Participants' perspectives of being recruited into a randomised trial of a weight loss intervention before colorectal cancer surgery: a qualitative interview study.

BACKGROUND: The period between cancer diagnosis and surgery presents an opportunity for trials to assess the feasibility of behaviour change interventions. However, this can be a worrying time for patients and may hinder recruitment. We describe the perspectives of patients with excess weight awaiting colorectal cancer surgery about their recruitment into a randomised trial of a prehabilitation weight loss intervention. METHODS: We interviewed the first 26 participants from the 8 recruitment sites across England in the 'CARE' feasibility trial. Participants were randomised into either usual care (n = 13) or a low-energy nutritionally-replete total diet replacement programme with weekly remote behavioural support by a dietitian (n = 13). The semi-structured interviews occurred shortly after recruitment and the questions focused on participants' recollections of being recruited into the trial. We analysed data rapidly and then used a mind-mapping technique to develop descriptive themes. Themes were agreed by all co-authors, including a person with lived-experience of colorectal surgery. RESULTS: Participants had a mean body mass index (± SD) of 38 kg/m2 (± 6), age of 50 years (± 12), and 42% were female. People who participated in the trial were motivated by the offer of structured weight loss support that could potentially help them improve their surgical outcomes. However, participants also had concerns around the potential unpalatability of the intervention diet and side effects. Positive attitudes of clinicians towards the trial facilitated recruitment but participants were disappointed when they were randomised to usual care due to clinical teams' overemphasis on the benefits of losing weight. CONCLUSIONS: Patients were motivated to take part by the prospect of improved surgical outcomes. However, the strong preference to be allocated to the intervention suggests that balanced communication of equipoise is crucial to minimise disappointment from randomisation to usual care and differential dropout from the trial. CLINICAL TRIAL REGISTRATION: ISRCTN39207707, Registration date 13/03/2023.

A qualitative study of the perceptions and experiences of participants and healthcare professionals in the DiRECT-Australia type 2 diabetes remission service.

BACKGROUND: The UK Diabetes Remission Clinical Trial (DiRECT) study was replicated in an Australian primary care setting. This qualitative study aimed to explore and understand the perceptions and experiences of both participants and healthcare professionals (HCPs) involved in the DiRECT-Australia Type 2 Diabetes Remission Service. METHODS: All participants and HCPs delivering the service were invited to participate in semi-structured interviews via online videoconferencing. The interview guides explored perceptions and experiences in DiRECT-Australia, covering aspects such as barriers and facilitators to recruitment and participation, motivations and challenges across service phases, adequacy of support provided and the overall acceptability of the service. All interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Eight DiRECT-Australia participants and six HCPs (three general practitioners, two practice nurses and one dietitian) participated. Four overarching themes were identified: (1) Enablers and barriers to recruitment and continuous participation in DiRECT-Australia; (2) Motivators and overcoming barriers across the total diet replacement, food reintroduction and weight maintenance phases; (3) Importance of participant-HCP interactions and continuous support; (4) Acceptance and long-term need for DiRECT-Australia. Adherence to total diet replacement was less challenging than anticipated by participants. Transitioning to the food reintroduction phase was difficult but overcome through HCP support. DiRECT-Australia was well accepted by both participants and HCPs, and participants expressed willingness to continue with the service, if provided on a long-term basis. CONCLUSIONS: Both participants and HCPs were highly interested in the new diabetes remission service set up in an Australian primary care setting. The acceptability of DiRECT-Australia was underscored by participants emphasising the effectiveness of the service in achieving significant weight loss and diabetes remission. There is a need for long-term and wider implementation of the service to ensure that anyone with recent onset type 2 diabetes is offered the best possible chance to achieve remission.

Adaptation and qualitative evaluation of the BETTER intervention for chronic disease prevention and screening by public health nurses in low income neighbourhoods: views of community residents.

BACKGROUND: The BETTER intervention is an effective comprehensive evidence-based program for chronic disease prevention and screening (CDPS) delivered by trained prevention practitioners (PPs), a new role in primary care. An adapted program, BETTER HEALTH, delivered by public health nurses as PPs for community residents in low income neighbourhoods, was recently shown to be effective in improving CDPS actions. To obtain a nuanced understanding about the CDPS needs of community residents and how the BETTER HEALTH intervention was perceived by residents, we studied how the intervention was adapted to a public health setting then conducted a post-visit qualitative evaluation by community residents through focus groups and interviews. METHODS: We first used the ADAPT-ITT model to adapt BETTER for a public health setting in Ontario, Canada. For the post-PP visit qualitative evaluation, we asked community residents who had received a PP visit, about steps they had taken to improve their physical and mental health and the BETTER HEALTH intervention. For both phases, we conducted focus groups and interviews; transcripts were analyzed using the constant comparative method. RESULTS: Thirty-eight community residents participated in either adaptation (n = 14, 64% female; average age 54 y) or evaluation (n = 24, 83% female; average age 60 y) phases. In both adaptation and evaluation, residents described significant challenges including poverty, social isolation, and daily stress, making chronic disease prevention a lower priority. Adaptation results indicated that residents valued learning about CDPS and would attend a confidential visit with a public health nurse who was viewed as trustworthy. Despite challenges, many recipients of BETTER HEALTH perceived they had achieved at least one personal CDPS goal post PP visit. Residents described key relational aspects of the visit including feeling valued, listened to and being understood by the PP. The PPs also provided practical suggestions to overcome barriers to meeting prevention goals. CONCLUSIONS: Residents living in low income neighbourhoods faced daily stress that reduced their capacity to make preventive lifestyle changes. Key adapted features of BETTER HEALTH such as public health nurses as PPs were highly supported by residents. The intervention was perceived valuable for the community by providing access to disease prevention. TRIAL REGISTRATION: #NCT03052959, 10/02/2017.

