Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

Methods and background characteristics of the TOHNN study : a population-based study of oral health conditions in northern Norway

OBJECTIVES: The aim of the Tromstannen - Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. STUDY DESIGN: Cross-sectional population-based study including a questionnaire and clinical dental examination. METHODS: A randomly selected sample of 2,909 individuals (20-79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20-34, 35-49, 50-64 and 65-79) and ethnicity (Norwegian, Sámi, other European and other world). RESULTS: From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20-34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. CONCLUSION: The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.

On the nature of income inequality across nations

In this paper, we investigate the nature of income inequality across nations. First, rather than functional forms or parameter values in calibration exercises that can potentially drives results, we estimate, test, and distinguish between types of aggregate production functions currently used in the growth literature. Next, given our panel-regression estimates, we perform several exercises, such as variance decompositions, simulations and counter-factual analyses. The picture that emerges is one where countries grew in the past for different reasons, which should be an important ingredient in policy design. Although there is not a single-factor explanation for the difference in output per-worker across nations, inequality, followed by distortions to capital accumulations and them by human capital accumulation.

Study of the innovation management process in the development of a discontinuous product case: Motorola RAZR V3

This study will collaborate by bringing some detailed analysis and findings on a special case study of a discontinuous product development process, trying to answer how the discontinuous product development process takes place and the main factors that influence this process. Additionally, it tried to explore some explanations for the difficulties generally faced by the companies to sustain innovation. The case is about the Motorola cell phone RAZR V3, launched in 2004. RAZR V3 was noted by industry experts as game-changing feat of design and engineering, selling more than 110 million units by end of 2008 and recognized as one of the fastest selling products in the industry. The study uses a single case methodology, which is appropriate given the access to a phenomenon that happened inside corporate dominium and it is not easily accessed for academic studies, besides being a rare case of success in the cellular phone industry. In order to magnify the understanding of the phenomenon, the exploration was extended to contrast the RAZR development process and the standard product development process in Motorola. Additionally, it was integrated a longitudinal reflection of the company product development evolution until the next breakthrough product hitting the cellular phone industry. The result of the analysis shows that discontinuous products do not fit well traditional product development process (in this case, stage-gate). This result reinforces the results obtained on previous studies of discontinuous product development conducted by other authors. Therefore, it is clear that the dynamics of discontinuous product development are different from the continuous product development, requiring different treatment to succeed. Moreover, this study highlighted the importance of the management influence in all the phases of the process as one of the most important factors, suggesting a key component to be carefully observed in future researches. Some other findings of the study that were considered very important for a discontinuous product development process: have champions (who believe and protect the project) and not only one champion; create a right atmosphere to make flow the creative process; question paradigms to create discontinuous products; simple guiding light to focus the team; company culture that accepts and knows how to deal with risks; and undoubtedly, have a company strategy that understands the different dynamics of continuous and discontinuous product development processes and treat them accordingly.

A study of the impacts of quantitative easing on the macroeconomics variables

Neste trabalho, propusemos um modelo DSGE que busca responder algumas questões sobre políticas de afrouxamento monetário (Quantitative Easing - QE) recentemente implementadas em resposta à crise de 2008. Desenvolvemos um modelo DSGE com agentes heterogêneos e preferred-habitat nas compras de títulos do governo. Nosso modelo permite o estudo da otimalidade da compra de portfolio (em termos de duration dos títulos) para os bancos centrais quando estão implementando a política. Além disso, a estrutura heterogênea nos permite olhar para distribuição de renda provocada pelas compras de títulos. Nossos resultados preliminares evidenciam o efeito distributivo do QE. No entanto, nosso modelo expandido apresentou alguns problemas de estabilidade.

Do brazilian states engage in the fiscal war of ports? An empiric study of tax competition and an analysis of a natural experiment: the brazilian senate resolution 13/2012

