Digitalisation promotes adoption of soft information in SME credit evaluation: the case of Indian banks.

Small and Medium Enterprises (SMEs) account for half of the employment in developing economies and are a significant part of their economic growth. In spite of this, SMEs are under-financed by banks, which have been disrupted by financial technology (fintech) firms. This qualitative multi-case study examines how Indian banks are utilising digitalisation, soft information, and Big data to improve SME financing. The participants shared their insights on the way banks adopt digital tools, sources of soft information (e.g., customer and supplier relationships, business plans), and factors that influence the implementation of Big data in the SME credit evaluation process. The major themes include: banks are improving SME financing operations through digitalisation, and IT tools can verify SME soft information. Soft information attributes that emerge from addressing SME information opacity include supplier relationships, customer relationships, business plans, and managerial successions. For SME credit managers, developing partnerships to access publicly available soft information created by industry associations and "online B2B trade platforms" is a high-priority recommendation. To enhance the efficiency of SME financing, banks should obtain the consent of SMEs before they access their private hard information through trade platforms.

An Evaluation Process for IoT Platforms in Time-Sensitive Domains.

Determining the temporal behavior of an IoT platform is of utmost importance as IoT systems are time-sensitive. IoT platforms play a central role in the operation of an IoT system, impacting the overall performance. As a result, initiating an IoT project without the exhaustive knowledge of such a core software piece may lead to a failed project if the finished systems do not meet the needed temporal response and scalability levels. Despite this fact, existing works on IoT software systems focus on the design and implementation of a particular system, providing a final evaluation as the validation. This is a risky approach as an incorrect decision on the core IoT platform may involve great monetary loss if the final evaluation proves that the system does not meet the expected validation criteria. To overcome this, we provide an evaluation process to determine the temporal behavior of IoT platforms to support early design decisions with respect to the appropriateness of the particular platform in its application as an IoT project. The process defines the steps towards the early evaluation of IoT platforms, ranging from the identification of the potential software items and the determination of the validation criteria to running the experiments and obtaining results. The process is exemplified on an exhaustive evaluation of a particular mainstream IoT platform for the case of a medical system for patient monitoring. In this time-sensitive scenario, results report the temporal behavior of the platform regarding the validation parameters expressed at the initial steps.

Inconsistency analysis between metagenomic next-generation sequencing results of cerebrospinal fluid and clinical diagnosis with suspected central nervous system infection.

BACKGROUND: Recently, with the rapid progress of metagenomic next-generation sequencing (mNGS), inconsistency between mNGS results and clinical diagnoses has become more common. There is currently no reasonable explanation for this, and the interpretation of mNGS reports still needs to be standardised. METHODS: A retrospective analysis was conducted on 47 inpatients with suspected central nervous system (CNS) infections, and clinical data were recorded. The final diagnosis was determined by an expert group based on the patient's clinical manifestation, laboratory examination, and response to treatment. mNGS results were compared with the final diagnosis, and any inconsistencies that occurred were investigated. Finally, the credibility of mNGS results was evaluated using the integral approach, which consists of three parts: typical clinical features, positive results with the traditional method, and cerebrospinal fluid cells ≥ 100 (× 106/L) or protein ≥ 500 mg/L, with one point for each item. RESULTS: Forty-one patients with suspected CNS infection were assigned to infected (ID, 31/41, 75.61%) and non-infected groups (NID, 10/41, 24.39%) after assessment by a panel of experts according to the composite diagnostic criteria. For mNGS-positive results, 20 of the 24 pathogens were regarded as contaminants when the final score was ≤ 1. The remaining 11 pathogens detected by mNGS were all true positives, which was consistent with the clinical diagnosis when the score was ≥ 2. For mNGS negative results, when the score was ≥ 2, the likelihood of infection may be greater than when the score is ≤ 1. CONCLUSION: The integral method is effective for evaluating mNGS results. Regardless of whether the mNGS result was positive or negative, the possibility of infection was greater when the score was ≥ 2. A negative mNGS result does not necessarily indicate that the patient was not clinically infected, and, therefore, clinical features are more important.

