran, Geoffrey | Whiteside-Mansell, Leanne | Ward, Wendy | Holt, Cheryl | Santos, Sheri Lou | Tagai, Erin | Scheirer, Mary Ann | Carter, Roxanne | Bowie, Janice | Haider, Muhiuddin | Slade, Jimmie | Wang, Min Qi | Masica, Andrew | Ogola, Gerald | Berryman, Candice | Richter, Kathleen | Shelton, Rachel | Jandorf, Lina | Erwin, Deborah | Truong, Khoa | Javier, Joyce R. | Coffey, Dean | Schrager, Sheree M. | Palinkas, Lawrence | Miranda, Jeanne | Johnson, Veda | Hutcherson, Valerie | Ellis, Ruth | Kharmats, Anna | Marshall-King, Sandra | LaPradd, Monica | Fonseca-Becker, Fannie | Kepka, Deanna | Bodson, Julia | Warner, Echo | Fowler, Brynn | Shenkman, Elizabeth | Hogan, William | Odedina, Folakami | De Leon, Jessica | Hooper, Monica | Carrasquillo, Olveen | Reams, Renee | Hurt, Myra | Smith, Steven | Szapocznik, Jose | Nelson, David | Mandal, Prabir | Teufel, James
Implementation Science : IS  2016;11(Suppl 2):100.
Table of contents
A1 Introduction to the 8th Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health
David Chambers, Lisa Simpson
D1 Discussion forum: Population health D&I research
Felicia Hill-Briggs
D2 Discussion forum: Global health D&I research
Gila Neta, Cynthia Vinson
D3 Discussion forum: Precision medicine and D&I research
David Chambers
S1 Predictors of community therapists’ use of therapy techniques in a large public mental health system
Rinad Beidas, Steven Marcus, Gregory Aarons, Kimberly Hoagwood, Sonja Schoenwald, Arthur Evans, Matthew Hurford, Ronnie Rubin, Trevor Hadley, Frances Barg, Lucia Walsh, Danielle Adams, David Mandell
S2 Implementing brief cognitive behavioral therapy (CBT) in primary care: Clinicians' experiences from the field
Lindsey Martin, Joseph Mignogna, Juliette Mott, Natalie Hundt, Michael Kauth, Mark Kunik, Aanand Naik, Jeffrey Cully
S3 Clinician competence: Natural variation, factors affecting, and effect on patient outcomes
Alan McGuire, Dominique White, Tom Bartholomew, John McGrew, Lauren Luther, Angie Rollins, Michelle Salyers
S4 Exploring the multifaceted nature of sustainability in community-based prevention: A mixed-method approach
Brittany Cooper, Angie Funaiole
S5 Theory informed behavioral health integration in primary care: Mixed methods evaluation of the implementation of routine depression and alcohol screening and assessment
Julie Richards, Amy Lee, Gwen Lapham, Ryan Caldeiro, Paula Lozano, Tory Gildred, Carol Achtmeyer, Evette Ludman, Megan Addis, Larry Marx, Katharine Bradley
S6 Enhancing the evidence for specialty mental health probation through a hybrid efficacy and implementation study
Tonya VanDeinse, Amy Blank Wilson, Burgin Stacey, Byron Powell, Alicia Bunger, Gary Cuddeback
S7 Personalizing evidence-based child mental health care within a fiscally mandated policy reform
Miya Barnett, Nicole Stadnick, Lauren Brookman-Frazee, Anna Lau
S8 Leveraging an existing resource for technical assistance: Community-based supervisors in public mental health
Shannon Dorsey, Michael Pullmann
S9 SBIRT implementation for adolescents in urban federally qualified health centers: Implementation outcomes
Shannon Mitchell, Robert Schwartz, Arethusa Kirk, Kristi Dusek, Marla Oros, Colleen Hosler, Jan Gryczynski, Carolina Barbosa, Laura Dunlap, David Lounsbury, Kevin O'Grady, Barry Brown
S10 PANEL: Tailoring Implementation Strategies to Context - Expert recommendations for tailoring strategies to context
Laura Damschroder, Thomas Waltz, Byron Powell
S11 PANEL: Tailoring Implementation Strategies to Context - Extreme facilitation: Helping challenged healthcare settings implement complex programs
Mona Ritchie
S12 PANEL: Tailoring Implementation Strategies to Context - Using menu-based choice tasks to obtain expert recommendations for implementing three high-priority practices in the VA
Thomas Waltz
S13 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Siri, rate my therapist: Using technology to automate fidelity ratings of motivational interviewing
David Atkins, Zac E. Imel, Bo Xiao, Doğan Can, Panayiotis Georgiou, Shrikanth Narayanan
S14 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Identifying indicators of implementation quality for computer-based ratings
Cady Berkel, Carlos Gallo, Irwin Sandler, C. Hendricks Brown, Sharlene Wolchik, Anne Marie Mauricio
S15 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Improving implementation of behavioral interventions by monitoring emotion in spoken speech
Carlos Gallo, C. Hendricks Brown, Sanjay Mehrotra
S16 Scorecards and dashboards to assure data quality of health management information system (HMIS) using R
Dharmendra Chandurkar, Siddhartha Bora, Arup Das, Anand Tripathi, Niranjan Saggurti, Anita Raj
S17 A big data approach for discovering and implementing patient safety insights
Eric Hughes, Brian Jacobs, Eric Kirkendall
S18 Improving the efficacy of a depression registry for use in a collaborative care model
Danielle Loeb, Katy Trinkley, Michael Yang, Andrew Sprowell, Donald Nease
S19 Measurement feedback systems as a strategy to support implementation of measurement-based care in behavioral health
Aaron Lyon, Cara Lewis, Meredith Boyd, Abigail Melvin, Semret Nicodimos, Freda Liu, Nathanial Jungbluth
S20 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Common loop assay: Methods of supporting learning collaboratives
Allen Flynn
S21 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Innovating audit and feedback using message tailoring models for learning health systems
Zach Landis-Lewis
S22 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Implementation science and learning health systems: Connecting the dots
Anne Sales
S23 Facilitation activities of Critical Access Hospitals during TeamSTEPPS implementation
Jure Baloh, Marcia Ward, Xi Zhu
S24 Organizational and social context of federally qualified health centers and variation in maternal depression outcomes
Ian Bennett, Jurgen Unutzer, Johnny Mao, Enola Proctor, Mindy Vredevoogd, Ya-Fen Chan, Nathaniel Williams, Phillip Green
S25 Decision support to enhance treatment of hospitalized smokers: A randomized trial
Steven Bernstein, June-Marie Rosner, Michelle DeWitt, Jeanette Tetrault, James Dziura, Allen Hsiao, Scott Sussman, Patrick O’Connor, Benjamin Toll
S26 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A patient-centered approach to successful community transition after catastrophic injury
Michael Jones, Julie Gassaway
S27 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - Conducting PCOR to integrate mental health and cancer screening services in primary care
Jonathan Tobin
S28 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A comparative effectiveness trial of optimal patient-centered care for US trauma care systems
Douglas Zatzick
S29 Preferences for in-person communication among patients in a multi-center randomized study of in-person versus telephone communication of genetic test results for cancer susceptibility
Angela R Bradbury, Linda Patrick-Miller, Brian Egleston, Olufunmilayo I Olopade, Michael J Hall, Mary B Daly, Linda Fleisher, Generosa Grana, Pamela Ganschow, Dominique Fetzer, Amanda Brandt, Dana Farengo-Clark, Andrea Forman, Rikki S Gaber, Cassandra Gulden, Janice Horte, Jessica Long, Rachelle Lorenz Chambers, Terra Lucas, Shreshtha Madaan, Kristin Mattie, Danielle McKenna, Susan Montgomery, Sarah Nielsen, Jacquelyn Powers, Kim Rainey, Christina Rybak, Michelle Savage, Christina Seelaus, Jessica Stoll, Jill Stopfer, Shirley Yao and Susan Domchek
S30 Working towards de-implementation: A mixed methods study in breast cancer surveillance care
Erin Hahn, Corrine Munoz-Plaza, Jianjin Wang, Jazmine Garcia Delgadillo, Brian Mittman Michael Gould
S31Integrating evidence-based practices for increasing cancer screenings in safety-net primary care systems: A multiple case study using the consolidated framework for implementation research
Shuting (Lily) Liang, Michelle C. Kegler, Megan Cotter, Emily Phillips, April Hermstad, Rentonia Morton, Derrick Beasley, Jeremy Martinez, Kara Riehman
S32 Observations from implementing an mHealth intervention in an FQHC
David Gustafson, Lisa Marsch, Louise Mares, Andrew Quanbeck, Fiona McTavish, Helene McDowell, Randall Brown, Chantelle Thomas, Joseph Glass, Joseph Isham, Dhavan Shah
S33 A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: A cluster randomized controlled trial protocol
Jane Liebschutz, Karen Lasser
S34 Implementing collaborative care for substance use disorders in primary care: Preliminary findings from the summit study
Katherine Watkins, Allison Ober, Sarah Hunter, Karen Lamp, Brett Ewing
S35 Sustaining a task-shifting strategy for blood pressure control in Ghana: A stakeholder analysis
Juliet Iwelunmor, Joyce Gyamfi, Sarah Blackstone, Nana Kofi Quakyi, Jacob Plange-Rhule, Gbenga Ogedegbe
S36 Contextual adaptation of the consolidated framework for implementation research (CFIR) in a tobacco cessation study in Vietnam
Pritika Kumar, Nancy Van Devanter, Nam Nguyen, Linh Nguyen, Trang Nguyen, Nguyet Phuong, Donna Shelley
S37 Evidence check: A knowledge brokering approach to systematic reviews for policy
Sian Rudge
S38 Using Evidence Synthesis to Strengthen Complex Health Systems in Low- and Middle-Income Countries
Etienne Langlois
S39 Does it matter: timeliness or accuracy of results? The choice of rapid reviews or systematic reviews to inform decision-making
