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Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se realizó un estudio epidemiológico descriptivo del índice de asistencia de los pacientes remitidos por el estomatólogo hacia las consultas de cirugía máxilo facial y todos los pacientes examinados realmente en estas consultas de atención secundaria, durante los años 1986 al 1990, por provincias, según el Programa de Detección Precoz del Cáncer Bucal. Una proporción considerable de los pacientes remitidos (71,6%) no concurren al especialista para su seguimiento y tratamiento. Sólo las provincias de Vílla Clara, Granma y Ciego de Avila presentan tendencias hacia el incremento. Esto indica que existen fallas en las actividades de rescate de los casos. Se suguiere realizar actividades educativas y cumplimentar lo estabelecido por el Programa, mediante trabajo conjunto entre el estomatólogo, el médico de familia y las organizaciones de masas

Background: A fundamental strategy to achieve satisfactory results in maternal and child care was the implementation of the National Program for Maternal and Child Care (PAMI). The results of the PAMI in 2021 are not what is expected each year at the country level and it was not far from the reality of the Paquito Glez University Pediatric Hospital.Objective: Mention the results of the work of the Maternal and Child Program at the University Pediatric Hospital of Cienfuegos in the year 2021.Methods: descriptive, cross-sectional study, carried out at the Pediatric Hospital of Cienfuegos and which includes the comprehensive results of the Maternal and Child Program at said institution. All the indicators of the program are exposed. It also offers a contextualization of the scenario in the year 2021.Results: The scenario of confrontation with COVID-19 in Cienfuegos had an impact during the year 2021 on the results obtained by the institution, increasing care in the emergency room to 45,151 consultations, as the main reason for Acute Respiratory Diseases. Hospital mortality increases by six more deaths compared to 2020, responding to the main cause of emergency care followed by Sepsis. The municipal seat remains the main issuer of patients and is followed in frequency by Cumanayagua and Rodas, corresponding to the municipalities that contribute the greatest number of admissions. The average hospital stay was 4.3 and the general survival behaves in 96.8%.Conclusions: The group of the institution continues to develop clinical management to achieve the quality of optimal hospital services to influence, modify and make sustainable the indicators with unfavorable results.

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Objetivo. Identificar los mecanismos reportados en intervenciones de atención primaria en salud (APS) en poblaciones rurales y urbanas marginales entre los años 1997 y 2019. Métodos. Se utilizó el método de revisión sistemática exploratoria para identificar la literatura. La búsqueda de literatura fue realizada en las bases de datos Medline (Pubmed y Ovid), Global health, Embase, Web of science, Scopus y Lilacs. La inclusión de literatura consideró estudios de intervención primaria, observacionales con metodologías cualitativas, cuantitativas o mixtas. Se incluyeron artículos en inglés, portugués y español publicados entre 1997 y 2019. Para la selección de documentos definitivos se utilizó Rayyan QCRI, se excluyeron fuentes de información de literatura gris o investigación en progreso. Resultados. A nivel individual se identificaron tres grupos de mecanismos: niveles de relaciones entre las intervenciones y los sujetos, transformaciones que pueden generar en los individuos y las relaciones recíprocas. A nivel institucional se relacionaron con la temporalidad, el dinero, relaciones de poder, relaciones de confianza, el sistema de salud, las expectativas y las condiciones administrativas. Conclusiones. Los mecanismos individuales son similares en los diferentes contextos, los mecanismos institucionales son susceptibles a la variación del contexto, se representan en la temporalidad, recursos económicos, relaciones de poder y de confianza, el sistema de salud, las expectativas y condiciones administrativas.

