Aspectos que influenciam a contagem bacteriana total e a contagem de células somáticas do leite de propriedades rurais do interior do estado de São Paulo, Brasil / Aspects that influence milk total bacterial count and somatic cell count from farms in interior of São Paulo State, Brazil / Aspectos que influyen el contaje bacteriano total y el contaje de células somáticas de la leche de propiedades rurales del interior del estado de São Paulo, Brasil

Este estudo objetivou avaliar aspectos que exercem influência sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS) do leite e avaliar a adequação das amostras do produto à Instrução Normativa nº 76, de 26 de novembro de 2018, do Ministério da Agricultura e Pecuária do Brasil (IN 76). A pesquisa foi realizada em propriedades rurais da microrregião de Birigui, São Paulo, Brasil, e se baseou em coleta de dados, por entrevista estruturada, e coletas de leite nas propriedades. Foi realizada amostragem por conveniência, sendo escolhidos 15 produtores de cada estrato (de acordo com a produção diária de leite: pequeno - até 100 L; médio - 101 a 300 L; grande - mais de 300 L), totalizando 45 produtores de leite. Participaram da pesquisa somente propriedades com base da alimentação volumosa em sistema de pastejo ou em semiconfinamento. Para avaliar a influência de diferentes fatores sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS), separadamente, realizou-se regressão multivariada. Ainda, foi determinado o coeficiente de correlação entre variáveis desta pesquisa. As variáveis resposta foram transformadas em logaritmo para normalização dos dados. Foi feita comparação entre os resultados da pesquisa e os parâmetros da IN 76 para verificar o cumprimento das normas pelos produtores. Foram encontrados valores médios de 6.986.977,818.961.790,7 UFC/mL para CBT e de 608.911,1 ± 414.802,9 CS/mL para CCS. A utilização de tanque de resfriamento individual mostrou-se favorável à baixa CBT, em comparação com não uso de tanque ou uso de tanque comunitário, conforme o esperado, pois quanto mais tempo leva para resfriar o leite, maior é a proliferação de bactérias no produto. Foi verificado que o leite de produtores que realizam o California Mastitis Test (CMT) com maior frequência apresentou CCS mais elevada, o que não era esperado. As análises físico-químicas médias foram densidade 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, teor de proteína 3,58%, teor de gordura 4,06%, extrato seco total 12,75%, extrato seco desengordurado 8,69%, acidez titulável 16,2 °D e estabilidade ao álcool (Alizarol 72%) 100%. Em 13,3% (6/45) das amostras foi detectada presença de antibióticos. Considerando a IN 76, o leite de somente 8,9% (4/45) dos produtores apresentou-se adequado simultaneamente para todos os parâmetros analisados (CBT, CCS, densidade, índice crioscópico, proteína, gordura, extrato seco total, extrato seco desengordurado, acidez titulável, estabilidade ao alizarol e pesquisa de antibióticos). A utilização de tanque de resfriamento individual e a realização de CMT favoreceram menor CBT e maior CCS, respectivamente.

This study aimed to evaluate aspects that exerts influence on the total bacterial count (TBC) and somatic cell count (SCC) of milk and evaluate the conformity of the samples to the Normative Instruction no. 76, from November 26, 2018, of the Brazilian Agriculture and Livestock Ministry (NI 76). The research was done in farms around Birigui micro-region, São Paulo State, Brazil, and was based on data collection obtained by structured interviews and milk collection in the farms. Convenience sampling was carried out from 15 producers of each stratum (according to daily milk production: small - up to 100 L; medium - 101 to 300 L; large - more than 300 L), totalizing 45 milk producers. Only farms with grazing or semi-feedlot system for roughage feeding base were included. To evaluate the influence of different factors on Total Bacterial Count (TBC) and Somatic Cell Count (SCC), separately, a multivariate regression was done. Moreover, the correlation coefficient among variables was determined. The response variables were transformed into logarithms for the normalization of the data. A comparison between results and NI 76 parameters was done to verify the standard compliance by producers. Mean TBC was 6.986.977,8 ± 18.961.790,7 CFU/mL and mean SCC was 608.911,1414.802,9 cells/mL. The use of individual cooler tank was favorable to lower TBC, compared with the non-use of the tank or with the use of the communitarian tank, as expected, since the longer it takes to cool the milk, the higher the proliferation of bacteria in the product. It was verified that milk from farmers that more frequently perform California Mastitis Test (CMT) showed higher SCC, which was not expected. The average physicochemical analyzes were density 1.031 g/mL at 15°C, cryoscopic index -0.538 °H, protein content 3.58%, fat content 4.06%, total dry extract 12.75%, dry extract defatted 8.69%, titratable acidity 16.2 °D and alcohol stability (Alizarol 72%) 100%. The presence of antibiotics was detected in 13.3% (6/45) of the samples. Considering NI 76, milk from only 8.9% (4/45) farmers were proper simultaneously for all the parameters analyzed (TBC, SCC, density, cryoscopic index, protein, fat, total dry extract, defatted dry extract, titratable acidity, alizarol stability and antibiotics). The use of individual cooling tank and the CMT performance support lower TBC and higher SCC respectively.

Este estudio tuvo como objetivo evaluar los aspectos que influyen en el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS) de la leche y evaluar la adecuación de las muestras del producto a la Instrucción Normativa nº 76, de 26 de noviembre de 2018, del Ministerio de Agricultura y Ganadería en Brasil (IN 76). La investigación se llevó a cabo en propiedades rurales en la microrregión de Birigui, São Paulo, Brasil, y se basó en la recolección de datos, a través de entrevistas estructuradas, y colectas de leche en las propiedades. Se realizó un muestreo por conveniencia, escogiendo 15 productores de cada estrato (de acuerdo con la producción diaria de leche: pequeño - hasta 100 L; medio - 101 hasta 300 L; grande ­ más de 300 L), totalizando 45 productores de leche. Participaron de la investigación únicamente propiedades basadas en alimentación voluminosa en sistema de pastoreo o, a lo sumo, en semiconfinamiento. Para evaluar la influencia de diferentes factores sobre el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS), por separado, se realizó una regresión multivariada. Asimismo, se determinó el coeficiente de correlación entre las variables de esta investigación. Las variables de respuesta se transformaron en logaritmos para la normalización de datos. Se realizó una comparación entre los resultados de la investigación y los parámetros de la IN 76 para verificar el cumplimiento de las normas por parte de los productores. Se encontraron valores medios de 6.986.977,818.961.790,7 UFC/mL para CBT y de 608.911,1 +414.802,9 CS/mL para CCS. El uso de un tanque de enfriamiento individual se ha mostrado favorable a la baja CBT, en comparación con no usar un tanque o usar un tanque comunitario, conforme lo esperado, ya que cuanto más se tarda en enfriar la leche, mayor es la proliferación de bacterias en el producto. Se verificó que la leche de los productores que realizan el California Mastitis Test (CMT) con mayor frecuencia presentó CCS más alto, lo cual no se esperaba. Los análisis fisicoquímicos promedio fueron densidad 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, contenido de proteína 3,58%, contenido de grasa 4,06%, extracto seco total 12,75%, extracto seco desgrasado 8,69%, acidez titulable 16,2°D y estabilidad del alcohol (Alizarol 72%) 100%. En el 13,3% (6/45) de las muestras se detectó la presencia de antibióticos. Considerando la IN 76, la leche de solo el 8,9% (4/45) de los productores se presentó adecuado simultáneamente para todos los parámetros analizados (CBT, CCS, densidad, índice crioscópico, proteína, grasa, extracto seco total, extracto seco desgrasado, acidez titulable, estabilidad al alizarol e investigación de antibióticos). El uso de un tanque de enfriamiento individual y la realización de CMT favorecieron un CBT más bajo y un CCS más alto respectivamente.

