Roles of the non-medical prescribing leads within organisations across a Strategic Health Authority: perceived functions and factors supporting the role

Objectives Extending the roles of nurses, pharmacists and allied health professionals to include prescribing has been identified as one way of improving service provision. In the UK, over 50 000 non-medical healthcare professionals are now qualified to prescribe. Implementation of non-medical prescribing ( NMP) is crucial to realise the potential return on investment. The UK Department of Health recommends a NMP lead to be responsible for the implementation of NMP within organisations. The aim of this study was to explore the role of NMP leads in organisations across one Strategic Health Authority (SHA) and to inform future planning with regards to the criteria for those adopting this role, the scope of the role and factors enabling the successful execution of the role. Methods Thirty-nine NMP leads across one SHA were approached. Semi-structured telephone interviews were conducted. Issues explored included the perceived role of the NMP lead, safety and clinical governance procedures and facilitators to the role. Transcribed audiotapes were coded and analysed using thematic analytical techniques. Key findings In total, 27/39 (69.2%) NMP leads were interviewed. The findings highlight the key role that the NMP lead plays with regards to the support and development of NMP within National Health Service trusts. Processes used to appoint NMP leads lacked clarity and varied between trusts. Only two NMP leads had designated or protected time for their role. Strategic influence, operational management and clinical governance were identified as key functions. Factors that supported the role included organisational support, level of influence and dedicated time. Conclusion The NMP lead plays a significant role in the development and implementation of NMP. Clear national guidance is needed with regards to the functions of this role, the necessary attributes for individuals recruited into this post and the time that should be designated to it. This is important as prescribing is extended to include other groups of non-medical healthcare professionals.

Factors affecting the concentration in seven-spotted ladybirds (Coccinella septempunctata L.) of Cd and Zn transferred through the food chain

The transfer of Cd and Zn from soils amended with sewage sludge was followed through a food chain consisting of wheat, aphids and the predator Coccinella septempunctata. Multiple regression models were generated to predict the concentrations of Cd and Zn in C. septempunctata. No significant model could be generated for Cd, indicting that the concentration of this metal was maintained within relatively narrow limits. A model predicting 64% of the variability in the Zn concentration of C. septempunctata was generated from of the concentration of Zn in the diet, time and rate of Zn consumption. The results suggest that decreasing the rate of food consumption is an effective mechanism to prevent the accumulation of Zn and that the availability of Zn in the aphid prey increased with the concentration in the aphids. The results emphasise the importance of using ecologically relevant food chains and exposure pathways during ecotoxicological studies.

Resources, staff beliefs and organizational culture: factors in the use of information and communication technology for adults with intellectual disabilities

Background  Access to, and the use of, information and communication technology (ICT) is increasingly becoming a vital component of mainstream life. First-order (e.g. time and money) and second-order factors (e.g. beliefs of staff members) affect the use of ICT in different contexts. It is timely to investigate what these factors may be in the context of service provision for adults with intellectual disabilities given the role ICT could play in facilitating communication and access to information and opportunities as suggested in Valuing People. Method  Taking a qualitative approach, nine day service sites within one organization were visited over a period of 6 months to observe ICT-related practice and seek the views of staff members working with adults with intellectual disabilities. All day services were equipped with modern ICT equipment including computers, digital cameras, Internet connections and related peripherals. Results  Staff members reported time, training and budget as significant first-order factors. Organizational culture and beliefs about the suitability of technology for older or less able service users were the striking second-order factors mentioned. Despite similar levels of equipment, support and training, ICT use had developed in very different ways across sites. Conclusion  The provision of ICT equipment and training is not sufficient to ensure their use; the beliefs of staff members and organizational culture of sites play a substantial role in how ICT is used with and by service users. Activity theory provides a useful framework for considering how first- and second-order factors are related. Staff members need to be given clear information about the broader purpose of activities in day services, especially in relation to the lifelong learning agenda, in order to see the relevance and usefulness of ICT resources for all service users.