Objective: To evaluate the "Transformem els patis" (Let's transform the schoolyards) program in Barcelona in terms of schoolyard use, social interaction, physical activity, and diverse forms of play with a gender perspective., Method: A cross-sectional pilot evaluation study with mixed methodology involving eight primary schools (four in intervention group and four in control group). For the quantitative analysis, 16 systematic observations were performed in the schoolyards of both groups. The group size, group composition according to sex, physical activity, the carried-out activity and play structures or material use, and environmental variables were analyzed. For the qualitative analysis, three structured group interviews were held with teachers and the monitoring team of the intervention group. A thematic content analysis with a phenomenological perspective was conducted, exploring changes related to the physical schoolyard transformation, its educational use, and interactions among children, and the overall assessment of the schoolyard transformation., Results: 192 groups of schoolchildren were observed in the intervention group and 203 in the control group. The transformed schoolyards had more natural elements, play structures, places to sit and non-cemented flooring. Compared to the non-transformed schoolyards, both in the boys' and girls' groups, a higher proportion of active play was registered, as well as a higher proportion of non-sport games and imaginative games among boys and a lower proportion of girls watched the schoolyard., Conclusions: Transformed the schoolyards are more inclusive, naturalized, playable, and equitable, with a greater diversity of elements and play structures., (Copyright © 2024 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: A fundamental strategy to achieve satisfactory results in maternal and child care was the implementation of the National Program for Maternal and Child Care (PAMI). The results of the PAMI in 2021 are not what is expected each year at the country level and it was not far from the reality of the Paquito Glez University Pediatric Hospital. Objective: Mention the results of the work of the Maternal and Child Program at the University Pediatric Hospital of Cienfuegos in the year 2021. Methods: descriptive, cross-sectional study, carried out at the Pediatric Hospital of Cienfuegos and which includes the comprehensive results of the Maternal and Child Program at said institution. All the indicators of the program are exposed. It also offers a contextualization of the scenario in the year 2021. Results: The scenario of confrontation with COVID-19 in Cienfuegos had an impact during the year 2021 on the results obtained by the institution, increasing care in the emergency room to 45,151 consultations, as the main reason for Acute Respiratory Diseases. Hospital mortality increases by six more deaths compared to 2020, responding to the main cause of emergency care followed by Sepsis. The municipal seat remains the main issuer of patients and is followed in frequency by Cumanayagua and Rodas, corresponding to the municipalities that contribute the greatest number of admissions. The average hospital stay was 4.3 and the general survival behaves in 96.8%. Conclusions: The group of the institution continues to develop clinical management to achieve the quality of optimal hospital services to influence, modify and make sustainable the indicators with unfavorable results. [ABSTRACT FROM AUTHOR]

Objetivos. Presentar la metodología de evaluación integral de la implementación del Programa de Acción Mundial para Superar las Brechas en Salud Mental (mhGAP) en Chile y exponer sus resultados. Métodos. Estudio evaluativo de corte transversal basado en una encuesta a referentes clave del programa, desplegados en los 29 servicios públicos de salud del país, y entrevistas individuales y grupos focales con actores clave y expertos. El foco de la evaluación estuvo en la relevancia e impacto del mhGAP en la prestación de servicios de salud mental y en la implementación del programa. Resultados. Los participantes evaluaron positivamente la implementación progresiva del mhGAP en Chile, en particular: 1) manifestaron contar con mejores herramientas de detección, diagnóstico y tratamiento de trastornos frecuentes, y estrategias eficientes de derivación; 2) calificaron todos los módulos como importantes; los más relevantes fueron autolesión/suicidio (x = 4,77) y trastornos mentales y conductuales del niño y el adolescente (x = 4,58); 3) evaluaron favorablemente las Jornadas Nacionales y sus réplicas y su contribución al éxito de la implementación del mhGAP; 4) coincidieron en la necesidad de incorporar nuevos actores, fortalecer algunos aspectos y ampliar la información sobre el programa. Conclusiones. La implementación del mhGAP en Chile constituye un caso emblemático de aprendizaje, apoyado por el desarrollo de la salud mental comunitaria y la salud familiar, entre otros factores. Lo logrado abre una oportunidad única para continuar avanzando en la implementación de este programa en el país y transmitir esta experiencia a otros contextos de América Latina y el Caribe.

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Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Evaluaruna intervención de base poblacional denominada “Malnutrición por exceso de peso en la primera infancia”, implementada con recursos del programa de Presupuesto Participativo en Salud de Medellín, Colombia, en 2017. Método: Perspectiva deinvestigación de tipo evaluativa, con base en el modelo de teoría del cambio, utilizado en el campo de la evaluación de programas y proyectos en salud. Se desarrolló un estudio de caso de método mixto convergente e igualdad de estatus. El caso de análisis fue la implementación y los resultados de la intervención “Malnutrición por exceso de peso en la primera infancia”. La evaluación se dio en dos fases: 1) la planeación de la evaluación, y 2) la evaluación de los procesos durante su implementación y de los efectos al finalizar la intervención. Resultados: Al finalizar la intervención, no se observaron efectos significativos para los indicadores antropométricos de los niños y las niñas. En el peso para la talla, la mediana al iniciar el tratamiento era de 2,52, y al finalizarlo, de 2,49 (p (0,174) > 0,05). Para el índice de masa corporal, la mediana al iniciar el tratamiento era de 2,4, y al finalizarlo, de 2,3 (p (0,236) > 0,05). Sin embargo, de forma individual hubo variaciones en las desviaciones estándar de los valores Z antropométricos de los niños y las niñas; esto se explica porque en la evaluación de los procesos se identificó el compromiso, la aceptabilidad y la adopción de las recomendaciones nutricionales y psicosociales por parte de los padres y cuidadores. También se encontraron cambios no previstos en el modelo de teoría del cambio, los cuales hacen referencia a variaciones antropométricas en los cuidadores de los niños y las niñas. Conclusión: Los efectos individuales a corto plazo que se dieron en la intervención “Malnutrición por exceso de peso en la primera infancia” favorecieron variaciones antropométricas y el mejoramiento del estado nutricional de niños, niñas y cuidadores, lo cual se explica por la adopción de estilos de vida saludables, lo que permitió alcanzar el cambio global definido para la intervención en el modelo de teoría del cambio.

