Factores asociados a la predisposición a vacunarse contra la gripe pandémica A/H1N1 en población adulta del Departamento de Salud de Elche (España): influencia de las fuentes de información

Fundamento. Evaluar en población general las fuentes de información, actitudes y predisposición hacia la vacunación contra la gripe pandémica A/H1N1 de 2009. Métodos. Estudio descriptivo de carácter transversal realizado entre el 25 de noviembre y 30 de diciembre de 2009 mediante entrevista personal cara a cara a una muestra aleatoria (826) de adultos residentes en el Departamento de Salud de Elche (España). Resultados. Los encuestados manifestaron que la televisión (57%) y el médico de familia (47,9%) eran su fuente principal de información sobre vacunas. El 82,2% tenía una buena opinión sobre las vacunas, un 30,5% percibía la gripe A/H1N1 como más grave que la estacional, siendo esta percepción creciente entre los de mayor edad y con menos estudios. Un 25,4% de encuestados sentía preocupación por padecerla, sobre todo los de menor nivel educativo. Un 42,1% manifiesta su buena predisposición para vacunarse contra la gripe estacional, disminuyendo hasta un 18,4% la intención hacia la gripe A/H1N1. La predisposición hacia la vacunación crece con la edad y en el caso de la gripe A/H1N1 decrece a mayor nivel educativo. El médico de familia es la fuente de información más determinante para inmunizarse frente a gripe estacional (OR 1,43) y gripe A/H1N1 (OR 2,47). Conclusiones. Existe baja aceptabilidad de la vacuna pandémica y baja percepción de gravedad sobre la gripe A/H1N1. La experiencia previa de vacunación ante gripe estacional predispone hacia la inmunización contra gripe A/H1N1. Aunque los medios de comunicación encabezan la fuente de información más usual durante este episodio, la influencia del médico de familia en la decisión de vacunarse resulta significativa.

Acceptability of pandemic A(H1N1) influenza vaccination by Essential Community Workers in 2010 Alicante (Spain), perceived seriousness and sources of information

Objective. Describe acceptability of pandemic A(H1N1) influenza vaccination by Essential Community Workers (ECWs) from Alicante province (Spain) in January 2010. Evaluate the correlation with attitudes, beliefs, professional advice and information broadcasted by media. Method. In this cross-sectional study, face-to-face interviews were conducted with 742 ECWs to assess their attitudes towards vaccination against the pandemic influenza strain. A multivariable regression model was made to adjust the Odds Ratios (ORs). Results. Some ECWs reported having been vaccinated with seasonal vaccine, 21.5% (95%IC 18.6–24.9); only 15.4% (95%IC 12.8–18.4) with the pandemic one. ECWs vaccinated regularly against seasonal flu (OR 5.1; 95%IC 2.9–9.1), those who considered pandemic influenza as a severe or more serious disease than seasonal flu (OR 3.8; 95%IC 2.1–6.7) and those who never had doubts about vaccine safety (OR 3.7; 95%IC2.1–6.7) had a better acceptance of pandemic vaccine. Finally, 78.7% (95%IC 75.1–81.4) had doubts about pandemic vaccine's effectiveness. Conclusion. The vast amount of information provided by the media did not seem to be decisive to prevent doubts or to improve the acceptability of the vaccine in ECWs. Professional advice should be the focus of interest in future influenza vaccination campaigns. These results should be taken into account by health authorities.

HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa.

BACKGROUND Prisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa. METHODS Screening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis. RESULTS Overall, 680 inmates were included with a median age of 30 years [interquartile range: 24-35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8-32.1), HBV infection (OR = 4.8; CI 1.8-12.8), HCV infection (OR = 52.6; CI 4.1-673.8), use of traditional medicines (OR = 3.7; CI 1.4-10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1-9.8) compared to Dakar. CONCLUSIONS HIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.

“There’s No Place Like Home”: An Analysis of Rental Market Conditions and Coping Mechanisms in the Emerald City

This mixed-methods study analyzed quantitative and qualitative data on rental market conditions in the Seattle area, their effects on renters, and coping mechanisms used by renters. Data was collected from 111 individuals using an online survey and face-to-face interviews. While the focus of the study was on low-income renters and other marginalized populations, results show that a majority of renters surveyed are struggling to make ends meet, and that rental market conditions are impacting renters’ residential situations, as well as their life choices in other areas, such as education, their career, and decisions to have children. Future research should investigate these relationships further and in more detail, particularly for renters from marginalized populations, and investigate what types of solutions or improvements renters would like to see.