Andrea Tricco
S40 Evaluation of the veterans choice program using lean six sigma at a VA medical center to identify benefits and overcome obstacles
Sherry Ball, Anne Lambert-Kerzner, Christine Sulc, Carol Simmons, Jeneen Shell-Boyd, Taryn Oestreich, Ashley O'Connor, Emily Neely, Marina McCreight, Amy Labebue, Doreen DiFiore, Diana Brostow, P. Michael Ho, David Aron
S41 The influence of local context on multi-stakeholder alliance quality improvement activities: A multiple case study
Jillian Harvey, Megan McHugh, Dennis Scanlon
S42 Increasing physical activity in early care and education: Sustainability via active garden education (SAGE)
Rebecca Lee, Erica Soltero, Nathan Parker, Lorna McNeill, Tracey Ledoux
S43 Marking a decade of policy implementation: The successes and continuing challenges of a provincial school food and nutrition policy in Canada
Jessie-Lee McIsaac, Kate MacLeod, Nicole Ata, Sherry Jarvis, Sara Kirk
S44 Use of research evidence among state legislators who prioritize mental health and substance abuse issues
Jonathan Purtle, Elizabeth Dodson, Ross Brownson
S45 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 1 designs
Brian Mittman, Geoffrey Curran
S46 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 2 designs
Geoffrey Curran
S47 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 3 designs
Jeffrey Pyne
S48 Linking team level implementation leadership and implementation climate to individual level attitudes, behaviors, and implementation outcomes
Gregory Aarons, Mark Ehrhart, Elisa Torres
S49 Pinpointing the specific elements of local context that matter most to implementation outcomes: Findings from qualitative comparative analysis in the RE-inspire study of VA acute stroke care
Edward Miech
S50 The GO score: A new context-sensitive instrument to measure group organization level for providing and improving care
Edward Miech
S51 A research network approach for boosting implementation and improvement
Kathleen Stevens, I.S.R.N. Steering Council
S52 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - The value of qualitative methods in implementation research
Alison Hamilton
S53 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Learning evaluation: The role of qualitative methods in dissemination and implementation research
Deborah Cohen
S54 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Qualitative methods in D&I research
Deborah Padgett
S55 PANEL: Maps & models: The promise of network science for clinical D&I - Hospital network of sharing patients with acute and chronic diseases in California
Alexandra Morshed
S56 PANEL: Maps & models: The promise of network science for clinical D&I - The use of social network analysis to identify dissemination targets and enhance D&I research study recruitment for pre-exposure prophylaxis for HIV (PrEP) among men who have sex with men
Rupa Patel
S57 PANEL: Maps & models: The promise of network science for clinical D&I - Network and organizational factors related to the adoption of patient navigation services among rural breast cancer care providers
Beth Prusaczyk
S58 A theory of de-implementation based on the theory of healthcare professionals’ behavior and intention (THPBI) and the becker model of unlearning
David C. Aron, Divya Gupta, Sherry Ball
S59 Observation of registered dietitian nutritionist-patient encounters by dietetic interns highlights low awareness and implementation of evidence-based nutrition practice guidelines
Rosa Hand, Jenica Abram, Taylor Wolfram
S60 Program sustainability action planning: Building capacity for program sustainability using the program sustainability assessment tool
Molly Hastings, Sarah Moreland-Russell
S61 A review of D&I study designs in published study protocols
Rachel Tabak, Alex Ramsey, Ana Baumann, Emily Kryzer, Katherine Montgomery, Ericka Lewis, Margaret Padek, Byron Powell, Ross Brownson
S62 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Model simulation techniques to estimate the cost of implementing foundational public health services
Cezar Brian Mamaril, Glen Mays, Keith Branham, Lava Timsina
S63 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Inter-organizational network effects on the implementation of public health services
Glen Mays, Rachel Hogg
S64 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Implementation fidelity, coalition functioning, and community prevention system transformation using communities that care
Abigail Fagan, Valerie Shapiro, Eric Brown
S65 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Expanding capacity for implementation of communities that care at scale using a web-based, video-assisted training system
Kevin Haggerty, David Hawkins
S66 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Effects of communities that care on reducing youth behavioral health problems
Sabrina Oesterle, David Hawkins, Richard Catalano
S68 When interventions end: the dynamics of intervention de-adoption and replacement
Virginia McKay, M. Margaret Dolcini, Lee Hoffer
S69 Results from next-d: can a disease specific health plan reduce incident diabetes development among a national sample of working-age adults with pre-diabetes?
Tannaz Moin, Jinnan Li, O. Kenrik Duru, Susan Ettner, Norman Turk, Charles Chan, Abigail Keckhafer, Robert Luchs, Sam Ho, Carol Mangione
S70 Implementing smoking cessation interventions in primary care settings (STOP): using the interactive systems framework
Peter Selby, Laurie Zawertailo, Nadia Minian, Dolly Balliunas, Rosa Dragonetti, Sarwar Hussain, Julia Lecce
S71 Testing the Getting To Outcomes implementation support intervention in prevention-oriented, community-based settings
Matthew Chinman, Joie Acosta, Patricia Ebener, Patrick S Malone, Mary Slaughter
S72 Examining the reach of a multi-component farmers’ market implementation approach among low-income consumers in an urban context
Darcy Freedman, Susan Flocke, Eunlye Lee, Kristen Matlack, Erika Trapl, Punam Ohri-Vachaspati, Morgan Taggart, Elaine Borawski
S73 Increasing implementation of evidence-based health promotion practices at large workplaces: The CEOs Challenge
Amanda Parrish, Jeffrey Harris, Marlana Kohn, Kristen Hammerback, Becca McMillan, Peggy Hannon
S74 A qualitative assessment of barriers to nutrition promotion and obesity prevention in childcare
Taren Swindle, Geoffrey Curran, Leanne Whiteside-Mansell, Wendy Ward
S75 Documenting institutionalization of a health communication intervention in African American churches
Cheryl Holt, Sheri Lou Santos, Erin Tagai, Mary Ann Scheirer, Roxanne Carter, Janice Bowie, Muhiuddin Haider, Jimmie Slade, Min Qi Wang
S76 Reduction in hospital utilization by underserved patients through use of a community-medical home
Andrew Masica, Gerald Ogola, Candice Berryman, Kathleen Richter
S77 Sustainability of evidence-based lay health advisor programs in African American communities: A mixed methods investigation of the National Witness Project
Rachel Shelton, Lina Jandorf, Deborah Erwin
S78 Predicting the long-term uninsured population and analyzing their gaps in physical access to healthcare in South Carolina
Khoa Truong
S79 Using an evidence-based parenting intervention in churches to prevent behavioral problems among Filipino youth: A randomized pilot study
Joyce R. Javier, Dean Coffey, Sheree M. Schrager, Lawrence Palinkas, Jeanne Miranda
S80 Sustainability of elementary school-based health centers in three health-disparate southern communities
Veda Johnson, Valerie Hutcherson, Ruth Ellis
S81 Childhood obesity prevention partnership in Louisville: creative opportunities to engage families in a multifaceted approach to obesity prevention
Anna Kharmats, Sandra Marshall-King, Monica LaPradd, Fannie Fonseca-Becker
S82 Improvements in cervical cancer prevention found after implementation of evidence-based Latina prevention care management program
Deanna Kepka, Julia Bodson, Echo Warner, Brynn Fowler
S83 The OneFlorida data trust: Achieving health equity through research & training capacity building
Elizabeth Shenkman, William Hogan, Folakami Odedina, Jessica De Leon, Monica Hooper, Olveen Carrasquillo, Renee Reams, Myra Hurt, Steven Smith, Jose Szapocznik, David Nelson, Prabir Mandal
S84 Disseminating and sustaining medical-legal partnerships: Shared value and social return on investment
James Teufel
doi:10.1186/s13012-016-0452-0
PMCID: PMC4977475  PMID: 27490260
6.  A Model for Interprofessional Health Disparities Education: Student-Led Curriculum on Chronic Hepatitis B Infection 
Journal of General Internal Medicine  2010;25(Suppl 2):140-145.
BACKGROUND
Although health disparities are commonly addressed in preclinical didactic curricula, direct patient care activities with affected communities are more limited.
PURPOSE
To address this problem, health professional students designed a preclinical service-learning curriculum on hepatitis B viral (HBV) infection, a major health disparity affecting the Asian/Pacific Islander (API) population, integrating lectures, skills training, and direct patient care at student-run clinics.
SETTING
An urban health professions campus.
METHODS
Medical and other health professional students at University of California, San Francisco, organized a preclinical didactic and experiential elective, and established two monthly clinics offering HBV screening, vaccination, and education to the community.
