001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p less then 0.001). CONCLUSIONS Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery. Copyright by the Universidad de Antioquia.OBJECTIVES To know the social representations of female sex workers about their sexuality. METHODS Qualitative study based on the Theory of Social Representations. Thirty-nine women from a health region of Alto Sertão Produtivo Baiano - Brazil agreed to participate. For the production of empirical data, the techniques of Free Word Association and in-depth interviews were used. The answers were analyzed based on Constellation Target Content Analysis and Semantic Content Analysis. RESULTS Two thematic categories emerged "negative representation of sexuality"; "my pleasure is the money". Therefore, the theme sexuality and meanings derived from the social representations elaborated by the sex workers about sexuality, based on their experiences and daily life, showed that the work involved a negative representation of sexuality when associated with sexual satisfaction with the client, in addition to the allusion to sex as a source of income. CONCLUSIONS The social representations about sexuality constructed by sex workers are linked to the feeling of denial of pleasure and obtaining money for subsistence. Reflecting on sexuality points out ways to rethink the care to be provided for a stigmatized and vulnerable group. Copyright by the Universidad de Antioquia.OBJECTIVES This work sought to determine the effect of an educational intervention based on the stages of change in promoting physical activity in employees in the Mashhad airport in Iran. METHODS This was a quasi-experimental study conducted with the participation of 60 volunteers (30 in the intervention group and 30 in the control group) who were in the stages of contemplating or preparing for change in physical activity. The intervention consisted in educational activities provided during home visits, telephone calls, group training sessions, and delivery of printed material. To gather the information, the study used five questions on the stage in which they were for behavioral change in physical activity, according to the Theoretical Model by Marcus et al., (1. pre-contemplation, 2. contemplation, 3. preparation, 4. action, and 5. maintenance), and the International Questionnaire on Physical Activity. Changes in the stages were evaluated during three moments upon entering the study, at the end of the intervention (8th month), and two months after the second evaluation (10th month). RESULTS During the 10th month evaluation, it was noted that 26.7% of the subjects from the intervention group versus 3.3% from the control group improved their physical activity and were in the action stage (p less then 0.01). CONCLUSIONS The educational intervention based on stages of change is effective in promoting physical activity in the participants and may be used in educational programs that seek to improve physical activity in the employees studied. Copyright by the Universidad de Antioquia.OBJECTIVE To compare the von Mises stresses of the pedicle screw system and the displacement of injured vertebrae using 3-D finite element analysis, and to evaluate the curative effect of the pedicle screw system. METHODS Finite element methods were used for biomechanical comparison of four posterior short segment pedicle screw fixation techniques. The different pedicle screw models are traditional trajectory (TT), Universal Spine System (USS), cortical bone trajectory (CBT), and CBT at the cranial level and pedicle screw (PS) at the caudal level (UP-CBT). The stress distribution of the screws and connecting rods under different working conditions and the displacement of the injured vertebrae were compared and analyzed. RESULTS After the pedicle screw system was fixed, the stress under vertical compression was mainly concentrated at the proximal end of the screw, while the stress was mainly concentrated on the connecting rod during flexion, extension, lateral flexion, and rotation. The TT group had the greate © 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.AIM The aims of this prospective study were to determine the dimension of adherence in rheumatoid arthritis (RA) patients receiving subcutaneously administered anti-tumor necrosis factor-α (anti-TNFα) agents and to evaluate the influence of injection site pain and skin perceptions following subcutaneous administration of anti-TNFα drugs on patients' adherence. AY-22989 purchase METHOD An inception cohort of patients starting subcutaneously administered anti-TNFα treatment was enrolled. Injection site pain perception was assessed through the Self-Injection Assessment Pain Questionnaire (SIAPQ), and adherence to treatment was ascertained by the Compliance Questionnaire for Rheumatology (CQR5). Associations between beliefs and non-adherence, and the influence of demographic (age, disease duration, educational level), clinical (body mass index, patient global assessment, physician global assessment, Numerical Rating Scale of pain, Health Assessment Questionnaire-Disability Index, Simplified Disease Activity Index, and comorbidities measured by the modified Rheumatic Disease Comorbidty Index), and radiographic (Simple Erosion Narrowing Score) variables were assessed using logistic regression models. RESULTS Adherence data over a 12-month interval were available for 193 patients. Of these, 21.7% reported non-adherence to anti-TNFα therapy. No difference (P = .383) was found for anti-TNFα drugs (adalimumab, etanercept, certolizumab pegol and golimumab). In the logistic model, age (P = .0029), higher disease activity (P = .020), low numbers of comorbidity conditions (P = .0004), injection site pain and skin perception (P = .0008), were significantly associated with increased likelihood of medication adherence. CONCLUSION Adherence is