The quality of rapid HIV testing in South Africa: an assessment of testers’ compliance.

Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa. Method: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a means of data collection. In total, 63 HCT sites (one HIV tester per site) were included in the survey assessing qualification, training, testing practices and attitudes towards rapid tests. Quantitative data was analysed using descriptive statistics and qualitative data was content analysed. Results: Of the 63 HIV testers, 20.6% had a nursing qualification, 14.3% were professional counsellors, 58.7% were lay HIV counsellors and testers and 6.4% were from other professions. Most HIV testers (87.3%) had had a formal training in testing, which ranged between 10-14 days, while 6 (9.5%) had none. Findings revealed sub-standard practices in relation to testing. These were mainly related to non-adherence to testing algorithms, poor external quality control practices, poor handling and communication of discordant results. Conclusion: Quality of HIV rapid testing may be highly compromised through poor adherence to guidelines as observed in our study.

Política pública para o idoso : um estudo da cidadania no Grupo Cabelos de Neve do Programa Conviver em Campina Grande-PB

The main objective of the study about the citizenship development in elderly attended by the Conviver Program of the City Hall of Campina Grande in Paraiba, Brazil was to evaluate how the actions of the Program contribute for the citizenship practice according to the users. The Citizenship analyzed is the existence of political, civil and social rights according to Marshall. For that it was utilized a descriptive research and a study of case based on technical procedure. The research was settled by the people who are benefited by the Conviver Program of the Snow Hair Group and the sample was formed by the active participants that it is in the Group for over ten years, corresponding to a total of ten elderly. For the data collection was utilized basic questionnaire in function of the low schooling of the interviewed, according to Marshall (2002) theory about the citizenship construction from each person. It was utilized the methodological procedure proposed by Bardin (2006), categorical analysis, in the qualitative data analysis, that was divided in four parts. In relation to Political Rights, noted that the program has stimulated your Watched on the exercise of voting and being voted. On the Civil Rights was observed that the Program has given incentive to actions which provide the users the justice rights in and in occupational activities as a job. In relation to Social Rights it was observed that the Conviver Program has contributed in order that its users can lead their lives according to the standards imposed by the society, which have being failed in the education area. As for the type of citizenship it was verified that the Program has given incentive to the served users, becoming more evidence on the speech basis

Étude d’évaluabilité et évaluation des processus et des effets d’un programme de prévention de l’usage de substances psychoactives lors de la transition primaire-secondaire

