Introdução: Frente à dependência funcional de idosos após um acidente vascular cerebral (AVC), os cuidadores familiares enfrentam a falta de conhecimento e de habilidades para realizarem os cuidados necessários no domicílio, o que tende a influenciar sua sobrecarga. Objetivos: Comparar o efeito de intervenção educativa no domicílio na sobrecarga de cuidadores familiares de idosos após AVC, com orientações usuais de cuidado no período de um mês. Métodos: Ensaio clínico randomizado (ECR), denominado Nursing Home Care Intervention Post Stroke (SHARE). O grupo intervenção (GI) recebeu o acompanhamento sistemático de enfermeiras por meio de três visitas domiciliares (VDs) no período de um mês, para preparo dos cuidadores na realização das atividades de vida diária (AVD) do idoso, suporte emocional e orientações para utilização dos serviços de saúde. O grupo controle (GC) contou com as orientações usuais de cuidado dos serviços de saúde. O desfecho primário foi a sobrecarga do cuidador, e os desfechos secundários foram a capacidade funcional e as reinternações hospitalares dos idosos, avaliados em sete dias e 60 dias após a alta. As análises foram realizadas por intenção de tratar e foi utilizado o programa SPSS 21.0. Para análise do efeito da intervenção nos desfechos foram utilizados os testes t-student pareado, com intervalo de confiança de 95% e t independente. Para verificação do efeito de interação foi realizada análise de variância (ANOVA) para medidas repetidas. / Introduction: Faced with the functional dependence of the elderly after a stroke, family caregivers face the lack of knowledge and skills to perform the necessary health care at home, which tends to negatively influence their overload. Objectives: Compare the effect of home educational intervention (SHARE), on the overload of family caregivers of the elderly with stroke when compared to usual care in one month. Methods: Randomized clinical trial denominated Nursing Home Care Intervention Post Stroke (SHARE). The intervention group (GI) receive a systematic follow-up of nurses through three home visits (VDs) during one month, to prepare the family caregivers in performing daily life activities of the elderly, emotional support and orientations for the use of health services. The control group (CG) did not receive the VDs and had the usual care of the health services. The primary outcome was a caregiver burden, and the secondary outcomes were functional capacity and hospital readmissions of the elderly, evaluete at 7 days and 60 days after discharge. The analyzes were performed by intention to treat and the SPSS 21.0 program was used. For the analysis of the effect of the intervention on the results we used the t-student paired tests, with 95% confidence interval and independent t. For analysis of the interaction effect, analysis of variance (ANOVA) was performed for repeated measures. A significant value was considered p <0.05. For the control of confounding factors, multivariate analyzes were used. The study was approved by the Research Committee of the Hospital de Clínicas of Porto Alegre (nº 160181). Results: From May 2016 to September 2017, 48 elderly and their family caregivers were randomized, 24 for the intervention group (GI) and 24 for the CG. Among the elderly, 54.1% were female, and 95.8% had ischemic stroke. Of the caregivers, 87.5% were women, mean of 53.3 ± 12.9 years. There was no statistically significant difference between the groups regarding burden (0.43 GI vs 0.78 GC, p = 0.717), functional capacity (16 GI vs 18.7 GC, p = 0.999) and hospital readmissions (17% GI vs. 8.3% GC, p = 0.854). Conclusion: The SHARE intervention seems to have not influenced in the outcomes. Other intervention compositions are suggested and evaluation of other outcomes. Clinical Trial Registration: NCT02807012.