O fim do ano de 2014 marcou o segundo aniversário da Resolução 13/2012 (R13) do Senado brasileiro. Grosso modo, R13 constituiu-se de um normativo do Senado cujo objetivo era o de por um fim na Guerra Fiscal dos Portos (FWP), uma competição fiscal entre os estados que se dá através da concessão de benefícios fiscais sobre operações interestaduais com mercadorias importadas de modo a atrair empresas importadoras para o território do estado concedente. R13 diminuiu o nível da tributação sobre tais operações, esperando com isso diminuir os lucros auferidos e a propensão das firmas de aceitarem tais regimes especiais de incentivação fiscal. Nada obstante, R13 gerou uma grande discussão sobre se os benefícios da atração de investimentos para um estado em particular superariam ou não os custos que esse estado incorreria em renunciar receitas tributárias em razão concessão desses benefícios fiscais. O objetivo do presente trabalho é o de dar uma contribuição a essa discussão, testando se um comportamento de interação estratégica entre estados, tal como aquele que supostamente ocorre no contexto da FWP, de fato emerge dos dados de importação coletados de janeiro de 2010 a maio de 2015, e, também, testando se a R13 de fato afetou tal comportamento de interação estratégica. Utiliza-se aqui um modelo de econometria espacial, no qual se especifica uma matriz de pesos que agrega o nível de importação das jurisdições concorrentes, organizando os dados em um painel de efeitos fixos. Os resultados sugerem que existe um comportamento de interação estratégica entre os estados e que a R13 de fato impactou tal comportamento.

A sociodemographic, clinical study of patients with venous ulcer

Background Venous ulcer is the most serious consequence of chronic venous insufficiency and is responsible for almost 70% of chronic leg ulcers. The main purpose of this research was to describe social, demographic and clinical characteristics of patients with venous ulcers and to identify some professional repercussions of this pathology.Subjects and methods We evaluated patients with a clinical picture compatible with venous ulcer. The sociodemographic characteristics of the patients, and the clinical characteristics and professional repercussions of the pathology were studied. We used the ankle-brachial index to identify associated arterial disease. The body mass index (BMI) was used for the classification of the nutritional condition of the patients.Results A total of 120 patients were included in the study (90 females and 30 males; 80.8% White; 44.2% > 60 years old). Ninety-one per cent of the patients had been in education for less than 4 years, and 89.7% were on the poverty line. Thirty-five per cent were retired, 2.5% were receiving government help due to disease and 4.2% were unemployed. About 16% of patients were out of work due to the disease, and 49.2% presented some degree of disability in terms of work tasks. The ulcer area was less than 30 cm(2) in 69.1% of patients. The first ulcer episode occurred in 13.4 years on average, and 64.2% of patients had recurrent episodes. Females presented on average 5.65 pregnancies, and 75.4% of patients were overweight.Conclusion Venous ulcer occurred mainly in the low-income population, who presented with little formal education. Generally, the ulcers were present for a long time and were recurrent, with repercussions for the capabilities of patients to work.

A comparative study of the immunoantigenicity of eight Paracoccidioides brasiliensis isolates

Para se detectar diferenças imuno-antigênicas entre 8 amostras de P. brasiliensis isoladas de diferentes áreas endêmicas (Botucatu: Pb 1, 2 e 3; São Paulo: Pb: 18, 192 e 265; Venezuela: Pb 9 e 73), esutdaram-se: 1. A reatividade antigênica de cada amostra nas reações de imunofluorescência indireta (II) e de imunodifusão dupla em gel de agar (ID) contra painel de 20 soros controles positivos para paracoccidioidomicose; 2. A capacidade de induzir resposta imune humoral (medida por imunodifusão) e celular (medida pelo teste de coxim plantar) em camundongos imunizados com an-tígenos de cada amostra. Observamos: 1. As amostras Pb 265 e Pb 9 mostraram-se mais reativas na II; 2. Os antígenos das amostras Pb 192 e Pb 73 foram significativamente mais reativas na ID; 3. Estes dados demonstram diferenças de antigenicidade entre estas amostras; 4. A amostra Pb 18 mostrou baixo poder indutor de resposta imune celular e alta capacidade de indução de resposta imune humoral em camundongos imunizados, revelando dissociação de sua imunogenicidade. Estas diferenças podem indicar a existência de cepas distintas do fungo ou refletir modificações do parasita no hospedeiro ou du rante seu cultivo.

Morphological characterization of the ovary and vitellogenesis dynamics in the tick Amblyomma cajennense (Acari : Ixodidae)

In this work we describe the internal morphology of the female reproductive system of the cayenne tick Amblyomma cajennense. This system is represented by a panoistic ovary, which lacks nurse cells in the germarium. This ovary consists of a single tube, in which a large number of oocytes develop asynchronously, thus accompanying the processes of yolk deposition in the oocytes. The oocytes were classified into stages that varied from I to V, according to: cytoplasm appearance, presence of the germ vesicle, presence of yolk granules, and presence of chorion. The study of vitellogenesis dynamics suggest that the yolk elements are deposited in the oocyte following a preferencial sequence, in which the lipids are the first to appear, followed by proteins an finally by the carbohydrates. In this way the yolk of A. cajennense ticks have these three elements that may be free in the cytoplasm or chemically bounded forming glycoprotein or lipoprotein complexes. (C) 2004 Elsevier B.V. All rights reserved.