Objective. Identify mechanisms reported in primary health care (PHC) interventions in rural and marginal urban populations from 1997 to 2019. Methods. A scoping review was used to identify the literature. The literature search was conducted using the Medline (PubMed and Ovid), Global Health, Embase, Web of Science, Scopus, and Lilacs databases. Inclusion criteria considered literature on primary intervention and observational studies using qualitative, quantitative, or mixed methods. Articles in English, Portuguese, and Spanish published from 1997 to 2019 were included. Rayyan QCRI was used for definitive document selection; sources of information from gray literature or research in progress were excluded. Results. At the individual level, three groups of mechanisms were identified: levels of relationships between interventions and subjects, transformations that can occur in individuals, and reciprocal relationships. At the institutional level, mechanisms were related to temporality, money, power relations, trust relations, the health system, expectations, and administrative conditions. Conclusions. Individual mechanisms are similar in different contexts. Institutional mechanisms are susceptible to variations in context and are expressed in terms of temporality, economic resources, power and trust relations, the health system, expectations, and administrative conditions. [ABSTRACT FROM AUTHOR]

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Antecedentes: el programa de primera infancia Buen Comienzo Medellín se ha convertido en un referente nacional por sus logros en la atención integral a los niños. Las evaluaciones realizadas hasta el momento se han centrado, sobre todo, en los efectos que tiene el programa en el estado nutricional de los niños participantes. Objetivo: evaluar algunas categorías sociopolíticas, como la construcción de ciudadanía y la participación que se desarrollan y potencializan en los momentos de la alimentación de los niños. Materiales y métodos: se utilizó un modelo que combina el análisis multidimensional (estructura, proceso y resultados) y la triangulación de métodos. Resultados: luego de analizar las entrevistas, las observaciones y los documentos del programa se encontraron las siguientes temáticas: a) autonomía y autocuidado, bases para la construcción de ciudadanía en los niños; b) compromiso familiar; c) participación y límites de la libertad; y d) más participación en el hogar, un llamado de los agentes educativos.

Introduction: in Colombia, educational and preventive strategies to improve oral health in early childhood have been developed, but few evaluative studies have been conducted to assess their results. The aim of this study was to assess the knowledge on early childhood oral care acquired by education agents after participating in an educational strategy, and to evaluate the results of the implementation of the Ministry of Health’s preventive protocol “I am a more smiling generation” (Soy una generación más sonriente). Methods: this was a mixed-focus study. The qualitative component was a participatory assessment of learning. It involved 45 education agents registered in a state program, who participated in workshops and focus groups. The quantitative component was a longitudinal study with the participation of 54 mother-child pairs belonging to the same program. The preventive protocol was applied three times over a twelve-month period. It included educational reinforcement and application of fluoride varnish to the children, using oral examination and assessment of their dental caries risk, as well as a survey to identify the families’ social conditions. Results: after applying the preventive protocol, the average carious teeth in children decreased from 3.1 teeth in the first examination to 2.2 in the third one. Prior to application of the preventive protocol, 49% of children had a high risk of developing cavities and in the last visit 63% were at low risk while 5.6% were at high risk. A number of positive aspects result from this learning assessment, including the adoption of new pedagogical strategies to accompany children during oral care practices; there are also some aspects to improve in relation to the persistence of conflicting knowledge concerning children’s rights to oral health. Conclusion: following the application of the preventive protocol, the children’s average carious teeth decreased, as well as their risk for dental caries. Educational agents acquired new knowledge, but uniform knowledge in terms of children’s health rights is still lacking.