Introdução: Frente à dependência funcional de idosos após um acidente vascular cerebral (AVC), os cuidadores familiares enfrentam a falta de conhecimento e de habilidades para realizarem os cuidados necessários no domicílio, o que tende a influenciar sua sobrecarga. Objetivos: Comparar o efeito de intervenção educativa no domicílio na sobrecarga de cuidadores familiares de idosos após AVC, com orientações usuais de cuidado no período de um mês. Métodos: Ensaio clínico randomizado (ECR), denominado Nursing Home Care Intervention Post Stroke (SHARE). O grupo intervenção (GI) recebeu o acompanhamento sistemático de enfermeiras por meio de três visitas domiciliares (VDs) no período de um mês, para preparo dos cuidadores na realização das atividades de vida diária (AVD) do idoso, suporte emocional e orientações para utilização dos serviços de saúde. O grupo controle (GC) contou com as orientações usuais de cuidado dos serviços de saúde. O desfecho primário foi a sobrecarga do cuidador, e os desfechos secundários foram a capacidade funcional e as reinternações hospitalares dos idosos, avaliados em sete dias e 60 dias após a alta. As análises foram realizadas por intenção de tratar e foi utilizado o programa SPSS 21.0. Para análise do efeito da intervenção nos desfechos foram utilizados os testes t-student pareado, com intervalo de confiança de 95% e t independente. Para verificação do efeito de interação foi realizada análise de variância (ANOVA) para medidas repetidas. / Introduction: Faced with the functional dependence of the elderly after a stroke, family caregivers face the lack of knowledge and skills to perform the necessary health care at home, which tends to negatively influence their overload. Objectives: Compare the effect of home educational intervention (SHARE), on the overload of family caregivers of the elderly with stroke when compared to usual care in one month. Methods: Randomized clinical trial denominated Nursing Home Care Intervention Post Stroke (SHARE). The intervention group (GI) receive a systematic follow-up of nurses through three home visits (VDs) during one month, to prepare the family caregivers in performing daily life activities of the elderly, emotional support and orientations for the use of health services. The control group (CG) did not receive the VDs and had the usual care of the health services. The primary outcome was a caregiver burden, and the secondary outcomes were functional capacity and hospital readmissions of the elderly, evaluete at 7 days and 60 days after discharge. The analyzes were performed by intention to treat and the SPSS 21.0 program was used. For the analysis of the effect of the intervention on the results we used the t-student paired tests, with 95% confidence interval and independent t. For analysis of the interaction effect, analysis of variance (ANOVA) was performed for repeated measures. A significant value was considered p <0.05. For the control of confounding factors, multivariate analyzes were used. The study was approved by the Research Committee of the Hospital de Clínicas of Porto Alegre (nº 160181). Results: From May 2016 to September 2017, 48 elderly and their family caregivers were randomized, 24 for the intervention group (GI) and 24 for the CG. Among the elderly, 54.1% were female, and 95.8% had ischemic stroke. Of the caregivers, 87.5% were women, mean of 53.3 ± 12.9 years. There was no statistically significant difference between the groups regarding burden (0.43 GI vs 0.78 GC, p = 0.717), functional capacity (16 GI vs 18.7 GC, p = 0.999) and hospital readmissions (17% GI vs. 8.3% GC, p = 0.854). Conclusion: The SHARE intervention seems to have not influenced in the outcomes. Other intervention compositions are suggested and evaluation of other outcomes. Clinical Trial Registration: NCT02807012.

Objetivo: O presente estudo objetivou comparar o efeito da intervenção de instrução complementar isolada e associada a recursos auxiliares, na adesão terapêutica medicamentosa de pacientes com epilepsia, além de verificar a correlação entre as medidas de adesão utilizadas - dosagem sérica de drogas antiepilépticas (DAEs), frequência de crises e autorrelato. Método: Realizou-se uma pesquisa clínica, experimental, incluindo 91 indivíduos com diagnóstico de epilepsia em acompanhamento ambulatorial que apresentavam alteração na adesão ao tratamento medicamentoso (Universal Trial Number- U1111-1142-3660). A alocação foi realizada de forma randomizada em Grupo Intervenção 1 (instrução complementar), Intervenção 2 (instrução complementar e lembrete da tomada da medicação por alarme de celular) e Intervenção 3 (instrução complementar e caixa organizadora de medicação). As mensurações da adesão foram realizadas imediatamente antes e quatro semanas após a implantação das intervenções. Resultados: A distribuição dos participantes quanto ao gênero foi similar. A idade média foi de 37,8 anos (dp= 12,1). A escolaridade foi, em média, de 9,8 anos (dp= 3,3). Cerca de metade dos pacientes era da raça negra, não tinha vínculo conjugal e não estava inserida no mercado de trabalho. A duração do tratamento com DAEs foi em média de 20,7 anos (dp=12,9), o