La mise en œuvre d’activités de prévention de la consommation de substances psychoactives (SPA) (tabac, alcool et cannabis) en milieu scolaire est une stratégie couramment utilisée pour rejoindre un grand nombre de jeunes. Ces activités s’inspirent, soit de programmes existant, soit d’innovations dictées par le contexte d’implantation ou l’existence de données de recherche. Dans un cas comme dans l’autre, l’évaluation de ces programmes représente la meilleure voie pour mesurer leur efficacité et/ou connaître comment ceux-ci sont implantés. C’est cet impératif qui a motivé une commission scolaire du Québec a recommandé l’évaluation de l’Intervention en Réseau (IR), un programme développé en vue de retarder l’âge d’initiation et de réduire la consommation problématique de SPA chez les élèves. Ce programme adopte une approche novatrice avec pour principal animateur un intervenant pivot (IP) qui assure le suivi des élèves de la 5e année du primaire jusqu’en 3e secondaire. Inspiré des modèles en prévention de la santé et de l’Approche École en santé (AES), le rôle de l’IP ici se démarque de ceux-ci. Certes, il est l’interface entre les différents acteurs impliqués et les élèves mais dans le cadre du programme IR, l’IP est intégré dans les écoles primaires et secondaires qu’il dessert. C’est cet intervenant qui assure la mobilisation des autres acteurs pour la mise en œuvre des activités. Cette thèse vise à rendre compte de ce processus d’évaluation ainsi que des résultats obtenus. L’approche d’évaluation en est une de type participatif et collaboratif avec des données quantitatives et qualitatives recueillies par le biais de questionnaires, d’entrevues, de groupes de discussion, d’un journal de bord et de notes de réunions. Les données ont été analysées dans le cadre de trois articles dont le premier concerne l’étude d’évaluabilité (ÉÉ) du programme. Les participants de cette ÉÉ sont des acteurs-clés du programme (N=13) rencontrés en entrevues. Une analyse documentaire (rapports et journal de bord) a également été effectuée. Cette ÉÉ a permis de clarifier les intentions des initiateurs du programme et les objectifs poursuivis par ces derniers. Elle a également permis de rendre la théorie du programme plus explicite et de développer le modèle logique, deux éléments qui ont facilité les opérations d’évaluation qui ont suivi. Le deuxième article porte sur l’évaluation des processus en utilisant la théorie de l’acteur-réseau (TAR) à travers ses quatre moments du processus de traduction des innovations (la problématisation, l’intéressement, l’enrôlement et la mobilisation des alliés), l’analyse des controverses et du rôle des acteurs humains et non-humains. Après l’analyse des données obtenues par entrevues auprès de 19 informateurs-clés, les résultats montrent que les phases d’implantation du programme passent effectivement par les quatre moments de la TAR, que la gestion des controverses par la négociation et le soutien était nécessaire pour la mobilisation de certains acteurs humains. Cette évaluation des processus a également permis de mettre en évidence le rôle des acteurs non-humains dans le processus d’implantation du programme. Le dernier article concerne une évaluation combinée des effets (volet quantitatif) et des processus (volet qualitatif) du programme. Pour le volet quantitatif, un devis quasi-expérimental a été adopté et les données ont été colligées de façon longitudinale par questionnaires auprès de 901 élèves de 5e et 6e année du primaire et leurs enseignants de 2010 à 2014. L’analyse des données ont montré que le programme n’a pas eu d’effets sur l’accessibilité et les risques perçus, l’usage problématique d’alcool et la polyconsommation (alcool et cannabis) chez les participants. Par contre, les résultats suggèrent que le programme pourrait favoriser la réduction du niveau de consommation et retarder l’âge d’initiation à l’alcool et au cannabis. Ils suggèrent également un effet potentiellement positif du programme sur l’intoxication à l’alcool chez les élèves. Quant au volet qualitatif, il a été réalisé à l’aide d’entrevues avec les intervenants (N=17), de groupes de discussion avec des élèves du secondaire (N=10) et d’une analyse documentaire. Les résultats montrent que le programme bénéficie d’un préjugé favorable de la part des différents acteurs ayant participé à l’évaluation et est bien acceptée par ces derniers. Cependant, le roulement fréquent de personnel et le grand nombre d’écoles à suivre peuvent constituer des obstacles à la bonne marche du programme. En revanche, le leadership et le soutien des directions d’écoles, la collaboration des enseignants, les qualités de l’IP et la flexibilité de la mise en œuvre sont identifiés comme des éléments ayant contribué au succès du programme. Les résultats et leur implication pour les programmes et l’évaluation sont discutés. Enfin, un plan de transfert des connaissances issues de la recherche évaluative est proposé.

Proteômica diferencial da Chromobacterium violaceum em resposta ao estresse oxidativo induzido por peróxido de hidrogênio

The β-proteobacterium Chromobacterium violaceum is a Gram-negative, free-living, saprophytic and opportunistic pathogen that inhabits tropical and subtropical ecosystems among them, in soil and water of the Amazon. It has great biotechnological potential, and because of this potential, its genome was completely sequenced in 2003. Genome analysis showed that this bacterium has several genes with functions related to the ability to survive under different kinds of environmental stresses. In order to understand the physiological response of C. violaceum under oxidative stress, we applied the tool of shotgun proteomics. Thus, colonies of C. violaceum ATCC 12472 were grown in the presence and absence of 8 mM H2O2 for two hours, total proteins were extracted from bacteria, subjected to SDS-PAGE, stained and hydrolysed. The tryptic peptides generated were subjected to a linear-liquid chromatography (LC) followed by mass spectrometer (LTQ-XL-Orbitrap) to obtain quantitative and qualitative data. A shotgun proteomics allows to compare directly in complex samples, differential expression of proteins and found that in C. Violaceum, 131 proteins are expressed exclusively in the control condition, 177 proteins began to be expressed under oxidative stress and 1175 proteins have expression in both conditions. The results showed that, under the condition of oxidative stress, this bacterium changes its metabolism by increasing the expression of proteins capable of combating oxidative stress and decreasing the expression of proteins related processes bacterial growth and catabolism (transcription, translation, carbon metabolism and fatty acids). A tool with of proteomics as an approach of integrative biology provided an overview of the metabolic pathways involved in the response of C. violaceum to oxidative stress, as well as significantly amplified understanding physiological response to environmental stress. Biochemical and "in silico" assays with the hypothetical ORF CV_0868 found that this is part of an operon. Phylogenetic analysis of superoxide dismutase, protein belonging to the operon also showed that the gene is duplicated in genome of C. violaceum and the second copy was acquired through a horizontal transfer event. Possibly, not only the SOD gene but also all genes comprising this operon were obtained in the same manner. It was concluded that C. violaceum has complex, efficient and versatile mechanisms in oxidative stress response

