Policy as a struggle for meaning: disentangling knowledge translation across international health contexts

Over the last decade, research in medical science has focused on knowledge translation and diffusion of best practices to enable improved health outcomes. However, there has been less attention given to the role of policy in influencing the translation of best practice across different national contexts. This paper argues that the underlying set of public discourses of healthcare policy significantly influences its development with implications for the dissemination of best practices. Our research uses Critical Discourse Analysis to examine the policy discourses surrounding the treatment of stroke across Canada and the U.K. It focuses in specific on how concepts of knowledge translation, user empowerment, and service innovation construct different accounts of the health service in the two countries. These findings provide an important yet overlooked starting point for understanding the role of policy development in knowledge transfer and the translation of science into health practice. © 2011 Operational Research Society. All rights reserved.

Development of a nanoporous and multilayer drug-delivery platform for medical implants.

Biodegradable polymers can be applied to a variety of implants for controlled and local drug delivery. The aim of this study is to develop a biodegradable and nanoporous polymeric platform for a wide spectrum of drug-eluting implants with special focus on stent-coating applications. It was synthesized by poly(DL-lactide-co-glycolide) (PLGA 65:35, PLGA 75:25) and polycaprolactone (PCL) in a multilayer configuration by means of a spin-coating technique. The antiplatelet drug dipyridamole was loaded into the surface nanopores of the platform. Surface characterization was made by atomic force microscopy (AFM) and spectroscopic ellipsometry (SE). Platelet adhesion and drug-release kinetic studies were then carried out. The study revealed that the multilayer films are highly nanoporous, whereas the single layers of PLGA are atomically smooth and spherulites are formed in PCL. Their nanoporosity (pore diameter, depth, density, surface roughness) can be tailored by tuning the growth parameters (eg, spinning speed, polymer concentration), essential for drug-delivery performance. The origin of pore formation may be attributed to the phase separation of polymer blends via the spinodal decomposition mechanism. SE studies revealed the structural characteristics, film thickness, and optical properties even of the single layers in the triple-layer construct, providing substantial information for drug loading and complement AFM findings. Platelet adhesion studies showed that the dipyridamole-loaded coatings inhibit platelet aggregation that is a prerequisite for clotting. Finally, the films exhibited sustained release profiles of dipyridamole over 70 days. These results indicate that the current multilayer phase therapeutic approach constitutes an effective drug-delivery platform for drug-eluting implants and especially for cardiovascular stent applications.

Analysis of lateral current spreading in solar cell devices by spatially-resolved electroluminescence

Spatially-resolved electroluminescence (EL) images from solar cells contain information of local current distribution. By theoretical analysis of the EL intensity distribution, the current density distribution under a certain current bias and the sheet resistance can be obtained quantitatively. Two-dimensional numerical simulation of the current density distribution is employed to a GaInP cell, which agrees very well with the experimental results. A reciprocity theorem for current spreading is found and used to interpret the EL images from the viewpoint of current extraction. The optimization of front electrodes is discussed based on the results. (C) 2010 American Institute of Physics. [doi:10.1063/1.3431390]

The structure and current-voltage characteristics of multi-sheet InGaN quantum dots grown by a new multi-step method

Multi-sheet InGaN/GaN quantum dots (QDs) were grown successfully by surface passivation processing and low-temperature growth in metalorganic chemical vapor deposition. This method based on the principle of increasing the energy barrier of adatom hopping by surface passivation and low-temperature growth, is quite different from present methods. The InGaN quantum dots in the first layer of about 40-nm-wide and 15-nm-high grown by this method were revealed by atomic force microscopy. The InGaN QDs in upper layer grew bigger. To our knowledge, the current-voltage characteristics of multi-sheet InGaN/GaN QDs were measured for the fist time. Two kinds of resonance-tunneling-current features were observed which were attributed to the low-dimensional localization effect. Some current peaks only appeared in positive voltage for sample due to the non-uniformity of the QDs in the structure. (C) 2002 Elsevier Science B.V. All rights reserved.

INVESTIGATING A NEAR-BED SUBMARINE PIPELINE IN A CURRENT

This paper considers the lift forces acting on a pipeline with a small gap between the pipeline and the plane bottom or scoring bottom. A more reasonable fluid force on the pipeline has been obtained by applying the knowledge of modified potential theory (MPT), which includes the influences of the downstream wake. By finite element method, an iteration procedure is used to solve problems of the nonlinear fluid-structure interaction. Comparing the deflection and the stress distributions with the difference sea bottoms, the failure patterns of a spanning pipeline have been discussed. The results are essential for engineers to assess pipeline stability.