Índice de Complexidade do Tratamento Medicamentoso em Epilepsia (ICTME) médio foi 18,8 pontos (dp= 9,8), predominou a politerapia (68,3%) e as crises do tipo focal sintomática (75,6%). Na avaliação inicial, 59,4% dos pacientes tinham percepção de que suas crises não estavam adequadamente controladas e os participantes da amostra informaram apresentar em média 4,9 crises no mês anterior (dp= 13,0). Indicação de baixa e média adesão pelo teste de Morisky foi um critério para inclusão na amostra e 84,6% dos participantes apresentou média adesão antes das intervenções. Na dosagem sérica inicial das DAEs, somente 42% dos participantes tiveram nível inferior ao terapêutico. Não houve correlação entre os resultados das medidas de adesão utilizadas, também não houve associação estatisticamente significativa das categorias do Morisky com a presença de crises e dosagem sérica inferior ao nível terapêutico. Além de tudo, a presença de crise foi independente da dosagem sérica abaixo da desejável. Segundo o teste de Morisky, os três grupos apresentaram melhora na adesão, significativa (p<0,001) e similar (p=0,870), após as intervenções. A frequência de crises e a dosagem sérica indicaram que somente o grupo de intervenção 2 apresentou aumento na adesão na avaliação final; entretanto, quando o efeito clínico desejado com as intervenções foi analisado, não se observou diferença estatisticamente significativa entre os três grupos. Conclusão: A instrução complementar, sobre a doença e regime terapêutico prescrito, aplicada isoladamente apresentou efeito similar ao seu uso associado com o lembrete de tomada de medicamentos por alarme de celular e caixa organizadora de medicamentos. Não obstante, os valores das medidas de adesão não convergiram e, enquanto o escore do teste de Morisky indicou o aumento da adesão dos três grupos após as intervenções, a dosagem sérica e a frequência de crises apontaram essa melhora somente no grupo em que o alarme de celular foi utilizado. / Goal: This studys purpouse is compare the effect of the intervention of additional instruction alone and its association to ancillary resources to the medication adherence of patients with epilepsy, as well as investigate the correlation between the adherence measures used - serum levels of antiepileptic drugs (AEDs), frequency of crisis and self-report. Method: We performed a clinical, experimental research, including 91 individuals with a diagnosis of epilepsy in outpatient following with altered adherence to drug treatment (Universal Trial Number- U1111-1142-3660). The allocation was done randomly in Intervention Group 1 (supplementary statement), Intervention 2 (supplementary investigation and medication reminder alarm of mobile phone) and Intervention 3 (supplementary instruction and medication organizer box). Measurements were taken immediately before and four weeks after the implantation of the interventions. Results: The distribution of participants according to gender was similar. The average age was 37,8 years (SD = 12,1). Schooling was on average 9,8 years (SD = 3,3). About half of patients were black, had no marital bond and were not inserted in the labor market. The treatment with AEDs lasted on average 20,7 years (SD = 12,9), the Epilepsy Medication and Treatment Complexity Index (EMTCI) average was 18,8 points (SD = 9,8), polytherapy (68,3%) and symptomatic focal seizures (75,6%) were predominant. At baseline, 59,4% of patients thought that their seizures were not adequately controlled and the sample reported an average of 4,9 seizures the previous month (SD = 13,0). Indication of low and intermediate adherence by Morisky test was a criterion for inclusion in the sample and 84,6% of participants showed an average adherence before interventions. Considering the initial serum levels of AEDs, only 42% of participants had less than the therapeutic level. There was no correlation between the results of the adherence measures used, and there was no statistically significant association of the categories of Morisky on the presence of seizures and serum level less than the therapeutic level. Above all, the frequency of crisis was independent of the serum level below the desired dosage. According to the Morisky test, the three groups showed improvement in adherence, significant (p <0,001) and similar (p = 0,870) after the intervention. The frequency of seizures and the serum level indicated that only the intervention group 2 showed increase in adherence at the final evaluation; however, when the desired clinical effect with the interventions was analyzed, no statistically significant difference among the three groups was seen. Conclusion: The additional instruction on the illness and prescribed treatment regimen applied alone had similar effect to its use associated with medication reminder alarm by mobile phone and medication organizer box. Nevertheless, the values of the adherence measurements have not converged, and while the score of the Morisky test indicated increased adherence of the three groups after intervention, the serum level and the frequency of seizures showed improvement only in the group where the alarm cell was used.

