Programa del Adulto Mayor y su impacto integral en el municipio Trinidad, periodo 2020-2022 / Elderly Adult Program and its integral impact in Trinidad municipality, period 2020-2022

Fundamento: Con el aumento de la esperanza de vida en Cuba se hace necesario insertar al adulto mayor en la actividad física comunitaria, que es uno de los procesos de funcionamiento del Instituto Nacional de Deportes, Educación Física y Recreación, mediante el Programa del Adulto Mayor para mejorar la calidad de vida de este grupo etario. Objetivo: Determinar los rasgos distintivos que caracterizan el impacto integral del Programa del Adulto Mayor en la calidad de vida de los practicantes del municipio Trinidad en la provincia Sancti Spíritus. Metodología: Se realizó estudio exploratorio que incluyó a 10 directivos y 65 profesores que atienden directamente el Programa del Adulto Mayor en el municipio Trinidad y 64 adultos mayores practicantes sistemáticos; a profesores y directivos se les realizaron entrevistas. Se utilizaron los métodos inductivo-deductivo, análisis de documento, medición y la entrevista. Los métodos estadísticos matemáticos se aplicaron para el procesamiento de los datos, específicamente dentro de la estadística descriptiva se utilizaron tablas de distribución empírica de frecuencias. Resultados: El Programa e Indicaciones metodológicas no ofrecen información relacionada con el impacto integral del mismo, el 100 % de los directivos considera necesario que se investigue en relación con el impacto integral de este Programa, la totalidad de los profesores entrevistados expresaron que solo se evalúa la condición física del adulto mayor. El 80 % de los adultos mayores se sienten satisfechos con su estado de salud y el 98 % consideraron que el Programa mejora su calidad de vida. Conclusiones: Se ofrecen los rasgos distintivos que caracterizan el impacto integral del Programa del Adulto Mayor; las deficiencias detectadas orientan la necesidad de evaluar de forma integral el impacto del mismo en la calidad de vida de los practicantes sistemáticos.

Background: Due to the increase in life expectation in Cuba, it becomes necessary to insert the elderly adults in community physical activity, which is one of National Institute of Sports, Physical Education and Recreation functioning processes, by means of the Elderly Adult Program to improve quality of life in this age group. Objective: To determine the distinguishing features that characterize the integral impact of the Elderly Adult Program on the quality of life of the participants of the Municipality of Trinidad in the Province of Sancti Spiritus. Methodology: An exploratory study was conducted that included 10 managers and 65 teachers who directly attend the Elderly Adult Program in the municipality of Trinidad and 64 systematically practicing elderly adults; interviews were conducted with teachers and managers. Inductive-deductive methods, document analysis, measurement and interview were used. Mathematical-statistical methods were applied to process the data, specifically, within the descriptive statistics, empirical frequency distribution tables were used. Results: The Program and Methodological Indications do not offer information relating to the integral program impact, 100% of the managers consider necessary to investigate the integral impact of the program, most of the teachers interviewed said that only the physical condition of elderly adults is evaluated. The 80% of them are satisfied with their health and 98% believe the program improves their quality of life. Conclusions: The features that characterize the integral impact of the Senior Program are offered; the deficiencies detected suggest the need for a comprehensive evaluation of its impact on the life quality of systematic practitioners.

Concepción integradora para la evaluación de impacto de los procesos sustantivos en la universidad médica de Santiago de Cuba / Integrative conception for the impact evaluation of the fundamental processes in the medical university of Santiago de Cuba

La Universidad de Ciencias Médicas de Santiago de Cuba se ha apropiado de la práctica de gestión de la calidad como una cultura necesaria para elevar los estándares de sus procesos sustantivos. Todos los subsistemas que componen el Sistema de Evaluación y Acreditación de la educación superior evalúan variables relacionadas con el impacto. En este artículo se presenta una concepción integradora para dicha evaluación en la Universidad de Ciencias Médicas de Santiago de Cuba. La propuesta integra de manera coherente y con carácter sistémico categorías y conceptos de la evaluación de la calidad en la educación superior. Su implementación permite a la institución el establecimiento de acciones de mejora continua para la formación de recursos humanos de la salud, que protagonicen la transformación social y del estado de salud de la población.

The University of Medical Sciences in Santiago de Cuba has appropriated of the quality administration practice as a necessary culture to elevate the standards of its fundamental processes. All the subsystems that compose the evaluation and accreditation system of the higher education evaluate variables related to the impact. An integrative conception for this evaluation in the University of Medical Sciences of Santiago de Cuba is presented in this work. The proposal integrates in a coherent way and with systemic character categories and concepts of the quality evaluation in higher education. Its implementation allows the institution the establishment of continuous improvement actions for the training of health human resources that play leading role in the social transformation and the population health state.

