Abstract In this technical note, we present an unprecedented database that solves a major problem in the study of electoral strategies: The lack of data to identify where, when, and how candidates carry out activities during the electoral campaign. The Superior Electoral Court (TSE) has made available the records of income and spending during each candidate’s campaign. Among the many pieces of information contained therein, we collected the bank and branch numbers of the beneficiaries of the transactions indicated by the candidates and cross-referenced them with a list of bank branch addresses in Brazil. From these cross-references, we were able to georeference the spending of candidates for the national legislature for the whole country and thus build a proxy of campaign strategies in the electoral contest. This unprecedented database will allow us to advance our understanding of how electoral campaigns are designed, what strategies are employed, and how the relationship between representatives and citizens takes place, since it will be possible to dissociate campaign efforts from the outcome of the election. note where when TSE (TSE candidate s therein crossreferenced cross referenced Brazil crossreferences, crossreferences references, references cross-references contest designed employed place election

Resumo

Resumen En esta nota técnica, presentamos una base de datos sin precedentes que soluciona un gran problema en el estudio de las estrategias electorales: la falta de datos que permitan identificar dónde, cuándo y cómo los candidatos realizan actividades durante la campaña electoral. El Tribunal Supremo Electoral (TSE) ha puesto a disposición de los ciudadanos los registros de ingresos y gastos durante la campaña de cada candidato. Entre las muchas informaciones que contienen, recogimos los números de banco y de sucursal de los beneficiarios de las transacciones indicadas por los candidatos y los cruzamos con una lista de direcciones de sucursales bancarias en Brasil. A partir de estas referencias cruzadas, pudimos georreferenciar los gastos de los candidatos a las legislativas nacionales para todo el país y construir así un proxy de las estrategias de campaña en la contienda electoral. Esta base de datos sin precedentes nos permitirá avanzar en la comprensión de cómo se construye la campaña electoral, qué estrategias se emplean y también cómo se produce la relación entre representantes y ciudadanos, ya que será posible disociar los esfuerzos de campaña del resultado de las elecciones. técnica electorales dónde electoral TSE (TSE candidato contienen Brasil cruzadas elecciones

Résumé Dans cette note technique, nous introduisons une base de données innovante qui résout une lacune importante dans l’étude des stratégies électorales : l’absence de données permettant d’identifier où, quand et comment les candidats réalisent des activités pendant la campagne électorale. Le Tribunal Supérieur Électoral (TSE) a rendu disponibles les enregistrements des revenus et des dépenses de chaque candidat pendant la campagne. Parmi les nombreuses informations contenues, nous avons collecté le numéro de la banque et de l’agence du bénéficiaire des transactions indiquées par les candidats et les avons croisés avec une liste d’adresses des agences bancaires au Brésil. Grâce à ces croisements, nous avons pu géoréférencer les dépenses des candidats au législatif national pour tout le pays et ainsi construire une proxy des stratégies de campagne dans la compétition électorale. Cette nouvelle base de données nous permettra de mieux comprendre comment se structurent les campagnes électorales, les stratégies adoptées, et la relation entre les représentants et les citoyens, en permettant de dissocier les efforts de campagne des résultats électoraux. technique létude l étude labsence absence didentifier d identifier où électorale TSE (TSE contenues lagence agence dadresses adresses Brésil croisements adoptées citoyens électoraux

Resumen Marco contextual: Los teléfonos móviles inteligentes permiten acceder a información de manera inmediata. La adicción al uso de estos dispositivos es cada vez mayor, los teléfonos móviles inteligentes se han convertido en un elemento importante para los estudiantes de enfermería. Objetivo: Identificar la adicción al uso del teléfono móvil inteligente en estudiantes de enfermería. Metodología: Estudio descriptivo correlacional, el muestreo fue aleatorio, la muestra se calculó considerando un nivel de confianza de 0,05, una potencia de 90%, un tamaño de efecto mediano de 0,09, la muestra se conformó por 149 estudiantes de enfermería. Resultados: El componente de uso, abuso y adicción al teléfono móvil inteligente se relacionó negativamente con el componente rasgo de personalidad (r s = -0,228; p = 0,005), el uso, abuso y adicción al teléfono móvil inteligente se relacionó positivamente con el gasto monetario (r s = 0,376; p = 0,001). Conclusión: Se identificó que existe un alto uso de los teléfonos móviles inteligentes, comprender el alcance de dicho fenómeno puede ayudar a plantear estrategias eficaces para prevenir la adicción al teléfono móvil inteligente.