Mixed methods evaluation of a jail diversion program: Impact on arrests and functioning.

This mixed methods study had two aims: (1) to examine the effectiveness of a jail diversion program in reducing recidivism and promoting educational and employment outcomes; and (2) to qualitatively explore mechanisms through which the program was effective. Participants were 17 individuals arrested for drug offenses who participated in an intensive, law enforcement-based jail diversion program, and 17 individuals in a comparison group. Arrests were extracted from police records, and education and employment were extracted from program data. Four intervention participants completed qualitative interviews. Arrest rates in the intervention group decreased significantly postintervention, and arrest rates in the intervention group were numerically lower than those in the comparison group. Participants experienced significant increases in employment and driver's license status. Participants also identified mechanisms through which the program was effective. This jail diversion program shows promise in reducing recidivism and promoting adaptive functioning. Jail diversion programs that include mentorship, peer support, and removal of barriers to success may be particularly effective.

[Dementia Care Nurses in the networked care of people with dementia: a qualitative evaluation study]. / Dementia Care Nurses in der vernetzten Versorgung von Menschen mit Demenz.

Dementia Care Nurses in the networked care of people with dementia: A qualitative evaluation study Abstract: Background: To coordinate networked dementia care counselling concepts with case management (CM) structures are recommended. This approach has been explored and evaluated within the Dementia Care Nurse project in Saxony-Anhalt. Studies on the implementation of CM are mostly limited to cooperation between case managers and medical and nursing professional groups. Networking processes with all stakeholders involved in dementia care have hardly been described so far. Objective: The aim was to describe the experienced collaboration with Dementia Care Nurses (DCNs) from the perspective of the participating cooperation partners and to derive approaches for the continuation of the DCNs in routine care. Method: Eight semi-structured interviews were conducted with cooperation partners from the health and social care sector who participated in the DCN project. The interviews were analysed for content. Results: The interviews were evaluated by content analysis. Results: Overall, the interviewed cooperation partners rated the collaboration with the DCNs in the project as positive, especially the proactive approach and the continuous support of people with dementia. The continuation in routine care depends on the institutional location and the qualification of the DCNs. Conclusion: The commitment of DCNs enables a more demand-oriented involvement of relevant stakeholders in the individual planning of dementia care.

Enhancing Elderly Nutrition: A Qualitative Evaluation of Menus in a Social Solidarity Institution in the North of Portugal.

This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social solidarity institution in Portugal. The aim of this study is to conduct a qualitative evaluation of menus furnished by a social solidarity institution situated in the northern region of Portugal in order to prevent and/or treat malnutrition in the elderly. The methodology involves the evaluation of four weekly menus, totaling 28 complete daily menus for the elderly, using the "Avaliação Qualitativa de Ementas Destinadas a Idosos" (AQEDI) tool. This assessment tool comprises six domains: general items, soup, protein suppliers, carbohydrate suppliers, vegetable suppliers, and dessert, each consisting of various parameters. The findings reveal that all menus were classified as "acceptable," with percentages ranging from 60.73% to 68.84%, and suggest that there exists room for improvement. This study emphasizes the necessity for coordinated efforts within the institution to enhance menu planning, taking into account both nutritional guidelines and sensory aspects of food. Effective coordination within the institution is crucial for maintaining positive aspects and rectifying inadequacies in menu planning.

Creep level qualitative evaluating of crushed rock based on uncertainty measurement theory and hierarchical analysis.

A large number of tectonically mixed rock belts and complex tectonic zones are distributed in the southwestern part of China. In these areas, high geostress and tectonic stresses have caused some underground rock layers to be crushed and broken, eventually forming crushed rock zones. Which may undergo creep deformation under long-term loads. The manuscript is based on a typical crushed rock in the southwestern China. Firstly, the factors affecting creep deformation were analysed, and the response law of each influencing factor to rock creep is demonstrated. Then, the theory of uncorroborated measures and hierarchical analysis were used to systematically correlate the factors influencing creep. Thereby, a creep level qualitative evaluating model of crushed rock is established. Finally, this model was used to qualitatively evaluate the creep level of the crushed rock in the study area. It is concluded that the creep level qualitative evaluating of this crushed rock is rated as Class II, which is characterised by a low creep level and small creep deformations (0-10 mm). The research results can provide a reference for the creep analysis of crushed rock and provide a basis for the safe construction of engineering slopes.

A Qualitative Evaluation of ChatGPT4 and PaLM2's Response to Patient's Questions Regarding Age-Related Macular Degeneration.