Evaluación de impacto en las especialidades deportivas de posgrado. Fundamentos teóricos / Evaluation of impact in the sport specialties in postgraduate courses. Theoretical Fundamentals

Resumen El presente trabajo versa sobre los referentes teóricos a considerar para la evaluación de impacto en las especialidades de posgrado, en los deportes de alto rendimiento del sistema deportivo cubano. El estudio bibliográfico, desde los precursores hasta la actualidad, trata la conceptualización de evaluación, la evaluación de desempeño y su relación con la evaluación de impacto. La utilización de métodos investigativos del nivel empírico como son: el análisis documental, la encuesta, la entrevista grupal y el criterio de expertos, permitió construir una relación lógica para cumplir con el objetivo propuesto, que consiste en establecer las posiciones teóricas generales para la evaluación de impacto en los programas de especialidades de posgrado para el deporte de alto rendimiento en Cuba.

Abstract The present work deals with the theoretical referents to be considered for the evaluation of impact in postgraduate specialties, in the high performance sports of the Cuban sports system. The bibliographic study from the precursors to the present, deals with the conceptualization of evaluation, the evaluation of performance, and its relation with the evaluation of impact. The use of investigative methods of the empirical level such as the documentary analysis, the survey, the group interview and the criterion of experts, allowed to build a logical relationship to fulfill the proposed objective that consists on establishing the general theoretical positions for the impact evaluation. In postgraduate specialties programs for high performance sport in Cuba.

A direct comparison of the performance of public-private partnerships with that of traditional contracting / Una comparación directa del desempeño de una CPP con el modelo tradicional de contratación pública / Uma comparação direta do desempenho de uma PPP com o modelo tradicional de contratação pública

Abstract This paper assesses the city of Belo Horizonte's experience building school infrastructure through public-private partnerships (PPPs). Between 2009 and 2015, Belo Horizonte built very similar schools using both PPPs and traditional public contracting (TPC). As the choice of mode of contracting was unrelated to our outcomes of interest, the experience constitutes a quasi-experiment that allows for a simple and direct comparison of PPPs to TPC. We examine construction- and operation-phase outcomes measured using administrative data and a survey of school administrators. We find that schools constructed under the PPP contracting model outperformed those built using TPCs in most outcomes.

Resumen Este artículo evalúa la experiencia del municipio de Belo Horizonte en la construcción y operación de infraestructura escolar a través de una Colaboración Público-Privada (CPP). Entre 2009 y 2015, Belo Horizonte construyó escuelas similares usando tanto CPPs como el modelo tradicional de contratación pública (MTCP). Dado que la elección del modelo de contratación no tenía relación causal con los resultados evaluados, se puede afirmar que esa experiencia constituye un cuasi experimento que permite la comparación simple y directa de las CPPs con el MTCP. Evaluamos los principales resultados en las etapas de construcción y operación usando datos administrativos sumistrados por la alcaldía y con cuestionario aplicado a los directores de las escuelas. El artículo muestra que las escuelas construidas en el modelo de CPP tuvieron un desempeño mejor que las que usaron el MTCP.

Resumo Este artigo avalia a experiência do município de Belo Horizonte na construção e operação de infraestrutura escolar por meio de Parcerias Público-Privadas (PPPs). Entre 2009 e 2015, Belo Horizonte construiu escolas similares usando tanto PPPs como o modelo tradicional de contratação pública (MTCP). Dado que a escolha do modelo de contratação não tinha relação causal direta com os resultados avaliados, pode-se afirmar que essa experiência constitui um quasi experimento que permite a comparação simples e direta das PPPs com o MTCP. Avaliamos os principais resultados nas fases de construção e operação usando dados administrativos fornecidos pela prefeitura e com questionário aplicado aos diretores das escolas. O artigo mostra que as escolas construídas no modelo de PPP tiveram um desempenho melhor do que as que usaram o MTCP.

Efecto de una capacitación sobre los puntajes de la prueba de admisión de la Universidad de Costa Rica: una aproximación bayesiana

Se usó un diseño cuasi-experimental con pre y post-test para estimar el efecto de una capacitación para la prueba de admisión de la Universidad Costa Rica, un test estandarizado que mide habilidades de razonamiento en contextos verbales y matemáticos. Cuatro colegios públicos del área metropolitana central del país participaron en el estudio, asignándose dos de ellos aleatoriamente al grupo de intervención y los otros dos al grupo de control, con 61 estudiantes en el primer grupo y 80 en el segundo. La intervención consistió de 5 sesiones de capacitación de 3 horas, utilizando como guía un manual desarrollado por una experta pedagoga, con enfoque constructivista. Las medidas antes y después fueron formas reducidas de la prueba de admisión 2014. La variable dependiente fue la diferencia entre ambas mediciones. El efecto de la capacitación fue de 3.5 puntos porcentuales y significativo, y se estimó utilizando un modelo bayesiano de regresión multinivel.