Saberes en juego en una práctica extensionista. Construcciones comunes entre una cooperativa integrada por personas privadas de libertad y acompañantes universitarixs

Tomando como insumo la etnografía realizada con objeto de la escritura de la tesis, pero realizando el recorte que demanda un artículo, me centraré en reconstruir tres puntos que dan cuenta de aspectos vinculados a la dimensión comunicativa, y que resultan ejemplos paradigmáticos de dimensiones constitutivas del vínculo entre cooperativistas y acompañantes, los cuales nos permiten advertir las huellas institucionales de la cárcel y la universidad en el modo de trabajo conjunto con la intención de advertir cómo se articulan, potencian o complejizan la relación en el marco de la experiencia extensionista. Asimismo, en las reuniones de producción los saberes jerarquizados se invertían en relación a los días de reunión general, y también el rol de lxs sujetxs. Lxs cooperativistas detentaban cierta autoridad en estos días, marcándose una asimetría en torno al saber que se construía de modo situacional y contextual - los días de producción primaban los saberes en torno a la tela, a diferencia de los días de reunión general, en los que primaba la palabra-, lo cual nos permite entender que los conocimientos que se ponen a dialogar deben ser comprendidos en vínculo con sus condiciones de enunciación y según el contexto. Son las diferencias las que se constituyen en punto de contacto y que deben hacerse inteligibles para el diálogo y trabajo con otrxs, las cuales pueden ser entendidas como saberes prácticos que se entrelazan con otros saberes en la experiencia, o en el "mientras tanto" se buscan otros diálogos de saberes conceptuales.

Tomando como aporte a etnografia realizada para a redação da tese, mas fazendo o recorte que um artigo exige, vou me concentrar em reconstruir três pontos que dão conta de aspectos relacionados à dimensão comunicativa, e que são exemplos paradigmáticos de dimensões constitutivas do vínculo entre cooperados e acompanhantes, que permitem perceber os traços institucionais da prisão e da universidade no modo de trabalho conjunto com a intenção de perceber como a relação se articula, se fortalece ou se complexifica no âmbito da experiência de extensão. Da mesma forma, nas reuniões de produção, os saberes hierarquizados se inverteram em relação aos dias da assembléia geral, e também o papel dos sujeitos. Os cooperados detinham certa autoridade nesses dias, marcando uma assimetria em torno do conhecimento que se construía de forma situacional e contextual - os dias de produção eram dominados pelo conhecimento sobre o tecido, ao contrário dos dias da reunião geral, quando a palavra prevalecia -, o que nos permite compreender que os saberes que se colocam em diálogo devem ser entendidos em conexão com suas condições de enunciação e de acordo com o contexto. São as diferenças que constituem o ponto de contato e que devem ser tornadas inteligíveis para o diálogo e o trabalho com os outros, que podem ser entendidas como saberes práticos que se entrelaçam com outros saberes na experiência, ou no "enquanto" buscam outros diálogos de conhecimento conceitual.

Taking as input the ethnography carried out for the purpose of writing the thesis, but making the cut that an article demands, I will focus on reconstructing three points that account for aspects related to the communicative dimension, and that are paradigmatic examples of dimensions constitutive of the link between cooperative members and companions, which allow us to notice the institutional traces of the prison and the university in the way of joint work with the intention of noticing how the relationship is articulated, strengthened or made more complex within the framework of the extension experience. Likewise, in the production meetings, the hierarchical knowledge was inverted in relation to the days of the general meeting, and also the role of the subjects. The cooperative members held a certain authority in these days, marking an asymmetry around the knowledge that was built in a situational and contextual way - the days of production prevailed the knowledge around the fabric, unlike the days of general meeting, in which the word prevailed-, which allows us to understand that the knowledge that is put into dialogue must be understood in connection with its conditions of enunciation and according to the context. It is the differences that constitute the point of contact and that must be made intelligible for dialogue and work with others, which can be understood as practical knowledge that is intertwined with other knowledge in experience, or in the "meanwhile" They look for other dialogues of conceptual knowledge.

Trabalho remoto e uso de redes sociais como instrumentos de extensão e aprendizagem durante a pandemia de COVID-19 / Remote work and the use of social networks as extension and learning tools during the COVID-19 pandemic

Objetivo: Descrever a experiência do uso de redes sociais como instrumentos em ações de educação em saúde, promoção e prevenção durante a pandemia de COVID-19. Metodologia: Trata-se de um estudo descritivo realizado no projeto de extensão "Sustentabilidade do PET-SAÚDE Interprofissionalidade" dando continuidade às ações interventivas do curso de Odontologia da Universidade Federal de Juiz de Fora, campus Governador Valadares-MG, que realizou ações de promoção de saúde em atenção primária entre abril de 2020 e junho de 2021. O projeto teve a participação de 4 discentes e 2 docentes do curso de Odontologia da UFJF/GV com parceria da Secretaria Municipal de Saúde de Governador Valadares-MG. As ações foram desenvolvidas pelos discentes, os quais dividiram o processo em nove etapas. As atividades foram veiculadas pelas redes sociais sob o título "Vida Saudável e Autocuidado: PET-Saúde Interprofissionalidade UFJF/GV". Resultados: Foram realizadas 37 postagens com abordagem de 33 assuntos, alguns temas foram divididos entre partes 1 e 2, para melhor enfoque das comunicações. Obtivemos na rede social Instagram um total de 175 seguidores que acompanhavam as publicações feitas semanalmente. Os materiais produzidos também foram postados em formato de vídeo no Youtube e compartilhados no Facebook, visando aumentar a interação com os seguidores, somando 642 visualizações. As postagens atingiram o total de 1510 curtidas nas páginas do projeto. Conclusão: As redes sociais demostraram ser inovadoras na disseminação de informação para a população, alcançando a troca de saberes, no processo ensino-aprendizagem em tempos de pandemia, possibilitando o desenvolvimento de competências necessárias para a formação profissional.(AU)