influenced by both demographic characteristics (age) and clinical factors (disease activity, comorbidity burden and injection site pain and skin perception) in RA patients. © 2020 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.This study was conducted to evaluate the effects of dietary sodium butyrate (SB) supplementation on growth performance, the development of gastrointestinal tract and immune organs (thymus, spleen and bursa of fabricius), and serum antibody titer after Newcastle disease (ND) vaccination in broilers. The total of 288 1-day-old broilers were randomly allocated to four groups with six replications according to initial body weight. Four treatment groups were designed as follows and fed the indicated diets CON, basal diet; T1, basal diet supplemented with 0.3 g/kg SB; T2, basal diet supplemented with 0.6 g/kg SB; T3, basal diet supplemented with 1.2 g/kg SB. During days 1-21, broilers fed the T2 diet had higher (p  less then  .05) average daily gain (ADG) than broilers fed the CON diet. link2 On day 21, dietary SB supplementation showed linear increase (p  less then  .05) in relative weight of the duodenum, jejunum, ileum, small intestine (the sum weight of duodenum, jejunum and ileum), pancreas and thymus, and linear increase (p  less then  .05) in relative length of the duodenum, jejunum, ileum, small intestine (the sum length of duodenum, jejunum and ileum) and caeca. Meanwhile, dietary SB supplementation showed linear increase in the antibody titer against ND on days 14, 21, 28 and 35. In conclusion, dietary SB supplementation improved the development of gastrointestinal by increasing the relative weight and length, as well as enhanced the immune response of ND vaccine. © 2020 The Authors. Veterinary Medicine and Science Published by John Wiley & Sons Ltd.High numbers of children and adolescents in South-East Asia are traumatized by either natural disasters or human-made violence. Addressing traumatic sequelae in local populations with empirically based trauma treatments is challenged by the insufficiency inappropriately trained mental health provision. To meet this need for qualified therapists, the humanitarian/trauma capacity-building organization, Trauma Aid Germany, trained 37 therapists in psychotraumatology, including trauma stabilization. This study analyses the impact of trauma stabilization as a sole treatment intervention for post-traumatic stress (PTS) problems in children and adolescents. Each client was screened for PTS problems pre- and post-treatment using the Child Behaviour Checklist. Trauma stabilization (including psychoeducation) was the focus for subsequent data analysis. Those excluded were clients in receipt of trauma confrontation interventions. Trauma stabilization, as a sole treatment intervention, appeared to be sufficiently effective in reducing the PTS problems. The data set suggests that trauma stabilization has the potential to be effective, efficient, and sufficient treatment intervention for PTS problems in children and adolescents. Trauma stabilization techniques have the advantage of being relatively straightforward to teach and easy to integrate into practice. They are clinically safe, flexible, adaptable to the development stage and age of the client, and culturally and spiritually sensitive. A further advantage of trauma stabilization interventions is that they are bespoke - adjusted and adapted to the specific needs of the client. The discussion considers the implications for the potential utilization of mental health nurses and paraprofessionals in low- and middle-income countries in trauma stabilization interventions. © 2020 Australian College of Mental Health Nurses Inc.OBJECTIVE To assess the changes in fifth-year medical students' perceptions of the importance of frailty and competence in assessing, diagnosing and managing frailty after a 4.5-week geriatric medicine course. METHODS Students' perceived importance and competence was assessed before and after the course using a 26-item Likert scale questionnaire with scores ranging from 1 to 6. RESULTS Students' perceptions of the importance of defining frailty (P = .01), explaining what frailty is (P = .03), advising on nutritional needs (P = .001) and exercise (P = .001) and prescribing an exercise program (P  less then  .001) significantly improved after the course. Medical students' perceived competence in assessing, diagnosing and managing frailty was low to moderate precourse and increased significantly postcourse (2.3 [1.2] 4.9 [2.9], mean [IQR], P  less then  .001) across all items. CONCLUSION An appropriate curriculum focusing on geriatric health conditions such as frailty can improve senior medical students' perceived importance and competence in assessing, diagnosing and managing frailty. © 2020 AJA Inc.OBJECTIVE We aimed to evaluate the trends and estimate the long-term effects of age, calendar period and birth cohort on liver cancer (LC) incidence and mortality rates in an urban district of Shanghai. METHODS Crude and age-standardized rates of LC incidence and mortality were calculated annually from 1973 to 2013 by sex, and the direction and magnitude of the trends were estimated by the average annual percent change (AAPC) using the model of Joinpoint regression. link3 Age-period-cohort (APC) model was also fitted to evaluate the non-linear effects of calendar time and birth cohort on LC incidence and mortality. RESULTS In periods of 1973-1977and2008-2013, the age-standardized rates of LC incidence and mortality (per 100 000 persons) are 24.27 and 22.60 in males, 7.50 and 7.26 in females, respectively. The declining trends of LC incidence and mortality rates were observed, for both sexes (AAPC, P  less then  0.05 for all). The fitting of APC models indicated that LC rates of incidence and mortality were significantly influenced by both calendar time and birth cohort effects.