Resumo Enquadramento: Os telemóveis inteligentes estão permitem acesso imediato à informação. O vício no uso desses dispositivos é cada vez maior, os celulares inteligentes tornaram-se um elemento importante para os estudantes de enfermagem. Objetivo: Identificar a dependência do uso do smartphone em estudantes de enfermagem. Metodologia: Estudo correlacional descritivo, a amostragem foi aleatória, a amostra foi calculada considerando nível de confiança de 0,05, poder de 90%, tamanho de efeito médio de 0,09, a amostra foi composta por 149 estudantes de enfermagem. Resultados: O componente de uso, abuso e dependência de smartphone foi negativamente relacionado ao componente de traço de personalidade (r s = -0,228; p = 0,005), o uso, abuso e dependência de smartphone foi relacionado positivamente com gastos monetários (r s = 0,376; p = 0,001). Conclusão: Identificou-se que existe um alto uso de telefones móveis inteligentes, compreender a abrangência desse fenômeno pode ajudar a propor estratégias eficazes para prevenir o vício em celulares.

Abstract Background: Smartphones provide immediate access to information, and nursing students consider them essential tools. However, the addiction to these devices is increasing. Objective: To identify smartphone addiction among nursing students. Methodology: A descriptive correlational study was conducted using the stratified random sampling method. The sample size was calculated based on a confidence level of 0.05, with 90% power, and a median effect size of 0.09. The study included 149 nursing students. Results: The component “Smartphone use, abuse, and addiction” correlated negatively with the component “Personality traits” (r s = -0.228; p = 0.005); the component “Smartphone use, abuse, and addiction” correlated positively with the component “Financial spending” (r s = 0.376; p = 0.001). Conclusion: Smartphone use is high. Understanding the extent of this phenomenon can aid in developing effective strategies to prevent smartphone addiction.

RESUMEN Paraguay ha aumentado la inversión en educación en la última década por medio del Fondo Nacional de Inversión Pública y Desarrollo (FONACIDE) cuya finalidad consiste en abordar las carencias que afectan a la educación paraguaya. Entonces, considerando la creciente preocupación por la gestión de los recursos públicos dada la escasa infraestructura y el deficiente servicio del almuerzo escolar, en este trabajo se pretende analizar la eficiencia de la gestión de los gastos públicos en educación del FONACIDE de los departamentos de Paraguay durante el período 2015 a 2017, a través de la aplicación de la técnica Data Envelopment Analysis (DEA) con análisis de ventana y retornos variables de escala con orientación producto. La técnica DEA con análisis de ventana consiste en medir el nivel de eficiencia de varias Decision Making Units (DMUs) en diferentes períodos de tiempo basado en el principio de promedios móviles. Los resultados muestran que la ineficiencia técnica pura media nacional es del 11,04%, por tanto, los departamentos en general podrían mejorar sus indicadores educativos utilizando los mismos niveles de financiamiento. Además, el mayor acceso a recursos no está vinculado a mejores rendimientos educativos. Por tanto, para potenciar el rendimiento educativo es necesario establecer otros criterios de redistribución presupuestaria del FONACIDE, considerando la necesidad de infraestructura y número de alumnos matriculados por departamento.

ABSTRACT Paraguay has increased investment in education over the past decade through the National Fund for Public Investment and Development (FONACIDE), whose goal is to address the deficiencies affecting Paraguayan education. Considering the growing concern over the management of public resources given the inadequate infrastructure and poor school lunch service, this paper aims to analyze the efficiency of public spending management in education by FONACIDE in the departments of Paraguay during the period 2015 to 2017. This is achieved through the application of the Data Envelopment Analysis (DEA) technique with window analysis and variable returns to scale with product orientation. The DEA technique with window analysis measures the efficiency level of several Decision-Making Units (DMUs) over different periods based on the moving averages principle. The results show that the average national pure technical inefficiency is 11.04%, meaning that the departments, in general, could improve their educational indicators using the same funding levels. Additionally, greater access to resources is not linked to better educational outcomes. Therefore, to enhance educational performance, it is necessary to establish other budget redistribution criteria for FONACIDE, considering the need for infrastructure and the number of enrolled students per department

RESUMEN El artículo examina la necesidad de introducir la presupuestación por programas, como parte de un proceso más amplio de modernización de las finanzas públicas en Cuba. Dentro de los factores que hacen necesaria su implementación están los nichos de eficiencia del gasto público y la desconexión entre el sistema presupuestario y el sistema de planificación. Esta metodología presupuestaria se orienta a la gestión basada en resultados, permitiendo analizar la productividad del gasto público durante el ejercicio fiscal. Asimismo, su introducción serviría al propósito de calzar financieramente la arquitectura establecida a través de macroprogramas, programas y proyectos, fortaleciendo la correspondecia entre planificación y presupuestación. Se concluye que el éxito en su implementación está condicionado por la existencia de problemas en el entorno macroeconómico, institucional y regulatorio.

ABSTRACT The article examines the need to introduce budgeting by programs, as part of a broader process of modernization of public finances in Cuba. Among the factors that make its implementation necessary are the niches of efficiency in public spending and the disconnection between the budget system and the planning system. This budgetary methodology is oriented towards results based management, making it possible to analyze the productivity of public spending during the fiscal year. Likewise, its introduction would serve the purpose of financially fitting the architecture established through Macroprograms, programs and projects, strengthening the correspondence between planning and budgeting. It is concluded that the success in its implementation is conditioned by the existence of problems in the macroeconomic, institutional and regulatory environment.