Evaluación y acreditación de especialidades de posgrado en la Universidad de Ciencias Médicas de Camagüey / Evaluation and accreditation of postgraduate specialties at the University of Medical Sciences of Camagüey

RESUMEN Fundamento: La evaluación y acreditación de especialidades de posgrado es un proceso voluntario mediante el cual una organización de salud es capaz de medir la calidad de sus servicios y el rendimiento de los mismos frente a estándares reconocidos a nivel nacional o internacional. Objetivo: Describir los resultados de la evaluación y acreditación de especialidades de posgrado en la Universidad de Ciencias Médicas de Camagüeydesde el año 2018 hasta la actualidad. Métodos: Se realizó un estudio descriptivo transversal. El universo estuvo constituido por 37 especialidades con créditos académicos actualizados, lo que las certifica como programas aptos para presentarse a un proceso de evaluación externa. Para el análisis estadístico de las variables cualitativa estudiadas, se emplearon números absolutos y por ciento para el resumen de la información. Los resultados se expresaron en texto y tablas estadísticas. Resultados: De las 37 especialidades con créditos académicos actualizadosnueve fueron acreditadas, siete de ellas con categorías superior de excelencia, dos con categoría de certificada. Conclusiones: Desde el año 2018 a la actualidad de las 37 especialidades con créditos académicos actualizados se han evaluado y acreditado nueve programas de especialidades, además existen ocho con expedientes de autoevaluación para someterse al proceso de evaluación externa virtual.

ABSTRACT Background: The evaluation and accreditation of postgraduate specialties is a voluntary process through which a health organization is able to measure the quality of its services and their performance against nationally or internationally recognized standards. Objective: Describe the results of the evaluation and accreditation of postgraduate specialties at the University of Medical Sciences of Camagüey from 2018 to the present. Methods: A descriptive cross-sectional study was carried out. The universe consisted of 37 specialties with updated academic credits, which certifies them as suitable programs to be submitted to an external evaluation process. For the statistical analysis of the qualitative variables studied, absolute numbers and percent were used for the summary of the information. The results were expressed in text and statistical tables. Results: Of the 37 specialties with updated academic credits, nine were accredited, seven of them with superior categories of excellence, two with certified categories. Conclusions: From 2018 to the present of the 37 specialties with updated academic credits, nine specialty programs have been evaluated and accredited, in addition there are eight with self-evaluation files to undergo the virtual external evaluation process.

Determining treatment choices after the cochlear implant evaluation process.

OBJECTIVES: Determine the proportion of patients starting the cochlear implant evaluation (CIE) process proceeding to cochlear implantation.Determine which patient factors are associated with undergoing cochlear implantation. METHODS: Retrospective case series of all patients scheduled for a CIE within a tertiary academic neurotology practice between January 1, 2014 and April 30, 2016. Management pathways of patients undergoing CIE were examined. RESULTS: Two hundred thirty-seven adult patients were scheduled for CIE during the study period. Two hundred twenty-six patients started the evaluation process, and 203 patients completed full evaluation. Of patients that completed CIE, 166/203 (82%) met criteria for implantation and 37/203 (18%) did not meet criteria. Fifty-nine patients out of 166 patients (36%) meeting criteria did not receive implants and 107/166 (64%) underwent implantation, yielding an overall implantation rate of 47% (107/226) among patients scheduled for CIE. Common reasons for deferring CI among candidates included failure to show up for preoperative appointment (24%), choosing hearing aids as an alternative (22%), patient refusal (21%) and insurance issues (17%). Overall, CIE led to a new adjunctive hearing device (CI or hearing aid) in 113 (113/203, 56%) cases. CONCLUSION: Fifty-six (113/203) percent of patients who underwent CIE at an academic medical center underwent CI surgery or received an adjunctive hearing device, but 36% (59/166) of candidates did not receive a CI. Patients who forewent CI despite meeting candidacy criteria did so due to cost/insurance issues, or due to preference for auditory amplification rather than CI. LEVEL OF EVIDENCE: 4.

