Analysis of maternal and child health policies in Malawi: The methodological perspective

The question of why most health policies do not achieve their intended results continues to receive a considerable attention in the literature. This is in the light of the recognized gap between policy as intent and policy as practice, which calls for substantial research work to understand the factors that improve policy implementation. Although there is substantial work that explains the reasons why policies achieve or fail to achieve their intended outcomes, there are limited case studies that illustrate how to analyze policies from the methodological perspective. In this article, we report and discuss how a mixed qualitative research method was applied for analyzing maternal and child health policies in Malawi. For the purposes of this article, we do not report research findings; instead we focus our dicussion on the methodology of the study and draw lessons for policy analysis research work. We base our disusssion on our experiences from a study in which we analyzed maternal and child health policies in Malawi over the period from 1964 to 2008. Noting the multifaceted nature of maternal and child health policies, we adopted a mixed qualitative research method, whereby a number of data collection methods were employed. This approach allowed for the capturing of different perspectives of maternal and child health policies in Malawi and for strengthening of the weaknesses of each method, especially in terms of data validity. This research suggested that the multidimensional nature of maternal and child health policies, like other health policies, calls for a combination of research designs as well as a variety of methods of data collection and analysis. In addition, we suggest that, as an emerging research field, health policy analysis will benefit more from case study designs because they provide rich experiences in the actual policy context.

"To Hold the World in Contempt": The British Empire, War, and the Irish and Indian Nationalist Press, 1899-1914

The era between the close of the nineteenth century and the onset of the First World War witnessed a marked increase in radical agitation among Indian and Irish nationalists. The most outspoken political leaders of the day founded a series of widely circulated newspapers in India and Ireland, placing these editors in the enviable position of both reporting and creating the news. Nationalist journalists were in the vanguard of those pressing vocally for an independent India and Ireland, and together constituted an increasingly problematic contingent for the British Empire. The advanced-nationalist press in Ireland and the nationalist press in India took the lead in facilitating the exchange of provocative ideas—raising awareness of perceived imperial injustices, offering strategic advice, and cementing international solidarity. Irish and Indian press coverage of Britain’s imperial wars constituted one of the premier weapons in the nationalists’ arsenal, permitting them to build support for their ideology and forward their agenda in a manner both rapid and definitive. Directing their readers’ attention to conflicts overseas proved instructive in how the Empire dealt with those who resisted its policies, and also showcased how it conducted its affairs with its allies. As such, critical press coverage of the Boxer Rebellion, Boer War, Russo-Japanese War, and World War I bred disaffection for the Empire, while attempts by the Empire to suppress the critiques further alienated the public. This dissertation offers the first comparative analysis of the major nationalist press organs in India and Ireland, using the prism of war to illustrate the increasingly persuasive role of the press in promoting resistance to the Empire. It focuses on how the leading Indian and Irish editors not only fostered a nationalist agenda within their own countries, but also worked in concert to construct a global anti-imperialist platform. By highlighting the anti-imperial rhetoric of the nationalist press in India and Ireland and illuminating their strategies for attaining self-government, this study deepens understanding of the seeds of nationalism, making a contribution to comparative imperial scholarship, and demonstrating the power of the media to alter imperial dynamics and effect political change.

Equity in Higher Education – Portuguese Perspective

Access, participation and exclusion from higher education for marginalized and disadvan-taged sections of the population are an intricate socio-political as well as economic practice that has manifold explanations and outcomes. During the last three decades, the higher education has experienced expansion in both enrolments and institutions. The approaches and means of delivery have changed besides the diversification in provision. The role of the state and mar¬ket has also reformed. This characteristic has also altered the nature of equity in higher edu¬cation across the globe. The chapters of this book on different countries of Asia, Europe and Latin America examine access and describe the several spaces where cohorts of relevant age group are included, excluded, or are at threat of exclusion in higher education. The chapters also narrate the state of affairs in which despite numerous alike structure in the experience and outcomes of social exclusion across disenfranchised groups and regions, how some critical differences have led to different paths of struggles and policy formation to attain the objective of equity in higher education.