RESULTS
Between 2004 and 2009, 477 students enrolled in the student-led HBV curriculum. Since the clinics’ inception in 2007, 804 patients have been screened for chronic HBV; 87% were API immigrants, 63% had limited English proficiency, and 46% were uninsured. Serologically, 10% were found to be chronic HBV carriers, 44% were susceptible to HBV, and 46% were immune.
DISCUSSION
Our student-led didactic and experiential elective can serve as an interprofessional curricular model for learning about specific health disparities while providing important services to the local community.
doi:10.1007/s11606-009-1234-z
PMCID: PMC2847097  PMID: 20352509
medical education-undergraduate; underserved populations; medical education-curriculum development/evaluation; disparities; community based interventions; student-run clinic
7.  Gateway to Care campaign: a public health initiative to reduce the burden of hepatitis B in Haimen City, China 
BMC Public Health  2014;14:754.
Background
An estimated one million people worldwide die each year from complications of chronic hepatitis B infection (CHB), including liver cancer. A disproportionate number of infections and deaths occur in China. The incidence and mortality of liver cancer in Haimen City is among the highest in China, and in the world. A multi-year citywide campaign was aimed at eliminating hepatitis B virus (HBV) infection and significantly reducing the number of liver cancer deaths due to CHB in Haimen City, China.
Methods
Strategies included a public health information campaign targeting the 1.03 million city residents; specialized health education for leaders and providers to increase adoption of evidence-based HBV management protocols; establishment of health care infrastructure and management systems; and increased prevention and care delivery to key subpopulations (especially pregnant women).
Results
The project developed and deployed broad-reaching public awareness and health education tools and modules to 280,000 households and at community-based events. More than 90% of targeted healthcare providers and 80% of the community leaders/government officials attended educational seminars during the project period (1,441 health care providers; 1,883 local government officials). A centralized registration and management system for pregnant women was developed and instituted, 100% of pregnant women were enrolled (5,407 women over one year), and all infants born to HBV-infected mothers received one dose of HBIG and the first dose of HBV vaccine by 24 hours of birth.
Conclusions
Lessons from the implementation phase of the project include the importance of: gaining early and ongoing support from the local government and health bureau for success in reaching the targeted populations; and having project management by a local, experienced, and trusted health expert to navigate implementation and relationships, and help develop culturally and linguistically appropriate materials.
Electronic supplementary material
The online version of this article (doi:10.1186/1471-2458-14-754) contains supplementary material, which is available to authorized users.
doi:10.1186/1471-2458-14-754
PMCID: PMC4124160  PMID: 25064309
Chronic hepatitis B infection; Hepatocellular carcinoma; Perinatal hepatitis B; Prevention; Health education campaign; Hepatitis B screening; Hepatitis B vaccination; Haimen City, China
8.  Clean Indoor Air in El Paso, Texas: A Case Study 
Preventing Chronic Disease  2004;2(1):A22.
Background
Exposure to secondhand smoke is an important preventable cause of illness and death. A Smoke-Free Paso del Norte Coalition in El Paso, Texas, led a drive to introduce an ordinance to protect nonsmoking persons from the health effects of secondhand smoke in public places. The ordinance was introduced in April 2001 and was passed on June 26, 2001.
Context
El Paso is the fifth largest city in Texas and the largest border city in the United States. It is the 10th poorest city in the United States; 37% of its residents do not have health insurance. Seventy-eight percent of El Paso's residents are Hispanic/Latino. A large percentage of El Paso's restaurant and bar workers are recent immigrants from Mexico.
Methods
Campaign activities included a letter-writing campaign to the El Paso Times, petition gathering, community outreach education, meetings with city council members, print and television advertising, a proactive media advocacy campaign, and a youth rally.
Consequences
One month after the ordinance went into effect, an opinion poll found solid support for the new ordinance. Another survey conducted in December 2002 also found a 22% decline in adult smoking, from 22.1% in 1996 to 17.3% at the time of the survey.
Interpretation
The El Paso campaign is an example of a successful grassroots campaign. El Paso's campaign relied on direct organizing to identify, recruit, and mobilize supporters, and involved relatively little paid media or paid advocacy efforts. These lessons are transferable to other communities, and the El Paso coalition serves as a model for developing a diverse, representative coalition in a predominantly Mexican American community.
PMCID: PMC1323325  PMID: 15670475
9.  Survival following non-small cell lung cancer among Asian/Pacific Islander, Latina, and non-Hispanic White women who have never smoked 
BACKGROUND
Lung cancer is the leading cause of cancer death among US Asian/Pacific Islander (API) and Latina women, despite low smoking prevalence. This study examined survival patterns following non-small cell lung cancer in a population-based sample of lung cancer cases from the San Francisco Bay Area Lung Cancer Study (SFBALCS).
METHODS
Women diagnosed with lung cancer from 1998–2003 and 2005–2008 and identified through the Greater Bay Area Cancer Registry were telephone-screened for eligibility for the SFBALCS. The screener data were linked to the cancer registry data to determine follow-up. This analysis included 187 non-Hispanic White, 23 US-born Latina, 32 foreign-born Latina, 30 US-born API, and 190 foreign-born API never smokers diagnosed with lung cancer and followed through 2008.
RESULTS
All-cause survival was poorer among APIs (hazard ratio (HR) and 95% confidence interval (CI) = 1.7 (1.0–2.8) among US-born APIs; 1.2 (0.9–1.5) among foreign-born APIs), and Latinas (HR (95% CI) = 2.1 (1.2–3.6) among US-born Latinas; 1.4 (0.9–2.3) among foreign-born Latinas), relative to non-Hispanic Whites. These survival differences were not explained by differences in selected sociodemographic or clinical factors.
CONCLUSIONS
Further research should focus on factors such as cultural behaviors, access to or attitudes toward health care, and genetic variations, as possible explanations for these striking racial/ethnic differences.
IMPACT
Latina and API female never smokers diagnosed with lung cancer were up to two-times more likely to die than non-Hispanic Whites, highlighting the need for additional research to identify the underlying reasons for the disparities, as well as heightened clinical awareness.
doi:10.1158/1055-9965.EPI-10-0965
PMCID: PMC3070404  PMID: 21239685
lung cancer survival; Asian; Latina; Hispanic; never smokers; nativity
10.  Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia 
BMC Public Health  2016;16:769.
Background
Hepatitis B and C are silent killers not yet recognized as major public health challenges in many developing countries with huge disease burden. In Ethiopia, Hepatitis B is endemic with an average prevalence of 10.8 %, and the prevalence of Hepatitis C is 2 %. The prevalence of both infections, however, is likely to be underreported due to the lack of diagnostic facilities and appropriate surveillance systems. Ethiopia is also among the many Sub-Sahara African countries lacking a coordinated and systematic national response to chronic viral hepatitis.
The objective of this study is to examine the current level of response to viral Hepatitis B & C in Ethiopia with the aim to bring identified gaps to the attention of relevant stakeholders and policy makers.
Methods
This cross-sectional qualitative study was based on semi-structured in-depth interviews with 21 key informants from health facilities, health offices, pharmaceutical companies, regulatory bodies, professional association and blood bank units. Participants were selected purposively based on their role in the national hepatitis response. The investigators also reviewed available policy and strategy documents, standards of practice and surveys, and paid visits to pharmaceutical premises to check the availability of antiviral drugs. Thematic analysis was employed to make sense of the data. During the data analysis process, all the authors critically read the materials, and data was triangulated by source, interpreter view and thematic perspective to ensure accurate representation and comprehensiveness, and validation of the interviewees’ responses. Once each investigator reviewed the data independently, the team reached a common understanding of the scope and contexts of the information attained. Data were subsequently reduced to key concepts, and case stories were taken with successive revisions. The key concepts were later coded into most basic meaningful categories. The World Health Organization (WHO) global hepatitis response framework was used to organize the analysis.
Results
Ethiopia is in the process of preparing strategic plan and guidelines for viral hepatitis. However, the country still lacks the required partnerships, and resource mobilization as a national health response is limited. Community awareness on the disease transmission and its sequel is poor. Viral hepatitis screening services are not widely available except for the occasional mandatory medical checkups for work or travel purposes. Healthcare providers often take no further action after diagnosing patients with viral hepatitis due to lack of treatment guidelines and strategic frameworks for screening, diagnosis, and treatment. Besides, drugs that are effective in the treatment of viral hepatitis are not available, mainly due to regulatory challenges.
Conclusions
Viral hepatitis and its disease burden are getting little attention in Ethiopia and many low-income countries. The levels of technical guidance and financial support from the international community are low. To date, the response to the infections in Ethiopia is patchy. Thus, the country needs to formulate policy and strategies in the areas of disease surveillance, risk group identification and screening, use of the birth dose of hepatitis B vaccine, and care and treatment. Improving availability of data on viral hepatitis, access to low-cost generic drugs and developing and dissemination of treatment guidelines are also critical. Leveraging the successful Health Extension Program for a hepatitis response, and exploring ways to learn from and integrate into the HIV/AIDS program should also be considered.
doi:10.1186/s12889-016-3459-1
PMCID: PMC4982409  PMID: 27514515
Chronic; Hepatitis B; Hepatitis C; Screening; Treatment; Policy; Strategy; Rights; Integration; Ethiopia
11.  Violent Deaths of Iraqi Civilians, 2003–2008: Analysis by Perpetrator, Weapon, Time, and Location 
PLoS Medicine  2011;8(2):e1000415.