The manifestations of politics in evaluation: An exploratory study across the evaluation process.

Evaluation has been described as a political act. Programs and policies are generated from a political process, and the decision to evaluate and how to use the evaluation are manifestations of the political dynamic. This exploratory study was conducted with practicing evaluators to understand what they view as political situations in the evaluation process and how they responded to these situations. Findings suggest that, in relation to the potential evaluation phases in which each respondent has been involved, evaluations are susceptible to politics when initially attempting to identify stakeholders and when it's time to report the evaluation findings. Evaluators have also developed multiple strategies for dealing with these situations, including finding allies for the evaluation and working to explain the evaluation process and its implications. We hope that this study will help to inform novice and expert evaluators about the various political situations they may encounter in their practice.

Discussion on the on-site audit management of practicing qualification certification of human organ transplantation / 器官移植

Human organ transplantation is an effective method to treat organ failure and save the life of patients. The practicing qualification certification of human organ transplantation is recognized as an administrative examination and approval item of the national health authority. National health authorities shall organize experts to conduct on-site audit of medical institutions that have applied for practicing qualification certification and have passed preliminary supervision at the provincial level. In this article, the management of on-site audit on the practicing qualification certification of human organ transplantation was illustrated and discussed from the practical significance, principles and highlights of on-site audit, and key points during on-site audit, aiming to provide reference for ensuring high-quality development of organ transplantation and strengthening the management of practicing qualification certification of human organ transplantation in medical institutions.

Detección de nudos críticos para la disminución del tiempo de espera en atención de prolapso de órganos pélvicos en hospital público chileno / Detecting critical knots to decrease the waiting time when caring the pelvic organ prolapse in a chilean public hospital

Resumen Introducción: El problema que se presenta en la atención de salud en los hospitales públicos es la alta cantidad de pacientes, generando un sostenido crecimiento en las listas de espera y provocando un aumento del tiempo de espera, generando un impacto negativo en los usuarios. Objetivo: Mejorar el proceso clínico de atención del prolapso de órganos pélvicos de un hospital público chileno. Metodología: Se identifican nudos críticos mediante diagramas de flujo, realizando un diagnóstico del proceso desde el ingreso del paciente hasta su alta del hospital. Resultados: Se identifican cada uno de los puntos críticos y se proponen soluciones para agilizar el proceso y con ello mejorar la atención a las usuarias, lo que en definitiva llevó a una disminución del tiempo de espera y, lo más relevante, a una disminución en la cantidad de personas en la lista de espera.

Abstract Introduction: The high number of patients is a common issue in public hospitals that causes a negative impact on the users due to the increment in the waiting lists and in the waiting time to be treated. Objective: To improve the clinical process for caring pelvic organ prolapse in a chilean public hospital. Methodology: The methodology was focused on identifying critical knots using flowcharts and diagnosing the patient's process from their admission until their discharge from the hospital. Results: Some solutions were proposed for each critical point identified so as to accelerate the process, thus improving users' health caring. As a result, the high number of people in the waiting lists and the waiting time decreased substantially.

Proceso de evaluación del desempeño del residente de Ginecología y Obstetricia en la Facultad de Ciencias Médicas "Finlay-Albarrán" / The Process of Performance Evaluation of the Gynaecology and Obstetrics Resident in Finlay Albarrán Medical School