ABSTRACT The macroeconomic approach is a way of analyzing and studying issues related to the global analysis of the economy. The objective of this paper is to estimate the influence of macro- economic determinants on the achievement of the monetary poverty reduction targets in Paraguay during the period 1997-2020. It works specifically with the first two targets that have to do with the eradication of extreme poverty and the reduction to 50% of total poverty. The macroeconomic determinants analyzed are GDP, CPI, the Gini index and social spending. For this purpose, we propose the application of an econometric model which, based on regression models, allows us to calculate the incidence of each of the variables analyzed on monetary poverty. In addition, projections are made to infer whether or not the objectives of SDG 1 can be met and under what conditions. The results obtained allow us to affirm, on one hand, that all the determinants analyzed have a significant impact on monetary poverty and, on the other hand, allow us to infer that none of the targets can be met by 2030, either by maintaining constant or even increasing economic growth. This leads to the conclusion that the effectiveness of poverty reduction strategies lies in combining efforts that link GDP growth with equitable redistribution of resources and social investment.

RESUMEN Este trabajo tiene como objetivo estimar la influencia de los determinantes macroeconómicos en la consecución de las metas de reducción de pobreza monetaria en Paraguay durante el período 1997-2020. Los determinantes macroeconómicos analizados son el PIB, el IPC, el índice de Gini y el gasto social. Para el efecto, se propone la aplicación de un modelo econométrico, el cual, a partir de modelos de regresión, permite calcular la incidencia de cada una de las variables analizadas sobre la pobreza monetaria. Además, se realizan proyecciones para inferir si se pueden cumplir o no con los objetivos del ODS 1 y bajo qué condiciones. Los resultados obtenidos permiten afirmar, por un lado, que todos los determinantes analizados inciden significativamente sobre la pobreza monetaria y, por otro lado, permiten inferir que ninguna de las metas se puede cumplir al 2030, ya sea manteniendo constante o incluso aumentando el crecimiento económico. Esto permite concluir que la eficacia en las estrategias de reducción de pobreza radica en combinar esfuerzos que vinculen el aumento del PIB con la redistribución equitativa de recursos y la inversión social.

Abstract This research addresses the relationship between budget efficiency and State participation in the Mexican economy, offering a historical vision and its evolution over time, with a focus on the current government known as the "Cuarta Transformación" (4T). The arguments for and against state intervention in the economy are reviewed and the importance of State participation in the allocation of the public budget is analyzed, emphasizing its impact on economic growth and the reduction of inequalities. The study focuses on evaluating how public spending affects the country's economic growth, using the current six-year term as an example. It is shown that the proper use of the public budget is crucial for the growth of the Mexican economy, through actions such as the creation of infrastructure, the protection of labor rights, the promotion of strategic sectors and the promotion of equal opportunities. Regarding the current government, the results reveal that, although actions have been undertaken to generate economic and social development through better use of public resources, the opacity in the management of resources in several projects makes it difficult to obtain good results, which raises questions about the efficient use of resources in the country. In this sense, it is crucial to have instruments that guarantee transparency, accountability and economic stability, preventing corruption. Likewise, the importance of finding a balance is highlighted so that the State fulfills its regulatory function without hindering innovation and economic growth.

Resumo Esta pesquisa aborda a relação entre eficiência orçamentária e participação do Estado na economia mexicana. Para isso, é oferecida uma visão histórica e sua evolução ao longo do tempo, com foco no atual governo, conhecido como a “quarta transformação” (4T). Especificamente, são revistos os argumentos a favor e contra a intervenção do Estado na economia e analisada a importância da participação do Estado na alocação do orçamento público, para o que é dada ênfase ao seu impacto no crescimento económico e na redução das desigualdades. O estudo centra-se na avaliação de como os gastos públicos durante o actual governo de seis anos afectam o crescimento económico do país. Neste sentido, demonstra-se que o uso adequado do orçamento público é crucial para o crescimento da economia mexicana, através de ações como a criação de infraestruturas, a proteção dos direitos laborais, a promoção de setores estratégicos, bem como a promoção da igualdade, das oportunidades. O atual governo apresenta resultados reveladores no que diz respeito à realização de ações para gerar desenvolvimento econômico e social através de melhor utilização dos recursos públicos; Da mesma forma, aponta que a opacidade na gestão de recursos em diversos projetos dificulta a obtenção de resultados positivos e levanta questões sobre o uso eficiente dos recursos no país. Portanto, é crucial ter instrumentos que garantam a transparência, a responsabilização e a estabilidade económica que permitam prevenir a corrupção. Da mesma forma, destaca-se a importância de encontrar um equilíbrio para que o Estado cumpra a sua função reguladora sem prejudicar a inovação e o crescimento económico.

