Toxoplasmosis: an examination of knowledge among health professionals and pregnant women in a municipality of the State of Paraná

Introduction The aim of this study was to investigate the knowledge of toxoplasmosis among professionals and pregnant women in the public health services in Paraná, Brazil. Methods A cross-sectional observational and transversal study of 80 health professionals (44 nurses and 36 physicians) and 330 pregnant women [111 immunoglobulin M (IgM)- and IgG-non-reactive and 219 IgG-reactive] was conducted in 2010. An epidemiological data questionnaire was administered to the professionals and to the pregnant women, and a questionnaire about the clinical aspects and laboratory diagnosis of toxoplasmosis was administered to the professionals. Results The participants frequently provided correct responses about prophylactic measures. Regarding the clinical and laboratory aspects, the physicians provided more correct responses and discussed toxoplasmosis with the pregnant women. The professionals had difficulty interpreting the avidity test results, and the physicians stated that they referred pregnant women with high-risk pregnancies to a county reference center. Of the professionals, 53 (91.4%) reported that they instructed women during prenatal care, but only 54 (48.6%) at-risk pregnant women and 99 (45.2%) women who were not at risk reported receiving information about preventive measures. The physicians provided verbal instructions to 120 (78.4%) women, although instructional materials were available in the county. The pregnant women generally lacked knowledge about preventive measures for congenital toxoplasmosis, but the at-risk pregnant women tended to respond correctly. Conclusions This study provides data to direct public health policies regarding the importance of updating the knowledge of primary care professionals. Mechanisms should be developed to increase public knowledge because prophylactic strategies are important for preventing congenital toxoplasmosis.

Longitudinal evaluation, acceptability and long-term retention of knowledge on a horizontally integrated organic and functional systems course

Undergraduate medical education is moving from traditional disciplinary basic science courses into more integrated curricula. Integration models based on organ systems originated in the 1950s, but few longitudinal studies have evaluated their effectiveness. This article outlines the development and implementation of the Organic and Functional Systems (OFS) courses at the University of Minho in Portugal, using evidence collected over 10 years. It describes the organization of content, student academic performance and acceptability of the courses, the evaluation of preparedness for future courses and the retention of knowledge on basic sciences. Students consistently rated the OFS courses highly. Physician tutors in subsequent clinical attachments considered that students were appropriately prepared. Performance in the International Foundations of Medicine examination of a self-selected sample of students revealed similar performances in basic science items after the last OFS course and 4 years later, at the moment of graduation. In conclusion, the organizational and pedagogical approaches of the OFS courses achieve high acceptability by students and result in positive outcomes in terms of preparedness for subsequent training and long-term retention of basic science knowledge.

Innovation, R&D spillovers and productivity: the role of knowledge-intensive services

This paper analyses the performance of companies’ R&D and innovation and the effects of intra- and inter-industry R&D spillover on firms’ productivity in Catalonia. The paper deals simultaneously with the performance of manufacturing and service firms, with the aim of highlighting the growing role of knowledge-intensive services in promoting innovation and productivity gains. We find that intra-industry R&D spillovers have an important effect on the productivity level of manufacturing firms, and the inter-industrial R&D spillovers related to computer and software services also play an important role, especially in high-tech manufacturing industries. The main conclusion is that the traditional classification of manufactured goods and services no longer makes sense in the ‘knowledge economy’ and in Catalonia the regional policy makers will have to design policies that favour inter-industrial R&D flows, especially from high-tech services.

Sorting out measures and definitions of screening participation to improve comparability: The example of colorectal cancer.

Participation is a key indicator of the potential effectiveness of any population-based intervention. Defining, measuring and reporting participation in cancer screening programmes has become more heterogeneous as the number and diversity of interventions have increased, and the purposes of this benchmarking parameter have broadened. This study, centred on colorectal cancer, addresses current issues that affect the increasingly complex task of comparing screening participation across settings. Reports from programmes with a defined target population and active invitation scheme, published between 2005 and 2012, were reviewed. Differences in defining and measuring participation were identified and quantified, and participation indicators were grouped by aims of measure and temporal dimensions. We found that consistent terminology, clear and complete reporting of participation definition and systematic documentation of coverage by invitation were lacking. Further, adherence to definitions proposed in the 2010 European Guidelines for Quality Assurance in Colorectal Cancer Screening was suboptimal. Ineligible individuals represented 1% to 15% of invitations, and variable criteria for ineligibility yielded differences in participation estimates that could obscure the interpretation of colorectal cancer screening participation internationally. Excluding ineligible individuals from the reference population enhances comparability of participation measures. Standardised measures of cumulative participation to compare screening protocols with different intervals and inclusion of time since invitation in definitions are urgently needed to improve international comparability of colorectal cancer screening participation. Recommendations to improve comparability of participation indicators in cancer screening interventions are made.

The relationship between HRM practices and organizational commitment of knowledge workers. Facts obtained from Swiss SMEs

This paper explores the effects of human resource management (HRM) practices in Swiss small -to-medium enterprises (SMEs). More specifically, the main objective of this study is to assess the impacts of HRM practices developed in Swiss SMEs upon the commitment of knowledge workers. Using data from a survey of over 198 knowledge workers, this study shows the importance of looking closer at HRM practices and, furthermore, to really investigate the impacts of the different HRM practices on employees' commitment. Results show, for example, that organisational support, procedural justice and the reputation of the organisation may clearly influence knowledge workers' commitment, whereas other HRM practices such as involvement in the decision-making, skills management or even the degree of satisfaction with pay do not have any impact on knowledge workers' commitment.