Introducción: El proceso de evaluación en las especialidades médicas es fundamentalmente cualitativo, de verificación de evidencias del desempeño para garantizar una adecuada formación profesional. El Programa de la especialidad de Ginecología y Obstetricia en Cuba, se ha enriquecido con nuevos contenidos desde su implementación, pero el sistema de evaluación del residente ha experimentado pocas modificaciones. Objetivo: Caracterizar el proceso de evaluación del desempeño del residente de Ginecología y Obstetricia en la Facultad de Ciencias Médicas "Finlay-Albarrán" para identificar los problemas y las potencialidades que permitan programar actividades para su mejoramiento. Métodos: Se realizó análisis documental e histórico-lógico. Se efectuó revisión documental. Se hicieron entrevistas, encuestas y la observación del desempeño del profesor durante el proceso docente educativo; parametrización y triangulación metodológica. Resultados: Se identificaron problemas en las tres dimensiones estudiadas entre los que se destacan: deficiente nivel de comprobación de los conocimientos de las ciencias básicas, limitada utilización del idioma inglés en la práctica profesional, insuficiente conocimiento entorno a la evaluación del desempeño y la insuficiente participación del profesor en actividades de superación profesional relacionadas con el proceso de evaluación. Se identificó una potencialidad. Conclusiones: La caracterización del proceso de evaluación del desempeño del residente de Ginecología y Obstetricia en la Facultad de Ciencias Médicas "Finlay-Albarrán" permitió la identificación de problemas y una potencialidad. Los resultados de esta investigación conducen al diseño y desarrollo de actividades que propicien el mejoramiento del sistema de evaluación con enfoque en el desempeño(AU)

Introduction: The process of evaluation in medical specialties is mainly a qualitative one, based on the verification of performance evidences that guarantee an adequate professional training. The specialty program for Gynecology and Obstetrics in Cuba has been enriched with new contents since its implementation, but the resident's evaluation system has undergone few modifications. Objective: To characterize the process of evaluation for the Gynecology and Obstetrics resident's performance in "Finlay-Albarrán" Medical School, in order to identify the problems and potentialities that allow to program activities for its improvement. Methods: Literature and historical-logical analyses were carried out. A documentary review was made. Interviews, surveys and the observation of the teacher's performance during the educational process; parametrization and methodological triangulation. Results: Problems were identified in the three dimensions studied; for example, a poor level of knowledge verification in basic sciences, limited use of the English language in the professional practice, insufficient knowledge about performance evaluation, and insufficient participation of the teacher in professional improvement activities related with the evaluation process. A potentiality was identified.Conclusions: The characterization of the process of performance evaluation for the Gynecology and Obstetrics resident in Finlay-Albarrán Medical School allowed the identification of problems and a potentiality. The results of this research lead to the design and development of activities that encourage the improvement of the evaluation system, with a focus on performance(AU)

Evaluación final del internado rotatorio de Medicina General Integral / Final evaluation of the rotational internship in Family Medicine

Introducción: el proceso evaluativo brinda retroalimentación acerca de la efectividad de la enseñanza y resultado del aprendizaje. Objetivo: caracterizar la evaluación final del internado de Medicina General Integral durante un curso académico. Métodos: se realizó estudio observacional descriptivo, cuanti-cualitativo, retrospectivo en la asignatura Medicina General Integral sexto año, Facultad "Manuel Fajardo" durante el curso escolar 2014-2015. El dato primario se obtuvo de información documental. Las variables se trabajaron en una hoja de cálculo Excel y su operacionalización se realizó con el sistema operativo Windows Xp; se calculó frecuencias absoluta y relativa, se realizó triangulación de información, se definió composición del instrumento y contenidos evaluativo evaluados. Resultados: el 76,3 por ciento obtuvo excelente en evaluación final y 1,1 por ciento resultó reprobado con promoción cualitativa de 93,5 por ciento. En evaluación frecuente el 81,8 por ciento obtiene excelente y 15 por ciento. En examen práctico el 71 por ciento obtiene excelente y 23,6 por ciento bien. En evaluación teórica 60,2 por ciento logra excelente y el 24,7 por ciento de los evaluados obtiene bien. El instrumento evaluativo corresponde a un test objetivo de siete preguntas. La pregunta con mayor error pertenece al contenido prevención y las de mejores resultados relacionados con familia y enfermedades transmisibles. El escenario docente con dificultades en la promoción correspondió al Policlínico Rampa. Conclusiones: predominó un buen índice de calidad en la evaluación final. En evaluación frecuente, examen práctico y teórico predominan las categorías excelente y bien. El contenido prevención aporta mayor error y las mejores respuestas fueron: familia y enfermedades transmisibles. El escenario docente con resultados inferiores fue el Policlínico Rampa(AU)