Resumen Esta investigación aborda la relación entre la eficiencia del presupuesto y la participación del Estado en la economía mexicana. Para ello, se ofrece una visión histórica y su evolución a lo largo del tiempo, con un enfoque en el actual gobierno, conocido como la “cuarta transformación” (4T). En concreto, se revisan los argumentos a favor y en contra de la intervención estatal en la economía y se analiza la importancia de la participación del Estado en la asignación del presupuesto público, para lo cual se hace hincapié en su impacto en el crecimiento económico y la reducción de las desigualdades. El estudio se centra en evaluar cómo el gasto público del actual sexenio gubernamental afecta al crecimiento económico del país. En tal sentido, se demuestra que el adecuado uso del presupuesto público es crucial para el crecimiento de la economía mexicana, mediante acciones como la creación de infraestructura, la protección de los derechos laborales, el impulso a sectores estratégicos, así como la promoción de igualdad de oportunidades. El actual gobierno presenta resultados reveladores en torno al emprendimiento de acciones para generar un desarrollo económico y social mediante un mejor uso de los recursos públicos; asimismo, señala que la opacidad en el manejo de recursos en varios proyectos dificulta la obtención de positivos resultados y genera cuestionamientos sobre el uso eficiente de los recursos en el país. Por eso, resulta crucial contar con instrumentos que garanticen transparencia, rendición de cuentas y estabilidad económica que permitan prevenir la corrupción. Asimismo, se destaca la importancia de encontrar un equilibrio para que el Estado cumpla su función reguladora sin obstaculizar la innovación y el crecimiento económico.

Abstract The tendency for government to grow is a hallmark of modernity. Current trends and future perspectives on public spending do confirm that cost increases will stay for long. In this scenario, adequate techniques and tools are needed to develop results-oriented public policies in order to achieve politically established goals through effective decisions and actions for public sector good management benefiting societies all over the world. This article goal is to introduce the concepts of costing models, budgeting methodologies, performance evaluation and control tools through specific methodologies based on real recent world evidence and case studies in different countries. Tools that help face this challenge are key to success (for worldwide societies): activity-based costing and activity-based management, zero-based budgeting and control tools have proven to be useful in this continuous journey, being New Public Management or Bureaucratic models, the schemes used to run states at country, province or city levels. JEL: M1, L3.

Resumen La tendencia al crecimiento de los gobiernos es una marca actual, y esta perspectiva de crecimiento del gasto público confirma que los costos continuarán incrementándose en el futuro. En este escenario las técnicas y herramientas adecuadas de gestión son necesarias para desarrollar políticas públicas orientadas a resultados que permitan alcanzar los objetivos fijados por los gobernantes mediante decisiones y acciones llevadas a cabo con buena gestión que beneficie a los ciudadanos. El presente artículo busca introducir los conceptos de modelos de costeo metodologías de presupuestación, evaluación de desempeño y control de gestión a través de metodologías específicas basadas en reciente “evidencia del mundo real” y casos de estudio en diferentes países. Los instrumentos que ayudan a afrontar este desafío son claves para alcanzar las metas: costeo basado en las actividades y gestión basada en las actividades, presupuesto base cero y herramientas de control han probado ser útiles en este proceso continuo, sea dentro de un contexto de gestión basada en la “Nueva Gestión Pública” o en los modelos “Burocráticos” tradicionales que se pueden emplear para gestionar el estado a nivel nacional, provincial o municipal. JEL: M1, L3.

Résumé La tendance à la croissance des administrations publiques est une marque actuelle, et cette perspective de croissance des dépenses publiques confirme que les coûts continueront d’augmenter à l’avenir. Dans ce scénario, des techniques et des outils de gestion appropriés sont nécessaires pour développer des politiques publiques axées sur les résultats qui permettent d’atteindre les objectifs fixés par les gouvernants à travers des décisions et des actions menées avec une bonne gestion et qui profitent aux citoyens. Cet article vise à introduire les concepts de modèles d’établissement des coûts, de méthodologies de budgétisation, d’évaluation de la performance et de contrôle de gestion à travers des méthodologies spécifiques basées sur des « preuves du monde réel » récentes et des études de cas dans différents pays. Les instruments qui permettent de relever ce défi sont essentiels pour atteindre les objectifs : le calcul des coûts par activité et la gestion par activité, la budgétisation base zéro et les outils de contrôle se sont avérés utiles dans ce processus en cours, soit dans un contexte de gestion basée sur la « nouvelle gestion publique », soit sur les modèles traditionnels « bureaucratiques » qui peuvent être utilisés pour gérer l’État au niveau national, provincial ou municipal. JEL: M1, L3.