Epidemiology of leishmaniasis in Ecuador: current status of knowledge - A review

Although leishmaniasis is regarded as a significant health problem in Ecuador by the Ministry of Health, and the incidence has increased over the last years, an official map on the geographic distribution of disease and sand fly vectors or a control strategy do not exist yet. This article reviews the current situation based on published information to improve our knowledge and understand the epidemiological situation of leishmaniasis in Ecuador in order to help future research and to develop a national control strategy. The disease is endemic in most provinces throughout Pacific coastal region, Amazonian lowlands, and some inter-Andean valleys with a total 21,805 cases reported during 1990-2003. Whereas cutaneous leishmaniasis (CL) is found throughout Ecuador, mucocutaneous leishmaniasis (MCL) appears to be restricted to the Amazon region; one, parasitologically unconfirmed case of visceral form was reported in 1949. Most human infections are caused by Leishmania (Viannia) spp., which is distributed in the subtropical and tropical lowlands; infections due to L. (Leishmania) spp. are found in the Andean highlands and in the Pacific lowlands as well. The proven vectors are Lutzomyia trapidoi and Lu. ayacuchensis. Canis familiaris, Sciurus vulgaris, Potos flavus, and Tamandua tetradactyla have been found infected with Leishmania spp. It is estimated that around 3000-4500 people may be infected every year, and that 3.1 to 4.5 millions people are estimated to be at risk of contracting leishmaniasis.

A Kilkenny Post-primary School Survey: A Survey of Knowledge, Attitudes and Behaviour Relevant to Noncommunicable Disease

The Kilkenny post-primary school survey was carried out in the spring of 1987 on a stratified random sample of 445 post-primary school children in county Kilkenny. The study was designed as the basis for evaluation of the Kilkenny Health Project's school health education programme. The study examined knowledge, attitudes and behaviour relevant to non-communicable disease. The results showed that levels of adolescent alcohol and tobacco use were similar to those found in neighbouring countries. Smoking and drinking increased during adolescence and were more prevalent in males. Physical activity decreased throughout adolescence and a high intake of 'snack' foods was found. Health related knowledge levels were high but were not related to behaviour; however attitudes were found to be consistent with behaviour. These and other results are discussed. Literature relevant to school health education and the aetiology of non-communicable disease is described, with particular reference to Ireland. The evidence supporting health promotion intervention programmes against non-communicable disease is examined and WHO and Irish policies on health promotion outlined. The importance of health and disease prevention programmes commencing in youth is emphasised and the suitability and efficacy of school health education programmes are noted. A number of school health education programmes world-wide are described. The role of the community physician in relation to such programmes is discussed. Finally recommendations are made and areas for further research are made.This resource was contributed by The National Documentation Centre on Drug Use.

Sorting out measures and definitions of screening participation to improve comparability : the example of colorectal cancer.

Participation is a key indicator of the potential effectiveness of any population-based intervention. Defining, measuring and reporting participation in cancer screening programmes has become more heterogeneous as the number and diversity of interventions have increased, and the purposes of this benchmarking parameter have broadened. This study, centred on colorectal cancer, addresses current issues that affect the increasingly complex task of comparing screening participation across settings. Reports from programmes with a defined target population and active invitation scheme, published between 2005 and 2012, were reviewed. Differences in defining and measuring participation were identified and quantified, and participation indicators were grouped by aims of measure and temporal dimensions. We found that consistent terminology, clear and complete reporting of participation definition and systematic documentation of coverage by invitation were lacking. Further, adherence to definitions proposed in the 2010 European Guidelines for Quality Assurance in Colorectal Cancer Screening was suboptimal. Ineligible individuals represented 1% to 15% of invitations, and variable criteria for ineligibility yielded differences in participation estimates that could obscure the interpretation of colorectal cancer screening participation internationally. Excluding ineligible individuals from the reference population enhances comparability of participation measures. Standardised measures of cumulative participation to compare screening protocols with different intervals and inclusion of time since invitation in definitions are urgently needed to improve international comparability of colorectal cancer screening participation. Recommendations to improve comparability of participation indicators in cancer screening interventions are made.

Luck and the control theory of knowledge

The dissertation accomplishes two aims: 1) to diagnose what prevents true beliefs from being knowledge; 2) to give an positive account of knowledge. Concerning the first aim, it offers an account of the notion of luck. It defends the view that luck is a form of risk and distinguishes two types of luck. Then, it applies the account to the problem of epistemic luck and distinguishes, accordingly, two types of epistemic luck. It is argued that these two types of epistemic luck explain the whole range of cases of not-known true belief. Concerning the second aim, the dissertation advances an account of knowledge in terms of the notion of cognitive control that deals with the two forms of epistemic luck distinguished.

Indicator taxa of benthic diatom communities: a case study in Mediterranean streams

A key issue in the implementation of the Water Framework Directive is the classification of streams and rivers using biological quality parameters and type-specific reference conditions. Four groups of stream types were defined in NE Spain on the basis of 152 diatom samples by means of detrended correspondence analysis and classification techniques. Diatom analysis was restricted to epilithic taxa, and the sites included gradients ranging from near-natural streams to sites with poor ecological quality. The main gradient shows a clear separation of sites in relation to the degree of human influence: polluted streams (mainly located in the lowlands) differ from streams in mountainous areas and in the Pyrenees. A second gradient is related to physiographical features. Headwater streams can be distinguished by their catchment geology. The type-specific diatom taxa for the stream types studied were determined by using indicator species analysis (IndVal). The type-specific taxa from near-natural streams are coincident with the indicator taxa for high ecological status. Human impact reduced the typological heterogeneity of the diatom community composition. Overall, the diatom communities in NE Spain exhibit a regional distribution pattern that closely corresponds with that observed in river systems elsewhere. Physiographical differences are only evident in undisturbed sites, while nutrient enrichment and other human disturbances may mask the regional differences in the distribution of diatom communities