Endothelin-1 and fibroblast growth factors stimulate the mitogen-activated protein kinase signaling cascade in cardiac myocytes. The potential role of the cascade in the integration of two signaling pathways leading to myocyte hypertrophy.

Maximally effective concentrations of endothelin-1 (ET-1), acidic FGF (aFGF), or 12-O-tetradecanoylphorbol-13-acetate (TPA) activated mitogen-activated protein kinase (MAPK) by 3-4-fold in crude extracts of myocytes cultured from neonatal rat heart ventricles. Maximal activation was achieved after 5 min. Thereafter, MAPK activity stimulated by ET-1 or aFGF declined to control values within 1-2 h, whereas activation by TPA was more sustained. Two peaks of MAPK activity (a 42- and a 44-kDa MAPK) were resolved in cells exposed to ET-1 or aFGF by fast protein liquid chromatography on a Mono Q column. One major and one minor peak of MAPK kinase (MAPKK) was stimulated by ET-1 or aFGF. Cardiac myocytes expressed protein kinase C (PKC)-alpha, -delta, -epsilon and -zeta as shown immunoblotting. Exposure to 1 microM TPA for 24 h down-regulated PKC-alpha, -delta, and -epsilon, but not PKC-zeta. This maneuver wholly abolished the activation of MAPK on re-exposure to TPA but did not affect the response to aFGF. The effect of ET-1 was partially down-regulated. ET-1 stimulated phospho[3H]inositide hydrolysis 18-fold, whereas aFGF stimulated by only 30%. Agonists which initially utilize dissimilar signaling pathways may therefore converge at the level of MAPKK/MAPK and this may be relevant to the hypertrophic response of the heart.

Explaining sleep duration in adolescents: The impact of socio-demographic and lifestyle factors and working status

Previous studies found students who both work and attend school undergo a partial sleep deprivation that accumulates across the week. The aim of the present study was to obtain information using a questionnaire on a number of variables (e.g., socio-demographics, lifestyle, work timing, and sleep-wake habits) considered to impact on sleep duration of working (n = 51) and non-working (n = 41) high-school students aged 14-21 yrs old attending evening classes (19:00-22:30h) at a public school in the city of Sao Paulo, Brazil. Data were collected for working days and days off. Multiple linear regression analyses were performed to assess the factors associated with sleep duration on weekdays and weekends. Work, sex, age, smoking, consumption of alcohol and caffeine, and physical activity were considered control variables. Significant predictors of sleep duration were: work (p < 0.01), daily work duration (8-10h/day; p < 0.01), sex (p = 0.04), age 18-21 yrs (0.01), smoking (p = 0.02) and drinking habits (p = 0.03), irregular physical exercise (p < 0.01), ease of falling asleep (p = 0.04), and the sleep-wake cycle variables of napping (p < 0.01), nocturnal awakenings (p < 0.01), and mid-sleep regularity (p < 0.01). The results confirm the hypotheses that young students who work and attend school showed a reduction in night-time sleep duration. Sleep deprivation across the week, particularly in students working 8-10h/day, is manifested through a sleep rebound (i.e., extended sleep duration) on Saturdays. However, the different roles played by socio-demographic and lifestyle variables have proven to be factors that intervene with nocturnal sleep duration. The variables related to the sleep-wake cyclenaps and night awakeningsproved to be associated with a slight reduction in night-time sleep, while regularity in sleep and wake-up schedules was shown to be associated with more extended sleep duration, with a distinct expression along the week and the weekend. Having to attend school and work, coupled with other socio-demographic and lifestyle factors, creates an unfavorable scenario for satisfactory sleep duration.

