Understanding Antenatal Genetics Services in Sri Lanka: Current Landscape of Screening and Diagnostic Services and Contextual Factors Influencing Their Availability and Uptake

Background: Too little information is available on Sri Lanka’s current capacity to provide community genetic services—antenatal genetic services in particular—to understand whether building that capacity could further improve and reduce disparity in maternal and child health. This qualitative research project seeks to gather information on congenital disorders, routine antenatal care, and the current state of antenatal screening testing services within that routine antenatal to assess the feasibility of and the need for scaling up antenatal genetics services in Sri Lanka. Methods: Nineteen key informant (KI) interviews were conducted with stakeholders in antenatal care and genetic services. Seven focus group discussions were held with a total of 56 Public Health Midwives (PHMs), the health workers responsible for antenatal care at the field level. Transcripts for all interviews and FGDs were analyzed for key themes, and themes were categorized to address the specific aims of the project. Results: Antenatal genetic services play a minor role in antenatal care, with screening and diagnostic procedures available in the private sector and paid for out-of-pocket. KIs and PHMs expect that demand for antenatal genetic services will increase as patients’ purchasing power and knowledge grow but note that prohibitive abortion laws limit the ability of patients to act on test results. Genetic services compete for limited financial and human resources in the free public health system, and inadequate information on the prevalence of congenital disorders limits the ability to understand whether funding for services related to those disorders should be increased. A number of alternatives to scaling up antenatal genetic services within the free health system might be better suited to the Sri Lankan structural and social context. Conclusions: Scaling up antenatal genetic services within the public health system is not feasible in the current financial, legal, and human resource context. Yet current availability and utilization patterns contribute to regional and economic disparities, suggesting that stasis will not bring continued improvements in maternal and child health. More information on the burden of congenital disorders is necessary to fully understand if and how antenatal genetic service availability should be increased in Sri Lanka, but even before that information is gathered, examination of policies for patient referral, termination of pregnancy, and government support for individuals with genetic disease are steps that might bring extend improvements and reduce disparity in maternal and child health.

A Qualitative Study of Contextual Factors’ Impact on the Adaptation of a Caregiver-mediated Early Autism Intervention in South Africa

Background: Autism Spectrum Disorder (ASD) is a major global health challenge as the majority of individuals with ASD live in low- and middle-income countries (LMICs) and receive little to no services or support from health or social care systems. Despite this global crisis, the development and validation of ASD interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in LMICs. This study sought to conduct explorative research on the contextual adaptation of a caregiver-mediated early ASD intervention for use in a low-resource setting in South Africa.

Methods: Participants included 22 caregivers of children with autism, including mothers (n=16), fathers (n=4), and grandmothers (n=2). Four focus groups discussions were conducted in Cape Town, South Africa with caregivers and lasted between 1.5-3.5 hours in length. Data was recorded, translated, and transcribed by research personnel. Data was then coded for emerging themes and analyzed using the NVivo qualitative data analysis software package.

Results: Nine contextual factors were reported to be important for the adaptation process including culture, language, location of treatment, cost of treatment, type of service provider, familial needs, length of treatment, support, and parenting practices. One contextual factor, evidence-based treatment, was reported to be both important and not important for adaptation by caregivers. The contextual factor of stigma was identified as an emerging theme and a specifically relevant challenge when developing an ASD intervention for use in a South African context.

Conclusions: Eleven contextual factors were discussed in detail by caregivers and examples were given regarding the challenges, sources, and preferences related to the contextual adaptation of a parent-mediated early ASD intervention in South Africa. Caregivers reported a preference for an affordable, in-home, individualized early ASD intervention, where they have an active voice in shaping treatment goals. Distrust of community-based nurses and health workers to deliver an early ASD intervention and challenges associated with ASD-based stigma were two unanticipated findings from this data set. Implications for practice and further research are discussed.

Ejecuciones capitales en Libro de Apolonio como estrategia de adecuación contextual

El Libro de Apolonio, compuesto en la primera mitad del siglo XIII en el marco del Mester de Clerecía, retoma la historia del Rey de Tyro directamente desde una versión de Historia Apollonii Regis Tyri y adapta las peripecias del héroe al contexto histórico y cultural del siglo XIII castellano, especialmente en el diseño de los personajes y de los espacios. En este sentido se ha señalado que, como consecuencia de su intencionalidad didáctica-escolar, el autor anónimo cifra en su reelaboración saberes propios del círculo escolar y de la corte, contextos para los cuales la obra habría sido compuesta. Dentro de los pasajes elaborados, centramos nuestra atención sobre las ejecuciones de los antagonistas, el rufián que regentea el burdel de Mitalena y los falsos amigos Estrángilo y su esposa Dionisia. La reelaboración de las escenas responde a discusiones sobre materia legal que estaban siendo llevadas a cabo en la corte castellana a mediados del siglo XIII. Así como el poema cifra conocimientos escolares contemporáneos y contextualiza la narración al entorno de los agentes participantes, escritor y público previsto, también adapta las secuencias legales al marco legal castellano, conservando de esta manera la importancia que las escenas legales poseen en la fuente latina

