RESUMO
BACKGROUND: Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. METHODS: We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. RESULTS: Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. CONCLUSIONS: Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru.
Assuntos
Acidentes de Trânsito/prevenção & controle , Ferimentos e Lesões/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Educação , Feminino , Humanos , Lactente , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Peru , Política Pública , Adulto JovemRESUMO
Objetivo: Describir la calidad de sueño en los pobladores andinos de Huaripampa-Ancash (3 200 msnm). Material y métodos: Se utilizó el Índice de Calidad de Sueño de Pittsburgh (ICSP). Se calculó el tamaño de la muestra (n=92) mediante el método de proporciones, y se realizó una aleatorización sistemática de casas, encuestando a los pobladores presentes que cumplieron con los criterios de inclusión. Resultados: Se encuestaron a 83 pobladores, 46% fueron hombres, la edad media fue de 40,59 +/- 17,5 (18-65 años) y la mediana del puntaje del PSQI fue de 6 más menos 4,5 (RIC) [2-18]. Se encontró que 53 (63,8%) fueron malos durmientes. La alteración de sueño más frecuente fue el insomnio, presente en 47% de la población. Conclusiones: La alteración del sueño es un problema frecuente en esta población. Una herramienta como la del Índice de calidad de sueño de Pittsburgh, con algunas modificaciones, puede ser implementada en poblaciones rurales-andinas.
Objective: To describe the sleep quality in the inhabitants of Huaripampa-Ancash. Material and methods: We usedthe Pittsburgh Sleep Quality Index (PSQI). Using the method of proportions was calculated the sample size (n = 92), and there was a systematic randomization of houses, surveying the present inhabitants that meet the inclusion criteria. Results: There were surveying a total of 83 inhabitants, 38 (46%) were men, mean age was 40.59 +/- 17.5 (18-65 years old) and the average score of PSQI was 6 +/- 4.5 [2 -18], 53 (63.8%) of the population were poor sleepers. The most frequent disruption of sleep was insomnia, which was present in 39 (47%) inhabitants. Conclusions: Symptoms associated with various sleep disorders are common in rural Andean population. A tool such as the sleep quality index in Pittsburgh, with some modifications, can be implemented in rural Andean populations.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , População Rural , Sono , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Epidemiologia Descritiva , Estudos Transversais , PeruRESUMO
We report a case of a large mobile myxoma of the left ventricle that caused obstruction of the outflow tract. Transthoracic and transesophageal echocardiography defined the extent and location of the mass providing crucial information for surgical treatment, which was successful.