Resumo A tendência de crescimento dos governos é uma marca atual, e essa perspectiva de crescimento do gasto público confirma que os custos continuarão a aumentar no futuro. Nesse cenário, são necessárias técnicas e ferramentas de gestão adequadas para o desenvolvimento de políticas públicas orientadas para resultados que permitam que os objetivos traçados por quem detém o poder sejam alcançados por meio de decisões e ações realizadas com boa gestão que beneficiem os cidadãos. Este artigo busca introduzir os conceitos de modelos de custeio, metodologias orçamentárias, avaliação de desempenho e controle gerencial por meio de metodologias específicas baseadas em recentes "evidências do mundo real" e estudos de caso em diferentes países. Os instrumentos que ajudam a enfrentar esse desafio são fundamentais para o alcance das metas: custeio baseado em atividades e gestão baseada em atividades, orçamento base zero e ferramentas de controle têm se mostrado úteis nesse processo contínuo, seja dentro de um contexto de gestão baseado na "Nova Gestão Pública" ou nos modelos tradicionais "burocráticos" que podem ser usados para gerir o Estado em nível nacional. provincial ou municipal. JEL: M1, L3.

Abstract Osteoarthritis (OA) can incapacitate the individual to perform their activities of daily living due to pain. This is an important public health issue that worsens worldwide and in Brazil, since the population goes through an aging process, and has caused increased public spending on the monitoring and maintenance of treatments that can last for years and still not be resolutive. Thus, the search for innovative and effective therapies that can reduce costs becomes necessary. In this context, the present study reports the first application of cell therapy with adipose-derived stem cells in the treatment of cases of OA that are refractory to the conservative treatment, performed in the Brazilian Unified Health System (Sistema Único de Saúde, SUS). The evaluation was performed with the application of the Visual Analog Scale (VAS), the Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities (WOMAC), specifics for OA evaluation, and also an analysis of the synovial fluid (inflammatory cytokines). The cell therapy improved the scores on the WOMAC, SF-36 and EVA, and reduced the inflammatory process. We observed a decrease of 0.73x in the TNF, of 0,71x in IL-1b, of 0,68x in IL-8, and of 0,70x in IL-10. For IL-6, an increase of 1,48x was observed. Therefore, this cell therapy can be considered promising in aiding the management of this disease, since it improved the patient's pain, decrease inflammatory markers, and enabled the return to activities of daily living, which resulted in an improvement in their quality of life. (OA pain Brazil process resolutive Thus necessary context adiposederived adipose derived Sistema Saúde SUS. SUS . SUS) VAS, VAS , (VAS) SF36 SF 36 (SF-36 WOMAC (WOMAC) cytokines. cytokines cytokines) SF-3 EVA 073x x 0 73x TNF 071x 71x IL1b, IL1b ILb IL 1b, 1b b IL-1b 068x 68x IL8, IL8 8, 8 IL-8 070x 70x IL10. IL10 10. 10 IL-10 IL6, IL6 6, 6 IL-6 148x 1 48x Therefore disease patients patient s markers life (VAS SF3 3 (SF-3 (WOMAC SF- IL- IL1 IL-1 (SF- (SF

Resumo A osteoartrite (OA) pode deixar o indivíduo incapacitado para realizar suas atividades da vida diária devido ao quadro álgico. Essa é uma importante questão de saúde pública que se agrava no mundo inteiro e no Brasil, uma vez que a população passa pelo processo de envelhecimento, e isso causa um aumento nos gastos públicos com o acompanhamento e manutenção dos tratamentos que podem perdurar por anos e mesmo assim não serem resolutivos. Assim, torna-se necessária a busca por terapias inovadoras e eficazes que possam reduzir esses custos. Nesse contexto, o presente estudo relata a primeira aplicação de terapia celular com células-tronco mesenquimais do tecido adiposo no tratamento de OA refratária ao tratamento conservador realizada no Sistema Único de Saúde (SUS). Na avaliação, foram usados os instrumentos Escala Visual Analógica (EVA), os questionários de qualidade de vida Short Form Health Survey (SF-36) e Western Ontario and McMaster Universities (WOMAC), específicos para avaliação da OA, e fez-se uma análise do líquido sinovial (citocinas inflamatórias). A terapia celular melhorou as pontuações no WOMAC, SF-36, e EVA, e reduziu o processo inflamatório. Observou-se redução de 0,73 × do TNF, de 0,71 × da IL-1b, de 0,68 × da IL-8, e de 0,70 × da IL-10. Já para a IL-6, observou-se aumento de 1,48 ×. Portanto, considera-se este tipo de terapia celular promissora no auxílio do manejo desta doença, pois melhorou o quadro álgico do paciente, reduziu os marcadores inflamatórios, e possibilitou o retorno às atividades da vida diária, o que resultou em uma melhora de sua qualidade de vida. (OA Brasil envelhecimento resolutivos Assim tornase torna custos contexto célulastronco células tronco SUS. SUS . (SUS) EVA , (EVA) SF36 SF 36 (SF-36 WOMAC (WOMAC) fezse fez citocinas inflamatórias. inflamatórias inflamatórias) SF36, 36, SF-36 inflamatório Observouse Observou 073 0 73 0,7 TNF 071 71 IL1b, IL1b ILb IL 1b, 1b b IL-1b 068 68 0,6 IL8, IL8 8, 8 IL-8 070 70 IL10. IL10 10. 10 IL-10 IL6, IL6 6, 6 IL-6 observouse observou 148 1 48 1,4 Portanto considerase considera doença paciente inflamatórios (SUS (EVA SF3 3 (SF-3 (WOMAC SF-3 07 7 0, 06 IL- IL1 IL-1 14 4 1, (SF- SF- (SF