Case-only study of interactions between genetic polymorphisms of GSTM1, P1, T1 and Z1 and smoking in Parkinson's disease

Current opinion contends that complex interactions between genetic and environmental factors play a role in the etiology of Parkinson's disease (PD). Cigarette smoking is thought to reduce risk of PD, and emerging evidence suggests that genetic factors may modulate smoking's effect. We used a case-only design, an approach not previously used to study gene-environment interactions in PD, specifically to study interactions between glutathione-S-transferase (GST) gene polymorphisms and smoking in relation to PD. Four-hundred PD cases (age at onset: 60.0 +/- 10.7 years) were genotyped for common polymorphisms in GSTM1, PI, T1 and Z1 using well-established methods. Smoking exposure data were collected in face-to-face interviews. The independence of the studied GST genotypes and smoking exposure was confirmed by studying 402 healthy, aged individuals. No differences were observed in the distributions of GSTM1, T1 or Z1 polymorphisms between ever-smoked and never-smoked PD cases using logistic regression (all P > 0.43). However, GSTP1 *C haplotypes were over-represented among PD cases who ever smoked (odds ratio for interaction (ORi) = 2.00 (95% Cl: 1.11-3.60, P = 0.03)). Analysis revealed that ORi between smoking and the GSTP1-114Val carrier status increased with increasing smoking dose (P = 0.02 for trend). These data suggest that one or more GSTP1 polymorphisms may interact with cigarette smoking to influence the risk for PD. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Acceptability and feasibility of a community-based screening programme for melanoma in Australia

The evaluation of a community-based screening programme for melanoma (SkinWatch) in 18 regional communities (total adult population >30 years 63 035) in Queensland, Australia is described. The aim of the SkinWatch programme was to promote whole-body skin screening for melanoma by primary care physicians. The programme included community education, education and support for local medical practitioners and open-access skin screening clinics. Programme delivery was achieved through assistance of local volunteers. All programme activities and resources were recorded for process evaluation. A baseline telephone survey (n = 3110) and a telephone survey four months after programme launch (n = 680) assessed community awareness of the SkinWatch programme and, 37 face-to-face interviews with community members, doctors and community leaders were conducted to assess satisfaction with the programme. A sample of 1043 of 16 383 residents who attended the skin screening clinics provided as part of the programme were interviewed to assess reasons for attending, and positive and negative aspects of SkinWatch programme. Community awareness of the SkinWatch programme increased by over 30% (p < 0.001) within four months of the start of the programme. Interview participants described the SkinWatch programme as a useful service for the communities and 90% stated they would revisit the clinics. A total of 43% of all attendees were over 50 years old, and nearly 50% were men. These findings demonstrate the acceptability and feasibility of a community-based screening programme for melanoma in rural areas. Volunteers were instrumental in increasing community ownership of and involvement in the SkinWatch programme.

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Health-protective behaviours and risk of fall-related hip fractures: a population-based case-control study

Background: fall-related hip fractures are one of the most common causes of disability and mortality in older age. The study aimed to quantify the relationship between lifestyle behaviours and the risk of fall-related hip fracture in community-dwelling older people. The purpose was to contribute evidence for the promotion of healthy ageing as a population-based intervention for falls injury prevention. Methods: a case-control study was conducted with 387 participants, with a case-control ratio of 1:2. Incident cases of fall-related hip fracture in people aged 65 and over were recruited from six hospital sites in Brisbane, Australia, in 2003-04. Community-based controls, matched by age, sex and postcode, were recruited via electoral roll sampling. A questionnaire designed to assess lifestyle risk factors, identified as determinants of healthy ageing, was administered at face-to-face interviews. Results: behavioural factors which had a significant independent protective effect on the risk of hip fracture included never smoking [adjusted odds ratio (AOR): 0.33 (0.12-0.88)], moderate alcohol consumption in mid- and older age [AOR: 0.49 (0.25-0.95)], not losing weight between mid- and older age [AOR: 0.36 (0.20-0.65)], playing sport in older age [AOR: 0.49 (0.29-0.83)] and practising a greater number of preventive medical care [AOR: 0.54 (0.32-0.94)] and self-health behaviours [AOR: 0.56 (0.33-0.94)]. Conclusion: with universal exposures, clear associations and modifiable behavioural factors, this study has contributed evidence to reduce the major public health burden of fall-related hip fractures using readily implemented population-based healthy ageing strategies.