A System for Representing and Using Real-World Knowledge

This report describes a knowledge-base system in which the information is stored in a network of small parallel processing elements ??de and link units ??ich are controlled by an external serial computer. This network is similar to the semantic network system of Quillian, but is much more tightly controlled. Such a network can perform certain critical deductions and searches very quickly; it avoids many of the problems of current systems, which must use complex heuristics to limit and guided their searches. It is argued (with examples) that the key operation in a knowledge-base system is the intersection of large explicit and semi-explicit sets. The parallel network system does this in a small, essentially constant number of cycles; a serial machine takes time proportional to the size of the sets, except in special cases.

Representing Knowledge of Large-Scale Space

This dissertation presents a model of the knowledge a person has about the spatial structure of a large-scale environment: the "cognitive map". The functions of the cognitive map are to assimilate new information about the environment, to represent the current position, and to answer route-finding and relative-position problems. This model (called the TOUR model) analyzes the cognitive map in terms of symbolic descriptions of the environment and operations on those descriptions. Knowledge about a particular environment is represented in terms of route descriptions, a topological network of paths and places, multiple frames of reference for relative positions, dividing boundaries, and a structure of containing regions. The current position is described by the "You Are Here" pointer, which acts as a working memory and a focus of attention. Operations on the cognitive map are performed by inference rules which act to transfer information among different descriptions and the "You Are Here" pointer. The TOUR model shows how the particular descriptions chosen to represent spatial knowledge support assimilation of new information from local observations into the cognitive map, and how the cognitive map solves route-finding and relative-position problems. A central theme of this research is that the states of partial knowledge supported by a representation are responsible for its ability to function with limited information of computational resources. The representations in the TOUR model provide a rich collection of states of partial knowledge, and therefore exhibit flexible, "common-sense" behavior.

Procurement of electronic content across the UK National Health Service and Higher Education sectors. Report to JISC executive and LKDN executive.

Spink, S., Urquhart, C., Cox, A. & Higher Education Academy - Information and Computer Sciences Subject Centre. (2007). Procurement of electronic content across the UK National Health Service and Higher Education sectors. Report to JISC executive and LKDN executive. Sponsorship: JISC/LKDN

Library management systems:current issues and developments

Tedd, L.A. (2006). Library management systems: current issues and developments. Umbrella 2007 conference of the Chartered Institute of Library and Information Professionals in Hatfield, July 2007.

Biological rationale for regular physical exercise as an effective intervention for the prevention and treatment of depressive disorders

Depression is a major medical and social problem. Here we review current body of knowledge on the benefits of exercise as an effective strategy for both the prevention and treatment of this condition. We also analyze the biological pathways involved in such potential benefits, which include changes in neurotrophic factors, oxidative stress and inflammation, telomere length, brain volume and microvessels, neurotransmitters or hormones. We also identify major caveats in this field of research: further studies are needed to identify which are the most appropriate types of exercise interventions (intensity, duration, or frequency) to treat and prevent depression.

A gestão na medicina dentária

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Rule Extraction, Fuzzy ARTMAP, and Medical Databases

This paper shows how knowledge, in the form of fuzzy rules, can be derived from a self-organizing supervised learning neural network called fuzzy ARTMAP. Rule extraction proceeds in two stages: pruning removes those recognition nodes whose confidence index falls below a selected threshold; and quantization of continuous learned weights allows the final system state to be translated into a usable set of rules. Simulations on a medical prediction problem, the Pima Indian Diabetes (PID) database, illustrate the method. In the simulations, pruned networks about 1/3 the size of the original actually show improved performance. Quantization yields comprehensible rules with only slight degradation in test set prediction performance.

A knowledge management system to optimise comfort throughout the building life-cycle