A quasi-experimental design with pre and post- test was used to estimate training effects for the University of Costa Rica's admission test, a standardized exam that measures reasoning abilities in mathematical and verbal contexts. Four secondary public schools from the metropolitan central area of the country participated in the study; two of them were randomly assigned to the intervention group and the other two to the control group, with 61 students in the first group and 80 in the second. The intervention consisted of five three-hour training sessions, using a written guide developed by a pedagogy expert with a constructivist approach. Before and after measures were reduced test forms of the real admission test from the year 2014. The dependent variable was the difference between the two measures. The effect of the training was estimated using a multilevel Bayesian regression model with a significant magnitude of 3.5 percentage points.

The need for better evidence to evaluate the health & economic benefits of India’s Rashtriya Swasthya Bima Yojana.

In this review the existing evidence on the impact of Rashtriya Swasthya Bima Yojana (RSBY) is discussed in the context of international literature available on health insurance. We describe potential pathways through which health insurance can affect health and economic outcomes, discuss evidence from other developing countries, and identify potential biases and inconsistencies in existing studies on RSBY impact. Given the relatively recent introduction of RSBY, lack of quality, verifiable data on utilization patterns, and the absence of reliable evaluation studies, there is a need to exercise caution while assessing the merits of the programme. Considering the enormous potential and cost of the programme, we emphasize the need for a rigorous impact evaluation of RSBY. It will not only help capture the real impact of the scheme, but may also be able to estimate the extent of systemic inefficiencies at the level of the consumer.

Dimensiones de la evaluación de impacto del posgrado académico desde la óptica de la Educación Avanzada en la Educación Médica / Postgraduated academic formative processes impact evaluation dimensions from an Advanced Education perspective

Las formas organizativas del posgrado académico como la especialidad, la maestría y el doctorado proporcionan a los graduados universitarios la formación académica en correspondencia con las necesidades del desarrollo económico, social y cultural del país. La evaluación de su impacto en lo social, el comportamiento profesional y humano de los docentes, así como la calidad de los servicios médicos precisa modificaciones que favorezcan la calidad del proceso formativo. De ahí la importancia de la determinación de las dimensiones a evaluar con este fin, así como ofrecer aristas para el debate en torno a las dimensiones de la evaluación de impacto del posgrado académico desde la óptica de la Educación Avanzada en la Educación Médica.

The organization structures of postgraduated academic formative processes like specialty, masters and doctorate programs provide university graduates according to the needs of the country's economic, social and cultural development. The evaluation of their impact in such areas as social, teachers professional and human behavior and medical services quality requires modifications towards a higher quality of the formative process. From there the importance of the determination of the dimensions to evaluate with this aim, as well as of offering edges for the debate in connection with the dimensions of the evaluation of impact of the postgraduated academic formative processes from Advanced Education perspective in Medical Education.

Impacto de la red taes en la prevención y control de la tuberculosis en jurisdicciones sanitarias del Distrito Federal / Impact of the taes network on the prevention and control of tuberculosis in health jurisdictions of the Federal District / Impacto da rede taes na prevenção e controle da tuberculose nas jurisdições de saúde do Distrito Federal

Introducción: Algunas investigaciones realizadas a nivel nacional e internacional, han demostrado que la eficacia y eficiencia de curación de la Tuberculosis ha sido exitosa y cumplen con parámetros descritos por la OMS (85%), mientras que el nivel de impacto debe de ser mayor a 75%, lo que demuestra la importancia de seguir evaluando el cumplimiento del TAES y la Red TAES en la prevención y control de la Tb, aunque tendría mayor relevancia si se evaluara con la presencia de pasantes en Servicio Social o residentes en el área de la salud, realizando dicha evaluación a nivel, local o jurisdiccional. Objetivo: Evaluar el Impacto de la Red TAES de Enfermería en la Prevención y Control de la Tuberculosis en las Jurisdicciones Sanitarias del Distrito Federal, a partir de la integración del Programa de Servicio Social en Tb de la Escuela Nacional de Enfermería y Obstetricia como Escuela Aliada en la lucha contra dicha enfermedad. Material y Métodos: Estudio transversal y retrospectivo, donde se evaluó el impacto a través de casos con tuberculosis diagnosticados en la estrategia TAES de cuatro Jurisdicciones Sanitarias del Distrito Federal, a partir de la incorporación del Programa de Servicio Social de tuberculosis de la escuela aliada a la lucha contra dicha enfermedad, del 2007 al 2011. El análisis estadístico se realizó a través de x2 y t de student. Resultados: En relación al estudio realizado en la Red TAES de cuatro Jurisdicciones Sanitarias del Distrito Federal (JSDF), que contaron con la integración del Programa de Servicio Social (PSS) de la Escuela Aliada en lucha contra la Tb "Escuela Nacional de Enfermería y Obstetricia", fue a partir del 2008, y se tomó como punto de referencia el 2007 donde aún no se integraba dicho programa; en promedio se integra anualmente a la Red TAES 1 pasante por cada ciclo escolar. El personal de salud que se encuentra adscrito o integrado a la Red TAES en promedio son 44 por año, de los cuales 36 pertenecen al personal de Enfermería. La evaluación del impacto de la Red TAES, de acuerdo a los estándares recomendados por el PNCT y SINAVE (85%), fue logrado en los últimos años (2008 - 2011), dado que la eficacia fue del 90% y al eficiencia fue del 85%; cabe señalar que la incidencia fue de 11.9 a 13 de acuerdo al 2007 y 2008-2011, respectivamente, la tasa de curación fue baja en relación a la meta (95%) la cual fue del 81% con la presencia de pasantes y ella fue de 74.1%, la cobertura TAES quedo debajo del límite establecido (90%), obteniendo un resultado hasta del 85%. Conclusión: El impacto evaluado fue bajen relación a las metas establecidas. Sin embargo, los resultados difieren de la presencia de pasantes entre el año donde no se integraba aún el programa de servicio social con los años en donde se contaba con la presencia de estos. Es importante realizar convenios entre escuelas formadoras de recursos humanos con las instituciones de salud para continuar en la lucha contra Tb en México, sobre todo en el área de Enfermería ya que es quien desarrolla diferentes roles en el cuidado y atención de las personas enfermas y sus contactos.