Patient compliance in chronic illnesses is essential for disease management. This also applies to age-related macular degeneration (AMD), a chronic acquired retinal degeneration that needs constant monitoring and patient cooperation. Therefore, patients with AMD can benefit by being properly informed about their disease, regardless of the condition's stage. Information is essential in keeping them compliant with lifestyle changes, regular monitoring, and treatment. Large language models have shown potential in numerous fields, including medicine, with remarkable use cases. In this paper, we wanted to assess the capacity of two large language models (LLMs), ChatGPT4 and PaLM2, to offer advice to questions frequently asked by patients with AMD. After searching on AMD-patient-dedicated websites for frequently asked questions, we curated and selected a number of 143 questions. The questions were then transformed into scenarios that were answered by ChatGPT4, PaLM2, and three ophthalmologists. Afterwards, the answers provided by the two LLMs to a set of 133 questions were evaluated by two ophthalmologists, who graded each answer on a five-point Likert scale. The models were evaluated based on six qualitative criteria: (C1) reflects clinical and scientific consensus, (C2) likelihood of possible harm, (C3) evidence of correct reasoning, (C4) evidence of correct comprehension, (C5) evidence of correct retrieval, and (C6) missing content. Out of 133 questions, ChatGPT4 received a score of five from both reviewers to 118 questions (88.72%) for C1, to 130 (97.74%) for C2, to 131 (98.50%) for C3, to 133 (100%) for C4, to 132 (99.25%) for C5, and to 122 (91.73%) for C6, while PaLM2 to 81 questions (60.90%) for C1, to 114 (85.71%) for C2, to 115 (86.47%) for C3, to 124 (93.23%) for C4, to 113 (84.97%) for C5, and to 93 (69.92%) for C6. Despite the overall high performance, there were answers that are incomplete or inaccurate, and the paper explores the type of errors produced by these LLMs. Our study reveals that ChatGPT4 and PaLM2 are valuable instruments for patient information and education; however, since there are still some limitations to these models, for proper information, they should be used in addition to the advice provided by the physicians.

How Mixed-Methods Research Can Improve the Policy Relevance of Impact Evaluations.

This paper describes how mixed methods can improve the value and policy relevance of impact evaluations, paying particular attention to how mixed methods can be used to address external validity and generalization issues. We briefly review the literature on the rationales for using mixed methods; provide documentation of the extent to which mixed methods have been used in impact evaluations in recent years; describe how we developed a list of recent impact evaluations using mixed methods and the process used to conduct full-text reviews of these articles; summarize the findings from our analysis of the articles; discuss three exemplars of using mixed methods in impact evaluations; and discuss how mixed methods have been used for studying and improving external validity and potential improvements that could be made in this area. We find that mixed methods are rarely used in impact evaluations, and we believe that increased use of mixed methods would be useful because they can reinforce findings from the quantitative analysis (triangulation), and they can also help us understand the mechanism by which programs have their impacts and the reasons why programs fail.

Long-Term Impacts on Clinical Practice Along the HIV Care Continuum: Addressing Workforce Gaps Through a Clinician Scholars Program.

The Clinician Scholars Program (CSP) was designed to expand the HIV care workforce by improving the clinical capacity of clinicians in underserved areas. This evaluation assessed program participants' long-term practice changes and system changes. The year-long program combined mentoring, training, and on-site clinical observation. Qualitative interviews (N = 46) were conducted with Scholars at least 2 years following CSP, supplemented by a 2023 survey. Multiple coders analyzed transcripts using open coding. Thematic analysis explored practice changes and efforts to move patients along the HIV care continuum. Findings indicate positive long-term impacts of CSP regarding the HIV care continuum and care system engagement. Over 90% of Scholars remained working in HIV care, with 75% maintaining or increasing patient loads and 72% making changes to their clinical practice. This training model appears to enhance care along the HIV care continuum and may be adaptable to other contexts that address complex chronic conditions.

Acceptability and feasibility of a comprehensive fall prevention model for independent older adults: A qualitative evaluation.

Background: Falls amongst the elderly represent a global public health challenge because of their potential to cause illness, death, and reduce the autonomy of this group. They also impact the emotional, family, social and economic well-being of those involved. Various strategies to prevent falls have been reported in the literature, focusing mainly on addressing individual risk factors, and on the continuous assessment of the risk of falls in older people. Objective: This study evaluated user satisfaction and acceptability of a comprehensive model, implemented in the community, to prevent falls amongst independent older adults aged 65 years and above. It sought to capture both the perceptions of the individuals who received the intervention and of the interventionists who implemented it. The study protocol was registered at ClinicalTrials.gov in November 2020 (ID: NCT04313062). Design: Qualitative, exploratory study using a case study design. The evaluation of the intervention followed the recommendations proposed by the Medical Research Council for complex interventions. Methods and participants: In the period between April 2021 to April 2022, 11 semi-structured interviews were conducted with independent older adults between 65 and 80 years of age who participated in the implementation of the comprehensive model in Santiago, Chile. Data were also collected with eight interventionists through: three semi-structured interviews at the beginning of the intervention; and two focus groups with seven interventionists at the end of the implementation of the model. The team members undertook a content analysis of the data collected. Results: Three themes emerged to account for the satisfaction and acceptability of the intervention with the model on the part of the participants and interventionists: (1) Previous experience of older persons and interventionists; (2) The older person-interventionist encounter and its context; and (3) Identification of facilitators, strengths and challenges for the implementation of the model. The results show a positive assessment of the model, highlighting the value of the social contact derived from the intervention by both participants and interventionists. Although the model involved an individual intervention, the participants' accounts indicate that it reached out to others, including family members and other elderly acquaintances. Moreover, the interventionists helped identify challenges in implementation and made recommendations to strengthen the model. Conclusion: The evaluation of satisfaction and feasibility of implementing the model showed positive results that will nurture the next phase of development of this model, which involves scaling up the intervention.