Los programas de educación continua en detección temprana del cáncer son una herramienta útil y necesaria en la adquisición de conocimientos, competencias y habilidades requeridas por los profesionales de la salud. En Colombia existen falencias en la formación de profesionales en estas áreas, derivando en la falta de estandarización de técnicas y procedimientos, e inadecuada unificación de criterios de abordaje diagnóstico y terapéutico de los pacientes. El estudio buscó evaluar el programa de educación continua en detección temprana del cáncer de mama implementado por el Instituto Nacional de Cancerología entre 2016-2018. Se realizó un estudio con metodología mixta concurrente, con diseño analítico descriptivo, a partir de un análisis documental, entrevistas semiestructuradas, análisis de las encuestas de satisfacción, y de los exámenes pre y pos de las capacitaciones realizadas. Se realizó un muestreo no probabilístico y a conveniencia, la población seleccionada fueron los sujetos involucrados (profesionales capacitados, capacitadores, creadores), entre los años 2016 a 2018. Dentro de los resultados se encontró, que el nivel de satisfacción con el curso fue del 97.5%; resaltando la metodología basada en el aprendizaje activo, la educación por competencias, la pertinencia de los temas abordados, la utilización de modelos anatómicos en silicona y la experticia de los capacitadores. Se encontraron diferencias estadísticamente significativas posterior a la intervención educativa (V=439; p=0.001). Quedaron en evidencia barreras de tipo económico, administrativo y de divulgación; además, se sugiere implementar el curso de manera sistemática, aumentando la cobertura, divulgación y tiempo de capacitación, ofreciendo prácticas con pacientes. Concluyendo que, la implementación de programas de educación continua en profesionales de la salud son una herramienta útil y necesaria en la adquisición de competencias básicas en detección temprana del cáncer y debe contar con una estructura definida, organizada y en concordancia con los programas y políticas públicas del país.

Los adultos mayores frágiles (AMF) tienen mayor riesgo de caídas, con morbi-mortalidad asociada. Nuestro objetivo fue disminuir el porcentaje de AMF con caídas luego de una intervención multifactorial y sistémica. Estudio cuasiexperimental antes-después, propio individuo control. Ámbito: domicilio de AMF, en área metropolitana de Buenos Aires. Periodo de reclutamiento: 01/10/17-31/04/18. Evaluación basal y seguimiento a 3 meses. Criterios de inclusión: ≥65 años con criterios de fragilidad según médico tratante. Criterios de exclusión: rechazo de intervención o paciente moribundo. Intervención: un orientador (agente) socio-sanitario evaluó sistemáticamente en domicilio distintas dimensiones para prevención de caídas e intervino según necesidad en cada caso en: seguridad ambiental, indicación y capacitación en uso de apoyos de marcha, ejercicios de fortalecimiento, mejora de la red de cuidado, y conciliación de medicación. Se analizó por intención de tratar el cambio en el porcentaje de personas con caídas en el último mes (McNemar). Incluimos 108 personas, edad promedio 85,2 años (DE 6,2), mujeres 79,6%. Barthel promedio 50,5 (DE 35,9). El 56,8% tenían dependencia severa o total; 29,6% demencia; 30,5% institucionalizados; 82,4% polimedicados. El 79,6% (IC95% 71,1-86,1) tenían alto riesgo de caídas. En evaluación inicial habían sufrido caídas en el último mes 33,3% (IC95% 25,2-42,7). Post intervención, 13,9% (IC95% 8,6-18,6), p

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Introduction: the evaluation of programs in Primary Health Care allows measuring the true impact of their application and arises as an instrument of accuracy and development. Objective: to show the results of the evaluation of the subprogram for the Community Care of the elderly at Dr. Juan Bruno Zayas Main Emergency Polyclinic in Mantua during 2017. Methods: an observational and analytical Research on Health Systems and Services was carried out. The target group of the study was comprised of 4648 people 60 years of age and older who were attended, as well as all the doctors and nurses of the 27 Family Physician Offices, with a total of 53 providers. For the selection of the sample of geronts, a simple random probability sampling was used, at a rate of eight per clinic until 216 old people were chosen, to whom a survey was applied to evaluate the level of satisfaction. Providers were given another survey designed for the same purpose. The indicators of activities, results established in the subprogram and the corresponding program standards were applied. Results: the three components of the subprograms were evaluated as unsatisfactory. Most of its tracer indicators of hospital management did not meet the desired standards. Conclusions: the subprogram of community care to the elderly was evaluated in the municipality of Mantua, which evidenced deficiencies in its implementation, as well as limited availability of medical literature concerning this topic.

