Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to improve neonatal survival in the Quang Ninh province, Vietnam

BACKGROUND: Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health - Knowledge Into Practice trial evaluated facilitation of community groups (2008-2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30-0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention. METHODS: Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models. RESULTS: To ensure eight active facilitators over 3 years, 11 Women's Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19-0.73) than control communes (n = 46). CONCLUSIONS: This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups' work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.

Estudo de simulação de modelos lineares mistos com distribuição normal contaminada no melhoramento genético animal

Objetivou-se com esse trabalho comparar estimativas de componentes de variâncias obtidas por meio de modelos lineares mistos Gaussianos e Robustos, via Amostrador de Gibbs, em dados simulados. Foram simulados 50 arquivos de dados com 1.000 animais cada um, distribuídos em cinco gerações, em dois níveis de efeito fixo e três valores fenotípicos distintos para uma característica hipotética, com diferentes níveis de contaminação. Exceto para os dados sem contaminação, quando os modelos foram iguais, o modelo Robusto apresentou melhores estimativas da variância residual. As estimativas de herdabilidade foram semelhantes em todos os modelos, mas as análises de regressão mostraram que os valores genéticos preditos com uso do modelo Robusto foram mais próximos dos valores genéticos verdadeiros. Esses resultados sugerem que o modelo linear normal contaminado oferece uma alternativa flexível para estimação robusta em melhoramento genético animal.

Recursive hierarchic segmentation analysis of bone mineral density changes on digital panoramic images

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estimativas de parâmetros genéticos para escores visuais e características de crescimento na raça Nelore

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Sofrimento mental do estudante da Faculdade de Medicina de Botucatu-UNESP: uma análise de dois estudos transversais seriados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação das propriedades nanomecânicas e do comportamento micromecânico da interface dentina/adesivo antes e após a degradação hidrolítica: análises através de nanoindentação e método dos elementos finitos tridimensional

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

Multiple Determinants of Anuran Richness and Occurrence in an Agricultural Region in South-Eastern Brazil

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

Uso de modelos lineares mistos na avaliação genética de escores visuais: estudo de simulação

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

Liquid nitrogen for the treatment of actinic keratosis: A longitudinal assessment

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Própolis na dieta de abelhas Apis mellifera L. e seu efeito no sistema imune, expressão de genes após o desafio bacteriano e detoxificação frente ao agroquímico fipronil

Pós-graduação em Zootecnia - FMVZ

Atividade cambial em ramos de Kielmeyera grandiflora (WAWRA) saddi (Callophylaceae) ocorrentes no cerrado paulista

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise espacial do potencial fotovoltaico em telhados de residências usando modelagem hierárquica bayesiana

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estimating the extent of spatial association of Mycobacterium bovis infection in badgers in Ireland

Mycobacterium bovis infects the wildlife species badgers Meles meles who are linked with the spread of the associated disease tuberculosis (TB) in cattle. Control of livestock infections depends in part on the spatial and social structure of the wildlife host. Here we describe spatial association of M. bovis infection in a badger population using data from the first year of the Four Area Project in Ireland. Using second-order intensity functions, we show there is strong evidence of clustering of TB cases in each the four areas, i.e. a global tendency for infected cases to occur near other infected cases. Using estimated intensity functions, we identify locations where particular strains of TB cluster. Generalized linear geostatistical models are used to assess the practical range at which spatial correlation occurs and is found to exceed 6 in all areas. The study is of relevance concerning the scale of localized badger culling in the control of the disease in cattle.

Influence Assessment in an Heteroscedastic Errors-in-Variables Model

The main goal of this article is to consider influence assessment in models with error-prone observations and variances of the measurement errors changing across observations. The techniques enable to identify potential influential elements and also to quantify the effects of perturbations in these elements on some results of interest. The approach is illustrated with data from the WHO MONICA Project on cardiovascular disease.

Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy

Objective: To compare clinical outcomes after laparoscopic cholecystectomy (LC) for acute cholecystitis performed at various time-points after hospital admission. Background: Symptomatic gallstones represent an important public health problem with LC the treatment of choice. LC is increasingly offered for acute cholecystitis, however, the optimal time-point for LC in this setting remains a matter of debate. Methods: Analysis was based on the prospective database of the Swiss Association of Laparoscopic and Thoracoscopic Surgery and included patients undergoing emergency LC for acute cholecystitis between 1995 and 2006, grouped according to the time-points of LC since hospital admission (admission day (d0), d1, d2, d3, d4/5, d ≥6). Linear and generalized linear regression models assessed the effect of timing of LC on intra- or postoperative complications, conversion and reoperation rates and length of postoperative hospital stay. Results: Of 4113 patients, 52.8% were female, median age was 59.8 years. Delaying LC resulted in significantly higher conversion rates (from 11.9% at d0 to 27.9% at d ≥6 days after admission, P < 0.001), surgical postoperative complications (5.7% to 13%, P < 0.001) and re-operation rates (0.9% to 3%, P = 0.007), with a significantly longer postoperative hospital stay (P < 0.001). Conclusions: Delaying LC for acute cholecystitis has no advantages, resulting in significantly increased conversion/re-operation rate, postoperative complications and longer postoperative hospital stay. This investigation—one of the largest in the literature—provides compelling evidence that acute cholecystitis merits surgery within 48 hours of hospital admission if impact on the patient and health care system is to be minimized.