How single is ‘single’ : some pragmatic reflections on single versus multifaceted interventions to facilitate implementation

An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science.

Making Energy Interventions more Effective : Situation, Interaction, and Precondition

A main purpose of this paper is to propose to policy makers, building professionals, and other non-social scientists a way to make energy interventions more culturally informed and, thereby, more effective. The case study on house purchasers gives an ample illustration of the richer results that can be achieved by paying attention to three aspects of energy efficiency initiatives: the contexts and situations of choice in each particular case, the interaction among relevant social actors, and the culture-specific preconditions for choice. Research on how purchasers of new pre-fabricated houses in Sweden choose their heating system show how such decisions tend to fall between two stools. Furthermore, the organizational structure of housing companies frames house purchasers' decision making. An important result is that energy saving or conversion measures must be promoted at an early stage amongst those who plan and construct buildings (rather than later amongst dwellers and energy end users).

Identification and estimation of interventions using changes in inequality measures

This paper presents semiparametric estimators of changes in inequality measures of a dependent variable distribution taking into account the possible changes on the distributions of covariates. When we do not impose parametric assumptions on the conditional distribution of the dependent variable given covariates, this problem becomes equivalent to estimation of distributional impacts of interventions (treatment) when selection to the program is based on observable characteristics. The distributional impacts of a treatment will be calculated as differences in inequality measures of the potential outcomes of receiving and not receiving the treatment. These differences are called here Inequality Treatment Effects (ITE). The estimation procedure involves a first non-parametric step in which the probability of receiving treatment given covariates, the propensity-score, is estimated. Using the inverse probability weighting method to estimate parameters of the marginal distribution of potential outcomes, in the second step weighted sample versions of inequality measures are computed. Root-N consistency, asymptotic normality and semiparametric efficiency are shown for the semiparametric estimators proposed. A Monte Carlo exercise is performed to investigate the behavior in finite samples of the estimator derived in the paper. We also apply our method to the evaluation of a job training program.

O behaviorismo radical de B. F. Skinner e sua aplicabilidade socialmente relevante

o presente trabalho tem como objetivo a avaliação da capacidade do behaviorismo radical skinneriano'para fundamentar aplicações práticas dotadas de efetiva relevância humana e social, assim definidas em' função do caráter politicamente progressista e democratizante que se lhes possa imprimir. Essa avaliação é desenvolvida através de dois distintos, mas interrelacionados, procedimentos acadêmicos: uma argumentação discursiva baseada em pesquisa bibliográfica pertinente, que se complementapor um estudo empírico de campo a nível exploratório. A apreciação discursiva do behaviorismo radical é inicialmente conduzida sob uma perspectiva histórico-acadêmica, cujo foco contínuo de referência é o próprio agente individual basicamente responsável pelo gradativo processo de constituição desse sistema científico - B. F. Skinner. Em uma da etapa, o behaviorismo radical vem a ser discutido deforma mais impessoalizada, contra os sucessivos panos de fundo da filosofia da ciência, das relações sociais humanas e da ética implicada nas intervenções práticas sobre tais relações. O estudo exploratório, que então-se segue, consiste no julgamento da utilidade potencial de um instrumento de educação política popular, elaborado previamente a partir dos princípios behavioristas radicais básicos e seus desdobramentos psicossociológicos, e destinado a uma clientela sócio-economicamente desprivi1egiada, constituída de indivíduos adultos, de ambos os sexos, com escolaridade 'em torno do 19 grau completo. A avaliação dessa Cartilha de Contracontole Social através de entrevistas semi-estruturadas e um breve questionário objetivo, por quatorze lnformantes - qualificados em termos de sua 1iderança e/ou militância em associações de moradores de bairros e de favelas, sindicatos de trabalhadores, núcleos comunitários re1igiosos, entidades assistenciais autônomas e associações de servidores em organizações de trabalho - vem a apresentar, em linhas gerais, resultados muito positivos. A iniciativa é considerada extremamente séria e responsável; e o conteúdo da Carti1ha, bastante compatível com os objetivos desses movimentos populares, assim como muito útil para dotar as suas atividades de uma maior eficácia social. Evidencia-se, não obstante, uma restrição generalizada quanto à possibilidade de compreensão do texto por parte da população-alvo; o que deve, portanto, ensejar sua reformu1ação para o emprego em futuros projetos de prosseguimento dessa linha de pesquisa. Conclui-se, enfim, que a tese em seu todo parece apta a contribuir, se suficientemente divulgada, para a promoção de um maior interesse pelo behaviorismo de Skinner no âmbito acadêmico do Rio de Janeiro, bem como para a produção de um exercício mais eficaz de contracontro1e sobre as atuais práticas aversivas e/ou exploratórias de controle social.