Introducción. Cada día son más las cirugías realizadas en el mundo, lo que aumenta el riesgo de cometer errores dentro del área quirúrgica. Por ello, es necesario contar con un arraigado clima de seguridad del paciente que permita desarrollar la efectividad de herramientas clave como el listado de verificación quirúrgica. Objetivos. Evaluar de forma realista la implantación del listado de verificación quirúrgica en un hospital de tercer nivel a través de sus profesionales. Metodología. La evaluación realista permite obtener una visión integral de una intervención compleja como es la incorporación del listado de verificación quirúrgica. Se llevarán a cabo tres etapas diferenciadas: análisis del contexto, análisis del mecanismo y análisis del resultado. Estas fases requieren distintas formas de recogida de datos: revisión de la literatura, entrevistas semiestructuradas, encuestas y recogida de indicadores de calidad del programa cirugía segura. Aplicabilidad práctica. Durante el análisis de los datos se obtendrán datos cuantitativos y cualitativos que se integrarán para conseguir una evaluación exhaustiva del proceso de implantación del listado de verificación quirúrgica desde el inicio hasta la actualidad con los correspondientes flujos entre el contexto y sus circunstancias. Con esto conseguiremos destacar la importancia de un plan de implantación con estrategias sólido a través de intervenciones programadas que permiten una mejora y evaluación constante de las herramientas. Abstract Introduction. Every day there are more surgeries performed in the world, which increases the risk of making mistakes within the surgical area. For this reason, it is necessary to have a developed patient safety climate that allows the development of the effectiveness of key tools such as the surgical safety checklist. Objective. Evaluate the implementation of the surgical safety checklist in a tertiary hospital through its professionals. Methodology. The realist evaluation allows obtain a comprehensive vision of a complex intervention such as the incorporation of the surgical safety checklist. Three different stages will be carried out: context analysis, mechanism analysis and result analysis. These phases require different forms of data collection: literature review, semi-structured interviews, surveys, and collection of quality indicators of the safe surgery program. Clinical relevance. Quantitative and qualitative data will be obtained that will be integrated to achieve an exhaustive evaluation of the surgical safety checklist implementation process from the beginning to the present with the corresponding flows between the context and its circumstances. This exhaustive evaluation will be able to highlight the importance of an implementation plan with solid strategies through programmed interventions that allow constant improvement and evaluation of the tools.

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Copyright of Diaeta is the property of Asociacion Argentina de Dietistas & Nutricionistas Dietistas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Chronic degenerative diseases have become a challenge for the Mexican health system. Faced with this problem, health institutions have focused on the therapeutic potential of organ and tissue donation and transplantation. Objective: To analyze the experience of the donation program and to identify areas of opportunity at the Hospital de Cardiología No. 34 (Hospital of Cardiology Number 34), in Monterrey, Nuevo León, Mexico. Material and methods: Observational, cross-sectional, and retrospective study. The study population was made up by deaths and successful interviews. Only groupings with values of p < 0.05 were considered statistically significant. Results: A global of 1947 deaths were registered and a total of 210 interviews were carried out; 83 (39.5%) family members accepted to donate and 127 (60.5%) refused to donate. Only 3 associations between variables had significant statistical value. The year was an important determinant in the increase in effective donations (p = 0.010), and so was the month of the year (p = 0.037), obtaining more positive interviews in the second half of the year; finally, the shift also contributed to the family response (p = 0.012), with the morning shift being the best shift to conduct a successful family interview. Conclusions: It is imperative to conduct studies that analyze and describe the experience of donation programs to promote and encourage the value of donation. [ABSTRACT FROM AUTHOR]

Objectives. Present the methodology for comprehensive evaluation of the implementation of the Mental Health Global Action Programme (mhGAP) in Chile and describe the program's results. Methods. Cross-sectional evaluative study based on a survey of key program informants deployed in 29 public health services in the country, as well as individual interviews and focus groups with key actors and experts. The evaluation was focused on the relevance and impact of mhGAP on the provision of mental health services and on the implementation of the program. Results. The participants gave a positive evaluation of the progressive implementation of mhGAP in Chile. In particular: 1) They reported having better tools for detecting, diagnosing, and treating common disorders, and efficient referral strategies; (2) They rated all modules as important, the most relevant being self-harm/suicide (... = 4.77) and mental and behavioral disorders in children and adolescents (... = 4.58); (3) They favorably assessed the National Mental Health Day training courses and the subsequent courses repeated at the local level, indicating that these courses contributed to successful implementation of mhGAP; (4) They agreed on the need to incorporate new actors, strengthen certain aspects, and expand information on the program. Conclusions. The implementation of mhGAP in Chile is an emblematic example of learning supported by the development of community mental health and family health, among other factors. These accomplishments offer a unique opportunity to continue advancing the implementation of this program in the country and to implement this experience in other contexts in Latin America and the Caribbean. [ABSTRACT FROM AUTHOR]

