Abstract Objective We implemented and evaluated the Parenting Skills Program for families in Spain 1) to examine differences in parenting skills, social support, children's behaviours and parental stress pre, immediately post and six months post intervention and 2) to identify mechanisms by which the intervention is related to changes in the four outcomes examined. Methods Quasi-experimental study design with pre (T0), post (T1), a follow-up (T2) and no control group, complemented by a qualitative study was used. The outcome variables were social support, parenting skills, parental stress and children's behaviours. 216 parents completed pre and post questionnaire and 130 parents the follow-up questionnaire. 39 professionals and 34 parents participated in 17 interviews and 5 discussion groups. Results Compared with T0, all four outcomes improved significantly at T1. 76% of the participants improved parenting skills and 61% social support. 56% reduced children's negative behaviours and 66% parental stress. All outcomes maintained this significant improvement at T2. Parents and professionals describe different changes in parents’ parenting skills, stress and social support after participation in the PSP, and in their children's behaviours. Some subcategories emerged after analysing parents’ and professionals’ discourses. Conclusions This study describes positive parenting effects on participants of a parent-training program in Spain, which is a country where implementation and evaluation of these kind of interventions is an incipient issue.

Resumen Objetivo Se introdujo y evaluó el Programa de Habilidades Parentales para familias a fin de: 1) examinar las diferencias en cuanto a habilidades parentales, apoyo social, comportamientos infantiles y estrés parental preintervención, inmediatamente después y 6 meses después de la intervención, y 2) identificar los mecanismos que explican los cambios generados por la intervención para las cuatro variables examinadas. Método Estudio cuasiexperimental con pre (T0), post (T1) y seguimiento (T2), sin grupo control, complementado con un estudio cualitativo. Variables: apoyo social, habilidades parentales, estrés parental y comportamientos infantiles. Completaron el cuestionario pre y post 216 padres/madres, y 130 el de seguimiento. Treinta y nueve profesionales y 34 padres/madres participaron en 17 entrevistas y cinco grupos de discusión. Resultados Comparado con T0, las cuatro variables mejoraron significativamente en T1. El 76% de los participantes mejoraron las habilidades parentales y el 61% el apoyo social. El 56% redujo los comportamientos infantiles negativos y el 66% el estrés parental. Las variables mantuvieron significativa la mejora en T2. Padres/madres y profesionales describieron cambios en las cuatro variables tras participar en el Programa de Habilidades Parentales. Surgieron subcategorías tras el análisis discursivo. Conclusiones Este estudio describe efectos positivos en la parentalidad de los participantes en un programa de educación parental español, siendo este un país donde la introducción y la evaluación de este tipo de programas son incipientes.

Abstract Objective We implemented and evaluated the Parenting Skills Program for families in Spain 1) to examine differences in parenting skills, social support, children's behaviours and parental stress pre, immediately post and six months post intervention and 2) to identify mechanisms by which the intervention is related to changes in the four outcomes examined. Methods Quasi-experimental study design with pre (T0), post (T1), a follow-up (T2) and no control group, complemented by a qualitative study was used. The outcome variables were social support, parenting skills, parental stress and children's behaviours. 216 parents completed pre and post questionnaire and 130 parents the follow-up questionnaire. 39 professionals and 34 parents participated in 17 interviews and 5 discussion groups. Results Compared with T0, all four outcomes improved significantly at T1. 76% of the participants improved parenting skills and 61% social support. 56% reduced children's negative behaviours and 66% parental stress. All outcomes maintained this significant improvement at T2. Parents and professionals describe different changes in parents’ parenting skills, stress and social support after participation in the PSP, and in their children's behaviours. Some subcategories emerged after analysing parents’ and professionals’ discourses. Conclusions This study describes positive parenting effects on participants of a parent-training program in Spain, which is a country where implementation and evaluation of these kind of interventions is an incipient issue.

Resumen Objetivo Se introdujo y evaluó el Programa de Habilidades Parentales para familias a fin de: 1) examinar las diferencias en cuanto a habilidades parentales, apoyo social, comportamientos infantiles y estrés parental preintervención, inmediatamente después y 6 meses después de la intervención, y 2) identificar los mecanismos que explican los cambios generados por la intervención para las cuatro variables examinadas. Método Estudio cuasiexperimental con pre (T0), post (T1) y seguimiento (T2), sin grupo control, complementado con un estudio cualitativo. Variables: apoyo social, habilidades parentales, estrés parental y comportamientos infantiles. Completaron el cuestionario pre y post 216 padres/madres, y 130 el de seguimiento. Treinta y nueve profesionales y 34 padres/madres participaron en 17 entrevistas y cinco grupos de discusión. Resultados Comparado con T0, las cuatro variables mejoraron significativamente en T1. El 76% de los participantes mejoraron las habilidades parentales y el 61% el apoyo social. El 56% redujo los comportamientos infantiles negativos y el 66% el estrés parental. Las variables mantuvieron significativa la mejora en T2. Padres/madres y profesionales describieron cambios en las cuatro variables tras participar en el Programa de Habilidades Parentales. Surgieron subcategorías tras el análisis discursivo. Conclusiones Este estudio describe efectos positivos en la parentalidad de los participantes en un programa de educación parental español, siendo este un país donde la introducción y la evaluación de este tipo de programas son incipientes.