Comfort is, in essence, satisfaction with the environment, and with respect to the indoor environment it is primarily satisfaction with the thermal conditions and air quality. Improving comfort has social, health and economic benefits, and is more financially significant than any other building cost. Despite this, comfort is not strictly managed throughout the building lifecycle. This is mainly due to the lack of an appropriate system to adequately manage comfort knowledge through the construction process into operation. Previous proposals to improve knowledge management have not been successfully adopted by the construction industry. To address this, the BabySteps approach was devised. BabySteps is an approach, proposed by this research, which states that for an innovation to be adopted into the industry it must be implementable through a number of small changes. This research proposes that improving the management of comfort knowledge will improve comfort. ComMet is a new methodology proposed by this research that manages comfort knowledge. It enables comfort knowledge to be captured, stored and accessed throughout the building life-cycle and so allowing it to be re-used in future stages of the building project and in future projects. It does this using the following: Comfort Performances – These are simplified numerical representations of the comfort of the indoor environment. Comfort Performances quantify the comfort at each stage of the building life-cycle using standard comfort metrics. Comfort Ratings - These are a means of classifying the comfort conditions of the indoor environment according to an appropriate standard. Comfort Ratings are generated by comparing different Comfort Performances. Comfort Ratings provide additional information relating to the comfort conditions of the indoor environment, which is not readily determined from the individual Comfort Performances. Comfort History – This is a continuous descriptive record of the comfort throughout the project, with a focus on documenting the items and activities, proposed and implemented, which could potentially affect comfort. Each aspect of the Comfort History is linked to the relevant comfort entity it references. These three components create a comprehensive record of the comfort throughout the building lifecycle. They are then stored and made available in a common format in a central location which allows them to be re-used ad infinitum. The LCMS System was developed to implement the ComMet methodology. It uses current and emerging technologies to capture, store and allow easy access to comfort knowledge as specified by ComMet. LCMS is an IT system that is a combination of the following six components: Building Standards; Modelling & Simulation; Physical Measurement through the specially developed Egg-Whisk (Wireless Sensor) Network; Data Manipulation; Information Recording; Knowledge Storage and Access.Results from a test case application of the LCMS system - an existing office room at a research facility - highlighted that while some aspects of comfort were being maintained, the building’s environment was not in compliance with the acceptable levels as stipulated by the relevant building standards. The implementation of ComMet, through LCMS, demonstrates how comfort, typically only considered during early design, can be measured and managed appropriately through systematic application of the methodology as means of ensuring a healthy internal environment in the building.

Ireland's knowledge economy policy: beliefs, drivers and prospects

This dissertation critically examines Ireland’s knowledge economy policy, the country’s basis for economic recovery and growth, to enhance future policy decisions and debate. Much has been written internationally on the ‘knowledge economy’ with its emergence closely related to globalisation and technological progression in the 1990s. Since the late 1990s, Irish policy-makers have been firmly committed to positioning Ireland as a leading knowledge economy. Transforming the country’s competitive base to a knowledge economy is pivotal, directly shaping the course of Ireland’s economy and society. Given Ireland’s current economic crisis, limited resources, global competition from leaders in science and technology and growing challenges from emerging economies, a systematic study of Ireland’s major competitive policy is imperative. Above all, this study explores the processes behind the policy and the multiple actors from different institutions who follow and seek to influence decisions. The advocacy coalition framework is used to identify the advocacy coalition operating in the knowledge economy policy subsystem. The theoretical insights of this framework are also combined with other public policy approaches, providing complementary insights into the policy process. The research is framed around three elements - the beliefs underpinning the policy; who is driving the policy; and the prospects of the policy. Primary information is collected by way of semi-structured in-depth interviews with 49 Irish elites (politicians, senior bureaucrats, academics and business leaders) involved in the formation and implementation of the policy. This study finds that a strong advocacy coalition has formed in this policy subsystem whose members are collectively driving the policy. Both exogenous and endogenous forces help frame a common perception of the problems the policy addresses and the solutions it offers. Evidence suggests that this policy is a sustainable option for Ireland’s economic future and the study concludes with policy recommendations for advancing Ireland’s knowledge economy.

Environmental management for malaria control: knowledge and practices in Mvomero, Tanzania.

Environmental conditions play an important role in the transmission of malaria; therefore, regulating these conditions can help to reduce disease burden. Environmental management practices for disease control can be implemented at the community level to complement other malaria control methods. This study assesses current knowledge and practices related to mosquito ecology and environmental management for malaria control in a rural, agricultural region of Tanzania. Household surveys were conducted with 408 randomly selected respondents from 10 villages and qualitative data were collected through focus group discussions and in-depth interviews. Results show that respondents are well aware of the links between mosquitoes, the environment, and malaria. Most respondents stated that cleaning the environment around the home, clearing vegetation around the home, or draining stagnant water can reduce mosquito populations, and 63% of respondents reported performing at least one of these techniques to protect themselves from malaria. It is clear that many respondents believe that these environmental management practices are effective malaria control methods, but the actual efficacy of these techniques for controlling populations of vectors or reducing malaria prevalence in the varying ecological habitats in Mvomero is unknown. Further research should be conducted to determine the effects of different environmental management practices on both mosquito populations and malaria transmission in this region, and increased participation in effective techniques should be promoted.