Introduction: The evaluation process provides feedback about the effectiveness of teaching and the outcomes of learning. Objective: To characterize the final evaluation of the internship in Family Medicine during an academic year. Methods: A descriptive, quantitative and qualitative, retrospective and observational study was carried out in the subject Family Medicine of the sixth academic year at Manuel Fajardo Medical School in 2014-2015. The primary data was obtained from documentary information. The variables were processed in an Excel worksheet operated in Windows XP. Absolute and relative frequencies were calculated, triangulation of information was carried out, together with the composition of the instrument, while the contents of the evaluation were defined. Results: 76.3 percent obtained excellent in the final evaluation and 1.1 percent failed with a qualitative promotion of 93.5 percent. In the frequent evaluation, 81.8 percent obtained excellent and 15 percent, good. In the practical examination, 71 percent obtained excellent and 23.6 percent, good. In the theoretical evaluation, 60.2 percent obtained excellent and 24.7 percent, good. The evaluative instrument is correspondent with an objective test of seven questions. The question with the greatest number of errors belongs to the prevention content and the best results were related to the family and the communicable diseases. The teaching setting with difficulties in the promotion corresponded to La Rampa Outpatient Polyclinic. Conclusions: A good quality index predominated in the final evaluation. In frequent evaluation, the practical and theoretical examination, there is a predominance of the categories excellent and good. The content about prevention provides more errors and the best answers were related to the contents about family and communicable diseases. The teaching setting with the lowest results was La Rampa Outpatient Polyclinic(AU)

Evaluación final del internado rotatorio de Medicina General Integral / Final evaluation of the rotational internship in Family Medicine

Introducción: el proceso evaluativo brinda retroalimentación acerca de la efectividad de la enseñanza y resultado del aprendizaje. Objetivo: caracterizar la evaluación final del internado de Medicina General Integral durante un curso académico. Métodos: se realizó estudio observacional descriptivo, cuanti-cualitativo, retrospectivo en la asignatura Medicina General Integral sexto año, Facultad "Manuel Fajardo" durante el curso escolar 2014-2015. El dato primario se obtuvo de información documental. Las variables se trabajaron en una hoja de cálculo Excel y su operacionalización se realizó con el sistema operativo Windows Xp; se calculó frecuencias absoluta y relativa, se realizó triangulación de información, se definió composición del instrumento y contenidos evaluativo evaluados. Resultados: el 76,3 por ciento obtuvo excelente en evaluación final y 1,1 por ciento resultó reprobado con promoción cualitativa de 93,5 por ciento. En evaluación frecuente el 81,8 por ciento obtiene excelente y 15 por ciento. En examen práctico el 71 por ciento obtiene excelente y 23,6 por ciento bien. En evaluación teórica 60,2 por ciento logra excelente y el 24,7 por ciento de los evaluados obtiene bien. El instrumento evaluativo corresponde a un test objetivo de siete preguntas. La pregunta con mayor error pertenece al contenido prevención y las de mejores resultados relacionados con familia y enfermedades transmisibles. El escenario docente con dificultades en la promoción correspondió al Policlínico Rampa. Conclusiones: predominó un buen índice de calidad en la evaluación final. En evaluación frecuente, examen práctico y teórico predominan las categorías excelente y bien. El contenido prevención aporta mayor error y las mejores respuestas fueron: familia y enfermedades transmisibles. El escenario docente con resultados inferiores fue el Policlínico Rampa(AU)