Aceitação e uso de ambiente virtual de aprendizagem no contexto de um curso de capacitação para servidores públicos

This study aimed to examine how students perceives the factors that may influence them to attend a training course offered in the distance virtual learning environment (VLE) of the National School of Public Administration (ENAP). Thus, as theoretical basis it was used the Unified Theory of Acceptance and Use of Technology (UTAUT), the result of an integration of eight previous models which aimed to explain the same phenomenon (acceptance/use of information technology). The research approach was a quantitative and qualitative. To achieve the study objectives were made five semi-structured interviews and an online questionnaire (websurvey) in a valid sample of 101 public employees scattered throughout the country. The technique used to the analysis of quantitative data was the structural equation modeling (SEM), by the method of Partial Least Square Path Modeling (PLS-PM). To qualitative data was the thematic content analysis. Among the results, it was found that, in the context of public service, the degree whose the individual believes that the use of an AVA will help its performance at work (performance expectancy) is a factor to its intended use and also influence its use. Among the results, it was found that the belief which the public employee has in the use of a VLE as a way to improve the performance of his work (performance expectation) was determinant for its intended use that, in turn, influenced their use. It was confirmed that, under the voluntary use of technology, the general opinion of the student s social circle (social influence) has no effect on their intention to use the VLE. The effort expectancy and facilitating conditions were not directly related to the intended use and use, respectively. However, emerged from the students speeches that the opinions of their coworkers, the ease of manipulate the VLE, the flexibility of time and place of the distance learning program and the presence of a tutor are important to their intentions to do a distance learning program. With the results, it is expected that the managers of the distance learning program of ENAP turn their efforts to reduce the impact of the causes of non-use by those unwilling to adopt voluntarily the e-learning, and enhance the potentialities of distance learning for those who are already users

Retour post-isolement en milieu psychiatrique : développement, implantation et évaluation d’une intervention en soins aigus