“Biomarkers in a One Health perspective: current knowledge of their ability to merge human and animal health

Biomarkers are nowadays essential tools to be one step ahead for fighting disease, enabling an enhanced focus on disease prevention and on the probability of its occurrence. Research in a multidisciplinary approach has been an important step towards the repeated discovery of new biomarkers. Biomarkers are defined as biochemical measurable indicators of the presence of disease or as indicators for monitoring disease progression. Currently, biomarkers have been used in several domains such as oncology, neurology, cardiovascular, inflammatory and respiratory disease, and several endocrinopathies. Bridging biomarkers in a One Health perspective has been proven useful in almost all of these domains. In oncology, humans and animals are found to be subject to the same environmental and genetic predisposing factors: examples include the existence of mutations in BR-CA1 gene predisposing to breast cancer, both in human and dogs, with increased prevalence in certain dog breeds and human ethnic groups. Also, breast feeding frequency and duration has been related to a decreased risk of breast cancer in women and bitches. When it comes to infectious diseases, this parallelism is prone to be even more important, for as much as 75% of all emerging diseases are believed to be zoonotic. Examples of successful use of biomarkers have been found in several zoonotic diseases such as Ebola, dengue, leptospirosis or West Nile virus infections. Acute Phase Proteins (APPs) have been used for quite some time as biomarkers of inflammatory conditions. These have been used in human health but also in the veterinary field such as in mastitis evaluation and PRRS (porcine respiratory and reproductive syndrome) diagnosis. Advantages rely on the fact that these biomarkers can be much easier to assess than other conventional disease diagnostic approaches (example: measured in easy to collect saliva samples). Another domain in which biomarkers have been essential is food safety: the possibility to measure exposure to chemical contaminants or other biohazards present in the food chain, which are sometimes analytical challenges due to their low bioavailability in body fluids, is nowadays a major breakthrough. Finally, biomarkers are considered the key to provide more personalized therapies, with more efficient outcomes and fewer side effects. This approach is expected to be the correct path to follow also in veterinary medicine, in the near future.

Dynamics of terricolous alpine lichen communities of the Alps and Mediterranean Mountains in a climate change perspective

This thesis focuses on the impact of climate change in alpine ecosystems stressing the response of high elevation terricolous lichen communities. In fact, despite the strong sensitivity of cryptogams to changes in climatic factors, information is still scanty.We collected records in 154 plots placed in the summit area of the Majella Massif. In Following a multitaxon approach, Chapter 1 includes cryptogams and vascular plants. We analysed patterns in species richness, beta diversity and functional composition. In Chapter 2, we analysed the relationships between climatic variables and phylogenetic diversity and structure indices. Chapter 3 provides a long-term response relative to the consequences of climate change on a representative terricolous lichen genus across the Alps. Chapter 4 explores the relationships between the species richness and the functional composition of lichen growing on two types of substrates (carbonatic and siliceous soils) along different elevation gradients in the Eastern Alps. Climate change could affect cryptogams and lichens much more than vascular plants in Mediterranean mountains. Contrasting species-climate and traits-climate relationships were found between lichens and bryophytes, suggesting that each group may be sensitive to different components of climate change. Ongoing climate change may also lead to a loss of genetic diversity at high elevation ranges in the Mediterranean mountains, pauperising the life history richness of lichens. Alpine results forecasted that moderate range loss dynamics will occur at low elevation and in peripheral areas of the alpine chain. Results also support the view that range dynamics could be associated with functional traits mainly related to water-use strategies, dispersal, and establishment ability. We also highlighted the importance of substrates as a main driver of both species’ richness and functional traits composition. A “trade-off” also occurs between stress tolerance and the competitive response of communities of terricolous lichens that grow above siliceous and carbonatic soils.