Introduction: Some research at national and international level, have shown that the effectiveness and efficiency of healing tuberculosis has been successful and meet with parameters described by WHO (85%), while the level of impact should be higher than 75%, demonstrating the importance to further evaluate the performance of DOTS and DOTS Network on prevention and control of TB, through it would more relevance if it evaluated with the presence of Social Service interns or residents in the area of health, whether the evaluation is held in local or jurisdictional levels. Objective: To evaluate the Impact of DOTS Network Nursing in Prevention and Control of tuberculosis in the sanitary jurisdictions of the Federal District, from the integration of Social Service TB of the National School of Nursing and Obstetrics as allied school in the fight against the disease. Material and Methods: Transversal and retrospective study, where the impact was evaluated through TB cases diagnosed in DOTS Network four sanitary jurisdictions of the Federal District, from the integration of allied school to the social service program of tuberculosis in combating disease, since 2007 to 2011. The statistical analysis was performed by x2 and Student t test. Results: Regarding the study in four DOTS Network sanitary jurisdictions of the Federal District (SJFD), which were benefited from the integration of the Social Service Program (SSP) of the allied school for the fight against TB: "National School of Nursing and Obstetrics", since 2008, it was taken as a reference point the year 2007 where the program was not yet integrated; in average, 1 intern is integrated into DOTS Network per school year. The attached or integrated health staff into DOTS Network is on average 44 per year, of which 36 belong to the nursing staff. The impact evaluation of DOTS Network, according to those standards recommended by the PNCT and SINAVE (85 %), was achieved in recent years (2008-2011), since the efficacy was 90% and the efficiency was 85 %; it should be noted that the incidence in 2007 was 11.9 and 13 for 2008-2011, the healing rate was low in relation to the target (95%) which was 81% in the presence of interns and without it was 74.1%. DOTS coverage remained below the set limit (90%), obtaining a result up to 85%. Conclusions:The evaluated global impact was achieved according to the set targets in the studied periods; however, the results are not different to those which contemplate the presence of interns between the year where the social service program was not yet included, over the years where the internship program had been applied. It is also important to create solid agreements between human resources training schools and health institutions, in order to continue fight against TB in Mexico, especially in the area of Nursing which develops different roles in the health care and treatment of sick people and their contacts.