Objective: To describe the experience of using social networks as instruments in health education, promotion and prevention actions during the COVID-19 pandemic. Methodology: This is a descriptive study carried out in the extension project "Sustainability of PET-SAÚDE Interprofissionalidade", continuing the interventional actions of the Dentistry course at the Federal University of Juiz de Fora, Governador Valadares-MG campus, which carried out actions to promote health in primary care between April 2020 and June 2021. The project had the participation of 4 students and 2 professors from the UFJF/GV Dentistry course in partnership with the Municipal Health Department of Governador Valadares-MG. The actions were developed by the students, who divided the process into nine stages. The activities were broadcast on social networks under the title "Healthy Life and Self-Care: PET-Saúde Interprofissionalidade UFJF/GV". Results: 37 posts were made covering 33 subjects, some themes were divided into parts 1 and 2, for a better focus on communications. We obtained a total of 175 followers on the Instagram social network that followed the publications made weekly. The materials produced were also posted in video format on Youtube and shared on Facebook, aiming to increase interaction with followers, totaling 642 views. Posts reached a total of 1510 likes on the project pages. Conclusion: Social networks proved to be innovative in disseminating information to the population, achieving the exchange of knowledge in the teaching-learning process in times of pandemic, enabling the development of skills necessary for professional training. (AU)

Tendencia del programa de intervención en DemoMinga, como estrategia para mejorar las dislipidemias y glucemia en la población Norma Luisa, Minga Guazú

Antecedentes: Las enfermedades no transmisibles siguen siendo un problema creciente en el mundo, sobre todo en los países de mediano y bajo ingresos. Los programas de intervención comunitaria se enfocan en su disminución mediante cambios en estilos de vida más saludables. Objetivos: Analizar la tendencia del programa de intervención en actividad física y nutrición, como estrategia para mejorar las dislipidemias y glucemia en los participantes del proyecto DemoMinga. Materiales y métodos: Estudio con enfoque cuantitativo. Diseño de investigación acción participativa, de carácter longitudinal, prospectivo. La población estuvo constituida por los participantes del Proyecto DemoMinga. Se determinó en cada participante: colesterol total, triglicéridos y glucemia en ayunas. Las muestras fueron procesadas en el Centro de Investigaciones Médicas de la FACISA-UNE. Se determinaron indicadores de tendencia central (mediana) de cada una de las variables. Resultados: Hubo mayor participación del sexo femenino, con predominio de personas con menos de 45 años. Las mediciones químicas arrojaron una tendencia de disminución a partir del quinto año de intervención, con talleres de cocina saludable incluyendo uso de aceite alto oleico, y actividad física. Sin embargo, la prueba no arrojó diferencias significativas de las mediciones entre la línea de base y el corte a los 6 años. Conclusión: El estudio resalta la importancia de los programas de intervención mediante terapias integrales para la promoción y prevención de las enfermedades cardiometabólicas a largo plazo.

Background: Non-communicable diseases remain a growing problem worldwide, especially in middle and low-income countries. Community intervention programs are focused on reducing their prevalence through promoting healthier lifestyle changes. Objectives: To analyze the trend of the physical activity and nutrition intervention program as a strategy to improve dyslipidemia and glycemia among participants of the DemoMinga project. Materials and methods: This study employed a quantitative approach with a participatory action research design, characterized as longitudinal and prospective. The population consisted of participants from the DemoMinga Project. For each participant, total cholesterol, triglycerides, and fasting glycemia were measured. Samples were processed at the Medical Research Center of FACISA-UNE. Indicators of central tendency (median) were determined for each of the variables. Results: There was a higher participation of females, with a predominance of individuals under the age of 45. Chemical measurements showed a decreasing trend starting from the fifth year of intervention, involving healthy cooking workshops that included the use of high oleic oil and physical activity. However, the test did not yield significant differences in measurements between the baseline and the 6-year cutoff. Conclusion: The study highlights the significance of intervention programs using comprehensive therapies for the long-term promotion and prevention of cardiometabolic diseases.

La superación de los profesionales de la Cultura Física, desde la extensión universitaria

El perfeccionamiento de los tres procesos sustantivos de la universidad, la docencia, la investigación y la extensión universitaria ha sido una prioridad para la educación superior cubana que ha desarrollado una serie de cambios y transformaciones en aras de garantizar una excelente formación de los profesionales que egresan de ella. En este sentido, la investigación abordó el tema de la extensión universitaria en la superación profesional y tuvo como objetivo favorecer la superación de los docentes universitarios y su vinculación con los avances científicos en un curso de posgrado para la Licenciatura en Cultura Física y Deportes, desde la extensión universitaria. El proceso investigativo se rigió por el método dialectico-materialista y se emplearon métodos del nivel teórico como el histórico-lógico y el análisis-síntesis y del nivel empírico el análisis documental, la entrevista en profundidad y la encuesta, para interpretar los resultados obtenidos en cada etapa de la investigación. Los resultados mostraron como principales debilidades el insuficiente reconocimiento de la importancia de la extensión universitaria en el contexto docente, así como la poca producción científica relacionada con la temática. Del estudio realizado se concluye que la extensión universitaria en la superación de este profesional constituye una vía expedita para un mejor conocimiento, gestión, preservación y difusión de actividades intra- y extracurriculares y en la mejora de la calidad de vida, con el fin de contribuir a formar ciudadanos capaces de ser, conocer, hacer y convivir juntos.

A melhoria dos três processos substantivos da universidade, o ensino, a pesquisa e a extensão universitária, tem sido uma prioridade para o ensino superior cubano, que tem desenvolvido uma série de mudanças e transformações a fim de garantir uma excelente formação dos profissionais que nela se graduam. Nesse sentido, a pesquisa abordou a questão da extensão universitária no desenvolvimento profissional e seu objetivo foi promover o desenvolvimento dos professores universitários e sua vinculação com os avanços científicos em um curso de pós-graduação para o Bacharelado em Cultura Física e Esportes, a partir da perspectiva da extensão universitária. O processo de pesquisa foi regido pelo método dialético-materialista, utilizando métodos teóricos como o histórico-lógico e a análise-síntese e métodos empíricos como a análise documental, a entrevista em profundidade e o survey, para interpretar os resultados obtidos em cada etapa da pesquisa. Os resultados apontaram como principais fragilidades o insuficiente reconhecimento da importância da extensão universitária no contexto do ensino, bem como a pouca produção científica relacionada ao tema. A partir do estudo realizado, conclui-se que a extensão universitária no aprimoramento desse profissional constitui um caminho expedito para um melhor conhecimento, gerenciamento, preservação e divulgação das atividades intra e extracurriculares e na melhoria da qualidade de vida, com o objetivo de contribuir para formar cidadãos capazes de ser, saber, fazer e conviver.