Psychotic symptom and cannabis relapse in recent-onset psychosis - Prospective study

Background: Cannabis use appears to exacerbate psychotic symptoms and increase risk of psychotic relapse. However, the relative contribution of cannabis use compared with other risk factors is unclear. The influence of psychotic symptoms on cannabis use has received little attention. Aims: To examine the influence of cannabis use on psychotic symptom relapse and the influence of psychotic symptom severity on relapse in cannabis use in the 6 months following hospital admission. Method: At baseline, 84 participants with recent-onset psychosis were assessed and 81 were followed up weekly for 6 months, using telephone and face-to-face interviews. Results: A higher frequency of cannabis use was predictive of psychotic relapse, after controlling for medication adherence, other substance use and duration of untreated psychosis. An increase in psychotic symptoms was predictive of relapse to cannabis use, and medication adherence reduced cannabis relapse risk. Conclusions: The relationship between cannabis use and psychosis may be bidirectional, highlighting the need for early intervention programmes to target cannabis use and psychotic symptom severity in this population. Declaration of interest: None. Funding detailed in Acknowledgements.

O PROFESSOR DO ENSINO MÉDIO E AS TRANSFORMAÇÕES NO MUNDO DO TRABALHO

O estudo objetivou entender como as mudanças que ocorrem na organização do trabalho interferem na maneira de o professor do ensino médio pensar e organizar o seu próprio trabalho. Trata-se de uma pesquisa de campo realizada com professores do Ensino Médio de uma escola estadual localizada num bairro da periferia do município de São Vicente, Estado de São Paulo. Contou-se com os estudos realizados por Harvey (2000), Castel (1998) e Sennett (2004) para entender como as transformações estão se processando no mundo do trabalho e como elas interferem nas condições de trabalho e vida do trabalhador. A organização da escola foi estudada a partir de Ferretti e Silva Júnior (2004) e a profissão docente, a partir das contribuições de Adorno (2003), Oliveira (2003, 2004) e Fanfani (2005). A metodologia adotada insere-se no contexto de uma pesquisa empírica, qualitativa do tipo etnográfico, de acordo com as definições de André (1995), e a coleta de dados foi realizada a partir de observação participante, questionários e entrevistas. Envolveu também estudo de documentos elaborados pela escola e referentes às legislações aplicadas ao ensino médio. Chegou-se à conclusão de que as conseqüências das transformações que ocorrem no mundo do trabalho chegam até a escola por vias diversas e acabam afetando a forma de esta organizar o seu trabalho. Ao chegarem até os professores elas são reinterpretadas e re-adaptadas. As representações que esses profissionais possuem acerca do trabalho e que são construídas ao longo de suas trajetórias de vida acabam interferindo nas interpretações que eles fazem sobre as transformações do mundo do trabalho, bem como na construção da identidade da própria profissão docente. No atual contexto de transformação do trabalho, muito há que se considerar nos caminhos que hoje se colocam como opção para a formação do professor. Esta pesquisa contou com o apoio da CAPES.(AU)

Assessing service satisfaction between a 3PL provider and a vehicle manufacturer using the SERVQUAL technique

This paper reports on a new study conducted within a leading UK based (and US owned) car manufacturing company looking at the satisfaction between parties within a newly formed third party logistics (3PL) relationship. The study contains a two-way assessment of the relationship (i.e. the vehicle manufacturer’s Parts Supply and Logistics Operation’s assessment of the 3PL’s service and the 3PL’s assessment of the vehicle manufacturer’s relationship management ability). The study principally used an online SERVQUAL survey, (backed up with an on-line questionnaire, and face to face interviews) for data collection. The paper discusses the background and problems that have arisen in the relationship, the analysis of how each of the parties sees one other in terms of the service provided. Also, the findings and recommendations presented to management are outlined: these include factors such as the need for information sharing, reliability, flexibility, role specificity, trust and effective requirements management.

Toward understanding inter-organizational knowledge transfer needs in SMEs:insight from a UK investigation

Purpose - External knowledge is generally believed to be of prime importance to small to medium-sized enterprises (SMEs). However, a review of the literature shows that no empirical research has looked at knowledge management issues at the inter-organizational level in SMEs. This paper seeks to report on an empirical investigation with UK SMEs in the service sector to identify their needs and practices regarding inter-organizational knowledge transfer, and thus provide empirical evidence to support the above belief. Design/methodology/approach - A two-tier methodology (i.e. using both questionnaire survey and interview approaches) is deployed to address the main research objectives. A questionnaire survey of SMEs is carried out to investigate their current inter-organizational knowledge transfer situation and managers' perception on various relevant issues. Then 12 face-to-face interviews with SME managers are conducted to further validate key findings drawn from the questionnaire survey. Findings - The empirical evidence collected from the survey and interviews confirms the general belief that external knowledge is of prime importance for SMEs, and demonstrates that SMEs have very strong needs for external knowledge and inter-organizational knowledge transfer. Research limitations/implications - The findings provide very strong underpinning for further theoretical research on inter-organizational knowledge transfer in SMEs. However, this study has certain limitations: its results may not be applicable to other industrial sectors or the same sector in other countries; or to micro or large companies; nor does it involve cross-cultural issues. Originality/value - By adopting a two-tier research methodology, this study provides more reliable understanding and knowledge on SMEs' inter-organizational knowledge transfer needs and practices, and fills the gap that exists in the empirical investigations on the subject. © Emerald Group Publishing Limited.