The overall aim of this thesis was to study the thinking strategies and clinical reasoning processes of registered nurses (RNs) and to implement and test a computerized decision support system (CDSS) integrated into the electronic health care record (EHR) to improve patient outcomes, i.e. to prevent pressure ulcers (PUs) and malnutrition among residents in nursing homes.  A think-aloud (TA) study with a purposeful sample of RNs (n=30) was conducted to explore their thinking strategies and clinical reasoning (Paper I). A quasi-experimental study with a convenience sample of residents (at baseline, n=491 and at follow-up, n=480) from nursing homes (n=15) allocated into two intervention groups and one control group was carried out in 2007 and 2009 (Paper II). In Paper III residents’ records were reviewed with three instruments. Nursing personnel (n=25) from four nursing homes that had used the CDSS for eight months were interviewed and the CDSS was tested by nursing personnel (n=5) in two usability evaluations (Paper IV). The results showed that the RNs used a variety of thinking strategies and a lack of systematic risk assessment was identified (Paper I). The proportion of malnourished residents decreased significantly in one of the intervention groups after implementing the CDSS, however there were no differences between the groups (Paper II). The CDSS resulted in more complete and comprehensive documentation of PUs and malnutrition (Paper III). The nursing personnel considered ease of use, usefulness and a supportive work environment as the main facilitators of CDSS use in nursing homes. Barriers were lack of training, resistance to using computers and limited integration of the CDSS within the EHR system (Paper IV). In conclusion, the findings support integrating CDSSs into the EHR in nursing homes to support the nursing personnel.

Young children with cleft lip and palate (CLP) are at risk for early speech and vocabulary delays. There have been few data-based investigations of specific early intervention approaches to remediate these early delays. This study examined the acquisition of obstruents in a group of children with CLP before, during and after an early speech and language intervention to identify the changes that occurred in the sound system as the children engaged in early intervention. Participants included 18 children with nonsyndromic cleft lip and/or palate (CLP) between 15 and 36 months (MN Age 22.5; MN IQ: 107) received a clinician administered naturalistic language and speech intervention in 32 sessions over four months. The children were tested prior to intervention, midway through the intervention and immediately after the conclusion of intervention. Speech assessment, the Profiles of Early Expressive Phonological Skills (PEEPS; Williams & Stoel-Gammon, 2010)) was administered at each time point. This newly developed age-appropriate assessment focuses on single words. Whole word phonetic transcriptions were completed by a clinician trained in transcription of children with CLP. Transcription reliability, assessed with a second transcriber, was 89%. The intervention was a hybrid naturalistic language and speech intervention that targeted production of obstruents. Acquisition of place, manner and voicing features across the 3 time points was examined for error features during intervention. Error pattern changes are compared to measures for consonant inventory by word position and place of production, and percentage of consonants correct (PCC). Profiles of speech acquisition will be discussed relative to typical performance. This preliminary data provides information regarding the acquisition of early speech production of obstruents for children with clefts. The data will assist clinicians to make evidence-based decisions about the effectiveness of early speech interventions.

Vitamin D is important for bone development with immunomodulatory effects. This study investigated whether feeding CD-1 and interleukin 10 (IL-10) knockout (KO) dams low (25 IU/kg diet) or high (5,000 IU/kg diet) vitamin D affected bone health of dams as well as their offspring. Offspring were weaned to 1 of the 2 diets and followed to young adulthood. Unlike CD-1 dams, IL-10 KO dams experienced greater femur strength with high vitamin D. CD-1 male offspring had reduced femur neck strength and female offspring had smaller, weaker femurs, and weaker lumbar vertebra 2 (LV2) with high maternal vitamin D. IL-10 KO male offspring had larger femurs and female offspring had stronger femurs when weaned to high vitamin D. Low vitamin D did not adversely impact bone health but the optimal level of dietary vitamin D seems to differ between healthy and inflammatory states.