Madelyn Hsiao-Rei Hicks and colleagues provide a detailed analysis of Iraqi civilian violent deaths during 2003-2008 of the Iraq war and show that of 92,614 deaths, unknown perpetrators caused 74% of deaths, Coalition forces 12%, and Anti-Coalition forces 11%.
Background
Armed violence is a major public health and humanitarian problem in Iraq. In this descriptive statistical analysis we aimed to describe for the first time Iraqi civilian deaths caused by perpetrators of armed violence during the first 5 years of the Iraq war: over time; by weapon used; by region (governorate); and by victim demographics.
Methods and Findings
We analyzed the Iraq Body Count database of 92,614 Iraqi civilian direct deaths from armed violence occurring from March 20, 2003 through March 19, 2008, of which Unknown perpetrators caused 74% of deaths (n = 68,396), Coalition forces 12% (n = 11,516), and Anti-Coalition forces 11% (n = 9,954). We analyzed the subset of 60,481 civilian deaths from 14,196 short-duration events of lethal violence to link individual civilian deaths to events involving perpetrators and their methods. One-third of civilian violent death was from extrajudicial executions by Unknown perpetrators; quadratic regression shows these deaths progressively and disproportionately increased as deaths from other forms of violence increased across Iraq's governorates. The highest average number of civilians killed per event in which a civilian died were in Unknown perpetrator suicide bombings targeting civilians (19 per lethal event) and Coalition aerial bombings (17 per lethal event). In temporal analysis, numbers of civilian deaths from Coalition air attacks, and woman and child deaths from Coalition forces, peaked during the invasion. We applied a Woman and Child “Dirty War Index” (DWI), measuring the proportion of women and children among civilian deaths of known demographic status, to the 22,066 civilian victims identified as men, women, or children to indicate relatively indiscriminate perpetrator effects. DWI findings suggest the most indiscriminate effects on women and children were from Unknown perpetrators using mortar fire (DWI  = 79) and nonsuicide vehicle bombs (DWI  = 54) and from Coalition air attacks (DWI  = 69). Coalition forces had higher Woman and Child DWIs than Anti-Coalition forces, with no evidence of decrease over 2003–2008, for all weapons combined and for small arms gunfire, specifically.
Conclusions
Most Iraqi civilian violent deaths during 2003–2008 of the Iraq war were inflicted by Unknown perpetrators, primarily through extrajudicial executions that disproportionately increased in regions with greater numbers of violent deaths. Unknown perpetrators using suicide bombs, vehicle bombs, and mortars had highly lethal and indiscriminate effects on the Iraqi civilians they targeted. Deaths caused by Coalition forces of Iraqi civilians, women, and children peaked during the invasion period, with relatively indiscriminate effects from aerial weapons.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Civilian deaths through armed violence is a public health and humanitarian problem in all wars, despite internationally agreed humanitarian standards regarding the treatment of civilians during wars—so-called laws of war such as the Geneva Conventions. Since the Iraq war began on March 20, 2003, when a multilateral force led by US and UK troops invaded Iraq, more than 100,000 Iraqi civilians (women, children, noncombatants, and police carrying out nonparamilitary duties) have died because of armed violence, according to the Iraq Body Count (IBC), a nongovernmental project that collates media reports of deaths of individual Iraqi civilians and cross-checks these reports with data from hospitals, morgues, nongovernmental organizations, and official figures. Indeed, according to a recent assessment of the global burden of armed violence, in 2006, people living in Iraq had the highest risk of dying violently in conflict. In that year, there were 91 violent deaths per 100,000 people in the country.
Why Was This Study Done?
Detailed analysis of civilian deaths during wars is important because it can improve the understanding of the impact of these deaths on general public health and on vulnerable subgroups in the population. In addition, data collected on the nature and effects of violence can guide the development of preventative policies. For example, an analysis that reveals that air attacks by invading troops cause a high proportion of civilian deaths might encourage policy changes that prohibit air attacks on populated areas. Finally, by linking violent deaths to perpetrators, analyses of civilian deaths can provide an indicator of combatants' compliance with the laws of war, which require the protection of civilians from targeted or indiscriminate harm. Here, IBC researchers provide a descriptive statistical analysis of Iraqi civilian deaths directly caused by perpetrators of armed violence during the first 5 years of the Iraq war.
What Did the Researchers Do and Find?
According to data from the Iraq Body Count, more than 92,000 Iraqi civilians died because of armed violence during this period. Coalition forces (identified by uniforms) caused 12% of these deaths, anti-coalition forces (un-uniformed combatants identified by attacks on coalition targets) caused 11% of the deaths; and unknown perpetrators, who targeted civilians and were indistinguishable from their victims (for example, a suicide bomber in a market), were responsible for three-quarters of civilian deaths. To link individual deaths with perpetrators and their methods, the researchers analyzed the 60,481 civilian deaths caused by short-duration events of lethal violence (events that lasted less than 24 hours and that occurred in a specific location; for example, overnight air strikes). Extrajudicial executions by unknown perpetrators were responsible for one-third of these deaths and disproportionately increased as deaths from other forms of violence increased across Iraq. Unknown perpetrator suicide bombings that targeted civilians and coalition aerial bombings killed most civilians per lethal event (19 and 17 deaths per lethal event on average, respectively). Finally, the researchers calculated the proportion of women and children among civilian deaths. Because men are the main targets of armed violence, this proportion—the “Dirty War Index” (DWI)—indicates the scale of indiscriminate killing in a conflict. The most indiscriminate effects on women and children in Iraq were from unknown perpetrators firing mortars (DWI  = 79) and nonsuicide vehicle bombs (DWI  = 54), and from coalition air attacks (DWI  = 69). Coalition forces had a higher DWI than anti-coalition forces for all weapons combined, with no decrease over the study period.
What Do These Findings Mean?
These findings show that during the first 5 years of the Iraq war, civilian deaths varied over time and location and in terms of victim characteristics and targeting of civilians. Although limited to direct deaths and possibly subject to some media bias, these findings show that most civilian deaths were inflicted by unknown perpetrators, and that unknown perpetrators had particularly lethal and indiscriminate effects on Iraqi civilians. However, they also show that Coalition forces had indiscriminate lethal effects on civilian populations. In part, this may be because Coalition forces had a high risk of killing civilians accidentally because they could not easily recognize anti-coalition combatants fighting without uniforms among civilians. Nevertheless, the relatively indiscriminate effects of Coalition aerial weapons highlight the need to change policies relating to the use of air power in future armed conflicts.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000415.
This study is further discussed in a PLoS Medicine Perspective by Robert Muggah
The International Committee of the Red Cross provides information about war and International humanitarian law (in several languages)
The Geneva Declaration on Armed Violence and Development Web site provides information on the global burden of armed violence
More details on the Iraq Body Count are available
The Human Security Report Project tracks global and regional trends in organized violence, their causes, and consequences
Every Casualty supports and is a resource for the documentation of individual casualties of armed conflict
doi:10.1371/journal.pmed.1000415
PMCID: PMC3039690  PMID: 21358813
12.  Epidemiology of the Viral Hepatitis-HIV Syndemic in San Francisco: A Collaborative Surveillance Approach 
Public Health Reports  2014;129(Suppl 1):95-101.
Objectives
To describe the epidemiology of people coinfected with hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV in San Francisco, the San Francisco Department of Public Health's Communicable Disease Control and Prevention Section and the HIV Epidemiology Section collaborated to link their registries.
Methods
In San Francisco, hepatitis reporting is primarily through passive laboratory-based surveillance, and HIV/AIDS reporting is primarily through laboratory-initiated active surveillance. We conducted the registry linkage in 2010 using a sequential algorithm.
Results
The registry match included 31,997 HBV-infected people who were reported starting in 1984; 10,121 HCV-infected people who were reported starting in 2001; and 34,551 HIV/AIDS cases reported beginning in 1981. Of the HBV and HCV cases, 6.3% and 12.6% were coinfected with HIV, respectively. The majority of cases were white males; however, black people were disproportionately affected. For more than 90% of the HBV/HIV cases, male-to-male sexual contact (men who have sex with men [MSM]) was the risk factor for HIV infection. Injection drug use was the most frequent risk factor for HIV infection among the HCV/HIV cases; however, 35.6% of the HCV/HIV coinfected males were MSM but not injection drug users.
Conclusions
By linking the two registries, we found new ways to foster collaborative work and expand our programmatic flexibility. This analysis identified particular populations at risk for coinfection, which can be used by viral hepatitis and HIV screening, prevention, and treatment programs to integrate, enhance, target, and prioritize prevention services and clinical care within the community to maximize health outcomes.
PMCID: PMC3862995  PMID: 24385655
13.  Successful Promotion of Hepatitis B Vaccinations Among Vietnamese-American Children Ages 3 to 18: Results of a Controlled Trial 
Pediatrics  2003;111(6 Pt 1):1278-1288.
Objective
Chronic infection with the hepatitis B virus is endemic in Southeast Asian populations, including Vietnamese. Previous research has documented low rates of hepatitis B vaccine coverage among Vietnamese-American children and adolescents ages 3 to 18. To address this problem, we designed and tested in a controlled trial 2 public health outreach “catch-up” campaigns for this population.