BACKGROUND. The COVID-19 pandemic highlighted the weakness of relying on in-person tuition in higher education. Massive open online courses (MOOCs) have been a successful addition to higher education. In this study, educators had to replace a planned elective in the medical curriculum with an online option during the pandemic. The roles of the competency framework of the Health Professions Council of South Africa (HPCSA) (Leader and Manager, Health Advocate, Professional, Communicator, Collaborator, Scholar, and Healthcare Practitioner) were used to guide its development. This elective emphasised the non-clinical roles of medical practitioners and was offered in 2020 and 2021. OBJECTIVES. To describe the choices of third-year medical students and time spent participating in a modified online elective in 2020 and 2021. METHODS. A descriptive cross-sectional study design was used, involving the participation of 629 medical students. Data were collected and analysed from three primary sources: registration data from LinkedIn Learning, data from the Foundation for Professional Development, and self-reported estimates by students of the average time spent on selected courses. Data included identification of the associated competency acquired. Data analysis was conducted using Python, version 3.10.11. RESULTS. The course choices of 629 students were analysed. In 2020 there were 300 participants and in 2021 there were 329. All the students had one compulsory inclusion in the elective (Management and Leadership Short Course for Undergraduate Healthcare Students). Students in both years reported spending the most average time on courses related to clinical knowledge (Healthcare Practitioner), followed by financial literacy and management (Professional), diversity management (Collaborator), and priority actions to identify and/or respond to (Health Advocate). The most popular courses related to the Leader and Manager role were around decision-making in human resources, problem-solving, and managing healthcare teams. Based on the top 10 LinkedIn Learning course selections of both cohorts, there appeared to be a preference for courses that were consistent with the role of medical professionals in practice. The most popular LinkedIn Learning course was The Six Morning Habits of High Performers. CONCLUSION. Students gravitated toward courses aligned with their role as professional doctors within the HPCSA competency framework. More studies are needed to understand how medical students develop the six non-clinical roles in the HPCSA framework and the effectiveness of MOOCs in a medical curriculum.

Abstract: The relationship between fiscal decentralization and the extraction of income by private agents is a constant element in the debates on territorial institutional design. Theoretical literature makes ambiguous predictions about this relationship, and it has been little studied empirically. An econometric model is estimated for a panel of data from 73 developing countries for the years 1996-2019. In general, the evidence found regarding the role of spending decentralization in a lower perception of corruption is consistent. However, a decentralization of income is related to greater corruption. In this way, possible accountability systems appear independent of the generation of own resources and transfer systems are highlighted in the control of public spending.

Resumen: La relación entre la descentralización fiscal y la extracción de rentas por parte de agentes privados es un elemento constante en los debates pertinentes al diseño institucional territorial. La literatura teórica hace predicciones ambiguas respecto de esta relación, y ha sido poco estudiada empíricamente. Se estima un modelo econométrico para un panel de datos de 73 países en desarrollo para 1996-2019. En general, es consistente la evidencia encontrada respecto del papel de la descentralización del gasto en una menor percepción de la corrupción. Sin embargo, una descentralización del ingreso se relaciona con una mayor corrupción. De este modo, aparecen posibles sistemas de rendición de cuentas independientes de la generación de recursos propios y se resaltan a los sistemas de transferencias en el control del gasto público.

ABSTRACT Introduction: Digital visual syndrome or digital visual fatigue is a disease caused by the ocular fatigue provoked by spending much time in front of a screen. Objective: To diagnose the digital visual syndrome in patients under 35 years assisted in the refraction service. Methods: A prospective descriptive and cross-sectional study of patients assisted in the refraction service of the Specialties Polyclinic in Saturnino Lora Teaching Clinical Surgical Provincial Hospital, was carried out from April to June, 2022. Results: There was a prevalence of patients aged 26 and 35 and female sex; the most frequent symptoms were visual fatigue, ocular burning, dry eye sensation, closely blurred vision, red eye and headache after visual effort. The most used digital devices were the cellphone and the computer with a time of use from one to three hours, with emphasis in the last one with more than 4 hours. The refractive defects constituted the main cause of visual limitations. The patients with digital visual syndrome and some type of ametropia without correction were those with more symptoms, followed by the patients inadequately corrected. Conclusions: This syndrome affects the youngest population to a great extent. The appropriate interrogation and the incorporation of correct procedures in the daily optometric study allowed the diagnosis of such a syndrome in the assisted patients and the pertinent optic correction.