Algumas pesquisas realizadas em nível nacional e internacional mostraram que a eficácia e a eficiência da cura da tuberculose foram bem-sucedidas e cumprem os parâmetros descritos pela OMS (85%), enquanto o nível de impacto deve ser superior a 75% , que demonstra a importância de continuar avaliando o cumprimento do TAES e da rede TAES na prevenção e controle da TB, embora seja mais relevante se for avaliado com a presença de estagiários no Serviço Social ou residentes na área da saúde, realizar a avaliação no nível local ou jurisdicional. Objetivo: Avaliar o impacto da Rede TAES de Enfermagem na Prevenção e Controle da Tuberculose nas Jurisdições em Saúde do Distrito Federal, com base na integração do Programa de Serviço Social em Tb da Escola Nacional de Enfermagem e Obstetrícia como Escola Aliada na luta contra esta doença. Material e Métodos: Estudo transversal e retrospectivo, onde o impacto foi avaliado através de casos de tuberculose diagnosticados na estratégia TAES de quatro Jurisdições Sanitárias do Distrito Federal, desde a incorporação do Programa de Serviço Social da Tuberculose da escola aliada a a luta contra esta doença, de 2007 a 2011. A análise estatística foi realizada através de x2 yt de aluno. Resultados: Em relação ao estudo realizado na Rede TAES das quatro Jurisdições Sanitárias do Distrito Federal (JSDF), que teve a integração do Programa de Serviço Social (PSS) da Escola Aliada no combate à TB "Escola Nacional de Enfermagem e Obstetrícia ", foi de 2008 e foi tomada como ponto de referência em 2007, onde o programa ainda não estava integrado; Em média, uma rede interna TAES 1 é integrada anualmente para cada ano escolar. O pessoal de saúde que está vinculado ou integrado à Rede TAES é em média de 44 por ano, dos quais 36 pertencem à equipe de Enfermagem. A avaliação do impacto da rede TAES, de acordo com os padrões recomendados pelo PNCT e SINAVE (85%), foi realizada nos últimos anos (2008 - 2011), uma vez que a efetividade foi de 90% e a eficiência foi 85%; Cabe ressaltar que a incidência foi de 11,9 a 13 de acordo com 2007 e 2008-2011, respectivamente, a taxa de cura foi de 81% com a presença de estagiários e sem 74,1%, na cobertura do TAES foi obtido um resultado Até 85%. Conclusão: O impacto avaliado foi baixo em relação às metas estabelecidas. No entanto, os resultados diferem da presença de estagiários entre o ano em que o programa de serviço social ainda não estava integrado aos anos em que estavam presentes. É importante fazer acordos entre escolas de formação de recursos humanos e instituições de saúde para continuar no combate à TB no México, especialmente na área de Enfermagem, uma vez que é quem desenvolve diferentes papéis no cuidado e cuidado de pessoas doentes e seus familiares. contatos

Opiniao das maes sobre a posicao do bebe dormir apos campanha nacional: estudo de base populacional no extremo sul do Brasil / The opinion of mothers regarding babies' sleeping position after a national campaign: a population-based study in the far south of Brazil

Avaliou-se o conhecimento materno sobre a posição do bebê dormir após campanha nacional. MÉTODOS: aplicou-se questionário padronizado às mães que tiveram filho em 2010 em Rio Grande, RS. RESULTADOS: dentre as 2395 mães entrevistadas, 20 por cento referiram conforme campanha o decúbito dorsal como a melhor posição para o bebê dormir. Destas, 39 por cento disseram ter obtido este conhecimento junto à campanha nacional. Dentre aquelas que indicaram o decúbito lateral como posição correta, 74 por cento disseram ter aprendido com suas mães. CONCLUSÕES: evidencia-se potencial impacto da campanha nacional e importante influência da avó materna sobre a opinião das mães em colocar o bebê para dormir em decúbito dorsal...

To evaluate the knowledge of mother's regarding the sleeping position of babies after a national campaign. METHODS: a standardized questionnaire was applied to mothers who had had a baby in 2010 in Rio Grande, in the Brazilian State of Rio Grande do Sul. RESULTS: of the 2395 mothers interviewed, 20 per cent agreed with the campaign that the dorsal decubitus position is the best sleeping position for babies. Of these, 39 percent stated that they had obtained this information from the national campaign. Of those who stated that the lateral decubitus position was the correct one, 74 percent said that they had learnt this from their mothers. CONCLUSIONS: the study provides evidence of the potential impact of the national campaign and the important influence of the maternal grandmother on the opinion of mothers regarding placing babies in the dorsal decubitus position when sleeping...

Políticas públicas de lazer e o impacto no desenvolvimento do cidadão / Public policies of leisure and the impact in the development of the citizen

O estudo se baseou na Teoria dos Sistemas Ecológicos (Micro-Meso-Exo-Macrossistema) e discutiu o lazer como direito social ao analisar o impacto das políticas públicas no desenvolvimento do cidadão. Trata-se de um estudo descritivoanalítico com análise de conteúdo das entrevistas semiestruturadas. Amostra (n=42) usuários de atividades de lazer (Micro); (n=6) gerentes da SMEL (Exo). Na entrevista com o Micro se identificaram 202 relatos (F.a), igual a 100% (F.r.), categorizados em elementos impactantes. Concluiu-se que houve impacto dos ambientes ecológicos sobre o Micro, prevalecendo interferências do Macro no Micro e menor interdependência entre os sistemas, embora o Micro tenha recebido interferência de todos os níveis. O Exo é importante nessa teia ao provocar interconexões ambientais que refletem no desenvolvimento do homem, que busca o lazer como direito de preservação da vida e exercício de cidadania.