Using normalization process theory to inform practice: evaluation of a virtual autism training for clinicians.

Background: There is growing demand for developmental and behavioral pediatric services including autism evaluation and care management. Clinician trainings have been found to result in an increase of knowledge and attitudes. This study utilizes Normalization Process theory (NPT) to evaluate a clinician training program and its effects on practice. Methods: The year-long virtual training program about autism screening and care management included didactic portions and case presentations. Focus groups and interviews were conducted with primary care clinicians (n = 10) from community health centers (n = 6) across an urban area five months post-training. Transcripts were deductively coded using NPT to uncover barriers to implementation of autism screening and care, benefits of the training program, and areas for future training. Results: Participants were motivated by the benefits of expanding and improving support for autistic patients but noted this effort requires effective collaboration within a complex network of care providers including clinicians, insurance agencies, and therapy providers. Although there were support that participants could provide to families there were still barriers including availability of behavior therapy and insufficient staffing. Overall, participants positively viewed the training and reported implementing new strategies into practice. Conclusion: Despite the small sample size, application of NPT allowed for assessment of both training delivery and implementation of strategies, and identification of recommendations for future training and practice sustainability. Follow-up focus groups explored participants' practice five months post-program. Variations in participants' baseline experience and context at follow-up to enable application of skills should be considered when using NPT to evaluate clinician trainings.

Feasibility and uptake of a digital mental health intervention for depression among Lebanese and Syrian displaced people in Lebanon: a qualitative study.

Introduction: Digital interventions are increasingly regarded as a potential solution for the inaccessibility of mental health treatment across low-and-middle-income settings, especially for common mental disorders. Step-by-Step (SbS) is a digital, guided self-help intervention for depression found effective in two Randomized Controlled Trials (RCTs) in Lebanon. For research implementation and further scale-up, this paper reports the results of a qualitative evaluation of SbS among the Lebanese and others and displaced Syrians in Lebanon. Methods: Thirty-four Key Informant Interviews (KIIs) were executed with participants of the RCTs, SbS staff members, and external stakeholders. Questions garnered feedback about the feasibility, acceptability, enabling factors, and barriers to adhering to the research, implementation, and the SbS intervention. A thematic analysis was conducted using NVivo, and key themes, topics, and recommendations, on research methods and the intervention itself, were generated and reported. Results: Results showed a high level of acceptability of SbS among Lebanese and Syrians and identified sub-groups for whom acceptance or use might be lower, such as older adults and people with limited access to the internet or smartphones. Furthermore, interviews identified the main enabling factors and barriers to adherence related to the research design, content, and delivery approach. Barriers related to feasibility included lengthy assessments as part of the RCTs, and mistrust related to delays in study compensations. Other common challenges were forgetting login credentials, poor internet connection, being busy and competing needs. Enabling factors and best practices included motivating participants to use the intervention through the weekly support provided by helpers, setting an oral contract for commitment, and dividing the compensations into several installments as part of the RCTs. Recommendations regarding sustainability were given. Discussion: The findings show that overall, SbS is feasible, acceptable, and much needed in Lebanon among the Lebanese and Syrians. This assessment identifies reasons for low adherence to the research and the intervention and presents improvement solutions. Recommendations generated in this paper inform the upscale of SbS and the planning, design, and implementation of future digital interventions in research and service provision settings in the mental health field.

Experiências em divulgação científica e sensibilização da população: importância do controle mecânico do vetor Aedes aegypti / Experiences in scientific outreach and public awareness: the importance of mechanical control of the Aedes aegypti vector / Experiencias en divulgación científica y sensibilización de la población: importancia del control mecánico del vector Aedes aegypti

Aedes aegypti é o principal vetor dos agentes etiológicos de dengue, zika e chikungunya, doenças para as quais não existem vacinas totalmente eficazes. Alternativas de controle visando mitigar essas arboviroses são primordiais. Entre essas, o controle mecânico aborda práticas de eliminação e/ou limpeza de criadouros do vetor. Neste relato, apresentamos e avaliamos criticamente ações realizadas pelo grupo, ocorridas entre 2016 e 2019, nas quais divulgamos informação científica clara através do diálogo com a população. Os métodos utilizados foram: 1) palestras em escolas (público infantojuvenil) utilizando slides, fotos e vídeos; 2) oficinas (público misto), estande com material in vivo do ciclo de vida do Aedes, jogos e desenhos. Analisamos dez palestras em escolas do ensino fundamental e médio e vinte oficinas realizadas em diferentes regiões do Brasil. Concluímos que tais ações e suas análises críticas devem ser realizadas continuamente para que sejam bem-sucedidas