Introduction: The evaluation process provides feedback about the effectiveness of teaching and the outcomes of learning. Objective: To characterize the final evaluation of the internship in Family Medicine during an academic year. Methods: A descriptive, quantitative and qualitative, retrospective and observational study was carried out in the subject Family Medicine of the sixth academic year at Manuel Fajardo Medical School in 2014-2015. The primary data was obtained from documentary information. The variables were processed in an Excel worksheet operated in Windows XP. Absolute and relative frequencies were calculated, triangulation of information was carried out, together with the composition of the instrument, while the contents of the evaluation were defined. Results: 76.3 percent obtained excellent in the final evaluation and 1.1 percent failed with a qualitative promotion of 93.5 percent. In the frequent evaluation, 81.8 percent obtained excellent and 15 percent, good. In the practical examination, 71 percent obtained excellent and 23.6 percent, good. In the theoretical evaluation, 60.2 percent obtained excellent and 24.7 percent, good. The evaluative instrument is correspondent with an objective test of seven questions. The question with the greatest number of errors belongs to the prevention content and the best results were related to the family and the communicable diseases. The teaching setting with difficulties in the promotion corresponded to La Rampa Outpatient Polyclinic. Conclusions: A good quality index predominated in the final evaluation. In frequent evaluation, the practical and theoretical examination, there is a predominance of the categories excellent and good. The content about prevention provides more errors and the best answers were related to the contents about family and communicable diseases. The teaching setting with the lowest results was La Rampa Outpatient Polyclinic(AU)

Disability Policy Evaluation: Combining Logic Models and Systems Thinking.

Policy evaluation focuses on the assessment of policy-related personal, family, and societal changes or benefits that follow as a result of the interventions, services, and supports provided to those persons to whom the policy is directed. This article describes a systematic approach to policy evaluation based on an evaluation framework and an evaluation process that combine the use of logic models and systems thinking. The article also includes an example of how the framework and process have recently been used in policy development and evaluation in Flanders (Belgium), as well as four policy evaluation guidelines based on relevant published literature.

Competence evaluation processes for nursing students abroad: Findings from an international case study.

BACKGROUND: Assessing clinical competence in nursing students abroad is a challenge, and requires both methods and instruments capable of capturing the multidimensional nature of the clinical competences acquired. OBJECTIVES: The aim of the study was to compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. DESIGN: A case study design was adopted in 2015. SETTING AND PARTICIPANTS: A purposeful sample of eight nursing programmes located in seven countries (Belgium, Denmark, Greece, Norway, Poland, Portugal and Italy) were approached. METHODS: Tools as instruments for evaluating competences developed in clinical training by international nursing students, and written procedures aimed at guiding the evaluation process, were scrutinised through a content analysis method. FINDINGS: All clinical competence evaluation procedures and instruments used in the nursing programmes involved were provided in English. A final evaluation of the competences was expected by all nursing programmes at the end of the clinical placement, while only four provided an intermediate evaluation. Great variability emerged in the tools, with between five and 88 items included. Through content analysis, 196 items emerged, classified into 12 different core competence categories, the majority were categorised as 'Technical skills' (=60), 'Self-learning and critical thinking' (=27) and 'Nursing care process' (=25) competences. Little emphasis was given in the tools to competences involving 'Self-adaptation', 'Inter-professional skills', 'Clinical documentation', 'Managing nursing care', 'Patient communication', and 'Theory and practice integration'. CONCLUSIONS: Institutions signing Bilateral Agreements should agree upon the competences expected from students during their clinical education abroad. The tools used in the process, as well as the role expected by the student, should also be agreed upon. Intercultural competences should be further addressed in the process of evaluation, in addition to adaptation to different settings. There is also a need to establish those competences achievable or not in the host country, aiming at increasing transparency in learning expectations and evaluation.

Practice guidelines for program evaluation in community-based rehabilitation.

