Diseño de intervención y estaciones ECOE sobre alimentación del menor de dos años / Design of intervention and oser stations on feeding children under two years of age

OBJETIVO: Probar una metodología de enseñanza-aprendizaje, instrumentos de medición y sistema de implementación de la ECOE en relación con lactancia materna, alimentación complementaria, crecimiento y consejería. MATERIAL Y MÉTODOS: Se estudió la adquisición de competencias sobre alimentación en menores de dos años en internos de pediatría aplicando la evaluación clínica objetiva estructurada (ECOE) antes y después del desarrollo de un proceso de enseñanza aprendizaje (PEA) estructurado. Se organizaron cuatro estaciones de evaluación de los aspectos centrales de alimentación y crecimiento, en un grupo de internos seleccionados al azar. RESULTADOS: Las cuatro estaciones de la ECOE se aplicaron sin dificultades antes y después del PEA. Los resultados mostraron una mejora en el rendimiento de los internos, de manera individual y de grupo; en este último las diferencias en la media fueron para alimentación complementaria pre 2,5 (DE 0,93) y post 5 (DE 2,39); consejería pre 5,75 (DE 1,49) y post 8,13 (DE 1,25); lactancia materna pre 12,63 (DE 2,5) y post 16,38 (DE 2) y velocidad de crecimiento pre 3,13 (DE 1,36) y post 3,38 (DE 0,92). Los resultados fueron estadísticamente significativos para los tres primeros rubros. CONCLUSIONES: En base a estos resultados se sugieren mejoras en el programa de enseñanza y se verifica la aplicabilidad de la ECOE en el internado del Hospital del Niño Dr. Ovidio Aliaga Uría.

OBJECTIVE: To test a teaching-learning methodology, measurement tools and OSCE implementation system in relation to breastfeeding, complementary feeding, growth and counseling. METHODOLOGY: The acquisition of competences was studied by applying objective structured clinical examination (OSCE) before and after the development of a structured teaching-learning process. Four assessment stations were organized considering central aspects on feeding and growth of children under two years of age, in a group of randomly selected students during medical internship. RESULTS: The four OSCE stations were applied without difficulties before and after the learning and teaching process. The results showed an improvement in the performance of interns, individually and in groups; in the latter, mean differences were: for complementary feeding pre 2.5 (SD 0.93) and post 5 (SD 2.39); counseling pre 5.75 (SD 1.49) and post 8.13 (SD 1.25); breastfeeding pre 12.63 (SD 2.5) and post 16.38 (SD 2) and growth velocity pre 3.13 (SD 1.36) and post 3.38 (SD 0.92). The results were statistically significant for the first three items. CONCLUSIONS: Based on these results, the authors suggest improvements in the teaching program, and verify the applicability of the OSCE for the evaluation of rotatory internship at the Hospital del Nino Dr. Ovidio Aliaga Uria.

Attitudes of Bolivian pharmacists in dealing with diarrhea cases.

To help learn about the recommendations made by Bolivian pharmacists dealing with diarrhea cases, 498 pharmacies in three Bolivian cities (Cochabamba, El Alto, and La Paz) were visited by female interviewers who indicated they were seeking treatment for a child with diarrhea. Ninety-eight of the Cochabamba pharmacies were also visited by a male interviewer who indicated he was suffering from diarrhea and was seeking treatment. In response, fewer than 2% of the pharmacists recommended using oral rehydration salts (ORS), increasing fluid intake, or consulting a physician. Most recommended antimicrobials, antidiarrheals, or some combination of the two. At 329 (66%) of the pharmacies, oral rehydration salts were unavailable, and those that did have such salts rarely offered them to customers. At the time of the survey, pharmacists were not integrated into the Bolivian National Health Secretariat's training program for control of diarrheal diseases. Steps have since been taken to resolve this matter.

[Attitudes of Bolivian pharmacy distributors in a case of diarrhea]. / Actitudes de los expendedores de farmacias bolivianas frente a un caso de diarrea.

In order to learn the recommendations given for a case of diarrhea by persons who sell medications at pharmacies, interviewers visited pharmacies in three Bolivian cities and said they had a child suffering from diarrhea. Less than 2% of the vendors recommended using oral rehydration salts, increasing fluid intake, or consulting a doctor. Most of them recommended antibiotics, antidiarrheals, or both. Oral rehydration salts were not available in nearly two-thirds of the establishments visited, and those that had the salts rarely offered them. This study revealed the lack of integration of these professionals into the Health Secretariat's training program, and as a result activities were initiated to solve this problem.