Design
In the Houston, Texas metropolitan area, we mounted a media-led information and education campaign, and in the Dallas metropolitan area, we organized a community mobilization strategy. We evaluated the success of these interventions in a controlled trial, using the Washington, DC metropolitan area as a control site. To do so, we conducted computer-assisted telephone interviews with random samples of ~500 Vietnamese-American households in each of the 3 study sites both before and after the interventions. We assessed respondents’ awareness and knowledge of hepatitis B and asked for hepatitis B vaccination dates for a randomly selected child in each household. When possible, we validated vaccination dates through direct contact with each child’s providers.
Results
Awareness of hepatitis B increased significantly between the pre- and postintervention surveys in all 3 areas, and the increase in the media education area (+21.5 percentage points) was significantly larger than in the control area (+9.0 percentage points). At postintervention, significantly more parents knew that free vaccines were available for children in the media education (+31.9 percentage points) and community mobilization (+16.7 percentage points) areas than in the control area (+4.7 percentage points). An increase in knowledge of sexual transmission of hepatitis B virus was significant in the media education area (+14.0 percentage points) and community mobilization (+13.6 percentage points) areas compared with the control area (+5.2 percentage points). Parent- or provider-reported data (n = 783 for pre- and n = 784 for postintervention surveys) suggest that receipt of 3 hepatitis B vaccinations increased significantly in the community mobilization area (from 26.6% at pre- to 38.8% at postintervention) and in the media intervention area (28.5% at pre- and 39.4% at postintervention), but declined slightly in the control community (37.8% at pre- and 33.5% at postintervention). Multiple logistic regression analyses estimated that the odds of receiving 3 hepatitis B vaccine doses were significantly greater for both community mobilization (odds ratio 2.15, 95% confidence interval 1.16–3.97) and media campaign (odds ratio 3.02, 95% confidence interval 1.62–5.64) interventions compared with the control area. The odds of being vaccinated were significantly greater for children who had had at least 1 diphtheria-tetanuspertussis shot, and whose parents were married, knew someone with liver disease, had heard of hepatitis B, and had greater knowledge about hepatitis B. The odds of being vaccinated were significantly lower for older children.
Conclusions
Both community mobilization and media campaigns significantly increased the knowledge of Vietnamese-American parents about hepatitis B vaccination, and the receipt of “catch-up” vaccinations among their children.
doi:10.1542/peds.111.6.1278
PMCID: PMC1592334  PMID: 12777542
hepatitis B vaccination; catch-up; Vietnamese-Americans; HBV, hepatitis B virus; HepB, hepatitis B vaccine; CDC, Centers for Disease Control and Prevention; DTP, diphtheria, tetanus toxoid and pertussis; VFC, Vaccines for Children; EDCC, East Dallas Counseling Center; OR, odds ratio; CI, confidence interval
14.  Self-report compared to electronic medical record across eight adult vaccines: Do results vary by demographic factors? 
Vaccine  2013;31(37):3928-3935.
Immunizations are crucial to the prevention of disease, thus, having an accurate measure of vaccination status for a population is an important guide in targeting prevention efforts. In order to comprehensively assess the validity of self-reported adult vaccination status for the eight most common adult vaccines we conducted a survey of vaccination receipt and compared it to the electronic medical record (EMR), which was used as the criterion standard, in a population of community-dwelling patients in a large healthcare system. In addition, we assessed whether validity varied by demographic factors. The vaccines included: pneumococcal (PPSV), influenza (Flu), tetanus diphtheria (Td), tetanus diphtheria pertussis (Tdap), Human PapillomaVirus (HPV), hepatitis A (HepA), hepatitis B (HepB) and herpes zoster (shingles). Telephone surveys were conducted with 11,760 individuals, ≥ 18, half with documented receipt of vaccination and half without. We measured sensitivity, specificity, positive and negative predictive value, net bias and over- and under-reporting of vaccination. Variation was found across vaccines, however, sensitivity and specificity did not vary substantially by either age or race/ethnicity. Sensitivity ranged between 63% for HepA to over 90% (tetanus, HPV, shingles and Flu). Hispanics were 2.7 times more likely to claim receipt of vaccination compared to whites. For PPSV and Flu those 65+ had low specificity compared to patients of younger ages while those in the youngest age group had lowest specificity for HepA and HepB. In addition to racial/ethnic differences, over-reporting was more frequent in those retired and those with household income less than $75,000. Accurate information for vaccination surveillance is important to estimate progress toward vaccination coverage goals and ensure appropriate policy decisions and allocation of resources for public health. It was clear from our findings that EMR and self-report do not always agree. Finding approaches to improve both EMR data capture and patient awareness would be beneficial.
doi:10.1016/j.vaccine.2013.06.041
PMCID: PMC4689428  PMID: 23806243
Immunization; Vaccination surveillance; Self-report
15.  The Asian American Hepatitis B Program: Building a Coalition to Address Hepatitis B Health Disparities 
Background
Community coalitions are increasingly recognized as important strategies for addressing health disparities. By providing the opportunity to pool resources, they provide a means to develop and sustain innovative approaches to affect community health.
Objectives
This article describes the challenges and lessons learned in building the Asian American Hepatitis B Program (AAHBP) coalition to conduct a community-based participatory research (CBPR) initiative to address hepatitis B (HBV) among New York City Asian-American communities.
Methods
Using the stages of coalition development as a framework, a comprehensive assessment of the process of developing and implementing the AAHBP coalition is presented.
Lessons Learned
Findings highlight the importance of developing a sound infrastructure and set of processes to foster a greater sense of ownership, shared vision, and investment in the program.
Conclusion
Grassroots community organizing and campus–community partnerships can be successfully leveraged to address and prevent a significant health disparity in an underserved and diverse community.
doi:10.1353/cpr.2011.0039
PMCID: PMC3369315  PMID: 22080774
Asian Americans; community-based participatory research; community health services; healthcare disparities; hepatitis B
16.  A Comprehensive Screening And Treatment Model For Reducing Disparities In Hepatitis B 
Health Affairs (Project Hope)  2011;30(10):1974-1983.
Chronic hepatitis B affects Asian Americans at a much higher rate than the general US population. Appropriate care can limit morbidity and mortality from hepatitis B. However, access to care for many Asian Americans and other immigrant groups is limited by their lack of knowledge about the disease, as well as cultural, linguistic, and financial challenges. This article describes the results of BfreeNYC, a New York City pilot program that, from 2004 to 2008, provided hepatitis B community education and awareness, free screening and vaccinations, and free or low-cost treatment primarily to immigrants from Asia, but also to residents from other racial and ethnic minority groups. The program was the largest citywide screening program in the United States, reaching nearly 9,000 people, and the only one providing comprehensive care to those who were infected. During the program, new hepatitis B cases reported annually from predominantly Asian neighborhoods in the city increased 34 percent. More than two thousand people were vaccinated; 57 percent of the 1,162 patients who tested positive for hepatitis B and were evaluated by program clinical services were still in care at the end of the program. Our analysis found that the program was effective in reaching the target population and providing care. Although follow-up care data will be needed to demonstrate long-term costeffectiveness, the program may serve as a useful prototype for addressing hepatitis B disparities in communities across the United States.
doi:10.1377/hlthaff.2011.0700
PMCID: PMC3333793  PMID: 21976342
17.  The Healthy Mothers, Healthy Babies Coalition: four years of progress. 
Public Health Reports  1986;101(2):147-156.
The Healthy Mothers, Healthy Babies Coalition is a cooperative venture of 80 national voluntary, health professional, and governmental organizations committed to improving maternal and infant health through education. In the 4 years since its creation, the Coalition has grown in scope and size, established an Executive Secretariat, and begun activities directed at breastfeeding, substance use, injury prevention, genetics, oral health, adolescent pregnancy, and motivation of low-income women. National Coalition educational materials on these subjects are produced by representatives of the national organization members contributing time and their organization's resources. In addition, member organizations sponsor the publication of a quarterly newsletter and other coalition-building materials including an exhibit, slide-tape show, television production kit, and a community organization guide. Combined with State and community enthusiasm for the Healthy Mothers, Healthy Babies concept, technical assistance from national members has led to the formation of coalitions in many States--more than 40 States have designated contacts with the national coalition. The State coalitions have undertaken a variety of campaigns; the achievements in 12 States are outlined. Of high priority during the next year will be support of these developing State coalitions through co-sponsorship of regional conferences. The national Coalition will also continue to recognize innovative programs through annual national achievement awards. The Healthy Mothers, Healthy Babies Coalition is dedicated to continued development and promotion of educational programs for pregnant women, those planning a pregnancy, and their caregivers until 1990, in support of the health Objectives for the nation.
Images
PMCID: PMC1477792  PMID: 3083469
18.  Hepatitis B in the Greater San Francisco Bay Area: an integrated programme to respond to a diverse local epidemic 
Journal of Viral Hepatitis  2011;18(4):e40-e51.