Domestic violence in Brazil: social problems and legislative interventions

Recent statistical data confirms that domestic violence is a structural problem of exceptional gravity. We analyze the frequent legislative changes in Brazil since 2000 as a result of social pressure for protection of abused women. Only the Law 11.340 of 2006 was well received by lawyers, judges and the public opinion. We present the innovations and peculiarities of this statute and the allegations on unconstitutionality. We discuss cases of judicial review of this law and reject the arguments of unconstitutionality. That notwithstanding, we argue that penalization decisions is the wrong way from a criminological point of view because they do not take into consideration the desires and needs of the victims.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Avaliação do programa de tutorização da EMATER-RN para servidores em estágio probatório

The present thesis evaluated the contributions and limitations of the tutorship program introduced in EMATER-RN, as a tactic of organizational socialization for civil servants in probationary stage. Tutorship was understood as an intensive and continuous relational process, in which a more experienced person in the organization the tutor offers psychosocial support, stimulates the development of the professional career and enables to the newcomer the tutee learning on job performance. The organizational socialization was considered in the perspective of the symbolic interactionism. The study was characterized as a program evaluation and as an action research. The practical interventions for the program implementation were conducted and, at the same time, the evaluations of process, results and reaction to the program were applied. Among the major contributions of the action research, it stood out: the diagnosis of reasons for the formation of the pair and of expectations of tutors and tutees, the improvement of the tutorship registration tools, the ascertainment of the success of the program in the socialization of the new civil servants, the confirmation of the importance of the compatibility among them and of the adequate performance of tutorship functions for achieving its benefits. Based in constraints of the program, one may quote as essential recommendations: the formation of a technical team supporting the program, the clear establishment of deadlines for each procedure and the reinforcement to its compliance, the investigation of the functions performed by the tutor, the sensitization of the managers to the resolution of problems that affect the program, the voluntary participation of the tutor and the continuous meetings of tutors and tutees. One settles for the relevance of the program and in favor of its continuation, provided that its improvement and systematic management are conducted.

Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme

Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Richards growth model and viability indicators for populations subject to interventions

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Malnutrition in the second year of life and psychosocial care: a case-control study in an urban area of Southeast Brazil

O objetivo do estudo foi identificar e medir a presença de associação entre cuidado psicossocial e desnutrição. Realizou-se estudo caso-controle incluindo 101 crianças desnutridas (peso/idade < percentil 5 do padrão NCHS/OMS), com idades entre 12 e 23 meses, que foram comparadas a 200 controles eutróficos (peso/ idade > percentil 25) em termos de sua exposição a uma série de comportamentos maternos indicadores da qualidade de seu cuidado psicossocial. Criou-se um escore de cuidado psicossocial, variando de 0 a 14, de acordo com o número de comportamentos maternos desejáveis não observados: quanto maior o escore, pior a qualidade do cuidado psicossocial. Mediante análise de regressão logística verificou-se maior risco de desnutrição para as crianças no 2º e 3º tercis do escore de cuidado psicossocial. Esta associação foi modificada pela renda per capita. Após ajustes para possíveis confundidores, nas crianças dos estratos superiores de renda não houve associação entre cuidado psicossocial e desnutrição. Para as crianças com nível mais baixo de renda, pior cuidado psicossocial dobrou o risco de desnutrição (OR = 7,26; IC95%: 2,42-21,82) em relação àquele associado apenas à baixa renda (OR = 3,08; IC95%: 1,28-7,42).

The flower workshop in psychosocial rehabilitation: A pilot study

We report a pilot study with the Flower Workshop, a new modality of psychosocial rehabilitation group activity. Cognitive performance in schizophrenia and other mental conditions can be impaired depending on the tasks to be executed and their respective social context. The vulnerability of these individuals can be reduced by means of cognitive and socio-affective facilitation. We conducted a pilot study to introduce the Flower Workshop in a public Mental Health Service in the city of Ribeirao Preto (Sao Paulo-Brasil) with 12 participants during 18 months (2002-2003). With cognitive and socio-affective facilitation, participants were able to construct vases and make flower arrangements successfully.