Objective: To evaluate a population-based intervention named "Early Childhood Malnutrition due to Overweight" implemented with resources of the Participatory Budget for Health program of Medellín, Colombia, in 2017. Methodology: Evaluative research perspective, based on the theory of change model, used in the field of health projects and programs evaluation. A case study of the convergent mixed method and equality of status was conducted. The case under analysis was the implementation and the results of the intervention "Early Childhood Malnutrition due to Overweight". The evaluation was made in two stages: 1) evaluation planning, and 2) evaluation of the processes during their implementation and the effects at the end of the intervention. Results: At the end of the intervention, significant effects in the anthropometric index of the children were not observed. The median weight-for-height at the beginning of the treatment was 2.52; at the end it was 2.49 (p (0.174) > 0.05). The median body mass index at the beginning of the treatment was 2.4, and at the end, it was (p (0.236) > 0.05). Nevertheless, there were individual variations in the standard deviations of the anthropometric Z-score of children, which is explained due to commitment, acceptability, and adoption of the nutritional and psychosocial recommendations by parents and child caregivers, which were identified during the evaluation of the processes. Changes not expected according to the theory of change model were also found. Those changes refer to the anthropometric variations in the child caregivers. Conclusion: The short-term individual effects that occurred during the "Early Childhood Malnutrition due to Overweight" intervention contributed to the anthropometric variations and the nutritional status improvement of the children and child caregivers. This is explained by the adoption of healthy lifestyles, which allow to reach the global change established for the intervention in the theory of change model. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Interface - Comunicação, Saúde, Educação is the property of Fundacao UNI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Interface - Comunicação, Saúde, Educação is the property of Fundacao UNI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción. Los programas de rehabilitación cardiovascular (PRC) representan una estrategia médicosanitaria multidisciplinaria eficaz en la prevención y control de los problemas cardiovasculares. Objetivos. Evaluar el impacto de un PRC realizado en el espacio de trabajo, en la reducción del riesgo cardiovascular absoluto en los trabajadores de INCOR. Métodos. Estudio experimental. Se incluyó a 41 trabajadores con diferentes niveles de riesgo cardiovascular, evaluados previa y posteriormente a su participación en el PRC sobre su capacidad funcional, sus factores de riesgo cardiovascular y niveles de estrés. El programa de intervención en el trabajo consistió en 36 sesiones de actividad física controlada, consejería nutricional, consejería psicológica y evaluación de laboratorio. Resultados. Se redujo el riesgo cardiovascular global al nivel bajo en el 100% medido mediante el índice de Framingham y en la medición con el score ASCVD 2013, se eliminó el nivel de riesgo alto y el nivel intermedio se redujo de 17,5% a 10%. La capacidad funcional mejoró, incrementándose la clase funcional I de 19,5% a 90%. Los niveles de VLDL, LDL, colesterol total y triglicéridos se redujeron significativamente en la post-intervención, mientras que para el HDL, la proporción de trabajadores con valores no recomendables se incrementó al final de la intervención. Se encontró disminución significativa del nivel de estrés. Conclusiones. Un PRC puede ser implementado en el mismo ámbito laboral y mostrar su comprobada eficacia para reducir el riesgo cardiovascular y el estrés.

Introduction. In Avia Terai city, in Northeast of Argentina, a local program of Prevention and Control of Chagas disease was developed, guided by the principles of Primary Health Care. The objective of this study was to evaluate the change in knowledge regarding Chagas disease after the implementation of the strategy of Information, Education and Social Communication component of the local program in the urban area of Avia Terai in 2012. Methods. A cross-sectional design was used in two moments. A multistage sampling was carried out. The unit of analysis corresponded to heads of household of the selected house. A questionnaire adapted from Sanmartino and Crocco was used, which includes 3 dimensions and 15 basic knowledge referring to Chagas disease. Results. 609 residents were surveyed. Regarding the level of basic knowledge about Chagas disease, in level III an increase was observed in 2012 with respect to the previous year, from 56.6% to 66.2% (p> 0.0001). While regarding the congenital transmission, a decrease in the proportion of correct responses was observed. Conclusion. After the implementation of a local program of information, education and social communication, an increase in basic knowledge about Chagas disease was observed.

Foundation: Along the years, in the National Program of Prevention and Control of Tuberculosis of Cuba several changes have been done as those related to its evaluation, including new synthetic indicators. Objective: to evlautae the synthetic indicators for the location and detection of new cases of pulmonary tuberculosis. Methods: descriptive research in health services and systems realized in health areas I and II of the Cienfuegos Municipality in the years 2013. The information was taken from the Department of Statistics of the Health Areas. The processing of the data to calculate the indicators was done with the program CALIND designed in Access, used with purpose in the Institute Pedro Kouri. Percentage and incidence rate were used as a Mathematical measures for the quantitative data analysis. Results: the application of the synthetic indicator was used to assess the quality of location of the tuberculosis cases in Area I. It was evaluated as deficient in this area and acceptable in Area II. The synthetic indicator was evaluated as deplorable in Area I and poor in Area II. Conclusion: the application of synthetic indicators for locating and detecting cases of Tuberculosis is coherent with the reality about the quality of case detection. It is corroborated its effectiveness to assess the process in the Program of Prevention and Control of Tuberculosis.

