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Preliminary evidence suggests that SAT is physically safe and not associated with increased anxiety or negative affect. Participant's perceptions of the experience were positive. Preliminary outcome measures suggest associations between participation in SAT and increased psychological flexibility as well as successful completion of a residential SUD treatment program. Further research is indicated to determine whether SAT may be developed as an effective complementary intervention for Veterans with SUDs.

There is a need to develop novel complementary interventions aimed at enhancing treatment engagement and/or response for veterans with psychiatric and substance use disorders. There is evidence that both mindfulness training and nature exposure (MT/NE) may be beneficial for this population and that combining the two approaches into one intervention might result in synergistic benefit. However, to date, the MT/NE concept has not been tested. This article reports a pilot feasibility and acceptability study of MT/NE which was, in this case, provided via recreational sailing. The primary aim of this project was to develop a model intervention and evaluation process that could be used for future studies of MT/NE interventions using a variety of methods of nature exposure (e.g., hiking, skiing, mountain biking). Results indicate preliminary evidence that it is feasible to utilize MT/NE interventions for the population studied and that the MT/NE model described can serve as a template for future investigations. Further, there were significant pre- to post-intervention decreases in state anxiety, as well as increases in trait mindfulness. Three psychological instruments were identified that might be used in future studies to evaluate MT/NE outcomes. Results from this project provide a model MT/NE intervention template along with evaluation metrics for use in future studies.

Introduction Complementary interventions have the potential to enhance treatment engagement and/or response among veterans with psychiatric disorders and/or substance use disorders (SUDs). Mindfulness-based therapeutic sailing (MBTS) is a novel three-session, complementary intervention, which combines nature exposure via recreational sailing and mindfulness training. It was developed specifically to augment both treatment response and engagement among veterans with psychiatric disorders or SUDs. The study reports a follow-up investigation of a version of MBTS modified based upon a previous initial pilot study. Materials and Methods This is an institutional review board–approved study of 25 veterans, 23 males and 2 females, who participated in MBTS along with a diagnosis-, gender-, and age-matched control group. All participants had at least one psychiatric disorder or SUD and most (92%) had two or more conditions, with the most common being any SUD (76%) and PTSD (72%). Instruments used to evaluate within-subjects pre- to post-intervention psychological changes were the Acceptance and Action Questionnaire II (AAQII), the Toronto Mindfulness Scale (TMS), and the Five Facet Mindfulness Questionnaire (FFMQ). The Physical Activity Enjoyment Scale (PACES) was administered to evaluate how much the participants enjoyed the intervention. Outcome measures were collected for 1-year pre-intervention and 1-year post-intervention for between-subject analyses. These were numbers of medical and psychiatric hospitalizations, emergency department visits, mental health (MH) and substance abuse treatment visits, and MH and substance abuse treatment failed appointments. Data analysis consisted of using paired, two-tailed t-tests on psychological instrument results, Poisson regression on discrete outcome measures, and chi-square test of independence on demographic factors. Results Within-subjects comparisons revealed significant mean pre- to post-intervention increases in AAQII (P = .04) and TMS scores (P = .009). The FFMQ scores increased but the change was nonsignificant (P = .12). The PACES scores were high for all sessions, indicating enjoyment of the intervention by participants. Although the coefficient was nonsignificant, Poisson regression uncovered reduction in substance abuse treatment visits post-intervention. There were no significant differences for the other variables. For demographic factors, the differences between intervention and control groups were not statistically significant. Conclusions The MBTS is associated with increases in psychological flexibility (AAQII) and state mindfulness (TMS). The intervention was perceived as pleasurable by participants (PACES) and is potentially associated with decreased utilization of substance use treatment services. These results must be considered as preliminary; however, these finding corroborate results from a previous pilot study and indicate that MBTS holds promise as a complementary intervention that could result in enhanced treatment engagement and/or outcomes for the population studied. A randomized controlled trial of MBTS is warranted. Further, the model of a three-session intervention combining mindfulness training with nature exposure could be adapted for other types of nature exposure, such as hiking or snowshoeing or other complementary interventions including equine-assisted activities and therapies.

Results: Of 1761 children studied 8.5% were malnourished according to z score P / E, 21.6%, according to E / I. The analysis of z score P / E revealed that 58.4% were male and 66.7% female. The mean age was 8.9 years. The z score of E / I 53.4% were male and 56.5% female. The risk of malnutrition was higher among boys: 59.7% for the index P / E and 53.9% for E / I. There was no statistically significant difference between the schools, gender and school year. Among nutritional status, period (P < 0.0001) and students grade (p = 0.0105), we observed statistical significance. Conclusion:Malnutrition is still continuing between the low-income population and males had a higher percentage of malnutrition. From the analysis in the region, one can consider that the nutritional assessment of school -the anthropometric technique in particular -is an extremely important tool for understanding the dynamics of child nutrition and development. 1428LITERATURE REVIEW ON LEAD POISONING E. Neary, O. Ahmareen, F. Sharif Department for Paediatrics, Midland Regional Hospital, Mullingar, IrelandThe adverse affects of high blood levels of lead are well established. There is now data emerging which looks at lower blood levels of lead associated with poor cognition and other developmental concerns. The authors undertook a literature review to examine the causal effect of low lead level and impaired cognitive function. The plausibility of including lead screening as part of developmental delay workup in Ireland is also explored. This review concludes that there is an adverse relationship between increasing level of lead and cognition. Children with developmental delay would be at an increased risk to the cognitive impairment associated with low levels of lead. Given that there are preventative and therapeutic options to minimise the effects of lead, we argue that this group of children should be routinely screened for lead. Currently there is lack of prevalence data in Ireland. The authors are working in conjunction with British Paediatric Surveillance Unit Project to undertake active surveillance of lead poisoning in Ireland. CORRELATION BETWEEN INTRADELTOID INJECTION AND DELTOID FIBROSIS T.T. Tu General Pediatrics Department, National Hospital of Pediatrics, Ha Noi, VietnamAim: To investigate a correlation between intradeltoid injection and deltoid fibrosis (DF) Material and methods:A case-control study based on a community population was conducted. Cases included patients from 1-20 years of age suffering from DF in three communes. The diagnosis criteria included 293 children.Controls included healthy individuals matched with cases by age and sex. Two controls were selected for one case. Results:There is an evident correlation between injection of antibiotic into Deltoid muscle and DF with OR= 27.2;P< 0.001. The degree of correlation decreased with an increase in age OR= 3.8; P< 0.001 when antibiotic injection was done in newborn period, OR= 2.1, p< 0.01 in children from 1 month to 5 years old.There was also correlation between intrade...