Although chronic hepatitis B (CHB) affects approximately 2 million United States residents, there is no systematic screening of at-risk individuals, and most remain unaware of their hepatitis B virus (HBV) infection. Unmonitored and untreated, CHB results in a 25–30% risk of death from liver cancer and/or cirrhosis, inflicting an increasing healthcare burden in high-prevalence regions. Despite high prevalence in immigrant Asians and Pacific Islanders, among whom CHB is a leading cause of death, community and healthcare provider awareness remains low. Because safe and effective vaccines and effective antiviral treatments exist, there is an urgent need for integrated programmes that identify, follow and treat people with existing CHB, while vaccinating the susceptible. We describe an extant San Francisco programme that integrates culturally targeted, population-based, HBV screening, vaccination or reassurance, management and research. After screening over 3000 at-risk individuals, we here review our operational and practical experience and describe a simple, rationally designed model that could be successfully used to greatly improve the current approach to hepatitis B while ultimately reducing the related healthcare costs, especially in the high-risk populations, which are currently underserved.
doi:10.1111/j.1365-2893.2010.01382.x
PMCID: PMC3084996  PMID: 21143342
Asians and Pacific Islanders; at-risk populations; cancer surveillance; chronic hepatitis B; culturally targeted screening; disease surveillance; hepatitis B virus; hepatocellular carcinoma; high-risk populations; screening; vaccination
19.  Efficacy of Pneumococcal Nontypable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) in Young Latin American Children: A Double-Blind Randomized Controlled Trial 
PLoS Medicine  2014;11(6):e1001657.
In a double-blind randomized controlled trial, Xavier Saez-Llorens and colleagues examine the vaccine efficacy of PHiD-CV against community-acquired pneumonia in young children in Panama, Argentina, and Columbia.
Please see later in the article for the Editors' Summary
Background
The relationship between pneumococcal conjugate vaccine–induced antibody responses and protection against community-acquired pneumonia (CAP) and acute otitis media (AOM) is unclear. This study assessed the impact of the ten-valent pneumococcal nontypable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) on these end points. The primary objective was to demonstrate vaccine efficacy (VE) in a per-protocol analysis against likely bacterial CAP (B-CAP: radiologically confirmed CAP with alveolar consolidation/pleural effusion on chest X-ray, or non-alveolar infiltrates and C-reactive protein ≥ 40 µg/ml); other protocol-specified outcomes were also assessed.
Methods and Findings
This phase III double-blind randomized controlled study was conducted between 28 June 2007 and 28 July 2011 in Argentine, Panamanian, and Colombian populations with good access to health care. Approximately 24,000 infants received PHiD-CV or hepatitis control vaccine (hepatitis B for primary vaccination, hepatitis A at booster) at 2, 4, 6, and 15–18 mo of age. Interim analysis of the primary end point was planned when 535 first B-CAP episodes, occurring ≥2 wk after dose 3, were identified in the per-protocol cohort. After a mean follow-up of 23 mo (PHiD-CV, n = 10,295; control, n = 10,201), per-protocol VE was 22.0% (95% CI: 7.7, 34.2; one-sided p = 0.002) against B-CAP (conclusive for primary objective) and 25.7% (95% CI: 8.4%, 39.6%) against World Health Organization–defined consolidated CAP. Intent-to-treat VE was 18.2% (95% CI: 5.5%, 29.1%) against B-CAP and 23.4% (95% CI: 8.8%, 35.7%) against consolidated CAP. End-of-study per-protocol analyses were performed after a mean follow-up of 28–30 mo for CAP and invasive pneumococcal disease (IPD) (PHiD-CV, n = 10,211; control, n = 10,140) and AOM (n = 3,010 and 2,979, respectively). Per-protocol VE was 16.1% (95% CI: −1.1%, 30.4%; one-sided p = 0.032) against clinically confirmed AOM, 67.1% (95% CI: 17.0%, 86.9%) against vaccine serotype clinically confirmed AOM, 100% (95% CI: 74.3%, 100%) against vaccine serotype IPD, and 65.0% (95% CI: 11.1%, 86.2%) against any IPD. Results were consistent between intent-to-treat and per-protocol analyses. Serious adverse events were reported for 21.5% (95% CI: 20.7%, 22.2%) and 22.6% (95% CI: 21.9%, 23.4%) of PHiD-CV and control recipients, respectively. There were 19 deaths (n = 11,798; 0.16%) in the PHiD-CV group and 26 deaths (n = 11,799; 0.22%) in the control group. A significant study limitation was the lower than expected number of captured AOM cases.
Conclusions
Efficacy was demonstrated against a broad range of pneumococcal diseases commonly encountered in young children in clinical practice.
Trial registration
www.ClinicalTrials.gov NCT00466947
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Pneumococcal diseases are illnesses caused by Streptococcus pneumoniae bacteria, pathogens (disease-causing organisms) that are transmitted through contact with infected respiratory secretions. S. pneumoniae causes mucosal diseases–infections of the lining of the body cavities that are connected to the outside world–such as community-acquired pneumonia (CAP; lung infection) and acute otitis media (AOM; middle-ear infection). It also causes invasive pneumococcal diseases (IPDs) such as septicemia and meningitis (infections of the bloodstream and the covering of the brain, respectively). Although pneumococcal diseases can sometimes be treated with antibiotics, CAP and IPDs are leading global causes of childhood deaths, particularly in developing countries. It is best therefore to avoid S. pneumoniae infections through vaccination. Vaccination primes the immune system to recognize and attack pathogens rapidly and effectively by exposing it to weakened or dead pathogens or to pathogen molecules that it recognizes as foreign (antigens). Because there are more than 90 S. pneumoniae variants (“serotypes”), each characterized by a different antigenic polysaccharide (complex sugar) coat, S. pneumoniae vaccines have to include antigens from multiple serotypes. For example, the PHiD-CV vaccine contains polysaccharides from ten S. pneumoniae serotypes.
Why Was This Study Done?
Although in most countries PHiD-CV has been licensed for protection against IPD and pneumococcal AOM, at the time of study, it was not known how well it protected against CAP and overall AOM, which are important public health problems. In this double-blind randomized controlled trial (the Clinical Otitis Media and Pneumonia Study; COMPAS), the researchers investigate the efficacy of PHiD-CV against CAP and AOM and assess other clinical end points, such as IPD, in Latin American infants. Double-blind randomized controlled trials compare the effects of interventions by assigning study participants to different interventions randomly and measuring predefined outcomes without the study participants or researchers knowing who has received which intervention until the trial is completed. Vaccine efficacy is the reduction in the incidence of a disease (the number of new cases that occur in a population in a given time) among trial participants who receive the vaccine compared to the incidence among participants who do not receive the vaccine.
What Did the Researchers Do and Find?
The researchers enrolled around 24,000 infants living in urban areas of Argentina, Panama, and Colombia. Half the infants were given PHiD-CV at 2, 4, and 6 months of age and a booster dose at age 15–18 months. The remaining infants were given a hepatitis control vaccine at the same intervals. The trial's primary end point was likely bacterial CAP (B-CAP) –radiologically confirmed CAP, with the airspaces (alveoli) in the lungs filled with liquid instead of gas (alveolar consolidation) or with non-alveolar infiltrates and raised blood levels of C-reactive protein (a marker of inflammation). In a planned interim analysis, which was undertaken after an average follow-up of 23 months, the vaccine efficacy in the per-protocol cohort (the group of participants who actually received their assigned intervention) was 22% against B-CAP. Intent-to-treat vaccine efficacy in the interim analysis (which considered all the trial participants regardless of whether they received their assigned intervention) was 18.2%. At the end of the study (average follow up 30 months), the vaccine efficacy against B-CAP was 18.2% and 16.7% in the per-protocol and intent-to-treat cohorts, respectively. Per-protocol vaccine efficacies against clinically confirmed AOM and vaccine serotype AOM were 16.1% and 67.1%, respectively. Against any IPD and against vaccine serotype IPD, the respective vaccine efficacies were 65% and 100%. Finally, about one-fifth of children who received PHiD-CV and a similar proportion who received the control vaccine experienced a serious adverse event (for example, gastroenteritis); 19 children who received PHiD-CV died compared to 26 children who received the control vaccine.
What Do These Findings Mean?
These findings indicate that in Latin America, a region with an intermediate burden of pneumococcal disease, PHiD-CV is efficacious against a broad range of pneumococcal diseases that often affect young children. The accuracy of these findings may be limited by the withdrawal of 14% of participants from the trial because of adverse media coverage and by the low number of reported cases of AOM. Moreover, because most study participants lived in urban areas, these findings may not be generalizable to rural settings. Despite these and other study limitations, these findings provide new information about the magnitude of the effect of PHiD-CV vaccination against CAP and AOM, two mucosal pneumococcal diseases of global public health importance.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001657.
The US Centers for Disease Control and Prevention provides information for patients and health professionals on all aspects of pneumococcal disease and pneumococcal vaccination, including personal stories
Public Health England provides information on pneumococcal disease and on pneumococcal vaccines
The not-for-profit Immunization Action Coalition has information on pneumococcal disease, including personal stories
The GAVI Alliance provides information about pneumococcal disease and the importance of vaccination
MedlinePlus has links to further information about pneumococcal infections, including pneumonia and otitis media (in English and Spanish)
More information about COMPAS is available
The European Medicines Agency provides information about PHiD-CV (Synflorix)
doi:10.1371/journal.pmed.1001657
PMCID: PMC4043495  PMID: 24892763
20.  HBV outreach programs significantly increase knowledge and vaccination rates among Asian Pacific Islanders 
Journal of community health  2015;40(4):619-624.