The study based itself in the Theory of Ecologic Systems (Micro-Meso-Exo-Macrosystem) and has discussed leisure as a social right when analyzing the impact of the public policies in the development of the citizen. A descriptive analytical study on the content of semi-structured interviews. Sample (n=42) users of leisure activities (Micro); (n=6) managers of SMEL (Exo). In the interview with the Micro 202 reports were identified (F.a), equal to 100% (F.r), categorized in impacting elements. It has been concluded that there was impact of the ecological environments on Micro, prevailing interferences of Macro on Micro and minor interdependence among the systems although Micro has suffered interference of all levels. Exo is important in this network when provoking environmental interconnections that reflect on the development of man that searches leisure as a right for the preservation of life and citizenship exercise.

Impacto de estrategias para aumentar el consumo de frutas y verduras en Colombia / Impact of strategies to increase the consumption of fruits and vegetables in Colombia

During the years 2007-2008, a study was carried out in Lebrija (Colombia) to evaluate the impact of two strategies implemented in families with school-age children to increase the consumption of fruits and vegetables at home. Sixteen homes were intervened with the A strategy while twenty-three homes were intervened with a B strategy. Thirty-four homes served like controls. These strategies included, among others, informative shops, preparation of recipes, activities in-group and evaluation of tasks. At the initiation, 3.0 percent of the intervened homes consumed five or more portions increasing to 26.3 percent at the end of the intervention, an increment of8.8 times. In the control group, the consumption of five or more daily portions was of 2.0 percent at the beginning and 0.0 percent at the end. There was no difference between strategy A and B in the increase in consumption (0 percent to 23.5 percent and 4.3 percent to 28.6 percent, respectively. The two evaluated strategies had positive impact, the A on the consumption of fruits and vegetables, the B on the consumption of fruits.

Durante los años 2007-2008 se realizó en Lebrija, Colombia, un estudio para evaluar el impacto de dos estrategias implementadas en familias de niños escolarizados, que tuvieron como objetivo incrementar el consumo de frutas y verduras en el hogar. Dieciséis hogares fueron intervenidos con la estrategia A. Veintitrés hogares fueron intervenidos con la estrategia B. Treinta y cuatro hogares sirvieron como controles. Las estrategias incluyeron entre otros, talleres informativos, preparación de recetas, actividades grupales y evaluación de tareas. En los hogares intervenidos el 3,0 por ciento en la línea de base consumían cinco o más porciones, al finalizar las estrategias aumentaron al 26,3 por ciento, un incremento de 8,8 veces. En el grupo control al inicio este consumo recomendado de cinco o más porciones/día fue de 2,0 por ciento, al final de 0,0 por ciento. El aumento no fue diferencial dada la estrategia de intervención, en la estrategia A paso del 0 por ciento de hogares en la línea de base al 23,5 por ciento, en la B del 4,3 al 28,6 por ciento. Las dos estrategias evaluadas tuvieron impacto positivo, la A sobre el consumo de frutas y verduras, la B sobre el consumo de frutas.

Conceptual model of comprehensive research metrics for improved human health and environment: [review] / Modelo conceitual de indicadores de desempenho abrangentes para a melhoria da saúde humana e do meio ambiente: [revisão]

Performance measurement predominantly consisted of near-term outputs measured through bibliometrics, but the recent focus is on accountability for investment based on long-term outcomes. Our objective is to build a logic model and associated metrics through which to measure the contribution of environmental health research programs to improvements in human health, the environment, and the economy. We developed a logic model that defines the components and linkages between extramural environmental health research grant programs and the outputs and outcomes related to health and social welfare, environmental quality and sustainability, economics, and quality of life, focusing on the environmental health research portfolio of the National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research and Training and delineates pathways for contributions by five types of institutional partners in the research process. The model is being applied to specific NIEHS research applications and the broader research community. We briefly discuss two examples and discuss the strengths and limits of outcome- based evaluation of research programs.

A avaliação de desempenho compreendia predominantemente resultados de curto prazo avaliados através de bibliometria, mas recentemente a ênfase voltou-se à prestação de contas dos investimentos com base em resultados a longo prazo. Nosso objetivo é criar um modelo lógico e métricas associadas através dos quais possamos avaliar a contribuição de programas de pesquisa em saúde ambiental para melhorar a saúde humana, o meio ambiente e a economia. Desenvolvemos um modelo lógico que define os componentes e elos entre os programas de pesquisa em saúde ambiental extramuros subsidiados e os resultados relacionados à saúde e ao bem-estar social, qualidade ambiental e sustentabilidade, economia e qualidade de vida, com ênfase no portfólio de pesquisa em saúde ambiental do National Institute of Environmental Health Sciences (NIEHS), divisão de pesquisa e treinamento extramuros, delineando caminhos para as contribuições de cinco tipos de parceiros institucionais no processo de pesquisa. O modelo está sendo usado em aplicações específicas do NIEHS e na comunidade de pesquisa como um todo. Analisamos brevemente dois exemplos e os pontos fortes e limitações da avaliação baseada em resultados dos programas de pesquisa.