Listeria monocytogenes in ready-to-eat, sliced, cooked ham and salami products, marketed in the city of Sao Paulo, Brazil Occurrence, quantification, and serotyping

The preference for ready-to-eat sliced foods may pose an increased risk for food-borne diseases and a major concern is the presence of Listeria monocytogenes L monocytogenes was assessed in two types of products cooked ham and salami One hundred and thirty samples of each product were acquired in retail shops in the city of Sao Paulo and submitted to laboratory analysis The rate of positives was significantly higher in salami samples than in ham samples (62% and 0 8% respectively) L. monocytogenes counts in salami samples varied between <10 and 1900 colony-forming units per gram (CFU/g) The serotypes found in both products were as follows according to incidence 4b (37 5%) 1/2b (25%) 3b (25%) and 1/2c (12 5%) Based on the results of the present study the authors suggest that the risk of listeriosis resulting from the consumption of salami is higher than that associated with the consumption of cooked ham (C) 2010 Elsevier Ltd All rights reserved

Product placement in movies: a cross cultural study between Brazil and the USA

The broader objective of this study undertaking can briefly be articulated in particulate aims as follows: to measure the attitudes of consumers regarding the brand displayed by this strategy as well as to highlight recall, recognition and purchase intentions generated by product placement on consumers. In addition, check the differences and similarities between the behavior of Brazilian and American consumers caused by the influence of product placements. The study was undertaken targeting consumer audience in Brazil and the U.S. A rang3 modeling set ups were performed in order to realign study instruments and hypothesis towards the research objectives. This study gave focus on the following hypothesized models. H1: Consumers / Participants who viewed the brands / products in the movie have a higher brand / product recall compared to the consumers / participants who did not view the brands / products in the movie. H2: US Consumers / Participants are able to recognize and recall brands / products which appear in the background of the movie than Brazil. H3: Consumers / participants from USA are more accepting of product placements compared to their counterparts in Brazil. H4: There are discernible similarities in consumer / participant brand attitudes and purchase intentions in consumers / participants from USA and Brazil in spite of the fact that their country of origin is different. Cronbach’s Alpha Coefficient ensured the reliability of survey instruments. The study involved the use of the Structural Equation Modeling (SEM) for the hypothesis testing. This study used the Confirmatory Factor Analysis (CFA) to assess both the convergent and discriminant validities instead of using the Exploratory Factor Analysis (EFA) or the Principal Component Analysis (PCA). This reinforced for the use of the regression Chi Square and T statistical tests in further. Only hypothesis H3 was rejected, the rest were not. T test provided insight findings on specific subgroup significant differences. In the SEM testing, the error variance for product placement attitudes was negative for both the groups. On this The Heywood Case came in handy to fix negative values. The researcher used both quantitative and qualitative approach where closed ended questionnaires and interviews respectively were used to collect primary data. The results were additionally provided with tabulations. It can be concluded that, product placement varies markedly in the U.S. from Brazil based on the influence a range of factors provided in the study. However, there are elements of convergence probably driven by the convergence in technology. In order, product placement to become more competitive in the promotional marketing, there will be the need for researchers to extend focus from the traditional variables and add knowledge on the conventional marketplace factors that is the sell-ability of the product placement technologies and strategies.

The failure of early-stage technology startups in Brazil: a study about the contributing factors to the early-death of startups between 2009 and 2014 in Southeastern Brazil

This research aimed to find out which are the main factors that lead technology startups to fail. The study focused on companies located in the Southeast region of Brazil that operated between 2009 and 2014. In the beginning, a review of the literature was done to have a better understanding of basic concepts of entrepreneurship as well as modern techniques for developing entrepreneurship. Furthermore, an analysis of the entrepreneurial scenario in Brazil, with a focus on the Southeast, was also done. After this phase, the qualitative study began, in which 24 specialists from startups were interviewed and asked about which factors were crucial in leading a technology startup to fail. After analyzing the results, four main factors were identified and these factors were validated through a quantitative survey. A questionnaire was then formulated based on the answers from the respondents and distributed to founders and executives of startups, which both failed and succeeded. The questionnaire was answered by 56 companies and their answers were treated with the factor analysis statistical method to check the validity of the questionnaire. Finally, the logistical regression method was used to know the extent to which the factors led to the startups’ failure. In the end, the results obtained suggest that the most significant factor that leads technology startups in southeastern Brazil to fail are problems with interpersonal relationship between partners or investors.