Vitamin D is important for bone development with immunomodulatory effects. This study investigated whether feeding CD-1 and interleukin 10 (IL-10) knockout (KO) dams low (25 IU/kg diet) or high (5,000 IU/kg diet) vitamin D affected bone health of dams as well as their offspring. Offspring were weaned to 1 of the 2 diets and followed to young adulthood. Unlike CD-1 dams, IL-10 KO dams experienced greater femur strength with high vitamin D. CD-1 male offspring had reduced femur neck strength and female offspring had smaller, weaker femurs, and weaker lumbar vertebra 2 (LV2) with high maternal vitamin D. IL-10 KO male offspring had larger femurs and female offspring had stronger femurs when weaned to high vitamin D. Low vitamin D did not adversely impact bone health but the optimal level of dietary vitamin D seems to differ between healthy and inflammatory states.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O consumo de frutas e hortaliças (F&H) tem sido incentivado em vários países como medida de prevenção de doenças crônicas não transmissíveis, sendo a escola um espaço privilegiado para a promoção do consumo desses alimentos. Este estudo tem como objetivo avaliar o impacto de uma intervenção de promoção de F&H sobre o consumo desses alimentos por alunos e professores de escolas públicas do município do Rio de Janeiro. Trata-se de estudo de avaliação do tipo antes e depois, realizado com turmas de primeiro ciclo do ensino fundamental em oito unidades públicas municipais situadas em territórios cobertos pela Estratégia da Saúde da Família. No diagnóstico pré-intervenção foram registradas as atividades de promoção da alimentação saudável desenvolvidas nas escolas e o consumo usual de F&H pelos professores. Foram também observados o ambiente escolar e o consumo, pelos alunos, das F&H oferecidas pelo Programa de Alimentação Escolar. A intervenção abarcou um curso de formação para professores e merendeiras sobre promoção da alimentação saudável, com ênfase na promoção de F&H; distribuição de materiais educativos e realização de eventos de mobilização. No diagnóstico pós-intervenção, foram incluídas questões referentes às estratégias da intervenção. Foram criados indicadores de cobertura da atividade e intensidade de exposição à intervenção, de síntese do nível de implementação da intervenção, de adesão à alimentação escolar, aceitação e consumo de F&H pelos alunos e do consumo de F&H pelos professores, e, também, indicadores de variação da aceitação (alunos) e do consumo (alunos e professores) de F&H. As variações observadas foram testadas estatisticamente por meio do teste t-Student pareado (no caso de médias) ou do Qui Quadrado de McNemar (no caso de proporções). A eventual influência do nível de implementação da intervenção sobre a variação do consumo e aceitação de F&H foi examinada por meio de modelos de regressão linear ou logística, dependendo do tipo de desfecho. Foram observados índices altos de aceitação de F&H entre alunos e de consumo de F&H entre alunos e professores no diagnóstico inicial. A intervenção alcançou 52,7% de implementação, tendo sido bem avaliada entre os professores. Nenhuma variação estatisticamente significativa foi observada após a intervenção tanto em relação à aceitação quanto em relação ao consumo de F&H. Foram observados resultados estatisticamente significativos somente para a associação positiva entre o nível de exposição à intervenção e a aceitação de hortaliças pelos alunos. A intervenção proposta alcançou nível intermediário de implementação e os resultados alcançados foram modestos em termos de variação do consumo de F&H por alunos e professores. / The consumption of fruits and vegetables (F&V) has been encouraged in several countries as a measure of preventing chronic diseases being the school a privileged space for the promotion of these foods. This study aims to evaluate the impact of an intervention focused on the promotion of F&V on the consumption of these foods among students and teachers of public schools in the municipality of Rio de Janeiro. This was a before-and-after evaluation study that involved students enrolled in the first cycle of primary schools in eight municipal units located in territories covered by the Family Health Strategy. In the baseline schools activities on healthy diet promotion and teacherss usual F&V intake were registered. The school environment and the students consumption of F&V delivered by the School Feeding Program were also observed. The intervention included a training course for teachers and schools cooks to promote healthy diet, with emphasis on F&V promotion; distribution of educational materials and carrying out mobilization events. Questions related to the intervention strategies intervention assessment were included in the pos-intervention assessment. Indicators of coverage of the activities, of intensity of exposure to the intervention, of adherence to school food program, of F&V acceptance and consumption by the students and F&V consumption by teachers, of variation in F&H acceptance (students) and consumption (students and teachers) as well as indicators that synthesized the delivery of the intervention were created. The observed variations were statistically tested using the paired Student t test (for means) or chi square McNemar (for proportions). The possible influence of the level of implementation of the intervention on the F&V acceptance and consumption was examined by using linear regression or logistic regression models, depending on the outcome. High levels of F&V acceptance among students and F&V consumption among students and teachers at the initial diagnosis have been observed. The intervention reached 52,7% of implementation, being well evaluated among teachers. No statistically significant variation was observed after the intervention for both F&V acceptance and consumption. Significant results were observed only for the positive association between level of exposure to the intervention and vegetable acceptance by students. The proposed intervention achieved an intermediate level of implementation and the results were modest in terms of variation of F&V consumption among students and teachers.