PURPOSE: This paper proposes practice guidelines to evaluate community-based rehabilitation (CBR) programs. METHOD: These were developed through a rigorous three-phase research process including a literature review on good practices in CBR program evaluation, a field study during which a South Africa CBR program was evaluated, and a Delphi study to generate consensus among a highly credible panel of CBR experts from a wide range of backgrounds and geographical areas. RESULTS: The 10 guidelines developed are summarized into a practice model highlighting key features of sound CBR program evaluation. They strongly indicate that sound CBR evaluations are those that give a voice and as much control as possible to the most affected groups, embrace the challenge of diversity, and foster use of evaluation processes and findings through a rigorous, collaborative and empowering approach. CONCLUSIONS: The practice guidelines should facilitate CBR evaluation decisions in respect to facilitating an evaluation process, using frameworks and designing methods. Implications for rehabilitation Ten practice guidelines provide guidance to facilitate sound community-based rehabilitation (CBR) program evaluation decisions. Key indications of good practice include: • being as participatory and empowering as possible; • ensuring that all, including the most affected, have a real opportunity to share their thoughts; • highly considering mixed methods and participatory tools; • adapting to fit evaluation context, local culture and language(s); • defining evaluation questions and reporting findings using shared CBR language when possible, which the framework offered may facilitate.

Students' views on the block evaluation process: A descriptive analysis.

BACKGROUND: Higher education institutions have executed policies and practices intended to determine and promote good teaching. Students' evaluation of the teaching and learning process is seen as one measure of evaluating quality and effectiveness of instruction and courses. Policies and procedures guiding this process are discernible in universities, but it isoften not the case for nursing colleges. OBJECTIVE: To analyse and describe the views of nursing students on block evaluation, and how feedback obtained from this process was managed. METHOD: A quantitative descriptive study was conducted amongst nursing students (n = 177) in their second to fourth year of training from one nursing college in KwaZulu-Natal. A questionnaire was administered by the researcher and data were analysed using the Statistical Package of Social Sciences Version 19.0. RESULTS: The response rate was 145 (81.9%). The participants perceived the aim of block evaluation as improving the quality of teaching and enhancing their experiences as students.They questioned the significance of their input as stakeholders given that they had never been consulted about the development or review of the evaluation tool, or the administration process; and they often did not receive feedback from the evaluation they participated in. CONCLUSION: The college management should develop a clear organisational structure with supporting policies and operational guidelines for administering the evaluation process. The administration, implementation procedures, reporting of results and follow-up mechanisms should be made transparent and communicated to all concerned. Reports and actions related to these evaluations should provide feedback into relevant courses or programmes.

Renal Transplantation in Advanced Chronic Kidney Disease Patients.

Kidney transplantation is the best option for patients with end-stage kidney disease. It is associated with better quality of life, lower medical costs, less hospitalization, and improved survival compared with wait-listed patients who remain on dialysis. Timely referral for transplantation is essential to reap the maximal benefit and should begin in the advanced chronic kidney disease stage prior to starting dialysis. Shortage of donor organs remains the biggest challenge to transplantation. With the improved success of kidney transplantation, candidate acceptance criteria continue to broaden. This article provides an overview of the pretransplantation multidisciplinary evaluation process detailing the factors that determine transplant candidacy.

O papel da avaliação para a tomada de decisão na gestão de serviços de saúde / The role of evaluation in decision-making in the management of health services

A gestão de serviços de saúde é uma prática administrativa complexa em função da amplitude desse campo e da necessidade de conciliar interesses individuais, corporativos e coletivos nem sempre convergentes. Nesse contexto, a avaliação necessita ter características particulares para poder cumprir com o seu papel. O objetivo deste estudo foi o de estabelecer as características que a avaliação para a gestão de serviços de saúde deve possuir para contribuir para a tomada de decisão. Utilidade, oportunidade, factibilidade, confiabilidade, objetividade e direcionalidade constituem o conjunto de princípios que deve ancorar essa avaliação. Uma avaliação que conduza a decisões que garantam não somente a sua eficiência e eficácia, mas também a sua implementação. O processo avaliativo deve buscar que as decisões tomadas levem em consideração as necessidades de saúde da população, as metas definidas pelos serviços e que envolvam todos os interessados de forma a tornar viável a implementação das decisões tomadas. O presente artigo tem o propósito de desencadear um debate entre os distintos interessados em avaliação na expectativa de que possam contribuir na reflexão quanto à real utilidade da avaliação em que o componente político na gestão tem sido cada vez mais predominante.