Impacto en la esfera intelectual del egresado de la especialidad de Bioestadística / Impact of the specialty of Biostatistics on the graduate's intellectual sphere

Evaluar el impacto de la especialidad de Bioestadística sobre la esfera intelectual de los egresados. Se realizó un estudio descriptivo y retrospectivo. Se construyó para este fin un modelo de entrevista personal dirigido a los egresados. Se sometió a criterio de expertos para su validación de aspecto y contenido. La información proveniente de variables cuantitativas se resumió mediante el promedio anual por egresado, que se utilizó para realizar una comparación antes, durante o después de la especialidad en el grupo en estudio. Para resumir las variables cualitativas se utilizó el porcentaje. Se encontró que 54 (94,7 por ciento), 49 (86 por ciento), 51 (89,5 por ciento) y 40 (70,2 por ciento) de los egresados opinaron que la especialidad influyó mucho en su nivel científico, en su capacidad para realizar proyectos de investigación, para comunicar los resultados encontrados y para impartir docencia respectivamente, se produjo además un incremento en el promedio anual de proyectos de investigación realizados por egresado (0,08 vs 0,32), de asistencia a eventos científicos (0,90 vs 1,40) y de publicaciones realizadas (0,22 vs 1,03). Cuarenta y tres egresados (76,8 por ciento) habían iniciado o realizado algún tipo de superación profesional después de cursar la especialidad. La especialidad tuvo impacto en la esfera intelectual de los egresados.

To assess the impact of the Biostatistics specialty on the intellectual sphere of the graduates. A descriptive and retrospective study was conducted. To this end, a model of personal interview for graduates was designed. It was submitted to the experts' criteria for its aspect and content validation. The information from quantitative variables was summarized by means of the annual average per graduate that was used to make comparisons before, during or after the specialty in the studied group. Percentage was used to summarize the qualitative variables. It was observed that 54 (94,7 percent), 49 (86 percent), 51 (89,5 percent), and 40 (70,2 percent) of the graduates considered that the specialty influenced very much on their scientific level, on their capacity to carry out research projects, to communicate the results achieved, and to teach, respectively. There was also an increase of the annual average of research projects made by the graduate (0,08 vs 0,32), of the attendance to scientific events (0,90 vs 1,40), and of the papers published (0,22 vs 1,03). Forty three graduates (76,8 percent) had begun or concluded some type of professional training after studying the specialty. The specialty had a impact on the intellectual sphere of the graduates.

Evaluation of Public Health Nutrition Education Program for High School Girls

Impact and process evaluations were performed in order to verify the effectiveness of a public health nutrition program developed for child-bearing aged women in Korea. Participants included 58 high school girls who were divided into two groups. Each group received four 50 - 60 minute nutrition education lectures regarding healthy eating, osteoporosis, constipation and nutrition labeling in every two weeks. Each session took 50 - 60 minutes. Regarding nutrition knowledge, there was a significant increase of degree of perception (p = 0.0004), but no change in degree of accuracy after implementation (p = 0.9522). Nutrition education was also effective in attitude change, showing more participants were ready to change their eating behaviors in terms of meal regularity (p = 0.0455) and less processed food intake (p = 0.0143). After implementing nutrition education, effective behavioral changes were observed in milk consumption (p = 0.0037) and meal regularity (p = 0.0882) as well as daily activity such as stair use (p = 0.0701). However, nutrition education had no effect on body mass index and perceived health status. In process evaluation conducted by a 9 item questionnaire, grand mean score was 4.17 +/- 0.72 out of 5. Proportion of items with scores higher than 4 ranged 68-91%. These results suggest that the nutrition education program used in this study was effective and useful. For a wider use of this program, more research was recommend for a strategy development of program diffuse.

Evaluación del impacto de los artículos publicados en la Revista Cubana de Medicina General Integral en los años 1995, 1998 y 1999

Nuestro país requiere que las investigaciones en salud desempeñen un papel cada vez más importante en el bienestar y el desarrollo integral de nuestra población. Uno de los indicadores que propician un mayor impacto de nuestras investigaciones en los territorios donde estas son realizadas es la concordancia entre el alcance geográfico del estudio por un lado, y el nivel geográfico al cual se justifica el estudio. En definitiva, se trata de que el problema que se investiga sea una prioridad para la comunidad estudiada. En el presente trabajo se hace una revisión de los artículos publicados en la Revista Cubana de Medicina General Integral en los años 1995, 1998 y 1999, donde se determina hasta qué punto esta concordancia se logra. Los resultados demuestran que en la mayoría de los artículos revisados (87 %) esta concordancia no se produce, lo que puede comprometer el impacto práctico de estos trabajos. Se comentan las posibles razones de esta problemática, de donde se pueden identificar acciones que ayuden a resolverla.