Study of the mechanism of action of anoplin, a helical antimicrobial decapeptide with ion channel-like activity, and the role of the amidated C-terminus

Anoplin, an antimicrobial, helical decapeptide from wasp venom, looses its biological activities by mere deamidation of its C-terminus. Secondary structure determination, by circular dichroism spectroscopy in amphipathic environments, and lytic activity in zwitterionic and anionic vesicles showed quite similar results for the amidated and the carboxylated forms of the peptide. The deamidation of the C-terminus introduced a negative charge at an all-positive charged peptide, causing a loss of amphipathicity, as indicated by molecular dynamics simulations in TFE/water mixtures and this subtle modification in a peptide's primary structure disturbed the interaction with bilayers and biological membranes. Although being poorly lytic, the amidated form, but not the carboxylated, presented ion channel-like activity on anionic bilayers with a well-defined conductance step; at approximately the same concentration it showed antimicrobial activity. The pores remain open at trans-negative potentials, preferentially conducting cations, and this situation is equivalent to the interaction of the peptide with bacterial membranes that also maintain a high negative potential inside. Copyright (C) 2007 European Peptide Society and John Wiley & Sons, Ltd.

Evaluation of seasonal dynamics and bioindication potential of macroalgal communities in a polluted tropical stream

Macroalgal communities and environmental variables were analyzed seasonally along a polluted tropical stream in São Paulo State, Brazil, We aimed to improve the knowledge of tropical macroalgal communities, to study the longitudinal and seasonal dynamics of these communities in influenced environments, to evaluate the relationship of algal frequency and abundance with selected environmental variables, and to look for potential macroalgal species indicators. The seasonal abundance pattern was similar to natural or low influenced systems and was mainly determined by rainfall regime. However, community composition was closely related to some chemical water pollution indicators, such as phosphorus and nitrogen compounds. Some species are suggested as potential indicators of organic pollution (e.g. Oscillatoria ornata, Stigeoclonium helveticum and Schizomeris leibleinii), but more detailed studies have to be developed to determine the tolerance limits of these species. on the basis of our results and literature data, the use of occurrence of Oscillatoriales in relation to other orders of Cyanoprokaryota is suggested to be a good indicator of organic pollution in tropical lotic ecosystems.

Nonlinear Schrodinger equation for a superfluid Bose gas from weak coupling to unitarity: Study of vortices

We introduce a nonlinear Schrodinger equation to describe the dynamics of a superfluid Bose gas in the crossover from the weak-coupling regime, where an(1/3)<<1 with a the interatomic s-wave scattering length and n the bosonic density, to the unitarity limit, where a ->+infinity. We call this equation the unitarity Schrodinger equation (USE). The zero-temperature bulk equation of state of this USE is parametrized by the Lee-Yang-Huang low-density expansion and Jastrow calculations at unitarity. With the help of the USE we study the profiles of quantized vortices and vortex-core radius in a uniform Bose gas. We also consider quantized vortices in a Bose gas under cylindrically symmetric harmonic confinement and study their profile and chemical potential using the USE and compare the results with those obtained from the Gross-Pitaevskii-type equations valid in the weak-coupling limit. Finally, the USE is applied to calculate the breathing modes of the confined Bose gas as a function of the scattering length.

Some aspects of the dynamics of fictitious Earth's satellites

In this work we study the dynamics of fictitious satellites of the Earth. In the first part we do not consider the effect of the Moon and study the dynamics in the restrict three-body model, i.e., a massless satellite under the effect of the gravitational force of an oblate Earth and that of the Sun. We show that a satellite starting with an almost circular orbit suffers very large variations of eccentricity, depending on the initial inclination of the orbit with respect to the reference plane. As the eccentricity may be driven to very large values (approximate to0.9) mutual collisions between satellites or collisions with the planet may occur. In the second part, we include the gravitational effect of the Moon. In this case, we find two regions with large variations of eccentricity due to the presence of the Moon. Consequently, in both scenarios, we find some large regions of the phase space where the long-term stability of some fictitious Earth's satellites is not possible. (C) 2001 Elsevier B.V. Ltd. All rights reserved.

Analytical study of the nonlinear behavior of a shape memory oscillator: Part II-resonance secondary

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Analytical study of the nonlinear behavior of a shape memory oscillator: Part I-primary resonance and free response at low temperatures

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