Employer perceptions of skills gaps in retail:issues and implications for UK retailers

Purpose – This paper seeks to identify the skills gaps associated with retail employees in SME and multiple retail companies, and to investigate the potential training and business implications that arise from these skills gaps, from the point of view of retail employers. Design/methodology/approach – Research was conducted within one geographical region and across five counties within the UK. Telephone and face-to-face interviews and focus group workshops were conducted, resulting in responses from 52 retailers. Findings – The key issues and areas of concern to emerge were: the industry image and impact on recruitment and retention; employee and management skills gaps; and barriers to training. Research limitations/implications – The findings highlight the need for UK retail industry to raise the image of the sector, to identify the skills sets for specific roles, and to clarify the retail qualifications and training required delivering these. Originality/value – Succeeds in identifying the skills gaps associated with retail employees in SME and multiple retail companies and in investigating the potential training and business implications arising from these skills gaps.

Personal uses and perceived social and economic effects of advertising in Bulgaria and Romania

Purpose - The objective of this paper is to uncover the underlying dimensions of, and examine the similarities and differences in, personal uses of advertising, perceived socio-economic effects of advertising, and consumer beliefs and attitudes toward advertising in Bulgaria and Romania. Moreover, it aims to identify the relative importance of the predictors of attitudes toward advertising in the two countries. Design/methodology/approach - The paper draws upon findings of previous research and theoretical developments by Bauer and Greyser, Sandage and Leckenby, and Pollay and Mittal. The study uses a stratified random sample of 947 face-to-face interviews with adult respondents from major urban areas in Bulgaria (507) and Romania (440). Variables are measured on multi-item scales as a typical application of the reflective indicator model. Findings - Results show that there are significant differences between Romanian and Bulgarian respondents in terms of their attitudes toward advertising. Romanians are more positive about advertising as an institution than the instruments of advertising. Romanians seem to accept the role of advertising in a free market economy, but have less confidence in advertising claims and techniques. Bulgarian respondents seem more sceptical toward advertising in general and are less enthusiastic about embracing the role of advertising as an institution. Moreover, Bulgarians are highly negative towards the instruments advertising uses to convey its messages to consumers. Research limitations/implications - The research findings reflect the views of urban dwellers and may not be generalisable to the wider population of the two countries. Interviewer bias was reduced by eliminating verbal or non-verbal cues to the respondents, and by the use of stratified random sampling. Practical implications - The paper suggests that the regulatory role of codes of advertising practice and industry regulating bodies should be enhanced, and their ability to protect consumers enforced. Marketing campaigns should be more inclusive to involve diverse social groups and reflect generally-accepted social norms. Originality/value - This study reveals that, while general attitudes toward advertising may be similar, attitudes toward the institution and instruments of advertising may differ even in countries with geographic proximity and low cultural distance. © Emerald Group Publishing Limited.

Evaluating the motives of informal entrepreneurs: some lessons from Ukraine

To understand entrepreneurs' motivations, it has become increasingly common to distinguish between those driven by necessity (or pushed) and those driven by opportunity (or pulled) into entrepreneurship. Until now, entrepreneurs operating wholly or partially in the informal economy have been widely assumed to be necessity-driven, pushed into this enterprise as a survival strategy in the absence of alternatives. To evaluate whether this is indeed the case, this paper reports one of the first surveys of informal entrepreneurs' motives. Reporting face-to-face interviews conducted in Ukraine during 2005–06 with 298 informal entrepreneurs, the finding is although most identified themselves as necessity entrepreneurs when initially asked whether they were either pushed or pulled, subsequent questions reveal in the vast majority of cases, there were not only both push and pull factors driving their original decision to start-up informal enterprises, but also a clear shift among these entrepreneurs as their business became established away from necessity-oriented motivations and toward more opportunity-oriented motivations. The outcome is a call for a transcendence of a static either/or approach and the adoption of a dynamic both/and approach that recognizes the coexistence of necessity- and opportunity-drivers as well as the fluidity of entrepreneurs' motivations.