Objective. To evaluate variables of tobacco health warnings associated with their emotional impact, the perception of smoking risks and the perceived effectiveness to avoid tobacco use. Materials and methods. Teenagers (151) andadults (168) evaluated 27 tobacco health warnings selected from the sets used on tobacco packages in Argentina and in other countries. A standardized affective rating-scale system and a structured questionnaire measured respectively the emotional impact (hedonic valence and emotional arousal), and the cognitive-behavioral attributions. The correlation between emotional and cognitive-behavioral evaluations was analyzed by age, sex, education level, smoker status, stage of quitting and susceptibility of non-smokers teenagers. Results. Strong significant correlations between cognitivebehavioral and emotional assessments were observed. The warnings depicting graphic images of tobacco-related injuries and suffering were considered more valuable for tobacco control, helping quitting and preventing initiation. Conclusions. Using graphic images with high emotional arousal is recommended for both adults and teenagers.

Copyright of Avances en Enfermería is the property of Editorial Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The infant program Buen Comienzo Medellin has become a national reference given its achievements in comprehensive assistance to young children. Evaluations undertaken to date have centered on, above all, the effects the program has on the nutritional state of participant children. Objective: To evaluate the socio-political categories of the program, such as community building and participation, that are developed and present as opportunities when families and children come to receive food. Materials and Methods: A model was used that combines multidimensional analysis (structure, process, and results) and triangulation of methods. Results: After analyzing the interviews, the observations, and the program documents, the following themes emerged: a) autonomy and self-care, staples for building good citizenship in children; b) family commitment; c) participation and limits on freedom; and d) increased participation in homes, a call from educational agencies. [ABSTRACT FROM AUTHOR]

Objective. To forecast the impact of alternative scenarios of coverage changes in Brazil's Family Health Strategy (Estratégia Saúde da Família) (ESF)--due to fiscal austerity measures and to the end of the Mais Médicos (More Doctors) Program (PMM)--on overall under-5 mortality rates (U5MRs) and under-70 mortality rates (U70MRs) from ambulatory care sensitive conditions (ACSCs) up through 2030. Methods. A synthetic cohort of 5 507 Brazilian municipalities was created for the period 2017-2030. A municipal-level microsimulation model was developed and validated using longitudinal data. Reductions in ESF coverage, and its effects on U5MRs and U70MRs from ACSCs, were forecast based on two probable austerity scenarios, as compared to the maintenance of current ESF coverage. Fixed effects longitudinal regression models were employed to account for secular trends, demographic and socioeconomic changes, variables related to health care, and program duration effects. Results. In comparison to maintaining stable ESF coverage, with the decrease in ESF coverage due to austerity measures and PMM termination, the mean U5MR and U70MR would be 13.2% and 8.6% higher, respectively, in 2030. The end of PMM would be responsible for a mean U5MR from ACSCs that is 4.3% higher and a U70MR from ACSCs that is 2.8% higher in 2030. The reduction of PMM coverage due only to the withdrawal of Cuban doctors who have been working in PMM would alone be responsible for a U5MR that is 3.2% higher, and a U70MR that is 2.0% higher in 2030. Conclusions. Reductions in primary health care coverage due to austerity measures and the end of the PMM could be responsible for many avoidable adult and child deaths in coming years in Brazil. [ABSTRACT FROM AUTHOR]

Copyright of Revista Facultad de Odontología Universidad de Antioquia is the property of Universidad de Antioquia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetives: To estimate the impact of a payment scheme by performance, known as a budget support agreement, applied by the government in three regions in Peru with the highest rates of chronic malnutrition (CM) in children in 2008—Apurimac, Ayacucho, and Huancavelica—on indicators of health service coverage (immunization, childhood growth and development, and iron supplementation) and the nutritional status of children (malnutrition, anemia, and diarrhea). These agreements were used to transfer resources to the budgets of these regions with the condition of fulfilling management commitments and coverage goals with a view toward improving the nutritional status of children. Materials and methods. Based on data from the Demographic and Family Health Survey conducted from 2008 to 2014, evolution of the indicators in a sample of children residing in the areas where the support programs were signed was compared to that of a control sample in the period in which the agreements were in force and in the subsequent years to estimate differences in the impact of this support strategy. Results. There was a positive impact of the programs on the increase in vaccination coverage provided by the basic health system and rotavirus vaccination, which consequently reduced the rates of diarrhea and malnutrition. Conclusions. The scheme was effective in increasing the vaccination coverage and reducing CM but did not seem to improve the coverage of other benefits, including childhood growth and iron supplementation to children and mothers.