The characteristics of tuberculosis (TB) patients related to a chain of recent TB transmissions were investigated. Mycobacterium tuberculosis (MTB) isolates (120) were genotyped using the restriction fragment length polymorphism-IS6110 (R), spacer oligotyping (S) and mycobacterial interspersed repetitive units-variable number of tandem repeats (M) methods. The MTB isolates were clustered and the clusters were grouped according to the similarities of their genotypes. Spearman’s rank correlation coefficients between the groups of MTB isolates with similar genotypes and those patient characteristics indicating a risk for a pulmonary TB (PTB) chain transmission were ana- lysed. The isolates showing similar genotypes were distributed as follows: SMR (5%), SM (12.5%), SR (1.67%), MR (0%), S (46.67%), M (5%) and R (0%). The remaining 35 cases were orphans. SMR exhibited a significant correlation (p < 0.05) with visits to clinics, municipalities and comorbidities (primarily diabetes mellitus). S correlated with drug consumption and M with comorbidities. SMR is needed to identify a social network in metropolitan areas for PTB transmission and S and M are able to detect risk factors as secondary components of a transmission chain of TB.

Nas últimas duas décadas observou-se um importante aumento da prevalência de obesidade no Brasil, contudo não existem dados populacionais atualizados sobre ingestão de alimentos e atividades físicas, que seriam em última instância os fatores que poderiam explicar este aumento de obesidade. Estudou-se a associação entre o consumo de calorias e gordura e a prática de atividades físicas com o índice de massa corporal, em um estudo transversal com 91 funcionários universitários. O consumo alimentar foi avaliado por um questionário semi-quantitativo de freqüência de consumo de alimentos e por quatro recordatórios de 24 horas. Peso e altura foram medidos e calculou-se o índice de massa corporal por meio da relação peso/altura em kg/m². As atividades físicas desenvolvidas no trabalho, no lazer e no deslocamento para o trabalho e/ou escola no mês que antecedeu a pesquisa foram investigadas através de questionário. Estimou-se o gasto energético associado às atividades físicas, através de equações propostas pela Organização Mundial da Saúde. Em análise linear multivariada associaram-se positivamente ao índice de massa corporal a idade (p=0,02), pertencer ao grupo de funcionários de nível médio e de apoio, comparados aos professores (p=0,004) e ser do sexo feminino (p=0,04). Ainda, nesta análise, um aumento de 500 calorias no gasto energético estimado equivaleu a uma redução de aproximadamente 2kg no peso de um indivíduo com 1,60m (p=0,008). Para os dois métodos usados para avaliação de consumo, a ingestão de calorias e de gordura associaram-se, significativamente, com o índice de massa corporal (p< 0,05), porém esta associação foi modificada pelo sexo, sendo negativa para as mulheres e fracamente positiva para os homens. Este estudo mostrou que o sexo feminino, nível socioeconômico e o gasto energético são preditivos de obesidade e sugere que mulheres obesas subestimam seu consumo alimentar.

Obesity has been increasing in Brazil in the last two decades, but there are no recent population data on dietary intake and physical activity, the two major components of body weight gain. The association of food intake (calorie and fat) and energy expenditure with body mass index (BMI) was studied in 91 university employers. Food intake was estimated by the means of four 24-hour recalls and by a semi-quantitative food frequency questionnaire developed using the most frequent consumed Brazilian foods. Weight and height were measured and the body mass index was calculated by dividing the weight in kg by the height in m². Physical activities developed in the previous month were estimated through a questionnaire that included activities developed at work, in the spare time and when commuting to work or school. Energy expenditure estimation was based on the WHO equations. Multivariate linear analysis having BMI as the dependent variable showed positive associations with age (p=0.02), occupation (support staff being heavier than professors, p=0.004), sex (females were heavier than males, p=0.04). Furthermore, the daily increase of 500 calories in the energy expenditure was associated to a weight reduction of approximately 2kg in an individual with a height of 1.60 m (p=0.008). For both methods used to estimate the food intake (24-hour recall and food frequency questionnaire), energy intake and fat intake were associated to BMI (p< 0.05), but sex modified these associations. For women there was a negative association between fat and energy intake and BMI, whereas for men this association was positive but irrelevant. This study indicated an increased risk of obesity with age, and an increased risk for staff employers and females. A possible misclassification of food intake among obese female was also suggested.