Introduction
Hepatitis B virus (HBV) testing and vaccination rates remain low among Asian-American/Pacific Islanders (APIs) despite high rates of HBV infection. The aim of our study was to assess the effectiveness of an outreach campaign to increase HBV knowledge, testing, and vaccination among a cohort of APIs.
Methods
Vietnamese Americans were invited to participate in a free HBV screening and vaccination outreach program though pubic service announcements. Attendees completed a survey to assess barriers to vaccination and HBV-related knowledge before and after a 30-minute education session by a bilingual board-certified gastroenterologist.
Results
Among 98 participants, 100% (22/22) of HBV naïve patients were provided a HBV vaccination series at no cost and over 75% (14/18) of HBV-infected patients were connected to further medical care. Notable reported barriers to prior testing and/or vaccination were cost of the vaccine, concern about missing work for evaluation, and lack of provider recommendation. Knowledge levels about HBV risk factors, potential consequences, and treatment options were poor at baseline but significantly increased after the education session (49% vs. 64%, p<0.001).
Conclusion
Outreach campaigns linked with education can successfully address several barriers to HBV testing and offer an approach to improve HBV awareness and prevention among difficult-to-reach populations.
doi:10.1007/s10900-014-9975-y
PMCID: PMC4457718  PMID: 25476035
Hepatitis B; outreach; vaccination; prevention; education
21.  The Impact of Cancer Coalitions on the Dissemination of Colorectal Cancer Materials to Community Organizations in Rural Appalachia 
Preventing Chronic Disease  2006;3(2):A55.
Introduction
The incidence of colorectal cancer in portions of rural Appalachia is higher than in much of the United States. To reduce this disparity, cancer-control strategies could be adapted to and implemented in rural Appalachian communities. The objectives of this pilot study were to develop and test community-based participatory research methods to examine whether cancer coalitions in Appalachia could effectively disseminate print materials from a national media campaign intended to promote colorectal cancer awareness to their rural communities.
Methods
This pilot study used a two-arm intervention design with random selection of 450 community organizations from nine counties with cancer coalitions (the coalition arm) and 450 organizations from nine matched counties without a cancer coalition (the noncoalition arm) in northern Appalachia. The primary outcome measures were participation by and interest of community organizations in dissemination of materials from Screen for Life: National Colorectal Cancer Action Campaign, a national campaign to promote colorectal cancer education and screening. The data were collected with prestudy and poststudy surveys.
Results
One-hundred thirty (29%) organizations participated in the coalition arm, and 38 (8%) participated in the noncoalition arm (P < .001). Within the coalition arm, 86 of the 119 (66%) organizations that responded to the question about influence reported being influenced to participate by the local coalition. Initial interest in dissemination was high in each of the study arms but remained higher throughout the study in the coalition arm than the noncoalition arm.
Conclusion
Community cancer coalitions can increase the local dissemination of material from a national media campaign in rural Appalachia. Continued development and study of methods for coalitions to translate and implement cancer-control strategies at a local level in Appalachia is warranted.
PMCID: PMC1563978  PMID: 16539796
22.  Yellow Fever in Africa: Estimating the Burden of Disease and Impact of Mass Vaccination from Outbreak and Serological Data 
PLoS Medicine  2014;11(5):e1001638.
Neil Ferguson and colleagues estimate the disease burden of yellow fever in Africa, as well as the impact of mass vaccination campaigns.
Please see later in the article for the Editors' Summary
Background
Yellow fever is a vector-borne disease affecting humans and non-human primates in tropical areas of Africa and South America. While eradication is not feasible due to the wildlife reservoir, large scale vaccination activities in Africa during the 1940s to 1960s reduced yellow fever incidence for several decades. However, after a period of low vaccination coverage, yellow fever has resurged in the continent. Since 2006 there has been substantial funding for large preventive mass vaccination campaigns in the most affected countries in Africa to curb the rising burden of disease and control future outbreaks. Contemporary estimates of the yellow fever disease burden are lacking, and the present study aimed to update the previous estimates on the basis of more recent yellow fever occurrence data and improved estimation methods.
Methods and Findings
Generalised linear regression models were fitted to a dataset of the locations of yellow fever outbreaks within the last 25 years to estimate the probability of outbreak reports across the endemic zone. Environmental variables and indicators for the surveillance quality in the affected countries were used as covariates. By comparing probabilities of outbreak reports estimated in the regression with the force of infection estimated for a limited set of locations for which serological surveys were available, the detection probability per case and the force of infection were estimated across the endemic zone.
The yellow fever burden in Africa was estimated for the year 2013 as 130,000 (95% CI 51,000–380,000) cases with fever and jaundice or haemorrhage including 78,000 (95% CI 19,000–180,000) deaths, taking into account the current level of vaccination coverage. The impact of the recent mass vaccination campaigns was assessed by evaluating the difference between the estimates obtained for the current vaccination coverage and for a hypothetical scenario excluding these vaccination campaigns. Vaccination campaigns were estimated to have reduced the number of cases and deaths by 27% (95% CI 22%–31%) across the region, achieving up to an 82% reduction in countries targeted by these campaigns. A limitation of our study is the high level of uncertainty in our estimates arising from the sparseness of data available from both surveillance and serological surveys.
Conclusions
With the estimation method presented here, spatial estimates of transmission intensity can be combined with vaccination coverage levels to evaluate the impact of past or proposed vaccination campaigns, thereby helping to allocate resources efficiently for yellow fever control. This method has been used by the Global Alliance for Vaccines and Immunization (GAVI Alliance) to estimate the potential impact of future vaccination campaigns.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Yellow fever is a flavivirus infection that is transmitted to people and to non-human primates through the bites of infected mosquitoes. This serious viral disease affects people living in and visiting tropical regions of Africa and Central and South America. In rural areas next to forests, the virus typically causes sporadic cases or even small-scale epidemics (outbreaks) but, if it is introduced into urban areas, it can cause large explosive epidemics that are hard to control. Although many people who contract yellow fever do not develop any symptoms, some have mild flu-like symptoms, and others develop a high fever with jaundice (yellowing of the skin and eyes) or hemorrhaging (bleeding) from the mouth, nose, eyes, or stomach. Half of patients who develop these severe symptoms die. Because of this wide spectrum of symptoms, which overlap with those of other tropical diseases, it is hard to diagnose yellow fever from symptoms alone. However, serological tests that detect antibodies to the virus in the blood can help in diagnosis. There is no specific antiviral treatment for yellow fever but its symptoms can be treated.
Why Was This Study Done?
Eradication of yellow fever is not feasible because of the wildlife reservoir for the virus but there is a safe, affordable, and highly effective vaccine against the disease. Large-scale vaccination efforts during the 1940s, 1950s, and 1960s reduced the yellow fever burden for several decades but, after a period of low vaccination coverage, the number of cases rebounded. In 2005, the Yellow Fever Initiative—a collaboration between the World Health Organization (WHO) and the United Nations Children Fund supported by the Global Alliance for Vaccines and Immunization (GAVI Alliance)—was launched to create a vaccine stockpile for use in epidemics and to implement preventive mass vaccination campaigns in the 12 most affected countries in West Africa. Campaigns have now been implemented in all these countries except Nigeria. However, without an estimate of the current yellow fever burden, it is hard to determine the impact of these campaigns. Here, the researchers use recent yellow fever occurrence data, serological survey data, and improved estimation methods to update estimates of the yellow fever burden and to determine the impact of mass vaccination on this burden.
What Did the Researchers Do and Find?
The researchers developed a generalized linear statistical model and used data on the locations where yellow fever was reported between 1987 and 2011 in Africa, force of infection estimates for a limited set of locations where serological surveys were available (the force of infection is the rate at which susceptible individuals acquire a disease), data on vaccination coverage, and demographic and environmental data for their calculations. They estimate that about 130,000 yellow fever cases with fever and jaundice or hemorrhage occurred in Africa in 2013 and that about 78,000 people died from the disease. By evaluating the difference between this estimate, which takes into account the current vaccination coverage, and a hypothetical scenario that excluded the mass vaccination campaigns, the researchers estimate that these campaigns have reduced the burden of disease by 27% across Africa and by up to 82% in the countries targeted by the campaigns (an overall reduction of 57% in the 12 targeted countries).
What Do These Findings Mean?
These findings provide a contemporary estimate of the burden of yellow fever in Africa. This estimate is broadly similar to the historic estimate of 200,000 cases and 30,000 deaths annually, which was based on serological survey data obtained from children in Nigeria between 1945 and 1971. Notably, both disease burden estimates are several hundred-fold higher than the average number of yellow fever cases reported annually to WHO, which reflects the difficulties associated with the diagnosis of yellow fever. Importantly, these findings also provide an estimate of the impact of recent mass vaccination campaigns. All these findings have a high level of uncertainty, however, because of the lack of data from both surveillance and serological surveys. Other assumptions incorporated in the researchers' model may also affect the accuracy of these findings. Nevertheless, the framework for burden estimation developed here provides essential new information about the yellow fever burden and the impact of vaccination campaigns and should help the partners of the Yellow Fever Initiative estimate the potential impact of future vaccination campaigns and ensure the efficient allocation of resources for yellow fever control.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001638.