The improvement of the three substantive processes of the university, teaching, research and university extension has been a priority for Cuban higher education that has developed a series of changes and transformations in order to guarantee an excellent training of the professionals who graduate from it. In this sense, the research addressed the issue of university extension in professional upgrading and had the objective of promoting the improvement of university teachers and their link with scientific advances in a postgraduate course for the Degree in Physical Culture and Sports, from the university extension. The research process was governed by the dialectical-materialist method; theoretical level methods such as historical-logical and analysis-synthesis and empirical level ones as documentary analysis, in-depth interview and survey were used to interpret the results obtained in each stage of the research. The results showed as main weaknesses the insufficient recognition of the importance of university extension in the teaching context, as well as the little scientific production related to the subject. From the study carried out, it is concluded that the university extension in the improvement of this professional constitutes an expeditious way for a better knowledge, management, preservation and dissemination of intra- and extracurricular activities and in the improvement of the quality of life, in order to contribute to form citizens capable of being, knowing, doing and living together.

Tendencia del programa de intervención en DemoMinga, como estrategia para mejorar las dislipidemias y glucemia en la población Norma Luisa, Minga Guazú / Trend of the DemoMinga intervention program as a strategy to improve dyslipidemia and glycemia in the Norma Luisa population, Minga Guazú

Antecedentes: Las enfermedades no transmisibles siguen siendo un problema creciente en el mundo, sobre todo en los países de mediano y bajo ingresos. Los programas de intervención comunitaria se enfocan en su disminución mediante cambios en estilos de vida más saludables. Objetivos: Analizar la tendencia del programa de intervención en actividad física y nutrición, como estrategia para mejorar las dislipidemias y glucemia en los participantes del proyecto DemoMinga. Materiales y métodos: Estudio con enfoque cuantitativo. Diseño de investigación acción participativa, de carácter longitudinal, prospectivo. La población estuvo constituida por los participantes del Proyecto DemoMinga. Se determinó en cada participante: colesterol total, triglicéridos y glucemia en ayunas. Las muestras fueron procesadas en el Centro de Investigaciones Médicas de la FACISA-UNE. Se determinaron indicadores de tendencia central (mediana) de cada una de las variables. Resultados: Hubo mayor participación del sexo femenino, con predominio de personas con menos de 45 años. Las mediciones químicas arrojaron una tendencia de disminución a partir del quinto año de intervención, con talleres de cocina saludable incluyendo uso de aceite alto oleico, y actividad física. Sin embargo, la prueba no arrojó diferencias significativas de las mediciones entre la línea de base y el corte a los 6 años. Conclusión: El estudio resalta la importancia de los programas de intervención mediante terapias integrales para la promoción y prevención de las enfermedades cardiometabólicas a largo plazo.

Background: Non-communicable diseases remain a growing problem worldwide, especially in middle and low-income countries. Community intervention programs are focused on reducing their prevalence through promoting healthier lifestyle changes. Objectives: To analyze the trend of the physical activity and nutrition intervention program as a strategy to improve dyslipidemia and glycemia among participants of the DemoMinga project. Materials and methods: This study employed a quantitative approach with a participatory action research design, characterized as longitudinal and prospective. The population consisted of participants from the DemoMinga Project. For each participant, total cholesterol, triglycerides, and fasting glycemia were measured. Samples were processed at the Medical Research Center of FACISA-UNE. Indicators of central tendency (median) were determined for each of the variables. Results: There was a higher participation of females, with a predominance of individuals under the age of 45. Chemical measurements showed a decreasing trend starting from the fifth year of intervention, involving healthy cooking workshops that included the use of high oleic oil and physical activity. However, the test did not yield significant differences in measurements between the baseline and the 6-year cutoff. Conclusion: The study highlights the significance of intervention programs using comprehensive therapies for the long-term promotion and prevention of cardiometabolic diseases.

Repercusión de la COVID-19 sobre los procesos sustantivos de la Universidad Municipal / Impact of COVID-19 on the Substantive Processes of the Municipal University

Introducción: Las funciones sustantivas universitarias constituyen claves en el análisis de los procesos de calidad de la universidad. Objetivo: Caracterizar la repercusión de la presencia de la COVID-19 en los procesos sustantivos desarrollados en el Departamento Docente de la Universidad de Ciencias Médicas del municipio Los Palacios durante el curso 2020-2021. Métodos: Investigación aplicada, que tuvo una fase descriptiva-evaluativa y una de evaluación de resultados. Se estudiaron los procesos sustantivos de la universidad (docente, investigativo y extensión); además, participaron 86 estudiantes de Medicina y 42 profesores aportando información. Se realizó revisión documental, entrevistas abiertas e intercambios virtuales y semipresenciales, se utilizó matriz DAFO estableciéndose prioridades por método de ranqueo. Resultados: Se identificaron dos prioridades por el área de docencia e investigación y una prioridad por el área de extensión, se acometieron acciones; entre los resultados positivos se destacaron: la culminación de estudios del 100 por ciento de los estudiantes previstos, uso intensivo de los recursos tecnológicos y de la educación a distancia, mayor adquisición de habilidades investigativas y fortalecimiento del proceso de extensión universitaria. Se identifica la necesidad de fortalecer la infraestructura tecnológica. Conclusiones: La repercusión de la COVID-19 sobre los procesos sustantivos se ha caracterizado por los cambios de la enseñanza presencial a la virtual, un uso intensivo de los recursos tecnológicos y una consolidación del proceso de extensión universitaria que ha fortalecido las relaciones universidad-sociedad(AU)

Introduction: University fundamental functions constitute keys in the analysis of university quality processes. Objective: To characterize the impact of the presence of COVID-19 on the substantive processes developed in the Teaching Department of the University of Medical Sciences of Los Palacios municipality during the academic year 2020-2021. Methods: Applied research, which had a descriptive-evaluative phase and a results evaluation phase. The substantive processes of the university (teaching, research and extension) were studied; in addition, 86 medical students and 42 professors participated and provided information. A documentary review, open interviews and virtual and semi-presential exchanges were carried out. In addition, the SWOT matrix was used to establish priorities by ranking method. Results: Two priorities were identified for the teaching and research area and one priority for the extension area and actions were undertaken. Among the positive results, the following stand out: completion of studies by 100percent of the expected students, intensive use of technological resources and distance education, greater acquisition of research skills and strengthening of the university extension process. The need to strengthen the technological infrastructure was identified. Conclusions: The impact of COVID-19 on substantive processes has been characterized by changes from face-to-face to virtual teaching, an intensive use of technological resources, and a consolidation of the university extension process that has strengthened university-society relations(AU)

Educação alimentar e nutricional em casa: a experiência do ensino remoto na escola pública em município paraibano / Food and nutrition education at home: the experience of carrying out activities in the remote teaching in public school in paraiban municipality / Educación alimentaria y nutricional en casa: la experiencia de realizar actividades en el modelo a distancia en la escuela pública del municipio paraibán