Aedes aegypti is the main vector of dengue, zika, and chikungunya etiological agents, diseases for which no effective vaccines are available. Control alternatives aimed at mitigating these arboviruses are essential. Among such, mechanical control addresses practices of elimination and/or cleaning of vector breeding sites. Here, we presented and critically evaluated actions carried out by ourselves. These actions took place between 2016 and 2019, where we disseminated clear scientific information through dialogue with the population. The following methods were employed: 1) lectures in schools (children and youth audiences) using slides, photos, and videos; 2) workshops (mixed audience), stand with in vivo material from the Aedeslife cycle, games, and drawings. Ten lectures in elementary and high schools and twenty workshops held in different regions of Brazil were analyzed. It was concluded that such actions and their critical analyzes must be carried out continuously to be successful

Aedes aegypti es el principal vector de los agentes etiológicos del dengue, zika y chikungunya, enfermedades para las que no existen vacunas totalmente eficaces. Las alternativas de control para mitigar estas arbovirosis son fundamentales. El control mecánico, representa una de estas alternativas, aborda prácticas de eliminación y/o limpieza de criaderos del vector. En este informe presentamos y evaluamos de manera crítica las acciones realizadas por el grupo entre los años 2016 y 2019. Presentamos información científica clara a través del diálogo con la población mediante los siguientes métodos: 1) conferencias en escuelas (público infantil) utilizando diapositivas, fotos y videos; 2) Talleres (público mixto), stand con material in vivo del ciclo de vida del Aedes, juegos y dibujos. Analizamos diez conferencias en escuelas (primarias y secundarias) y veinte talleres realizados en diferentes regiones de Brasil. Concluimos que tales acciones y el análisis crítico de las mismas deben llevarse a cabo de manera continua para que resulten exitosas.

Avaliação qualitativa das preparações servidas em um restaurante popular e os impactos do cenário pandêmico da covid-19 / Qualitative assessment of preparations served in a popular restaurant and the impacts of the COVID-19 pandemic scenario / Evaluación cualitativa de las preparaciones servidas en un restaurante popular y los impactos del escenario de pandemia COVID-19

Introdução:A chegadadapandemia da COVID-19 afetou diretamente o planejamento alimentar de instituições municipais, estaduais e de demais âmbitos, dentre eles as refeiçõesofertadas peloprograma restaurante popular, importante na garantia da segurança alimentarda população mais vulnerável.Objetivo:Avaliar de forma qualitativa as preparações do cardápio do almoço do Restaurante Popular do município de Santa Cruz-Rio Grande do Nortee os impactos do cenário pandêmico da COVID-19.Metodologia:Para tanto, avaliou-se os cardápios referentes aos meses de março, abril, maio, agosto e setembro de 2021, pelo método avaliação qualitativa das preparações do cardápio. Além disso, por meio da adaptação dométodosupracitado, designou-se as preparações de acordo com as recomendações do tipo de processamento segundo o Guia Alimentar para população Brasileira. Resultados:Identificou-se uma baixa oferta de frutas e folhosos, alta de carnes gordurosas e doce, regular de preparações ricas em enxofre e as cores iguais, todavia, quanto à fritura e ao conjunto de fritura + doce apresentou-se em apenas umdiada semana (n=109). Além disso, nos dois últimos meses de análisehouve aumento na oferta de folhosos, diminuição da monotonia, alimentos ricos em enxofre e doces, e ainda, as preparações com alimentos in natura ou minimamente processados + processados fizeram-se presentestodos os dias. Conclusões:Com a utilizaçãodométodo estudadofoipossível identificar ajustesno cardápiopara o período analisado, a fim de ofertar qualidade para os comensais.Ressalta-se que foi observadoque com a adaptação e redução dos casos da COVID-19, houve aumento na oferta de in natura e minimamente processados. Espera-se que melhorias e ajustes sejam realizadosnos cardápios, visto a necessidadede ser mais enfático em seu princípiode garantir a segurança alimentar (AU).

Introduction:The arrival of the COVID-19 pandemic affected directly the food planning of municipal, state and other institutions, including the meals offered by the popular restaurant program, which is important in guaranteeing the food security of the vulnerablepopulation. Objective: To qualitatively evaluate the preparations of the lunch menu at Restaurante Popular in the municipality of Santa Cruz-Rio Grande do Norteand the impacts of the COVID-19 pandemic scenario.Methodology:To this, the menus for the months of March, April, May, August and September 2021 were evaluated by the methodqualitative evaluation of menu preparations. Furthermore, through the adaptation of the methodaformentioned, preparations were designated according to the recommendations for type of processing following the Food Guide for the Brazilian population.Results:A low supply of fruits and leafy vegetables was identified, high supply of fatty and sweet meats, regular supply of preparations rich in sulfur and the same colors. However, regarding the frying and the frying + sweet combination, it was presented in just one daythe week(n=109).Moreover, in the last two months of analysis there was an increase in the supply of hardwoods, decrease in monotony,foods rich in sulfur and sweets, and even, preparations in natura or minimally processed + processed foods were presentsevery day. Conclusions:With the use of the method studied it waspossible to adjust the menufor the analyzed periodto offer qualityto diners. It should the increase in the supply of in natura and minimally processed foods stands out with the adaptation and progression of the reduction of COVID-19cases.It is expected that improvements and adjustments will be madethe menus,given the need to be more emphatic in its principleof ensuring food safety (AU).