RESUMEN Introducción: El síndrome visual informático o fatiga visual digital es una enfermedad causada por el cansancio ocular que provoca el pasar mucho tiempo frente a una pantalla. Objetivo: Diagnosticar el síndrome visual informático en pacientes menores de 35 años atendidos en la consulta de refracción. Métodos: Se realizó un estudio descriptivo prospectivo y transversal de pacientes atendidos en la consulta de refracción del Policlínico Especialidades del Hospital Provincial Docente Clínicoquirúrgico Saturnino Lora, durante el periodo de abril a junio de 2022. Resultados: Predominaron los pacientes en las edades comprendidas entre 26 y 35 años y del sexo femenino; los síntomas más frecuentes fueron el cansancio visual, ardor ocular, sensación de ojo seco, visión borrosa de cerca, ojo rojo y el dolor de cabeza después del esfuerzo visual. Los dispositivos digitales más usados fueron el celular y la computadora con un tiempo de uso de una a tres horas, destacándose este último con un tiempo superior a 4 horas. Los defectos refractivos constituyeron la principal causa de limitaciones visuales. Los pacientes con síndrome visual informático y alguna ametropía sin corrección fueron los que mayor cantidad de síntomas tuvieron, seguidos de los pacientes corregidos inadecuadamente. Conclusiones: Este síndrome afecta en gran medida a la población más joven. El adecuado interrogatorio y la incorporación de los procedimientos correctos en el estudio optométrico diario permitió el diagnóstico de tal síndrome en los pacientes atendidos y la corrección óptica pertinente.

Abstract Background: Type 2 diabetes has economic implications involving family income and out-of-pocket spending. Objective: Determine family out-of-pocket expenditure for type 2 diabetes mellitus care and percentage of family income. Material and methods: Study of family out-of-pocket spending in families with patients with type 2 diabetes treated at primary care level. Out-of-pocket expenses included expenses for transportation, food-drinks, and external medications. Family income corresponded to the total economic income contributed by family members. The percentage of out-of-pocket spending in relation to family income was identified with the relationship between these two variables. Statistical analysis included averages and percentages. Results: The annual family out-of-pocket expenditure on transportation was $2,621.24, the family out-of-pocket expenditure on food and beverages was $1,075.67, and the family out-of-pocket expenditure on external medications was $722.08. The total annual family out-of-pocket expense was $4,418.89 and corresponds to 4.73% of family income. Conclusion: The family out-of-pocket expense in the family with a patient with diabetes mellitus 2 was $4,418.89 and represents 4.73% of the family income.

Resumen Antecedentes: La diabetes tipo 2 tiene implicaciones económicas en el ingreso familiar y el gasto de bolsillo. Objetivo: Determinar el gasto de bolsillo familiar en la atención de la diabetes mellitus tipo 2 y el porcentaje que representa en el ingreso familiar. Material y métodos: Estudio de gasto de bolsillo de las familias con pacientes con diabetes tipo 2 atendidos en el primer nivel de atención. El gasto de bolsillo familiar incluyó gasto en traslado, alimentos-bebidas y medicamentos externos. El ingreso familiar correspondió al total de ingresos económicos aportados por los miembros de la familia. El porcentaje del gasto de bolsillo con relación al ingreso familiar se identificó con la relación entre estas dos variables. El análisis estadístico incluyó promedios y porcentajes. Resultados: El gasto de bolsillo familiar anual en transporte fue de $2621.24, en alimentos y bebidas fue de $1075.67 y en medicamentos externos fue de $722.08. El gasto familiar de bolsillo total anual fue de $4418.89 y correspondió a 4.73 % del ingreso familiar. Conclusión: El gasto de bolsillo en las familias con un paciente con diabetes mellitus tipo 2 fue de $4418.89 y representó 4.73 % del ingreso familiar.

RESUMEN La literatura teórica indica que el gasto en seguridad pública es importante para disuadir el comportamiento delictivo. Sin embargo, la mayoría de los estudios empíricos destinados a cuantificar la influencia del gasto en seguridad pública sobre la delincuencia no han podido establecer una relación estadísticamente significativa entre estas variables. En respuesta a esto, introdujimos un indicador novedoso que mide la asignación de los gastos de seguridad pública en cada región. Al probarlo para delitos de homicidio, robo y hurto de vehículos a través del estimador gmm-sys, encontramos evidencia estadística de que su ocurrencia influye en la conducta delictiva. Creemos que su inclusión aporta evidencia valiosa a la literatura económica, arrojando luz sobre el debate en torno a la eficiencia en la asignación de recursos del gasto en seguridad.