Introdução:Às medidas de segurança da COVID-19 direcionaram a adoção do modelo remoto de ensino, inclusive para ações de extensão universitária realizadas no ambiente escolar. A extensão contribui para a promoção da saúde ao abordar temas como a Educação Alimentar eNutricional. Objetivo:O objetivo deste trabalho é relatar a experiência da extensão universitária e a adaptação de ações de Educação Alimentar e Nutricional ao modelo remoto, com escolares de ensino fundamental do interior da Paraíba em 2020. Metodologia:O projeto "#Tecnologias da Informação e da Comunicação: Educação Alimentar e Nutricional em Casa" foi realizado com escolares do ensino infantil ao 5º ano de uma escola pública de Cuité, Paraíba. Utilizou-se o whatsapp como ferramenta para as atividadesbaseadas no incentivo a brincadeiras com movimentação física, o desenvolvimento cognitivo, os vínculos intergeracionais e a alimentação de baixo custo. Foram desenvolvidas 12 ações, adaptadas à idade escolar e de fácil execução no domicílio, através de vídeos explicativos, plataforma de jogos e atividades impressas. Resultados:Observou-se os desafios: desigualdade no acesso à internet, fragilidade na manutenção do vínculo entre a equipe universitária com a comunidade escolar, sobrecarga dos professores e diversos contextos no ambiente familiar como, por exemplo, a vulnerabilidade social e violência doméstica. Conclusão:Contudo, é possível a realização da extensão universitária no modelo remoto a partir da diversificação de estratégias e ferramentas digitais, apesar dos desafios enfrentados para manter o vínculo entre equipe universitária-comunidade escolar (AU).

Introduction:Security measures against COVID-19 led to the adoption of a remote teaching model, including university extension actions carried out in the school environment. The extension contributes to health promotion by addressing topics such as Food and Nutrition Education. Objective:This study aims to report the experience of a university extension and the adaptation of Food and Nutrition Education actions to the remote model applied to elementary school students from the interior of Paraíba in 2020. Methodology:The "#Information and Communication Technologies: Food and Nutrition Education at Home" project was carried out among elementary school students in the fifth grade of a public school in Cuité, Paraíba. Whatsapp was used as a tool for activities that involved encouraging play with physical movement, cognitive development, intergenerational bonds, and low-cost food. Twelve actions were developed and were adapted for school-age students. They were made easy to perform at home through explanatory videos, game platforms, and printed activities.Results:Challenges were observed in terms of unequal internet access, weakness in maintaining the connection betweenthe university team and the school community, overload of teachers, and different contexts in the family environment such as social vulnerability and domestic violence. Conclusions:Despite the challenges faced in maintaining the connection in the university­school community team, it is possible to carry out university extensions in the remote model based on the diversification of digital strategies and tools (AU).

ntroducción:Las medidas de seguridad del COVID-19 orientaron la adopción del modelo de enseñanza a distancia, incluso para acciones de extensión universitaria realizadas en el ámbito escolar. La extensión contribuye a la promoción de la salud al abordar temas como laEducación Alimentaria y Nutricional. Objetivo:El objetivo de este trabajo es relatar la experiencia de extensión universitaria y la adaptación de las acciones de la Educación Alimentaria y Nutricional al modelo a distancia, con estudiantes de enseñanza básica del interior de Paraíba en 2020.Metodología:El proyecto "#Tecnologías de la Información y la Comunicación: Educación Alimentaria y Nutricional en Casa" fue realizado con alumnos de jardín de infantes a 5o grado de una escuela pública de Cuité, Paraíba. Se utilizó WhatsApp como herramienta para realizar actividades basadas en fomentar el juego con el movimiento físico, el desarrollo cognitivo, los vínculos intergeneracionales y la comida a bajo costo. Se desarrollaron 12 acciones, adaptadas a la edadescolar y fáciles de realizar en casa, através de videos explicativos, una plataforma de juegos y actividades impresas. Resultados:Se observaron desafíos: desigualdad en el acceso a internet, fragilidad en el mantenimiento del vínculo entre el equipo universitario y la comunidad escolar, sobrecarga de docentes y diversos contextos en el entorno familiar, como vulnerabilidad social y violencia intrafamiliar. Conclusiones:Sin embargo, es posible realizar la extensión universitaria en el modelo a distancia a partir de la diversificación de estrategias y herramientas digitales, a pesar de los desafíos que se enfrentan para mantener el vínculo entre el equipo universitario y la comunidad escolar (AU).

A decade of Zoology Summer Course: impressions and impacts of the first university extension course on Zoology in Brazil / Uma década de Curso de Verão em Zoologia: impressões e impactos do primeiro curso de extensão universitária sobre Zoologia no Brasil

Although the diversity of animal groups distributed in Brazil provides countless research opportunities, the current scenario does not follow this demand. The reasons for the disconnections range from inequality in the availability of resources for teaching and research to the focus of researchers on specific groups of animals, while others remain neglected. Training new potential Brazilian researchers interested in Zoology is essential for a greater understanding of this diversity, as well as exposing those potential new researchers to new groups and different work possibilities. Thus, the Summer Course in Zoology (in Portuguese, CVZoo) promoted by the Graduate Program in Zoology at the University of São Paulo, over the last ten years, has been seeking to contribute to this training of new researchers in the field of Zoology, as well as in updating teachers through university extension activities. In order to assess the impacts caused by CVZoo on the academic and professional training of the participants, Google forms were sent to participants in the ten editions of the course, as well as compiled information available on the Lattes Platform. Qualitative and quantitative analyses showed the profile of graduates, their expectations, and perceptions about the course. Based on these data, we demonstrate the CVZoo's efficiency in popularizing Zoology throughout the country in contributing to the decentralization of knowledge as well as in meeting the urgent concerns of making access to knowledge more egalitarian and socially fair.

Embora a diversidade de grupos de animais existentes no Brasil ofereça inúmeras oportunidades de estudo, o cenário atual não acompanha essa demanda. Os motivos para essa desconexão vão desde a desigualdade na disponibilidade de recursos para ensino e pesquisa até o foco de pesquisadores em grupos específicos de animais, enquanto outros permanecem negligenciados. O treinamento de novos pesquisadores interessados em Zoologia é essencial para um maior entendimento da diversidade brasileira, assim como a exposição de tais pesquisadores a novos grupos e diferentes possibilidades de trabalho. O Curso de Verão em Zoologia (CVZoo) promovido pelo Programa de Pós-graduação em Zoologia da Universidade de São Paulo, ao longo de dez anos vem buscando contribuir para a formação de novos(as) pesquisadores(as) na área da Zoologia, bem como na atualização de docentes do Ensino Básico por meio de atividades de extensão universitária. Para avaliar os impactos causados pelo CVZoo na formação acadêmica e profissionalizante dos participantes, foram enviados formulários aos participantes das dez edições do curso, bem como compiladas informações disponíveis na Plataforma Lattes. Análises qualitativas e quantitativas evidenciaram o perfil das pessoas egressas, suas expectativas e percepções acerca do curso oferecido. Com base nesses dados, é apontada a eficiência do CVZoo na popularização da Zoologia por todo o país, contribuindo para a descentralização do conhecimento, bem como atendendo às preocupações prementes de tornar o acesso ao conhecimento mais igualitário e socialmente justo