French wine and the Brazilian consumer

Em um mercado internacional de vinhos cada dia mais competitivo, exportadores franceses estão procurando novos mercados para expandir suas atividades. Nesse cenário o Brasil aparece como um mercado potencial enorme e, por isso, é necessário aos empreendedores o perfeito entendimento das dinâmicas de mercado, a fim de moldar estratégias de marketing eficientes. A primeira etapa é entender o comportamento do consumidor final, a fim de oferecer o produto certo de maneira certa. Essa dissertação tem por objeto a análise dos hábitos de consumo, bem como a percepção do consumidor sobre os vinhos franceses no mercado do vinho brasileiro. A análise será efetuada em função do comportamento do consumidor; portanto, uma atenção especial será dada à demografia, aos hábitos de consumo e as tendências do mercado para os produtos vitivinícolas. Mais precisamente, a investigação tentará identificar diferentes grupos de consumidores com padrões semelhantes, baseados em dados demográficos, consumo atual ou potencial de vinho, e sua percepção particular sobre o vinho francês. A idéia por trás desse processo é a construção de um quadro que pode ajudar a desenvolver estratégias de marketing para profissionais do mercado de vinhos franceses no Brasil, fornecendo a potenciais exportadores uma melhor compreensão sobre como direcionar o seu posicionamento e atingir metas de forma eficaz. A realização desta dissertação foi um desafio importante porque o comportamento do consumidor de vinho no Brasil nao foi estudado inteiramente. É muito difícil hoje para exportadores franceses que desejam compreender melhor o consumidor brasileiro de vinho encontrar qualquer estudo ou análise. A fim de fazer isso, a literatura sobre o mercado do vinho brasileiro foi utilizada (especificidades dos produtos, produção, dados de consumo, etc.). A literatura também inclui os fatores de decisão que influenciam os consumidores nas suas decisões de compra, o que é uma questão muito complexa quando se trata de vinho. Finalmente, a literatura sobre as estratégias de marketing foi revista, a fim de avaliar o tanto o impacto potencial como a relevância para o mercado brasileiro. A segunda etapa do estudo foi a apresentação de questionários a consumidores brasileiros e a análise, com o intuito de determinar as preferências dos consumidores e compreender a percepção do vinho francês. O objetivo foi identificar potenciais grupos alvos para os produtores franceses de vinho.

Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors

SILVEIRA, Inavan Lopes da; MARANHÃO, T. M. O.; AZEVEDO, George Dantas. Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors. Climacteric (Carnforth), v.10, p.438-439, 2007.

Genetic parameters of total milk yield and factors describing the shape of lactation curve in dairy buffaloes

The objective of this study was to apply factor analysis to describe lactation curves in dairy buffaloes in order to estimate the phenotypic and genetic association between common latent factors and cumulative milk yield. A total of 31 257 monthly test-day milk yield records from buffaloes belonging to herds located in the state of São Paulo were used to estimate two common latent factors, which were then analysed in a multi-trait animal model for estimating genetic parameters. Estimates of (co)variance components for the two common latent factors and cumulated 270-d milk yield were obtained by Bayesian inference using a multiple trait animal model. Contemporary group, number of milkings per day (two levels) and age of buffalo cow at calving (linear and quadratic) as covariate were included in the model as fixed effects. The additive genetic, permanent environmental and residual effects were included as random effects. The first common latent factor (F1) was associated with persistency of lactation and the second common latent factor (F2) with the level of production in early lactation. Heritability estimates for Fl and F2 were 0.12 and 0.07, respectively. Genetic correlation estimates between El and F2 with cumulative milk yield were positive and moderate (0.63 and 0.52). Multivariate statistics employing factor analysis allowed the extraction of two variables (latent factors) that described the shape of the lactation curve. It is expected that the response to selection to increase lactation persistency is higher than the response obtained from selecting animals to increase lactation peak. Selection for higher total milk yield would result in a favourable correlated response to increase the level of production in early lactation and the lactation persistency.

Environmental and genetic factors affecting the weaning-estrus interval in sows

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ephemeroptera, Plecoptera and Trichoptera assemblages from riffles in mountain streams of Central Brazil: environmental factors influencing the distribution and abundance of immatures

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