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O consumo de frutas e hortaliças (F&H) tem sido incentivado em vários países como medida de prevenção de doenças crônicas não transmissíveis, sendo a escola um espaço privilegiado para a promoção do consumo desses alimentos. Este estudo tem como objetivo avaliar o impacto de uma intervenção de promoção de F&H sobre o consumo desses alimentos por alunos e professores de escolas públicas do município do Rio de Janeiro. Trata-se de estudo de avaliação do tipo antes e depois, realizado com turmas de primeiro ciclo do ensino fundamental em oito unidades públicas municipais situadas em territórios cobertos pela Estratégia da Saúde da Família. No diagnóstico pré-intervenção foram registradas as atividades de promoção da alimentação saudável desenvolvidas nas escolas e o consumo usual de F&H pelos professores. Foram também observados o ambiente escolar e o consumo, pelos alunos, das F&H oferecidas pelo Programa de Alimentação Escolar. A intervenção abarcou um curso de formação para professores e merendeiras sobre promoção da alimentação saudável, com ênfase na promoção de F&H; distribuição de materiais educativos e realização de eventos de mobilização. No diagnóstico pós-intervenção, foram incluídas questões referentes às estratégias da intervenção. Foram criados indicadores de cobertura da atividade e intensidade de exposição à intervenção, de síntese do nível de implementação da intervenção, de adesão à alimentação escolar, aceitação e consumo de F&H pelos alunos e do consumo de F&H pelos professores, e, também, indicadores de variação da aceitação (alunos) e do consumo (alunos e professores) de F&H. As variações observadas foram testadas estatisticamente por meio do teste t-Student pareado (no caso de médias) ou do Qui Quadrado de McNemar (no caso de proporções). A eventual influência do nível de implementação da intervenção sobre a variação do consumo e aceitação de F&H foi examinada por meio de modelos de regressão linear ou logística, dependendo do tipo de desfecho. Foram observados índices altos de aceitação de F&H entre alunos e de consumo de F&H entre alunos e professores no diagnóstico inicial. A intervenção alcançou 52,7% de implementação, tendo sido bem avaliada entre os professores. Nenhuma variação estatisticamente significativa foi observada após a intervenção tanto em relação à aceitação quanto em relação ao consumo de F&H. Foram observados resultados estatisticamente significativos somente para a associação positiva entre o nível de exposição à intervenção e a aceitação de hortaliças pelos alunos. A intervenção proposta alcançou nível intermediário de implementação e os resultados alcançados foram modestos em termos de variação do consumo de F&H por alunos e professores. / The consumption of fruits and vegetables (F&V) has been encouraged in several countries as a measure of preventing chronic diseases being the school a privileged space for the promotion of these foods. This study aims to evaluate the impact of an intervention focused on the promotion of F&V on the consumption of these foods among students and teachers of public schools in the municipality of Rio de Janeiro. This was a before-and-after evaluation study that involved students enrolled in the first cycle of primary schools in eight municipal units located in territories covered by the Family Health Strategy. In the baseline schools activities on healthy diet promotion and teacherss usual F&V intake were registered. The school environment and the students consumption of F&V delivered by the School Feeding Program were also observed. The intervention included a training course for teachers and schools cooks to promote healthy diet, with emphasis on F&V promotion; distribution of educational materials and carrying out mobilization events. Questions related to the intervention strategies intervention assessment were included in the pos-intervention assessment. Indicators of coverage of the activities, of intensity of exposure to the intervention, of adherence to school food program, of F&V acceptance and consumption by the students and F&V consumption by teachers, of variation in F&H acceptance (students) and consumption (students and teachers) as well as indicators that synthesized the delivery of the intervention were created. The observed variations were statistically tested using the paired Student t test (for means) or chi square McNemar (for proportions). The possible influence of the level of implementation of the intervention on the F&V acceptance and consumption was examined by using linear regression or logistic regression models, depending on the outcome. High levels of F&V acceptance among students and F&V consumption among students and teachers at the initial diagnosis have been observed. The intervention reached 52,7% of implementation, being well evaluated among teachers. No statistically significant variation was observed after the intervention for both F&V acceptance and consumption. Significant results were observed only for the positive association between level of exposure to the intervention and vegetable acceptance by students. The proposed intervention achieved an intermediate level of implementation and the results were modest in terms of variation of F&V consumption among students and teachers.