Clinical profile of spontaneous cerebellar hemorrhage - An original article

Spontaneous cerebellar hemorrhages are rare when compared to cerebral hemorrhages. They are characterized by occipital headache, repeated vomiting, and ataxia of gait. In mild cases there may be only gait ataxia. There may be Dizziness or vertigo, paresis of conjugate lateral gaze towards the side of the lesion, forced deviation of the eyes to the opposite side, or an ipsilateral sixth nerve palsy, blepharospasm, and skew deviation. Dysarthria and dysphagia may occur. The patient often becomes stuporous and then comatose from brainstem compression or obstructive hydrocephalus; immediate surgical evacuation before brainstem compression occurs, may be lifesaving. The introduction of computed tomography (CT) scan, had brought about a sea change in diagnosis and management. The most significant prognostic factors determining the outcome at one month were the grade of quadrigeminal cistern obliteration on the initial CT scan and the Glasgow Coma Scale on admission. The introduction of drugs like nimodepine made all the difference in the outcomes. We hereby share our experience in managing 12 cases of spontaneous cerebellar hemorrhage.

Evaluación de los indicadores demográficos de Pocillopora (Scleractinia: Pocilloporidae) en sitios insulares vs. costeros: implicaciones para un programa de restauración regional

Introducción: El mantenimiento de las comunidades coralinas depende directamente de la capacidad de los individuos para crecer como colonia. Dado que el crecimiento forma la base de la estructura física del arrecife, determinar la tasa de crecimiento de las especies de corales constructores y su respuesta a las variaciones ambientales nos permitirá identificar su potencial particular para implementar estrategias de restauración más efectivas. Objetivo: Determinar la tasa de crecimiento del coral constructor de arrecifes Pocillopora en todo el Pacífico Central Mexicano (PCM) y su relación con las fluctuaciones en las condiciones ambientales. Métodos: De agosto de 2019 a octubre de 2020, se monitorearon y trasplantaron un total de 153 fragmentos de coral ramificado del género Pocillopora como parte del programa de restauración en diferentes sitios de la PCM: Parque Nacional Islas Marietas y en la Caleta de Cuastecomates. Se calculó el crecimiento del coral (cm·año-1) y sobrevivencia (%), y se correlacionó con la temperatura, PAR y Kd490 para cada localidad. Resultados: Patrones similares en los parámetros examinados entre los fragmentos de coral fueron encontrados para todos los sitios, con un rango de sobrevivencia de 61.6 - 68 %, cuya mortalidad estuvo relacionada principalmente con huracanes y tormentas que afectaron la región. Sin embargo, la tasa de crecimiento oscila entre 2.0 - 8.0 cm·año-1, sin diferencias significativas entre localidades. Además, no se registraron diferencias en las condiciones ambientales entre las localidades. Conclusiones: Los corales ramificados del género Pocillopora presentan una tasa de crecimiento similar en sitios insulares y costeros de la PCM, por lo que se podría esperar que la implementación de un programa de restauración en toda esta región del Pacífico Mexicano sería potencialmente exitoso, ya que, las condiciones ambientales locales no son factores limitantes.

Introduction: The maintenance of the coral communities depends directly on the capacity of the individuals to grow as a whole colony. Since growth shapes the basis of the physical structure of the reef, determining the growth rate of builder coral-species and their response to environmental variations will allow us to identify their particular potential to implement more effective restoration strategies. Objective: To determine the growth rate of the reef-building coral Pocillopora throughout the Mexican Central Pacific (PCM) and its relationship with fluctuations in environmental conditions. Methods: From August 2019 - October 2020, a total of 153 branched coral fragments of the genus Pocillopora were monitored and transplanted as part of the restoration program in different PCM locations: Islas Marietas National Park and in the Caleta de Cuastecomates. Coral growth (cm·year-1) and survival rate (%), was calculated and correlated with temperature, PAR and Kd490 for each locality. Results: The results show similar patterns in the parameters examined among the coral fragments were found for all sites, with a survival range of 61.6 - 68 %, whose mortality was mainly related to hurricanes and storms that affected the region. However, growth rate range from 2.0 - 8.0 cm·year-1, with no significant differences between locations. Also, no differences in environmental conditions between locations were recorded. Conclusions: The branching corals of the genus Pocillopora present a similar growth rate in insular and coastal sites of the PCM, so it could be expected that the implementation of a restoration program throughout this region of the Mexican Pacific would be potentially successful, since local environmental conditions are not limiting factors.

Estudios de extensión para la estadificación del cáncer de mama infiltrante. Revisión de la evidencia y abordaje terapéutico en el Instituto Nacional de Cancerología - Colombia / Extension studies for the staging of infiltrating breast cancer. Review of evidence and therapeutic approach at the Instituto Nacional de Cancerología - Colombia

La estadificación del cáncer de mama tiene como objetivo determinar la extensión de la enfermedad, definir el tratamiento y el pronóstico de la misma. La American Joint Committee on Cancer(AJCC) ha asignado el estadio utilizando el tamaño del tumor (T), la presencia de compromiso ganglionar (N), y la presencia o ausencia de metástasis a distancia (M). Con el advenimiento de la biología molecular, se integra a la estadificación anatómica la información pronóstica con el grado histológico, el estado de los receptores hormonales y el resultado del receptor de HER2. En el Instituto Nacional de Cancerología (INC), la incorporación del TNM pronóstico trajo consigo un aumento de estadio en el 14,47% de los casos y una disminución en el 40,3%; este resultado se atribuyó en parte al mayor porcentaje de tumores localmente avanzados dentro de la institución. Por subtipo biológico, los tumores luminales presentan mayor riesgo de metástasis óseas, los tumores triple negativo a pulmón y sistema nervioso central; y los tumores HER2 a SNC, hígado y pulmón. Teniendo en cuenta este compromiso a distancia, los métodos de estadificación comúnmente utilizados son gammagrafía ósea (GO), radiografía de tórax (RxT), ecografía hepática (UH) y/o tomografía computarizada (TC). En el caso de identificar hallazgos sospechosos en estos exámenes o si el cuadro clínico del paciente lo sugiere, se realizan estudios adicionales como TC o resonancia magnética nuclear (RMN). Los cambios en la estadificación clínica y la biología del cáncer de mama motivaron a las Unidades de Seno y Tejidos Blandos y Oncología Clínica del Instituto Nacional de Cancerología a revisar la evidencia científica disponible para recomendar la pertinencia de los estudios de extensión.