ABSTRACT Theoretical literature indicates that public security spending matters to deter criminal behavior. Nevertheless, most empirical studies aiming to quantify the influence of public security spending on crime have largely been unable to establish a statistically significant relationship between these variables. In response to this, we introduced a novel proxy that measures the rationing of public security expenditures in each region. When testing it for crimes of homicide, robbery, and theft of vehicles through the gmm-sys estimator, we found statistical evidence that its occurrence influences criminal behavior. We believe its inception contributes valuable evidence to the economic literature, shedding light on the debate surrounding the allocative efficiency of security spending resources.

Abstract The study analyzes the level of technical efficiency of public investment in Education at the primary and secondary level in Peru, 2016 to 2022. Data envelopment analysis - DEA was used and for the association between the provision of resources and educational quality. the panel data fixed effects model. The results indicate that there are relative differences in efficiency between the regions, registering an average score of 49% for the primary level and 38% for the secondary level, with the most efficient being Moquegua, Tacna, Arequipa and Ica, and the least efficient being Loreto, Huánuco, Ucayali, and San Martín. From the input-output association, classroom size, infrastructure in good condition and public investment have a direct relationship, while students per teacher and per computer, the relationship is inverse with respect to educational achievement in communication and mathematics at the primary and secondary level. This suggests that inefficient regions should increase educational attainment at the primary and secondary levels by an average of 51% and 62%, respectively, while maintaining the same level of spending. Therefore, to improve their efficiency within the framework of public policies, they can adopt the management implemented by regions such as Moquegua and Tacna.

Resumen El estudio analiza el nivel de eficiencia técnica de la inversión pública en Educación en el nivel primario y secundario en Perú, 2016 a 2022. Se utilizó el análisis envolvente de datos - DEA y para la asociación entre la dotación de recursos y la calidad educativa, el modelo panel data efectos fijos. Los resultados indican que existen diferencias relativas de eficiencia entre las regiones, registrando una puntuación promedio de 49 % para el nivel primario y 38 % para el nivel secundario, siendo los más eficientes Moquegua, Tacna, Arequipa e Ica, y los menos eficientes Loreto, Huánuco, Ucayali, y San Martín. De la asociación insumo - producto, tamaño del aula, infraestructura en buen estado e inversión pública tienen relación directa, en tanto que alumnos por docente y por computadora, la relación es inversa respecto al logro educativo en comunicación y matemática a nivel primario y secundario. Ello sugiere que las regiones ineficientes deben aumentar en promedio 51 % y 62 % los logros educativos en el nivel primario y secundario respectivamente, manteniendo el mismo nivel de gasto. Por tanto, para mejorar su eficiencia en el marco de políticas públicas, pueden adoptar la gestión implementada por las regiones como Moquegua y Tacna.

ABSTRACT Objective: Determine the relationship between the budget execution of financial transfers from the SIS (Seguro Integral de Salud) and the availability of medical supplies in third-level establishments of the Ministry of Health of Metropolitan Lima. Material and method: Analytical and cross-sectional study, carried out in the 20 level III establishments of the MINSA in Lima; Likewise, documentary information was used such as Closing Minutes of Financial Supervision of the Macroregional Management of the SIS from which information on budget execution was obtained and the availability of medical supplies was obtained from the Mundo IPRESS web portal (Institutions Providing Health Services). After evaluating normality with the Shapiro-Wilk test, the Spearman correlation test was used. Result: Overall budget execution was not related to the availability of medical supplies (rho=-0.014; p=0.955). The evaluation by components showed that budget execution on medicines was positively related to the availability of supplies (rho=0.417; p=0.045), which was also valid in the segmented analysis only for hospitals (rho: 0.594; p=0.032). Although budget execution in segmented materials and supplies for hospitals was related to the availability of supplies, this relationship was inverse (rho=-0.552; p=0.043). Conclusions: The general budget execution of financial transfers from the SIS was not related to the availability of medical supplies, but the spending component on medicines was.

ABSTRACT Objective: Determine the relationship between the budget execution of financial transfers from the SIS (Seguro Integral de Salud) and the availability of medical supplies in third-level establishments of the Ministry of Health of Metropolitan Lima. Material and method: Analytical and cross-sectional study, carried out in the 20 level III establishments of the MINSA in Lima; Likewise, documentary information was used such as Closing Minutes of Financial Supervision of the Macroregional Management of the SIS from which information on budget execution was obtained and the availability of medical supplies was obtained from the Mundo IPRESS web portal (Institutions Providing Health Services). After evaluating normality with the Shapiro-Wilk test, the Spearman correlation test was used. Result: Overall budget execution was not related to the availability of medical supplies (rho=-0.014; p=0.955). The evaluation by components showed that budget execution on medicines was positively related to the availability of supplies (rho=0.417; p=0.045), which was also valid in the segmented analysis only for hospitals (rho: 0.594; p=0.032). Although budget execution in segmented materials and supplies for hospitals was related to the availability of supplies, this relationship was inverse (rho=-0.552; p=0.043). Conclusions: The general budget execution of financial transfers from the SIS was not related to the availability of medical supplies, but the spending component on medicines was.