Epidemiological studies on toxoplasma gondii infection in a one health perspective

The objective of the present Ph.D. thesis was to investigate with a One Health approach the epidemiological patterns of T. gondii infection in Italy, to better understand the transmission dynamics of the parasite, following different research lines. The results of a retrospective analysis in animals and human showed the widespread distribution of T. gondii in the study area, with specific antibodies found in various animal species and human populations, indicating its constant presence across diverse environments. The environment plays a significant role in T. gondii's epidemiology. Migratory aquatic birds, rodents, wolves, and wild boars were investigated as sentinels of their spread, highlighting the potential transmission across geographic areas and infection risks for wildlife in natural settings. The study also provided insights into seroprevalence in wolves. Dogs, subjected to serological investigations exhibited risk factors for T. gondii infection, such as cohabitation with cats, coprophagy behaviours, and continuous outdoor. Correlation between serological evidence of exposure to T. gondii and pathological anxiety in large-size dogs was observed, and the consumption of raw meat was associated with a higher risk of infection in these animals. Results of the investigations conducted in this thesis, demonstrate the dynamic nature of T. gondii infection in cattle, characterized by new infections and declining antibody levels over the production cycle. The study also describes a co-infection between T. gondii and Sarcocystis hominis in bovine eosinophilic myositis. In the final part of the Thesis, a comprehensive genotyping of T. gondii in Italy reveals the predominance of Type II strains, particularly in cases of ovine abortion and fatal toxoplasmosis among captive Lemur catta. This approach enhances our understanding of the parasite's genetic diversity and transmission patterns, vital for effective management of its impact on human and animal health in Italy.

YmpäristöjärjesteImän kehittäminen kouluissa

Ympäristöasioiden hallintajärjestelmät perustuvat kestävään kehitykseen. Peruslähtökohta ympäristöjärjestelmän käyttöönottoon on joko ideologiassa tai puhtaasti myynnin edistämisessä. Tässä diplomityössä lähestytään ympäristöjärjestelmää ensin yritysten näkökulmasta ja sen jälkeen koulujen ja oppilaitosten näkökulmista. Työn tavoitteina on vastata kysymykseen kuinka kehittää koulujen käyttämää Vihreä lippu ympäristöjärjestelmää entistä paremmaksi, sekä kuinka helpottaa Vihreä lippu ympäristöjärjestelmän käyttöönottoa kouluissa. Tämä tutkimus perustuu ympäristöministeriön rahoittamaan hankkeeseen "Kokemuksia Vihreä lippu ympäristöjärjestelmän käytöstä kouluissa". Hanke toteutettiin syksyn 2008 ja kevään 2009 aikana. Hankkeen tiedot kerättiin sekä kyselyiden että haastattelujen avulla. Tutkimus on luonteeltaan kvantitatiivinen, mutta siinä on myös kvalitatiivisen tutkimuksen elementtejä. Tutkimusmenetelmien yhdistäminen tässä tutkimuksessa lisää selvästi tutkimuksen validiutta. Tutkimuksen johtopaatokset näyttävät, että aivan "kivutta" ympäristöjärjestelmä ei synny kouluihin. Asiaa helpottaa suuresti, jos koulun johtoporras sitoutuu näyttävästi ympäristöjärjestelmään. Johdon sitoutuminen ympäristöjärjestelmään sitouttaa kaikki muut. Käyttöönottoa auttaa myös, jos ympäristöjärjestelmää käytetään johdon työkaluna. Lisaksi koulujen kannattaa olla avoimia kaikille sidosryhmille ja ottaa heitä reippaasti mukaan koulujen normaaliin arkeen. Myös koulujen ulkoinen ja sisäinen viestintä kannattaa ottaa suurennuslasin alle.