The staging of breast cancer has the objective to determine the extent of the disease, define treatment and prognosis. The American Joint Committee on Cancer (AJCC) has assigned the stage using the size of the tumor (T), the presence of lymph node involvement (N), and the presence or absence of distant metastases (M). With the advent of molecular biology, prognostic information with histological grade, hormone receptor status, and HER2 receptor is integrated with anatomic staging. In the National Institute of Cancerology (INC) the incorporation of TNM brought with it an increase in stage in 14.47% of cases and a decrease in 40.3%; this result was attributed in part to the higher percentage of locally advanced tumors within the institution. By biological subtype, luminal tumors have a higher risk of bone metastases, triple negative tumors to the lung and central nervous system; and HER2 tumors to CNS, liver and lung. Taking this distant involvement into account, the commonly used staging methods are bone scan (BS), chest radiography (CXR), liver ultrasound (UH) and/or computed tomography (CT) scans. In the case of identifying suspicious findings in these tests or if the patient's clinical condition suggests it, additional studies such as CT or magnetic resonance imaging (MRI) are performed. Changes in the clinical staging and biology of breast cancer motivated the Breast and Clinical Oncology Functional Unit of the National Cancer Institute to review the available scientific evidence to recommend the relevance of extension studies.

Evaluation of the Results of Septum Extension Batten Graft in Patients Referred for Septorhinoplasty

Abstract Introduction Correction of caudal septal deviations has always been a challenging subject in septorhinoplasty. The septum batten extension graft (SBEG) is a new graft that has potential properties in rhinoplasty. However, few reports have evaluated the surgical outcomes of this technique. Objective The purpose of this study was to evaluate the effectiveness of SBEG in correcting caudal septal deviation. Methods This cross-sectional study was conducted on patients with caudal septal deviation undergoing septorhinoplasty using SBEG at 2 different hospitals in 2019. We then retrospectively reviewed medical records and photographs of 50 patients at the preoperative period, as well as at 1-month, and 12-month postoperatively. Gross changes in nasolabial angle, columellar show, nasal tip projection, and dorsal nasal deviation were evaluated by a photographic analysis method, and nasal obstruction was assessed by patient satisfaction with breathing. Results There was a significant difference between the mean nasolabial angle and columellar show at 1 and 12-months postoperatively, compared with the previous values (p < 0.0001). The nasolabial angles were in a favorable position with an increase of 12 to 15 degrees compared with the preoperative state. The columellar show also improved by an average of 1.2 mm and was in good condition. The postoperative dorsal nasal deviation was significantly reduced, and projection was significantly increased (3.521 ± 0.087 mm vs. 0.719 ± 0.028; p < 0.0001; p < 0.001 ). Moreover, this method had a significant favorable effect on nasal obstruction (p = 0.049). Conclusion Our results showed that septorhinoplasty using SBEG is useful for correcting caudal septal deviation, with favorable surgical outcomes, and it has responded well to all five aforementioned criteria.

Participação social e educação popular em saúde: espaços possíveis de diálogo na forma de uma ouvidoria coletiva / Public participation and popular health education: potential spaces for dialogue in the form of a collective ombudsman / Participación social y educación popular en salud: espacios posibles de diálogo en la forma de una defensoría colectiva

Este trabalho relata a experiência de um projeto de pesquisa e extensão no âmbito da participação social e da educação popular em saúde, realizado na comunidade de Roda de Fogo, Recife, PE, entre 2019 e 2021. Tem como objetivo descrever como se deu essa experiência, apontar seus resultados e identificar suas potencialidades e desafios. Para a sistematização dos dados, utilizamos gravações, cadernos de campo e atas de reunião do projeto. Ao revisitar todo o material, foi possível ratificar o importante trabalho realizado pela ouvidoria coletiva no âmbito da formação dos estudantes, da participação dos moradores e da interlocução com diversos setores da máquina pública, que, juntos, visaram uma maior compreensão dos inúmeros desafios enfrentados pelos territórios mais empobrecidos. Entretanto, verificamos que as discussões no âmbito do projeto tenderam a se encaminhar para necessidades imediatas, o que comprometeu o sentido político da participação social.(AU)

This article recounts the experiences of a research and extension project in the area of public participation and popular health education developed between 2019 and 2021 in a community called Roda de Fogo in Recife, the capital of the state of Pernambuco, Brazil. We describe the experiences, outline the main results and identify strengths and challenges. The data were collected using recordings, field diaries and project meeting minutes. The findings reveal the importance of the work carried out by the collective ombudsman for student training, community participation and engagement with various sectors of the public sector apparatus, which together aimed to promote better understanding of the numerous challenges faced in poor areas. However, we found that project discussions tended to focus on immediate need, compromising the political meaning of public participation.(AU)

Este trabajo relata la experiencia de un proyecto de investigación y extensión en el ámbito de la participación social y de la educación popular en salud, realizado en la comunidad Roda de Fogo/Recife/Estado de Pernambuco, entre 2019 y 2021. Su objetivo es describir cómo se realizó esa experiencia, señalar sus resultados e identificar sus potencialidades y desafíos. Para la sistematización de los datos utilizamos grabaciones, cuadernos de campo y actas de reunión del proyecto. Al revisitar todo el material, fue posible ratificar el importante trabajo realizado por la defensoría colectiva en el ámbito de la formación de los estudiantes, de la participación de los moradores y de la interlocución con diversos sectores de la máquina pública que, en conjunto, tuvieron como objetivo una mayor comprensión de los innumerables desafíos enfrentados por los territorios más empobrecidos. No obstante, verificamos que las discusiones en el ámbito del proyecto tendieron a dirigirse hacia necesidades inmediatas, lo que comprometió el sentido político de la participación social.(AU)

University Pharmacy: from the foundation to the Pandemic times of Covid-19

Abstract The University Pharmacy Program (FU), from the Federal University of Rio de Janeiro (UFRJ), was created based on the need to offer a curricular internship to students of the Undergraduate Course at the Faculty of Pharmacy. Currently, it is responsible for the care of about 200 patients/day, offering vacancies for curricular internships for students in the Pharmacy course, it has become a reference in the manipulation of many drugs neglected by the pharmaceutical industry and provides access to medicines for low-income users playing an important social function. Research is one of the pillars of FU-UFRJ and several master and doctoral students use the FU research laboratory in the development of dissertations and theses. As of 2002, the Pharmaceutical Care extension projects started to guarantee a rational and safe pharmacotherapy for the medicine users. From its beginning in 1982 until the current quarantine due to the COVID-19 pandemic, FU-UFRJ has been adapting to the new reality and continued to provide patient care services, maintaining its teaching, research, and extension activities. The FU plays a relevant social role in guaranteeing the low-income population access to special and neglected medicines, and to pharmaceutical and education services in health promotion.

