[Forms of management of the national school meals program]. / As formas de gestão do programa nacional de alimentação escolar (PNAE).

The National School Meals Programme (PNAE in Portuguese initials) is a supplementary program to education that aims to provide school meals for pupils across the school system enrolled in public and philanthropic schools of primary education, secondary education, youth education, adult education and comprehensive education. The principles of the program are the universality and the expansion of student services in order to meet the Organic Law on Food and Nutritional Security (LOSAN), as well as the Food Security and Nutrition System. The objective of this study is to discuss forms of PNAE management to ensure that the students' right to school meals. This study is a reflection on how the resources of school meals are being managed, be it with a centralized, decentralized, semi-centralized or outsourced model. We conclude that the knowledge of the different forms of managing federal resources for food for school communities allows for making an informed choice regarding implementation and enforcement of PNAE.

Convenience stores are the key food environment influence on nutrients available from household food supplies in Texas Border Colonias.

BACKGROUND: Few studies have focused on the relationship between the retail food environment and household food supplies. This study examines spatial access to retail food stores, food shopping habits, and nutrients available in household food supplies among 50 Mexican-origin families residing in Texas border colonias. METHODS: The design was cross-sectional; data were collected in the home March to June 2010 by promotora-researchers. Ground-truthed methods enumerated traditional (supercenters, supermarkets, grocery stores), convenience (convenience stores and food marts), and non-traditional (dollar stores, discount stores) retail food stores. Spatial access was computed using the network distance from each participant's residence to each food store. Data included survey data and two household food inventories (HFI) of the presence and amount of food items in the home. The Spanish language interviewer-administered survey included demographics, transportation access, food purchasing, food and nutrition assistance program participation, and the 18-item Core Food Security Module. Nutrition Data Systems for Research (NDS-R) was used to calculate HFI nutrients. Adult equivalent adjustment constants (AE), based on age and gender calorie needs, were calculated based on the age- and gender composition of each household and used to adjust HFI nutrients for household composition. Data were analyzed using bivariate analysis and linear regression models to determine the association of independent variables with the availability of each AE-adjusted nutrient. RESULTS: Regression models showed that households in which the child independently purchased food from a convenience store at least once a week had foods and beverages with increased amounts of total energy, total fat, and saturated fat. A greater distance to the nearest convenience store was associated with reduced amounts of total energy, vitamin D, total sugar, added sugar, total fat, and saturated fat. Participation in the National School Lunch Program (NSLP) was associated with lower household levels of total energy, calcium, vitamin C, sodium, vitamin D, and saturated fat. Spatial access and utilization of supermarkets and dollar stores were not associated with nutrient availability. CONCLUSIONS: Although household members frequently purchased food items from supermarkets or dollar stores, it was spatial access to and frequent utilization of convenience food stores that influenced the amount of nutrients present in Texas border colonia households. These findings also suggest that households which participate in NSLP have reduced AE-adjusted nutrients available in the home. The next step will target changes within convenience stores to improve in-store marketing of foods and beverages to children and adults.

Economic evaluation of preventive dental programs: what can they tell us?

The role of public health program planners is to determine the effectiveness of public health programs, what recommendations should be made, what future initiatives should be taken, and what policies should be developed. At a basic level, to choose between competing alternatives, two characteristics of an intervention must be considered; these are its outcome and its cost. Based on cost and outcome, planners must select the option that offers the most advantages. Economic evaluation is commonly adopted by decision makers in the health sector to investigate the effectiveness of public health programs and to help plan future initiatives. Economic evaluation assists decision makers who must weigh the information it provides in the context of many and often competing options. In this way, an economic evaluation is an aid to decision making rather than the decision itself. Economic evaluation is becoming essential for informed decision making, with potential implications for public health policy and practice and for clinical practice too. While economic evaluations are commonly used in decision-making processes about health programs, few examples exist in the oral health literature. In the case of preventive oral health programs, economic analysis is often difficult, largely because it makes demands on epidemiological and demographic data that are hard to meet. This study will address the concepts and tools required to conduct economic evaluations of prevention programs. The emphasis will be on oral health and preventive dental programs, although the concepts presented could be useful for other public health programs by practitioners and managers with the aim of producing effective and efficient oral health programs.

Las políticas de salud y su impacto en los sectores populares: Chile, 1974-1986 / Health policies and their impact in population: Chile, 1974-1986

En el presente trabajo se analizan los antecedentes con respecto al gasto público en salud poniendo énfasis en su evolución, comportamiento pro-cíclico y su caracter redistributivo. A continuación se estudian el proceso de privatización de la salud y el traspaso de su costo a los usuarios, tratando de identificar los mecanismos a través de los cuales las reformas implementadas en el área de la salud ha tendido a producir una mayor segmentación en la calidad de las atenciones y prestaciones que reciben los chilenos según su nivel de ingresos. Finalmente, se analizan los programas de salud implementados y sus resultados. Nos centramos en el impacto de la política de salud y nutricional sobre: a) los escolares, jóvenes y adolescentes, grupo particularmente desatendidos por los programas públicos y, b) el sector materno infantil, grupo definido como prioritario por las autoridades del sector salud. El análisis y los antecedentes presentados a lo largo de todo el trabajo se refieren al periodo 1974-1986 en que se han producido importantes cambios estructurales en el área salud