The role of public policy in health care promotion: a comparative perspective

Comunicação apresentada na 17th International conference on Health Promotio Hospitals and Health Services em Hersonissis, Crete, Grécia de 6-8 de maio de 2009

Effect of price and in-store promotion on sales: a study of distinct regions in an emerging market

Increasing competition caused by globalization, high growth of some emerging markets and stagnation of developed economies motivate Consumer Packaged Goods (CPGs) manufacturers to drive their attention to emerging markets. These companies are expected to adapt their marketing activities to the particularities of these markets in order to succeed. In a country classified as emerging market, regions are not alike and some contrasts can be identified. In addition, divergences of marketing variables effect can also be observed in the different retail formats. The retail formats in emerging markets can be segregated in chain self-service and traditional full-service. Thus, understanding the effectiveness of marketing mix not only in country aggregated level data can be an important contribution. Inasmuch as companies aim to generate profits from emerging markets, price is an important marketing variable in the process of creating competitive advantage. Along with price, promotional variables such as in-store displays and price cut are often viewed as temporary incentives to increase short-term sales. Managers defend the usage of promotions as being the most reliable and fastest manner to increase sales and then short-term profits. However, some authors alert about sales promotions disadvantages; mainly in the long-term. This study investigates the effect of price and in-store promotions on sales volume in different regions within an emerging market. The database used is at SKU level for juice, being segregated in the Brazilian northeast and southeast regions and corresponding to the period from January 2011 to January 2013. The methodological approach is descriptive quantitative involving validation tests, application of multivariate and temporal series analysis method. The Vector-Autoregressive (VAR) model was used to perform the analysis. Results suggest similar price sensitivity in the northeast and southeast region and greater in-store promotion sensitivity in the northeast. Price reductions show negative results in the long-term (persistent sales in six months) and in-store promotion, positive results. In-store promotion shows no significant influence on sales in chain self-service stores while price demonstrates no relevant impact on sales in traditional full-service stores. Hence, this study contributes to the business environment for companies wishing to manage price and sales promotions for consumer brands in regions with different features within an emerging market. As a theoretical contribution, this study fills an academic gap providing a dedicated price and sales promotion study to contrast regions in an emerging market.

Promotion of health in older people: a randomised controlled trial of health risk appraisal in British general practice

BACKGROUND: there is inadequate evidence to support currently formulated NHS strategies to achieve health promotion and preventative care in older people through broad-based screening and assessment in primary care. The most extensively evaluated delivery instrument for this purpose is Health Risk Appraisal (HRA). This article describes a trial using HRA to evaluate the effect on health behaviour and preventative-care uptake in older people in NHS primary care. METHODS: a randomised controlled trial was undertaken in three London primary care group practices. Functionally independent community-dwelling patients older than 65 years (n = 2,503) received a self-administered Health Risk Appraisal for Older Persons (HRA-O) questionnaire leading to computer-generated individualised written feedback to participants and general practitioners (GPs), integrated into practice information-technology (IT) systems. All primary care staff received training in preventative health in older people. The main outcome measures were self-reported health behaviour and preventative care uptake at 1-year follow-up. RESULTS: of 2,503 individuals randomised, 2,006 respondents (80.1%) (intervention, n = 940, control n = 1,066) were available for analysis. Intervention group respondents reported slightly higher pneumococcal vaccination uptake and equivocal improvement in physical activity levels compared with controls. No significant differences were observed for any other categories of health behaviour or preventative care measures at 1-year follow-up. CONCLUSIONS: HRA-O implemented in this way resulted in minimal improvement of health behaviour or uptake of preventative care measures in older people. Supplementary reinforcement involving contact by health professionals with patients over and above routine clinical encounters may be a prerequisite to the effectiveness of IT-based delivery systems for health promotion in older people.