Since 2008, the evaluation of budget design and execution (EDEP for its acronym in Spanish) - one of the evaluations tools developed by the Peruvian Ministry of Economy and Finance (MEF) as part of the implementation of Performance Budgeting- seek to provide reliable information about design coherence and progress in the implementation of public interventions, in order to improve their management and make informed budget decisions. The EDEP methodology includes preparing an evaluation report and defining a matrix of commitments to improve performance. Commitments are defined based on the recommendation of the EDEP. The EDEP seeks to correct exiting problems in public programs and optimize their results. MEF tracks the fulfillment of these commitments and links together the analysis of public budget requests and the progress of these commitments. Now, almost 10 years after its implementation, 57 EDEP have been carried out in different sectors and 07 of them are related to health interventions such as: the comprehensive health system, vaccination service, normal births, acute respiratory infections and acute diarrheal diseases, among others. Beyond the discrepancies in the application of this tool, the EDEP and its matrix of commitments have allowed the use of the results of the evaluations and have become a mechanism to generate useful information to improve the public services.

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health promotion (HP) is a pillar of public health for the improvement of living and health conditions. However, the health promotion evaluation is a theoretical-practical field with incipient developments in permanent construction. Objective: The objective of this study was to provide elements to update the health promotion evaluation debate between the years 2005 and 2015. Methods: A state-of-the-art documentary research was conducted -from a thematic review of 23 databases- after defining the conceptual and comprehensive descriptors related to health promotion, health promotion evaluation and positive indicators in health promotion. A total of 49 publications with emphasis on the evaluation of health promotion were selected for analysis. Results: three health promotion evaluation trends were configured: realistic evaluation aimed at assessing the contexts and theories that underlie the action; participatory evaluation that highlights the participation of all the actors involved in the interventions; and impact evaluation aimed at identifying processes and results tending to health promotion effectiveness and overcoming health inequities. Conclusions: Despite the progress, there are challenges to the health promotion evaluation such as the approach from a complex perspective of both, interventions and evaluation; the development of evaluation models that allow the effective empowerment and intersectoriality; and the problematization of evidence as the guiding axis of effectiveness in health promotion. [ABSTRACT FROM AUTHOR]

The Cuban family medicine model has been developed, for more than three decades, as the third model of medical care of the revolutionary period in Cuba. It is the complete expression of the application of the primary health care strategy. However, it is still possible to improve the organization, quality and efficiency of health services in the first level of health care. The objective of this article is to describe the model, its singularities, distinctive elements, main achievements, and challenges. A documentary review was made from journal articles, books and official documents of the Ministry of Public Health of Cuba on the creation and development of the model; documents were selected and analyzed by experts for the preparation of this report. Conceptual elements of the model are presented, as well as indicators supporting the information. The main characteristics of family medicine in Cuba, its fundamental achievements, and challenges are presented. Based on its results, Cuba's family medicine model is a reference for the Region of the Americas. It is still a model in development, however, perfectible and susceptible to transformations to face new challenges, more importantly to renew the model keeping and strengthening the foundational ideas of the program. [ABSTRACT FROM AUTHOR]

Abstract OBJECTIVE To assess the degree of implementation of the Directly Observed Treatment, Short-course - DOTS for tuberculosis (TB) in a large city. METHOD Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. RESULTS The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. CONCLUSION: The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program.

Abstract OBJECTIVE Analyze the evaluation of the attributes of primary care made by users of basic units of Brazilian health by using PCATool instrument adapted to Brazil. METHOD A systematic literature review conducted in the PubMed database, IBECS, LILACS, SciELO and BDTD. RESULTS 4,405 documents were found, selected 23 full texts. After Full reading and application of eligibility criteria, 14 articles were evaluated. The studies showed that primary care performs well in longitudinality attributes, completeness and coordination and worse performance on attributes access first contact, family counseling and community orientation, even in the basic units with the Family Health. CONCLUSION The users of basic health units assessed as unsatisfactory attributes considered essential for a health care more equitable and competing for user autonomy and social control. It is inferred that there are still obstacles hindering user access to basic health services and care actions are still being developed without favoring user participation and the community context in which they live.