ntroducción: La llegada de la pandemia del COVID-19 afectó directamente la planificación alimentaria de las instituciones municipales, estatales y otras, incluyendo las comidas que ofrece el programa de restaurantes populares, importante para garantizar la seguridad alimentaria de la población más vulnerable. Objetivo:Evaluar cualitativamente las preparaciones del menú del almuerzo en el Restaurante Popular del municipio de Santa Cruz-Rio Grande do Nortey los impactos del escenario de pandemia del COVID-19.Metodología:Para ello, se evaluaron los menús de los meses de marzo, abril, mayo, agosto y septiembre de 2021 por el método evaluación cualitativa de la elaboración de menús. Además, al adaptar el métodocitado, las preparaciones fueron designadas de acuerdo con las recomendaciones del tipo de procesamiento según la Guía de Alimentos para la población brasileña.Resultados: Se identificó una baja oferta de frutas y hortalizas de hoja, alta oferta de carnes grasas y dulces, regular oferta de preparaciones ricasen azufre y los mismos colores,aún,en cuanto a la fritura y la combinación fritura + dulce, se presentó en un solo díade lasemana(n=109). Además, en los últimos dos meses de análisishubo un aumento en la oferta de maderas duras, una disminución de la monotonía, alimentos ricos en azufre y dulces, y aun, las preparaciones con alimentos in natura o mínimamente procesados + procesados presentes todos los días. Conclusiones: Con el uso del método estudió fueposible identificar ajustes en el menúpara el período analizado, con el fin de ofrecer calidad a los comensales. Cabe señalar que se observó que con la adaptación y reducción delcasosCOVID-19, hubo un aumento en la oferta de productos in natura y mínimamente procesados. Se espera que se realicenmejoras y ajustesa los menús, dada las necesidades más enfáticasen su principiode garantizar la seguridad alimentaria (AU).

Evaluación del proceso de implementación de un programa en habilidades para la vida en escuelas públicas de Córdoba (Argentina) / Evaluation of the Implementation Process of a Program on Skills for Life in Public Schools in Cordoba (Argentina) / Avaliação do processo de implementação de um programa de habilidades para a vida em escolas públicas de Córdoba (Argentina)

Los programas en habilidades para la vida son una de las estrategias más utilizadas en el ámbito escolar para la prevención de conductas que afectan la salud. Si bien la ciencia de la implementación señala que estos procesos deben ser evaluados para asegurar el alcance de los objetivos, pasados más de 30 años de desarrollo de estos programas, en América Latina ha sido poco el avance de esta área. En este trabajo se presenta una evaluación del proceso de implementación de un programa en habilidades para la vida orientado a la prevención del consumo de sustancias ­implementado en el 2010­, documentando aspectos complejos para formular recomendaciones a futuras aplicaciones. Para realizar la evaluación, se seleccionaron 30 salones de clase en los cuales se efectuó la intervención. De la experiencia participaron 60 docentes y 940 alumnos (entre 11 y 19 años), pertenecientes a un nivel socioeconómico medio-bajo de escuelas públicas del nivel secundario de la ciudad de Córdoba (Argentina). Se emplearon técnicas cualitativas de recolección de información ­observación no participante, registro de producciones de las actividades y entrevistas semiestructuradas­, y se realizó un análisis cualitativo y cuantitativo de los datos. Los resultados demuestran la complejidad del proceso de implementación, las dificultades contextuales y la necesidad de incrementar el conocimiento de las relaciones entre las dinámicas escolares y la implementación de programas en habilidades para la vida con estrategias eficaces. Así, se destaca la necesidad de superar la tensión entre los enfoques pedagógicos participativos de estos programas y la lógica escolar tradicional.

Life skills programs are one of the most used strategies in the school environment for health prevention. Although implementation science indicates that im-plementation processes must be evaluated to ensure achievement of objectives, after more than thirty years of development of these programs in Latin America, there has been little progress in this area. This report presents an evaluation of the implementation process of a life skills program oriented towards the prevention of substance use ­implemented in 2010­, documenting complex aspects to make rec-ommendations for future applications. To perform the evaluation, 30 courses were selected. 60 teachers and 940 students participated. The students belonged to a medium-low socioeconomic level and were in public secondary schools in Córdoba city, Argentina. Qualitative data collection techniques ­non-participant observation, records of productions of the activities, and semi-structured interviews­ were used, selecting a qualitative and quantitative approach to this data. The results demonstrate the complexity of the im-plementation process, the contextual difficulties, and the need to increase knowledge of the relationships between school dynamics and the implementation of life skills programs to design effective strategies. This highlights the need to overcome the tension between the participatory pedagogical approaches of these programs and the traditional school logic.