Language, Logos, and Social Ontology: Naturalist and Post-Naturalist Narratives of Human Rationality and Social Reality

I distinguish two ways that philosophers have approached and explained the reality and status of human social institutions. I call these approaches “naturalist” and “post-naturalist”. Common to both approaches is an understanding that the status of mind and its relation to the world or “nature” has implications on a conception of the status of institutional reality. Naturalists hold that mind is explicable within a scientific frame that conceives of mind as a fundamentally material process. By proxy, social reality is also materially explicable. Post-naturalists critique this view, holding instead that naturalism is parasitic on contemporary science—it therefore is non-compulsory and distorts how we ought to understand mind and social reality. A comparison of naturalism and post-naturalism will comprise the content of the first chapter. The second chapter turns to tracing out the dimensions of a post-naturalist narrative of mind and social reality. Post-naturalists conceive of mind and its activity of thought as sui generis, and it transpires from this that social institutions are better understood as a rational mind’s mode of the expression in the world. Post-naturalism conceives of social reality as a necessary dimension of thought. Thought requires a second person and thereby a tradition or context of norms that come to both structure its expression and become the products of expression. This is in contrast to the idea that social reality is a production of minds, and thereby derivative. Social reality, self-conscious thought, and thought of the second person are therefore three dimensions of a greater unity.

The gendered effects of family migration law: contextual interpretation as a possible judicial remedy

At all normative levels, family migration law can disproportionally and negatively affect immigrant women’s rights in this field, producing gendered effects. In some cases, such effects are related to the normative and judicial imposition of unviable family-related models (e.g., the ʻgood mother ̕ the one-breadwinner family, or a rigid distinction between productive and reproductive work). In other cases, they are due to family migration law’s overlooking of the specific needs and difficulties of immigrant women, within their families and in the broader context of their host countries’ social and normative framework.To effectively expose and correct this gender bias, in this article I propose an alternative view of immigrant women’s right to family life, as a cluster of rights and entitlements rather than as a mono-dimensional right. As a theoretical approach, this construction is better equipped to capture the complex experiences of immigrant women in the European legal space, and to shed light on the gendered effects generated not by individual norms but by the interaction of norms that are traditionally assigned to separated legal domains (e.g., immigration law and criminal law). As a judicial strategy, this understanding is capable of prompting a consideration by domestic and supranational courts of immigrant women not as isolated individuals, but as ‘individuals in context’. I shall define this type of approach as ‘contextual interpretation’, understood as the consideration of immigrant women in the broader contexts of their families, their host societies and the normative frameworks applicable to them. Performed in a gendersensitive manner, a contextual judicial interpretation has the potential to neutralize the gendered effects of certain family migration norms. To illustrate these points, I will discuss selected judicial examples offered by the European Court on Human Rights, as well as from domestic jurisdictions of countries with a particularly high incidence of immigrant women (Italy and Spain).

Contextual anomaly detection in crowded surveillance scenes

This work addresses the problem of detecting human behavioural anomalies in crowded surveillance environments. We focus in particular on the problem of detecting subtle anomalies in a behaviourally heterogeneous surveillance scene. To reach this goal we implement a novel unsupervised context-aware process. We propose and evaluate a method of utilising social context and scene context to improve behaviour analysis. We find that in a crowded scene the application of Mutual Information based social context permits the ability to prevent self-justifying groups and propagate anomalies in a social network, granting a greater anomaly detection capability. Scene context uniformly improves the detection of anomalies in both datasets. The strength of our contextual features is demonstrated by the detection of subtly abnormal behaviours, which otherwise remain indistinguishable from normal behaviour.

Trabalho em equipe de saúde: uma análise contextual

COSTA, Roberta Kaliny de Souza ; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de . Trabalho em equipe em saúde: uma análise contextual. Ciência, Cuidado e Saúde, v. 7, p. 530-536, 2008.

A visual and contextual comparative study of the work of Picasso and Chanel towards an understanding of the overlaps between Modern Art and Fashion.

From the beginning of the twentieth century, ``Modernism`` impacted and transformed art and clothing. Pablo Picasso and Gabrielle ``Coco`` Chanel were two of the most central characters in Modernism working simultaneously in their disciplines. Picasso`s innovations, particularly in abstract art and Chanel`s fashion designs, that dramatically departed from the previous corseted and highly deco-rative styles, were so significant that they have left an influence on contemporary art and fashion. This study will compare their visual works and documented evidence of their motivations, within the context of their cultural backgrounds, to reveal meaning in the occurrences of overlaps. This approach has ex-amined the historical, cultural background of the artist and designer`s environment from different per-spectives, adding to previous research in this area. Through this research, outcomes of the analysis have shown similarities and divergences in the wider genres of art and fashion and the practice of the artist and fashion designer. The reference list to this text, used in the survey, gives a comprehensive overview of pertinent publications disseminating Picasso and Chanel`s visual works, oral perspectives and cultural impact.