The World Health Organization provides detailed information about yellow fever (in several languages), including photo stories about vaccination campaigns in the Sudan and Mali; it also provides information about the Yellow Fever Initiative (in English and French)
The GAVI Alliance website includes detailed of its support for yellow fever vaccination
The US Centers for Disease Control and Prevention provides information about yellow fever for the public, travelers, and health care providers
The UK National Health Service Choices website also has information about yellow fever
Wikipedia has a page on yellow fever that includes information about the history of the disease (note that Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
doi:10.1371/journal.pmed.1001638
PMCID: PMC4011853  PMID: 24800812
23.  Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net 
Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.
doi:10.1155/2011/523161
PMCID: PMC3236479  PMID: 22187550
24.  The Impact of a One-Dose versus Two-Dose Oral Cholera Vaccine Regimen in Outbreak Settings: A Modeling Study 
PLoS Medicine  2015;12(8):e1001867.
Background
In 2013, a stockpile of oral cholera vaccine (OCV) was created for use in outbreak response, but vaccine availability remains severely limited. Innovative strategies are needed to maximize the health impact and minimize the logistical barriers to using available vaccine. Here we ask under what conditions the use of one dose rather than the internationally licensed two-dose protocol may do both.
Methods and Findings
Using mathematical models we determined the minimum relative single-dose efficacy (MRSE) at which single-dose reactive campaigns are expected to be as or more effective than two-dose campaigns with the same amount of vaccine. Average one- and two-dose OCV effectiveness was estimated from published literature and compared to the MRSE. Results were applied to recent outbreaks in Haiti, Zimbabwe, and Guinea using stochastic simulations to illustrate the potential impact of one- and two-dose campaigns. At the start of an epidemic, a single dose must be 35%–56% as efficacious as two doses to avert the same number of cases with a fixed amount of vaccine (i.e., MRSE between 35% and 56%). This threshold decreases as vaccination is delayed. Short-term OCV effectiveness is estimated to be 77% (95% CI 57%–88%) for two doses and 44% (95% CI −27% to 76%) for one dose. This results in a one-dose relative efficacy estimate of 57% (interquartile range 13%–88%), which is above conservative MRSE estimates. Using our best estimates of one- and two-dose efficacy, we projected that a single-dose reactive campaign could have prevented 70,584 (95% prediction interval [PI] 55,943–86,205) cases in Zimbabwe, 78,317 (95% PI 57,435–100,150) in Port-au-Prince, Haiti, and 2,826 (95% PI 2,490–3,170) cases in Conakry, Guinea: 1.1 to 1.2 times as many as a two-dose campaign. While extensive sensitivity analyses were performed, our projections of cases averted in past epidemics are based on severely limited single-dose efficacy data and may not fully capture uncertainty due to imperfect surveillance data and uncertainty about the transmission dynamics of cholera in each setting.
Conclusions
Reactive vaccination campaigns using a single dose of OCV may avert more cases and deaths than a standard two-dose campaign when vaccine supplies are limited, while at the same time reducing logistical complexity. These findings should motivate consideration of the trade-offs between one- and two-dose campaigns in resource-constrained settings, though further field efficacy data are needed and should be a priority in any one-dose campaign.
Modelling the efficacy of single-dose cholera vaccination in resource-limited settings.
Editors' Summary
Background
Cholera—a bacterial gut infection caused by Vibrio cholerae—is a major global killer. Every year, epidemics (outbreaks) of cholera make 2 to 3 million people ill and kill about 100,000 people. People get cholera by eating food or drinking water contaminated with feces from an infected person, so cholera epidemics occur in places with poor sanitation such as slums and refugee camps. Earthquakes, floods, and other natural disasters that disrupt water and sanitation systems can also trigger cholera epidemics. Most people who become infected with V. cholerae have no or mild symptoms, but they may shed bacteria in their feces for up to two weeks. Other infected individuals develop severe diarrhea, producing profuse watery feces. The standard treatment for cholera is replacement of the fluids and salts lost through diarrhea by drinking an oral rehydration fluid or, in the worst cases, by fluid replacement directly into a vein. With prompt treatment, less than 1% of patients die, but untreated patients with severe cholera can die from dehydration within hours of developing symptoms.
Why Was This Study Done?
The best way to control cholera is to ensure that everyone has access to safe water and good sanitation, but this is often impossible in poor countries, in refugee camps, or after natural disasters. In 2013, the World Health Organization created a global stockpile of an oral cholera vaccine (a preparation given by mouth that stimulates the immune system to attack V. cholerae) for use in cholera outbreaks. The licensed protocol for the currently stockpiled vaccine requires two doses of the vaccine to be given two weeks apart, but it can be difficult to ensure that everyone at risk of infection receives two doses. Moreover, the stockpile contains only one to two million doses of vaccine, which would have been insufficient to protect every individual at risk of infection in several recent cholera outbreaks. Here, the researchers use mathematical modeling to investigate whether one dose of oral cholera vaccine, rather than two doses, could be used to maximize the health impact of cholera vaccination and minimize logistical barriers to cholera vaccination during cholera outbreaks.
What Did the Researchers Do and Find?
The researchers used cholera transmission models to determine the “minimum relative single-dose efficacy” (MRSE), the threshold at which single-dose vaccination campaigns begun after an outbreak has started (reactive vaccination) are expected to be as or more effective than two-dose campaigns with the same amount of vaccine. The researchers report that, at the start of an epidemic, the MRSE is between 35% and 56%. That is, a single dose of vaccine must be at least 35%–56% as efficacious as two doses to avert the same number of cases with a fixed amount of vaccine. By searching the literature, the researchers estimated that the short-term protection against infection provided by oral cholera vaccines is 77% for two doses and 44% for one dose—a one-dose relative efficacy of 57%, which is above the MRSE estimate. Finally, the researchers used their models to project that, in three recent cholera outbreaks, a single-dose campaign could have prevented between 1.1 and 1.2 times more cases of cholera than a two-dose campaign using the same amount of vaccine.
What Do These Findings Mean?
The finding that the relative single-dose efficacy of oral cholera vaccination is above the estimated MRSE suggests that one-dose reactive vaccination campaigns might avert more cases and deaths than a standard two-dose campaign when vaccine supplies are limited. The accuracy of this and other study findings is limited, however, by the assumptions used to build the mathematical models and by the quality of the data used to run them. In particular, a lack of data on the efficacy of single-dose vaccination limits the ability to apply these findings. Thus, before one-dose campaigns are used widely, more data on the effectiveness on one-dose vaccination must be obtained. Notably, by increasing herd immunity (the vaccination of a significant portion of a population provides some protection for individuals in the population who have not been vaccinated), one-dose campaigns are likely to provide better population-level protection than two-dose campaigns. On the other hand, the individual who is given one rather than two vaccine doses is more vulnerable to cholera illness if exposed to cholera-causing bacteria. Strategies that balance the trade-off between individual- and population-level benefits must be carefully considered to ensure the best future use of the oral cholera vaccine stockpile. Moreover, every effort should be made to increase the size and availability of this stockpile.
Additional Information
This list of resources contains links that can be accessed when viewing the PDF on a device or via the online version of the article at http://dx.doi.org/10.1371/journal.pmed.1001867.
The World Health Organization provides information about cholera in several languages, including technical information about cholera vaccination and the oral cholera vaccine stockpile
The US Centers for Disease Control and Prevention also provides information about cholera for the public, medical professionals, and travelers
The UK National Health Service Choices website provides information about cholera and cholera vaccination; it also provides information, including a simple animation, about how vaccines work and herd immunity
MedlinePlus provides links to further resources about cholera
The not-for-profit organization Médecins Sans Frontières is tackling several cholera outbreaks around the world; its website includes a description of the recent vaccination of refugees against cholera in Tanzania
A personal story about the 2008–2009 cholera outbreak in Zimbabwe is available from UNICEF
StopCholera.org provides detailed information on oral cholera vaccines useful for public health officials, scientists, and clinicians
doi:10.1371/journal.pmed.1001867
PMCID: PMC4549326  PMID: 26305226
25.  Effectively Communicating Colorectal Cancer Screening Information to Primary Care Providers: Application for State, Tribe or Territory Comprehensive Cancer Control Coalitions 
Background
Patients are more likely to be screened for colorectal cancer if it is recommended by a health care provider. Therefore, it is imperative that providers have access to the latest screening guidelines.
Purpose
This practice-based project sought to identify Kentucky primary care providers’ preferred sources and methods of receiving colorectal cancer information to improve state comprehensive cancer control provider outreach initiatives.
Methods
Four focus groups were conducted with primary care physicians, nurse practitioners, and physician assistants. Discussion included preferred sources and methods of receiving updated screening guidelines, legislation, and statewide public awareness campaign materials.
Results
Providers (N = 17) identified their preferred methods for receiving colorectal cancer information as: routine emails from trusted sources (colleagues, professional societies and research, and advocacy agencies), scientific journals, existing conferences, and the media.
Discussion
When delivering colorectal cancer information to primary care providers, multiple approaches are needed. An ideal partner for dissemination of information is state comprehensive cancer control coalitions, considering their prioritization of colorectal cancer screening and existing networks of partners who were identified as trusted sources.
Translation to Health Education Practice
Assessment of primary care providers’ preferred methods and sources of receiving colorectal cancer information informs strategies for practice among comprehensive cancer control coalitions.
doi:10.1080/19325037.2012.10599235
PMCID: PMC4770578  PMID: 26937262

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