Os programas de habilidades para a vida são uma das estratégias mais utilizadas no ambiente escolar para a prevenção de comportamentos que afetam a saúde. Embora a ciência da implementação indique que os processos de implementação devem ser avaliados para garantir o alcance dos objetivos, após mais de 30 anos de desenvolvimento desses programas na América Latina, essa área está subdesenvolvida. Este artigo apresenta uma avaliação do processo de implementação de um programa de habilidades para a vida voltado à prevenção do uso de substâncias, que foi implementado em 2010, documentando aspectos complexos para formular recomendações para aplicações futuras. Para realizar a avaliação, foram selecionadas 30 salas de aula nas quais foi realizada a intervenção. O experimento envolveu a participação de 60 professores e 940 alunos (entre 11 e 19 anos) de nível socioeconômico médio-baixo, de escolas públicas secundárias da cidade de Córdoba (Argentina). Foram utilizadas técnicas qualitativas de coleta de dados ­observação não participativa, registro das produções das atividades e entrevistas semiestruturadas­ e foi realizada uma análise qualitativa e quantitativa dos dados. Os resultados demonstram a complexidade do processo de implementação, as di-ficuldades contextuais e a necessidade de ampliar o conhecimento das relações entre a dinâmica escolar e a implementação de programas de habilidades para a vida para o desenho de estratégias eficazes. Isso evidencia a necessidade de superar a tensão entre as abordagens pedagógicas participativas desses programas e a lógica escolar tradicional.

Brazilian Portuguese version of financial risk-taking and tolerance scales: validity evidence within and between measures / Versão brasileira das escalas de propensão e tolerância ao risco financeiro: evidências de validade intra e entre medidas

Abstract Objectives To construct and validate a psychological measure called the Financial Risk-Taking Scale (FRTakS) and to translate, adapt, and validate a psychological measure called the Financial Risk Tolerance Scale (FRTolS) with a Brazilian sample. Exploratory and confirmatory factor analyses were used to assess evidence of the validity of the scales' internal structures. We also tested the convergent validity between FRTakS and FRTolS. Method After construction (FRTakS) and adaption (FRTolS), the instruments were evaluated by expert judges for the relevance of their items to the scales, followed by pretesting. A cross-sectional study was then conducted using a convenience sample of 834 people who responded to invitations sent to a mailing list or to an online invitation on the Brazilian Securities and Exchange Commission website (Comissão de Valores Mobiliários [CVM]). Results Mean age of participants was 39.27 years (standard deviation [SD] = 10.82), they had high educational level (60.9% post-graduate), were married or living together (60%), and their spending power was 41.36 (SD = 13.27). Exploratory and confirmatory analysis identified two factors in FRTakS (Investment and Spending Money), both with 4 items; and identified a single factor in FRTolS, comprising 7 items. Conclusion Reliability indexes for the goodness of fit of the factor structure were satisfactory. There was a positive and significant correlation between the FRTakS Investment factor and FRTolS, confirming convergent validity. The results suggest the existence of a two-dimensional factor structure for FRTakS, and a one-dimensional factor structure for FRTolS. The instruments also exhibited convergent validity with each other.

Resumo Objetivos Construir e validar uma medida psicológica denominada Escala de Propensão ao Risco Financeiro (FRTakS), e também traduzir, adaptar e validar uma medida psicológica denominada Escala de Tolerância ao Risco Financeiro (FRTolS) em uma amostra brasileira. Evidências de validade interna foram avaliadas com base em análise fatorial exploratória e confirmatória. Além disso, verificamos a validade convergente entre FRTakS e FRTolS. Método Após a construção (FRTakS) e adaptação (FRTolS), os instrumentos passaram pela etapa de avaliação por juízes especialistas sobre a relevância dos itens para a escala e estágio de pré-teste. Um estudo transversal foi realizado com uma amostra de conveniência de 834 pessoas que responderam a convites enviados para uma lista de e-mails, ou a convites on-line publicados no site da Comissão de Valores Mobiliários (CVM). Resultados Os participantes tinham idade média de 39,27 anos [desvio padrão (DP) = 10,82], alta escolaridade (60,9% pós-graduação), eram casados ou viviam juntos (60%), e tinham poder de compra de 41,36 (DP = 13,27). A análise exploratória e confirmatória identificou dois fatores para FRTakS, cada um com 4 itens (Investimento e Gastar Dinheiro); e indicou 1 fator para FRTolS composto por 7 itens. Conclusão A estrutura fatorial apresentou boa adequação, com índices de confiabilidade satisfatórios. Foi encontrada uma correlação positiva e significativa entre o fator FRTakS Investimento e a FRTolS, confirmando a validade convergente. Os resultados sugerem a existência de uma estrutura fatorial bidimensional para FRTakS, e uma estrutura fatorial unidimensional para FRTolS. Além disso, os instrumentos mostraram validade convergente entre eles.

After-action reviews for emergency preparedness and response to infectious disease outbreaks

@#After-action reviews (AARs) are a qualitative evaluation methodology conducted after a public health event recommended by the World Health Organization. Of 86 screened articles, we identified eight using AARs to evaluate public health responses to infectious disease outbreaks. Our findings suggested the toolkit is suitable to evaluate responses to infectious disease outbreaks but needs to be adapted for use in particular settings.