Rehabilitation and reintegration needs of female inmates and promotion mental health in Georgian prison

RESUMO: As mulheres presas encontram-se num sistema essencialmente dirigido por e concebido para homens. As mulheres que entram na prisão geralmente vêm de ambientes marginalizados e desfavorecidos e muitas vezes têm histórias de violência e abuso físico e sexual. As mulheres presas são um grupo particularmente vulnerável, uma vez que dentro do sistema prisional as suas necessidades de saúde e higiene são muitas vezes negligenciadas. O primeiro passo para o desenvolvimento de programas e práticas sensíveis ao género é compreender as características das mulheres delinquentes e definir fatores de vida específicos que contribuem para a formação do comportamento criminoso de mulheres. Em junho de 2012 foi realizada uma investigação na única prisão feminina da Geórgia, para estudar as necessidades mentais e psicossociais das mulheres presas. O objetivo da pesquisa foi o desenvolvimento de programas de apoio pertinentes para a reabilitação, ressocialização e reintegração, e a elaboração de recomendações práticas para a gestão das prisões. Foi desenvolvido um instrumento de pesquisa (inquérito) com uma fundamentação conceptual baseada em quatro principais teorias: Teoria dos Caminhos (Pathways Theory), teoria do desenvolvimento psicológico da mulher (Theory of Women’s Psychological Development), Trauma e Teorias da Dependência (Trauma and Addiction Theories). Foram inquiridas 120 mulheres presas. Os resultados deste estudo mostram que muitas das necessidades das mulheres presas são diferentes das dos homens e requerem estratégias adaptadas às suas características e situações psicossociais específicas. A maioria das mulheres encarceradas é jovem, enérgica, pode trabalhar, tem profissão e família. As presas sofrem de problemas psicológicos e muitas vezes são rejeitadas pelas suas famílias. Uma parte substancial das mulheres presas tem múltiplos problemas de saúde física e mental. A maioria delas tem filhos e sofre com o facto das crianças estarem a crescer longe da mãe. Com base nos resultados desta investigação é possível elaborar um contexto promotor do planeamento e desenvolvimento de serviços com um enfoque de género na prisão. Na perspetiva de longo prazo, o conhecimento das necessidades básicas e a introdução de programas e serviços com necessidades específicas pertinentes irá beneficiar as presas e as suas famílias, e melhorar a eficácia do sistema de justiça criminal.----------ABSTRACT: Female inmates find themselves in a system essentially run by men for men. Women who enter prison usually come from marginalized and disadvantaged backgrounds and are often characterized by histories of violence, physical and sexual abuse. Female prisoners constitute an especially vulnerable group given their specific health and hygienic needs within the system are often neglected. The first step in developing gender-sensitive program and practice is to understand female offenders’ characteristics and the specific life factors that shape women’s patterns of offending. In June 2012 a research was carried out in the Georgian only female prison facility to assess the mental and psychosocial needs of women prisoners, aiming to develop effective support programs for their rehabilitation, re-socialization and reintegration, as well as to elaborate new recommendations concerning prison management. A survey instrument (questionnaire) was developed within a theoretical framework based on four fundamental theories: Pathways Theory, Theory of Women’s Psychological Development and Trauma and Addiction Theories. Sample size was defined to be 120 surveyed persons. The study showed that needs of incarcerated women were different from those of men, thus requiring approaches tailored to their specific psychosocial characteristics and situations. The basic population of imprisoned women consisted of young, energetic, working-age females, most often with a professional qualification. Female prisoners suffered from psychological problems and are were more likely to be rejected by their families. Most of them had children and suffered that the children were growing without mothers. A substantial proportion of women offenders had multiple physical and mental health problems. Based on the study findings a conceptual framework can be elaborated towards planning and developing gender-sensitive services in prison. In the long-term perspective, acknowledgement of baseline needs and introduction of the relevant needs-specific programs and services may benefit women prisoners as well as their families, improving the effectiveness of the criminal justice system.