Föreliggande arbete utgör en delstudie i projektet Automatiserad telefonuppföljning inom Kriminalvården. Projektets övergripande syfte var att undersöka tillämpbarheten av Interactive Voice Response (IVR) som en modern metod för utvärdering, övervakning och påverkan av intagna som blivit villkorligt frigivna från ett fängelsestraff. IVR är en metodik baserat på automatiserade telefonintervjuer som bl. a innebär att en dator har programmerats för att ringa upp, ställa frågor, registrera svar och ge feedback till klienterna. I tidigare publikation från projektet undersöktes med hjälp av automatiserade telefonuppföljningar (IVR) hur stress och mående samt användande av alkohol och droger utvecklas under de trettio första dagarna efter avslutad anstaltsvistelse (Andersson et al, 2011). Syftet med det här arbetet var att undersöka om det fanns skillnader i psykiskt mående, alkohol- och drogvanor samt personlighet mellan intagna som medverkade vid åtminstone en telefonuppföljning efter den villkorliga frigivningen respektive intagna som inte medverkade vid någon telefonuppföljning efter den villkorliga frigivningen. Ytterligare ett syfte med arbetet var att beskriva den totala undersökningsgruppen i projektet med avseende på psykiskt mående, alkohol- och drogvanor samt personlighet. Den enda signifikanta skillnaden mellan deltagarna och icke-deltagarna i telefonuppföljningarna återfanns för personlighetsdraget skuld. Individer som genomförde åtminstone en telefonuppföljning var något mer benägna att känna skuld- och skamkänslor än de som inte deltog vid någon telefonuppföljning efter den villkorliga frigivningen. Den beskrivande analysen av den totala undersökningsgruppen i projektet fann att klienterna utgjorde en problembelastad grupp intagna med avseende på psykiskt mående, alkohol-och drogmissbruk och personlighet; en hög andel av klienterna hade en möjlig missbruksdiagnos och depressions och/eller ångestrelaterade symptom samt skattade höga värden på personlighetsdragen socialisation, impulsivitet och monotoniundvikande. / This study is a part of the research project Automated Phone Follow-Up inCorrectional Services. The overall aim of the research project was to investigate if Interactive Voice Response can be used as tool to investigate, monitor and influence levels of stress, depression, anxiety, and use as well as urge of alcohol and drugs among paroled offenders. IVR is a technology based on automated phone interviews, which means that a computer has been programed to call up, ask questions, record answers and provide a feedback to the paroled offenders. Previous publication from the research project explored if it is possible to use automated phone interviews (IVR) to follow-up the development of stress, psychological mood, and use of alcohol and drugs in paroled offenders during the first 30 days following probation (Andersson et al, 2011). The main aim of this study was to investigate if there were any differences in psychological mood, substance use and personality between paroled offenders that participated in at least one automated phone follow-up and paroled offenders that did not participate in any automated phone follow-up. Another aim of this study was to describe the psychological mood, substance use and personality in the total sample group of paroled offenders. The only significant difference between participants and non-participants in the phone follow-up´s was found for the personality trait guilt. The paroled offenders that participated in the phone follow-up scored significant higher on guilt, a scale measuring feelings of guilt and shame after wrongdoing, cheating, of having bad thoughts. The results of the descriptive analysis showed high levels of substance misuse, depression and anxiety symptoms in the total sample group of paroled offenders. The paroled offenders also scored high on personality scales socialization, impulsivity and monotony avoidance compared to healthy subjects.