Avaliação de quarta geração: revisão integrativa sobre sua aplicação na pesquisa em saúde / Fourth-generation assessment: integrative review about its application in health research

O presente estudo objetivou identificar na produção científica existente, como vem sendo utilizado o referencial metodológico avaliação de quarta geração nas pesquisas em saúde. Trata-se de uma revisão integrativa a partir de publicações levantadas nas bases de dados PubMed, Banco de Dados em Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library Online, no período de 2005 a 2015. Utilizou-se a combinação dos descritores avaliação de quarta geração e avaliação qualitativa, em todos os idiomas, totalizando 27 estudos analisados. O processo de análise permitiu a construção de duas categorias temáticas: Potencialidades e desfechos da avaliação de quarta geração e Limitações da metodologia atreladas com estratégias no campo da pesquisa. Observou-se predomínio de estudos brasileiros na área de saúde mental e escassez de estudos internacionais. Aspectos positivos foram encontrados devido à escolha do referencial metodológico, principalmente no que se refere em dar voz aos grupos de interesses estudados. As publicações evidenciam a relevância do rigor metodológico a ser seguido quando se trabalha com a avaliação de quarta geração, uma vez que é necessário adotar os critérios estabelecidos pelos autores deste referencial.

The present study aimed to identify in the existing scientific production, how has been used the methodological reference fourth generation evaluation in health research. It is an integrative review based on publications published in the PubMed, Banco de Dados em Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde and Scientific Electronic Library Online databases, from 2005 to 2015. The combination of the four-generation evaluation descriptors and qualitative evaluation was used in all languages, totaling 27 studies analyzed. The analysis process allowed the construction of two thematic categories: Potentials and outcomes of the fourth generation evaluation and Limitations of the methodology coupled with strategies in the field of research. It was observed a predominance of Brazilian studies in the area of mental health and a shortage of international studies. Positive aspects were found due to the choice of methodological reference, especially in what refers to giving voice to the interest groups studied. The publications show the relevance of the methodological rigor to be followed when working with the fourth generation evaluation, since it is necessary to adopt the criteria established by the authors of this reference.

El presente estudio objetivó identificar en la producción científica existente, como viene siendo utilizado el referencial metodológico evaluación de cuarta generación en las investigaciones en salud. Se trata de una Revisión integrativa a partir de publicaciones levantadas en las bases de datos PubMed, Banco de Dados em Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library Online. Se utilizó la combinación de los descriptores evaluación de cuarta generación y evaluación cualitativa, en todos los idiomas , totalizando 27 estudios analizados. El proceso de análisis permitió la construcción de dos categorías temáticas: Potencialidades y resultados de la evaluación de cuarta generación y Limitaciones de la metodología vinculadas con estrategias en el campo de la investigación. Se observó predominio de estudios brasileños en el área de salud mental y escasez de estudios internacionales. Los resultados positivos fueron encontrados debido a la elección del referencial metodológico, principalmente en lo que se refiere en dar voz a los grupos de intereses estudiados. Las publicaciones evidencian la relevancia del rigor metodológico a seguir cuando se trabaja con la evaluación de cuarta generación, una vez que es necesario adoptar los criterios establecidos por los autores de este referencial.

Validación de la Encuesta de Percepción de Enfermedad Revisada (Illness Perception Questionnaire) entre pacientes con patologías crónicas médicas y psiquiátricas / Validation of Illness Perception Survey Revised (Illness Perception Questionnaire) among patients with medical and psychiatric chronic diseases

MARCO TEÓRICO: La Percepción de Enfermedad es una variable importante en la evolución de los pacientes. Existen métodos de evaluación cualitativa de éste parámetro, sin embargo, no son aplicables a la población chilena por no estar adaptados al lenguaje local y cotidiano. OBJETIVO: Realizar una traducción del Illness Perception Questionnaire Revised, conservando la validez y fiabilidad original. MATERIALES Y MÉTODOS: Traducción y retraducción de la escala por experto. Piloteo de evaluación a 33 pacientes con enfermedades crónicas. Encuesta a 112 pacientes (49 diabéticos, 37 hipertensos y 33 esquizofrénicos) todos pertenecientes al CRS Hospital El Pino. CONCLUSIONES: En base al porcentaje de concordancia obtenido (95%) entre la versión original y la traducida a la lengua española y al reporte de los entrevistadores con respecto a la comprensibilidad manifestada por los pacientes, podemos concluir que la traducción por nosotros aplicada cumple con los criterios de validez.

THEORETICAL FRAMEWORK: The perception of disease is an important variable in the patient evolution. There are methods of qualitative evaluation of this parameter, however, are not applicable to the Chilean people for not being adapted to the local and everyday language. OBJECTIVE: A translation of the Revised Illness Perception Questionnaire, preserving the original set reliability and validity. MATERIALS AND METHODS: Translation and back translation of the scale by an expert. Piloting assessment to 33 patients with chronic diseases. Survey of 112 patients (49 diabetic and 33 hypertensive schizophrenics 37) all belonging to the CRS Hospital Pino. CONCLUSIONS: Based on the percentage of concordance obtained (95%) between the original version and the translated version in the Spanish language and the interviewers' report regarding the comprehensibility expressed by the patients, we can conclude that the translation applied by us meets the criteria of validity