The British ‘failure’ that never was? The Anglo-American ‘productivity gap’ in large-scale interwar retailing—evidence from the department store sector

Interwar British retailing has been characterized as having lower productivity, less developed managerial hierarchies and methods, and weaker scale economies than its US counterpart. This article examines comparative productivity for one major segment of large-scale retailing in both countries—the department store sector. Drawing on exceptionally detailed contemporary survey data, we show that British department stores in fact achieved superior performance in terms of operating costs, margins, profits, and stock-turn. While smaller British stores had lower labour productivity than US stores of equivalent size, TFP was generally higher for British stores, which also enjoyed stronger scale economies. We also examine the reasons behind Britain's surprisingly strong relative performance, using surviving original returns from the British surveys. Contrary to arguments that British retailers faced major barriers to the development of large-scale enterprises, that could reap economies of scale and scope and invest in machinery and marketing to support the growth of their primary sales functions, we find that British department stores enthusiastically embraced the retail ‘managerial revolution’—and reaped substantial benefits from this investment.

Understanding the "black box" of a health-promotion program : keys to enable health among older persons aging in the context of migration

Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researcher-community partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

THE NETWORK EMBEDDEDNESS OF A FOREIGN SALES SUBSIDIARY The subsidiary personnel perspective

This study focuses on the network embeddedness of a subsidiary of a multinational company. Academic research has identified the rising role of geographically dispersed subsidiaries as valuable sources of strategic knowledge and value to the whole multinational company. Moreover, previous research suggests that in order to gather this knowledge and transfer it across the multinational company, a subsidiary needs to be insider, i.e. embedded, in both its local external network as well as in its internal corporate network. The purpose of this study is to describe the network embeddedness of a foreign sales subsidiary from the subsidiary personnel perspective and hence increase understanding on the phenomenon and provide suggestions to enhance overall subsidiary embeddedness. The empirical study was based on a theoretical framework on subsidiary network embeddedness and comprised a qualitative single-case study in a French sales subsidiary of a Nordic multinational company. Data collection included nine semi-structured interviews and six Network Pictures drawing tasks. Altogether eight people out of subsidiary staff of eleven participated in the study providing relatively exhaustive overview of the subsidiary personnel perspective. Based on the collected data, the relationships toward the most relevant network actors, both internal and external were identified and their impact on the subsidiary embeddedness were analyzed separately. Moreover, the subsidiary’s simultaneous embeddedness in both internal and external network, that is, the subsidiary dual embeddedness, was discussed to increase understanding how subsidiary personnel perceive their role between the two networks and its impact on the subsidiary activities. The findings of the study suggest that the subsidiary personnel perceives strong external embeddedness increasing internal and dual-embeddedness since intensive external collaboration requires including and activating other corporate units as well. The role of the local sales subsidiary is to act as the interpreter and connector between the internal and external network actors. Hence, by actively promoting relationship linkages between internal and external actors, the subsidiary may adopt an active role beyond its original corporate mandate. In order to achieve this, both managers on the subsidiary and corporate level need to promote open communication and increase cultural understanding between different corporate units.

Students' engagement in schools : differentiation and promotion

The objective of this work is to present elements of the project Student engagement in Schools (SES). The team consists of 10 researchers from six Universities. Student engagement in schools is a multidimensional construct that unites affective, behavioural, and cognitive dimensions of student adaptation in the school and has influence on students’outcomes. The team of researchers conceptualized two major studies, a differential study to analyze the relations between SES and contextual factors, personal factors, student’s outcomes, and a quasi-experimental study to analyze the effects on SES of a specific intervention programmes. In study 1, the sample size is around 600 students (150 6th graders, 150 7th graders, 150 9th graders, and 150 10th graders). We shall focus on years of school transition, with rural and urban populations, on different regions of the country, and on students with different family background. We shall conduct questionnaires with national and international scales. The study 2 will involve students in 7th and 9th grade, from four classes, two of the experimental group and two of the control group. Patterns of verbal communication between a teacher and students can influence the classroom environment and SES. This model of communication would result in more effective student management and more time on-task for learning.