Trabalho em equipe de saúde: uma análise contextual

COSTA, Roberta Kaliny de Souza ; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de . Trabalho em equipe em saúde: uma análise contextual. Ciência, Cuidado e Saúde, v. 7, p. 530-536, 2008.

Contextual text mining

With the dramatic growth of text information, there is an increasing need for powerful text mining systems that can automatically discover useful knowledge from text. Text is generally associated with all kinds of contextual information. Those contexts can be explicit, such as the time and the location where a blog article is written, and the author(s) of a biomedical publication, or implicit, such as the positive or negative sentiment that an author had when she wrote a product review; there may also be complex context such as the social network of the authors. Many applications require analysis of topic patterns over different contexts. For instance, analysis of search logs in the context of the user can reveal how we can improve the quality of a search engine by optimizing the search results according to particular users; analysis of customer reviews in the context of positive and negative sentiments can help the user summarize public opinions about a product; analysis of blogs or scientific publications in the context of a social network can facilitate discovery of more meaningful topical communities. Since context information significantly affects the choices of topics and language made by authors, in general, it is very important to incorporate it into analyzing and mining text data. In general, modeling the context in text, discovering contextual patterns of language units and topics from text, a general task which we refer to as Contextual Text Mining, has widespread applications in text mining. In this thesis, we provide a novel and systematic study of contextual text mining, which is a new paradigm of text mining treating context information as the ``first-class citizen.'' We formally define the problem of contextual text mining and its basic tasks, and propose a general framework for contextual text mining based on generative modeling of text. This conceptual framework provides general guidance on text mining problems with context information and can be instantiated into many real tasks, including the general problem of contextual topic analysis. We formally present a functional framework for contextual topic analysis, with a general contextual topic model and its various versions, which can effectively solve the text mining problems in a lot of real world applications. We further introduce general components of contextual topic analysis, by adding priors to contextual topic models to incorporate prior knowledge, regularizing contextual topic models with dependency structure of context, and postprocessing contextual patterns to extract refined patterns. The refinements on the general contextual topic model naturally lead to a variety of probabilistic models which incorporate different types of context and various assumptions and constraints. These special versions of the contextual topic model are proved effective in a variety of real applications involving topics and explicit contexts, implicit contexts, and complex contexts. We then introduce a postprocessing procedure for contextual patterns, by generating meaningful labels for multinomial context models. This method provides a general way to interpret text mining results for real users. By applying contextual text mining in the ``context'' of other text information management tasks, including ad hoc text retrieval and web search, we further prove the effectiveness of contextual text mining techniques in a quantitative way with large scale datasets. The framework of contextual text mining not only unifies many explorations of text analysis with context information, but also opens up many new possibilities for future research directions in text mining.

Belief and Bounded Rationality

Predictive accounts of belief ascription, either following the principle of charity or Dennett's intentional stance, have proved popular recently. However, such accounts require us first to treat agents as perfectly rational agents and then revise this assumption as appropriate. I argue that such downwards revision is no easy task and that several proposed accounts are not satisfactory. I propose a way of characterising agent's belief states which shares Dennett's approach but avoids treating agents as perfectly rational, and develop a formal account in terms of fan models.

On the application of contextual IoT service discovery in Information Centric Networks

The continuous flow of technological developments in communications and electronic industries has led to the growing expansion of the Internet of Things (IoT). By leveraging the capabilities of smart networked devices and integrating them into existing industrial, leisure and communication applications, the IoT is expected to positively impact both economy and society, reducing the gap between the physical and digital worlds. Therefore, several efforts have been dedicated to the development of networking solutions addressing the diversity of challenges associated with such a vision. In this context, the integration of Information Centric Networking (ICN) concepts into the core of IoT is a research area gaining momentum and involving both research and industry actors. The massive amount of heterogeneous devices, as well as the data they produce, is a significant challenge for a wide-scale adoption of the IoT. In this paper we propose a service discovery mechanism, based on Named Data Networking (NDN), that leverages the use of a semantic matching mechanism for achieving a flexible discovery process. The development of appropriate service discovery mechanisms enriched with semantic capabilities for understanding and processing context information is a key feature for turning raw data into useful knowledge and ensuring the interoperability among different devices and applications. We assessed the performance of our solution through the implementation and deployment of a proof-of-concept prototype. Obtained results illustrate the potential of integrating semantic and ICN mechanisms to enable a flexible service discovery in IoT scenarios.