Our country requires that health research plays an increasingly important role in the welfare and comprehensive development of our population. One of the indicators that favors a higher impact of our research works on the territories where they are carried out is the agreement between the geographical scope of the study on one hand and the geographical level at which this study is justified. Definitively, it is a question of to do research about a problem that is a real priority for the studied community. The present paper made a review of the articles published in Revista Cubana de Medicina General Integral in the years 1995, 1998 and 1999 and determined to what extent this agreement has been reached. The results showed that the majority of the reviewed articles (87 %) did not reach such an agreement, which may jeopardize the practical impact of these papers. Comments were made on the possible causes of this problem from which actions that might help to solve it can be identified.

Comportamento epidemiológico das meningites na Regional de Saúde de Piracicaba-SP, 1992 a 2001: impacto da introdução da vacina contra o Haemophilus influenzae tipo b (Hib) / Epidemiology of meningitis in Piracicaba region of São Paulo State, Brazil, from 1992 to 2001: the impacts of the introduction of the vaccine against Haemophilus influenzae type b (Hib)

As meningites bacterianas e particularmente aquelas causadas pelo Haemophilus influenzae tipo b constituem um sério problema de Sáude Coletiva em âmbito mundial, no Brasil e na Regional de Piracicaba locus do presente estudo, que teve como objetivos identificar o comportamento das meningites nessa regional entre 1992 a 2001; identificar o impacto da introdução da vacina contra o Hib (a partir do 2º semestre de 1999); além de identificar algumas características pessoais, sociais e relativas ao processo saúde-doença, das crianças acometidas pela doença. Foram sitematizadas as fichas de notificação compulsória e realizadas entrevistas como os responsáveis pelas crianças acometidas por meningite por Hib, de 1999 a 2001. Os resultados obtidos apontam a ocorrência de aproximadamente 300 casos/ano de meningite, sendo que as bacterianas representam 30% dos casos. As causadas pelo Hib apresentam as maiores incidências entre os menores de 1 ano e a letalidade da doença variou de 12 a 41%. A cobertura vacinal foi superior a 95%. Em 1998, foram notificados 17 casos de meningite por Hib (Coeficiente de Incidência-CI-12,5/100 mil menores de 5 anos) e, no ano 2001, registrou-se 4 casos (CI: 3,9 casos/100 mil menores de 5 anos), com redução de aproximadamente, 73%. As 20 entrevistas realizadas (80% das famílias com crianças acometidas pela doença entre 1999 a 2001), mostram que nenhum caso foi registrado em crianças que receberam 3 doses da vacina. Alguns potenciais indicadores de vulnerabilidade para a doença foram investigados e, em 75% das crianças, pelo menos 3 estiveram presentes, como pouca idade, presença de menores de 7 anos na residência e freqüência à escolas/creche. Os dados obtidos permitem subsidiar intervenções para monitorar a enfermidade na Regional de Piracicaba e indicam a necessidade de estudos com séries históricas extensas dado que a implantação da vacina é recente.

Bacterial meningitis is a serious health problem around the world and this situation is particularly inportant due the meningitis by Haemophilus influenzae b (Hib). The objectives of this study were to investigate the epidemiology of meningitis in the District of Health of Piracicaba, SP, Brazil, from 1992 to 2001; to evaluate the epidemiological impact of the introduction of the vaccine in the young population and to reveal some characteristics of the children who caught the disease by Hib in the locality. So, compulsory notification data were used to constitute a file. Besides, interviews with the parents of the children who presented meningitis by Hib from 1999 till 2001 were made. The results revealed the occurrence of around 300 cases/years of meningitis, being the bacterial types 30% of them. In that last group of meningitis, those due Hib represented its greatest rates of incidence in infants less than one year old. The disease lethality varied from 12 to 41% in the period. The vaccine coverage was above 95% of the young population in the 2 years that followed the beginning of the immunization programme. In 1998, the last year before the start of vaccination, 17 cases of Hib meningitis (Incidence Rate-IR-12,5/100.000 among children younger than 5 years) were recorded, while in 2001, only 4 cases occurred (IR: 3,88 cases/100.000), which shows that the reduction observed in that period was around 73%. In interviews done with 80% of the families with children affected by meningitis by Hib after 1999, it was verified that 50% of the cases had occurred before the beginning of the vaccination and also that there were no cases in children who receive 3 doses of the vaccine. Some potencial indicators of vulnerability for the development of the disease were investigated. At last 3 of the several indicators were always presents in the interviewed families, among them were the young age, the presence of children younger than 7 years old in the household, their environment in schools or day care centres. Another investigations must be developed, specially amplifying the series of cases. The data collected can support health interventions in order to monitor the disease in this region.