Role development and extension for radiographers in computed tomography: Literature review findings and their application to Zimbabwe

Computed Tomography(CT) technology has evolved into avital diagnostic tool in modern medical practice, leading to the development and extension of the CT radiographer's role. While some countries have made progress in developing and extending radiographers' roles in CT, resource-constrained settings like Zimbabwe have been slower to implement these changes. The purpose of this review is to inform role changes for radiographers in Zimbabwe and similar settings by reviewing the literature on role development and extension for radiographers in CT. The review explores the concepts of role development and extension, emphasizing the necessity for changes in radiographers' roles in CT due to factors such as radiologists shortages, cost containment, quality improvement needs and technological advancements. It also addresses the opposition to role development and extension, emphasizing the fundamental impetus for these changes should be to provide high-quality and effective patient-centered care. The paper delves into specific areas of role development and extension for radiographers in CT, including intravenous (IV) cannulation and contrast media administration, performing CT colonoscopy examinations, reporting on CT brains, and the significance of research and clinical audit in CT. It underscores the potential benefits of these expanded roles, such as improved patient care, workflow efficiency, and the workload of radiologists, as well as advancements in education, service delivery, and technological innovations. The review underscores the need for further research to ensure evidence-based implementation of role development and extension for radiographers in CT. Embracing these changes and providing the necessary support and training can lead to improved patient care, address skill shortages, and advance the radiography profession in resource-constrained settings like Zimbabwe.

National Assessment of the Health Extension Program in Ethiopia: Study Protocol and Key Outputs

BACKGROUND: The Health Extension Program (HEP) was introduced in 2003 to extend primary health care services by institutionalizing the former volunteer-based village health services.However, this program is not comprehensively evaluated.MATERIALS AND METHODS: The 2019 comprehensive national assessment of HEP involved (1) assessment through quantitative and qualitative primary data, (2) a thorough systematic review of the HEP literature, and (3) a synthesis of evidence from the two sources. The assessment included household survey(n=7122), a survey of health extension workers (HEWs) (n=584)_, and an assessment of health posts (HPs)(n=343) and their supervising health centers (HCs)(n=179)from 62 randomly selected woredas. As part of the comprehensive assessment.OUTPUT AND RESULTS: The outputs were (a) full and abridged reports, (b) 40 posters, (c) seven published, three under review scientific papers and (d) seven papers in this special issue. During the one-year period preceding the study, 54.8% of women, 32.1% of men, and 21.9% of female youths had at least a one-time interaction with HEWs. HPs and HEWs were universally available. There were critical gaps in the skills and motivation of HEWs and fulfillment of HP standards: 57.3% of HEWs were certified, average satisfaction score of HEWs was 48.6%, and 5.4% of HPs fulfilled equipment standards. CONCLUSIONS: The findings informed policy and program decisions of the Ministry of Health, including the design of the HEP Optimization Roadmap 2020­2035 and the development Health Sector Transformation Plan II. It is also shared with global community through published papers

Ethiopian Health Extension Workers' Training Status and Perceived Competency

BACKGROUND: Training and work experience are critical inputs for delivering quality health services. However, no nationwide assessment has been conducted on the status of training and the competency of Health Extension Workers (HEWs). Therefore, this study aimed to assess HEWs' pre service training status and perceived competency in Ethiopia. METHODS: The study was conducted in all regions and all HEWs training institutions in Ethiopia. We used cross sectional study design with a mixed method approach that included 585 HEWs, 1,245 HEW trainees, 192 instructors, and 43 key informants. Descriptive statistics and thematic analysis were used to analyse quantitative and quantitative data respectively. RESULT: Twenty-six percent of the HEWs said that they were competent to deliver all the HEP activities, and 73% of the HEWs said that they could confidently deliver 75% of the HEP activities. Receiving in-service training and having level III/IV qualifications are positively associated with the competency of HEWs. Similarly, HEP trainees perceived themselves as highly competent in executing their professional work, except in using computer and mobile health technology. Both instructors and trainees rated the quality of the curriculum and course materials positively. However, basic services and facilities in most training institutions were perceived to be inadequate. Additionally, individual learning, problem-solving, case-analysis, and assessment methods such as project work and portfolios were rarely practiced. CONCLUSIONS: Although the perceived competence of HEW trainees is high, the HEWs' training is not provided as per the curriculum because of limited resources. All the necessary resources should be made available to produce competent HEWs

Depression and Burnout among Health Extension Workers in Ethiopia: A Cross-Sectional Study

BACKGROUND: Depression and burnout are common among healthcare workers (HCWs) and negatively affect their well being and the quality of the service they provide. However, the burden of depression and burnout among health extension workers (HEWs) in Ethiopia and their relationship has not been documented well. The objective of this study was to estimate the prevalence of depression and burnout among HEWs in Ethiopia and to investigate the relationship between these conditions. MATERIALS AND METHODS: We used a cross-sectional study design and collected data from 584 rural and 581 urban HEWs in Ethiopia, as part of the 2019 national health extension program assessment. The Patient Health Questionnaire (PHQ-9) and Burnout Self-Test were used to screen HEWs for depression and burnout, respectively. We used descriptive statistics to estimate the magnitude of depression and burnout, and logistic regression to examine their relationship. RESULT: Based on PHQ-9 cutoff scores of 10, the prevalence of major depression was 16.5% among rural and 8.9% among urban HEWs, whereas burnout risk was 39.8% among rural and 12.6% among urban HEWs. The odds of having depression among HEWs with burnout risk was relatively higher compared to those without burnout risk [For rural HEWs, the adjusted odds ratio (AOR) is 11.88 at a 95% confidence interval (CI; 5.27, 26.80), and for urban HEWs, the AOR is 11.49 at a 95% CI (5.35, 24.63)]. CONCLUSION: The prevalence of depression and burnout is high among HEWs in Ethiopia, with a significant rural­urban difference, and burnout is a significant predictor of depression. Mental health interventions that enable prevention, early detection, and management are needed especially for rural HEWs who are in charge of preventive health service delivery for the disadvantaged rural communities

Relevance of the Health Extension Program to the current Health Needs and Evolving Demands of Rural Ethiopia: A Mixed-Method Analysi

BACKGROUND: Ethiopia has been implementing a health extension program (HEP) to respond to the high maternal and child mortality in rural communities. HEP has brought tremendous contributions to improved access and coverage of primary healthcare in the last 15 years. Despite its attributions, attention to HEP has declined in recent years due to several reasons. This study is designed to explore HEP's relevance to the current healthcare needs of the rural communities. METHODS: This study is a nested cross-sectional mixed method to the overall HEP's evaluation between March and May 2019. Descriptive statistics were used on qualitative and quantitative assessment. A literature review supplemented the assessment. A representative quantitative sample of 11,746 women, men, and young girls; a qualitative sample of 268 key informants from Kebele administrators, HEWs, program people in the health system and focus groups from community leaders, men and women from 185 Kebeles in 62 woredas were selected. A thematic approach was used for qualitative analysis. RESULTS: Rural communities and program managers asserted that HEP's service packages with the existing service delivery modalities were relevant. Eighty-two percent of men and women and 77% of young girls confirmed this relevance. Besides the existing packages, additional curative services for adults and children were recommended with emphasis on the pastoralist community. HEP's service uptake has declined as over 86% of targeted rural communities bypassed HPs due to unavailability of services and capacity problems of HEWs. CONCLUSION: The current HEP packages with the existing service delivery modalities are still relevant to the rural communities' health needs. However, on-going changes to address the evolving demands of the targeted rural communities are crucial