The management of health services is a complex administrative practice due to the breadth of the field of health and the need to reconcile individual, corporate and collective interests that are not always convergent. In this context, the evaluation needs to have specific characteristics in order to fulfill its role. The scope of this study was to establish the characteristics that the evaluation for the management of health services should have to contribute to decision-making. Usefulness, opportunity, feasibility, reliability, objectivity and directionality represent the set of principles upon which the evaluation should be based. Evaluations should lead to decisions that guarantee not only their efficiency and effectiveness but also their implementation. The evaluation process should ensure that decisions involve all stakeholders in order to render the implementation of decisions feasible, and take into account the health needs of the population and the goals set for the services. The scope of this article is to elicit a debate among different stakeholders in the evaluation in the hope that it can contribute to the reflection on the real usefulness of evaluations in which the political component in management has been increasingly prevalent.

Por que um jornal? / Why a journal?

O autor descreve sua experiência editorial em revistas científicas e discute sua função e funcionamento. Ao fazê-lo coteja a função e o funcionamento dessas revistas na área da psicanálise com a própria atividade psicanalítica.(AU)

The author describes his long editorial experience in regular Scientific Journals and he discusses its function and modus operandi. Subsequently he also discusses the relationship between the psychoanalytical activity in the clinic and the function of a Psychoanalytical Journal.(AU)

El autor describe su experiencia editorial en revistas científicas en el área del psicoanálisis y discute su función y funcionamiento comparándolos con la propia actividad psicoanalítica.(AU)

Por que um jornal? / Why a journal?

O autor descreve sua experiência editorial em revistas científicas e discute sua função e funcionamento. Ao fazê-lo coteja a função e o funcionamento dessas revistas na área da psicanálise com a própria atividade psicanalítica.

The author describes his long editorial experience in regular Scientific Journals and he discusses its function and modus operandi. Subsequently he also discusses the relationship between the psychoanalytical activity in the clinic and the function of a Psychoanalytical Journal.

El autor describe su experiencia editorial en revistas científicas en el área del psicoanálisis y discute su función y funcionamiento comparándolos con la propia actividad psicoanalítica.

Reforma da Saúde Familiar em Portugal: avaliação da implantação / Family Health Reform in Portugal: analysis of its implementation

Os cuidados de saúde primários de Portugal estão em processo de reforma, sendo as Unidades de Saúde Familiar (USF) uma das principais marcas desse processo. Este estudo teve como objectivo avaliar o processo de implantação das USF a partir de 2006. Utilizou-se metodologia de análise de implantação na mesma área de atenção primária em saúde de um estudo anterior no Brasil. Na análise foram empregadas as dimensões do cuidado integral, da organização dos cuidados e político-institucional. Evidenciaram-se como avanços principais a acessibilidade, trabalho em equipe, qualidade (técnico-científica) dos cuidados, inovações nas práticas de gestão, na sustentabilidade (condições de trabalho) e infraestrutura. Principais desafios: integração com especialidades hospitalares, indefinições político-institucionais, sistemas informatizados, integração nos centros de saúde e organização do processo de trabalho. Estes dados poderão vir a informar os decisores de gestão sobre correções a efetuar no processo de reforma.

Primary healthcare in Portugal is undergoing a major reform, of which family health units (FHU) are one of the more visible results. This study aimed to evaluate the FHU implementation process from 2006 onwards. Methods from a previous study of primary healthcare implementation in Brazil were used. Dimensions studied included comprehensiveness of care, organization of care, and the political-institutional perspective. The main improvements identified included better availability of care, team work, technical quality of care, innovative management practices, sustainability of the model, working conditions and infrastructure improvements. Main challenges remaining include integration with hospital care, political and institutional gray areas, need for better information systems, integration within health centers and workflow organization. These data may be useful for management decision-makers when making adjustments and corrections in the reform process.