L’isolement avec ou sans contention (IC) en milieu psychiatrique touche près d’un patient sur quatre au Québec (Dumais, Larue, Drapeau, Ménard, & Giguère-Allard, 2011). Il est pourtant largement documenté que cette pratique porte préjudice aux patients, aux infirmières et à l’organisation (Stewart, Van der Merwe, Bowers, Simpson, & Jones, 2010). Cette mesure posant un problème éthique fait l’objet de politiques visant à la restreindre, voire à l’éliminer. Les études sur l’expérience de l’isolement du patient de même que sur la perception des infirmières identifient le besoin d'un retour sur cet évènement. Plusieurs équipes de chercheurs proposent un retour post-isolement (REPI) intégrant à la fois l’équipe traitante, plus particulièrement les infirmières, et le patient comme intervention afin de diminuer l’incidence de l’IC. Le REPI vise l’échange émotionnel, l’analyse des étapes ayant mené à la prise de décision d’IC et la projection des interventions futures. Le but de cette étude était de développer, implanter et évaluer le REPI auprès des intervenants et des patients d’une unité de soins psychiatriques aigus afin d’améliorer leur expérience de soins. Les questions de recherche étaient : 1) Quel est le contexte d’implantation du REPI? 2) Quels sont les éléments facilitants et les obstacles à l’implantation du REPI selon les patients et les intervenants? 3) Quelle est la perception des patients et des intervenants des modalités et retombées du REPI?; et 4) L’implantation du REPI est-elle associée à une diminution de la prévalence et de la durée des épisodes d’IC? Cette étude de cas instrumentale (Stake, 1995, 2008) était ancrée dans une approche participative. Le cas était celui de l’unité de soins psychiatriques aigus pour premier épisode psychotique où a été implanté le REPI. En premier lieu, le développement du REPI a d’abord fait l’objet d’une documentation du contexte par une immersion dans le milieu (n=56 heures) et des entretiens individuels avec un échantillonnage de convenance (n=3 patients, n=14 intervenants). Un comité d’experts (l’étudiante-chercheuse, six infirmières du milieu et un patient partenaire) a par la suite développé le REPI qui comporte deux volets : avec le patient et en équipe. L’évaluation des retombées a été effectuée par des entretiens individuels (n= 3 patients, n= 12 intervenants) et l’examen de la prévalence et de la durée des IC six mois avant et après l’implantation du REPI. Les données qualitatives ont été examinées selon une analyse thématique (Miles, Huberman, & Saldana, 2014), tandis que les données quantitatives ont fait l’objet de tests descriptifs et non-paramétriques. Les résultats proposent que le contexte d’implantation est défini par des normes implicites et explicites où l’utilisation de l’IC peut générer un cercle vicieux de comportements agressifs nourris par un profond sentiment d’injustice de la part des patients. Ceux-ci ont l’impression qu’ils doivent se conformer aux attentes du personnel et aux règles de l’unité. Les participants ont exprimé le besoin de créer des opportunités pour une communication authentique qui pourrait avoir lieu lors du REPI, bien que sa pratique soit variable d’un intervenant à un autre. Les résultats suggèrent que le principal élément ayant facilité l’implantation du REPI est l’approche participative de l’étude, alors que les obstacles rencontrés relèvent surtout de la complexité de la mise en œuvre du REPI en équipe. Lors du REPI avec le patient, les infirmières ont pu explorer ses sentiments et son point de vue, ce qui a favorisé la reconstruction de la relation thérapeutique. Quant au REPI avec l’équipe de soins, il a été perçu comme une opportunité d’apprentissage, ce qui a permis d’ajuster le plan d’intervention des patients. Suite à l’implantation du REPI, les résultats ont d’ailleurs montré une réduction significative de l’utilisation de l’isolement et du temps passé en isolement. Les résultats de cette thèse soulignent la possibilité d’outrepasser le malaise initial perçu tant par le patient que par l’infirmière en systématisant le REPI. De plus, cette étude met l’accent sur le besoin d’une présence authentique pour atteindre un partage significatif dans la relation thérapeutique, ce qui est la pierre d’assise de la pratique infirmière en santé mentale. Cette étude contribue aux connaissances sur la prévention des comportements agressifs en milieu psychiatrique en documentant le contexte dans lequel se situe l’IC, en proposant un REPI comportant deux volets de REPI et en explorant ses retombées. Nos résultats soutiennent le potentiel du développement d’une prévention tertiaire qui intègre à la fois la perspective des patients et des intervenants.

Resilience and the cultural landscape : the case of the Lower Ninth Ward after Hurricane Katrina

Le but de cette recherche est d’évaluer l’importance du paysage culturel dans la résilience des communautés urbaines post-catastrophes. Ce travail se concentre sur le quartier du Lower Ninth Ward dans la ville de La Nouvelle-Orléans (États-Unis) après le passage de l’ouragan Katrina en 2005. Les catastrophes naturelles prennent une envergure et causent des dommages considérables lorsqu’elles touchent des villes. La reconstruction post -désastre est donc très dispendieuse pour les villes et les gouvernements, d’autant que certaines régions sont dévastées au point qu’elles doivent être reconstruites au complet. Cependant, le coût le plus lourd à assumer reste celui en vies humaines et si rebâtir les éléments concrets d’une ville est une tâche difficile à entreprendre, reconstruire une communauté est considérablement plus complexe. Dans le but de comprendre une telle démarche, cette recherche se concentre sur les éléments intangibles, comme l’attachement au lieu et les réseaux sociaux, dont une communauté a besoin pour se reconstituer de façon durable et résiliente. Le concept de résilience est très contesté dans la littérature et plusieurs chercheurs se sont essayés à le mesurer. Cette recherche adopte une perspective critique sur le concept et le revisite d’un point de vue holistique pour mettre en lumière sa complexité. Cette démarche permet de remettre en question l’importance de mesurer un concept finalement en perpétuelle redéfinition dans le temps et selon les échelles géographiques. De plus, en établissant une relation entre résilience et paysage culturel, il a été possible de mieux comprendre la complexité de la résilience. Touchant à plusieurs disciplines (architecture de paysage, urbanisme et sociologie), cette recherche utilise une méthodologie qui reflète son aspect multidisciplinaire : les méthodes mixtes. Ces dernières permettent la collecte de données quantitatives et qualitatives qui produisent une vue globale de la situation post-Katrina à travers le regroupement de recensions statistiques, d’observations de terrain et d’articles de journaux. Parallèlement, des entretiens ont été réalisés avec des résidents du quartier ainsi qu’avec des professionnels pour mieux comprendre les différents points de vue. Cette méthodologie a permis de produire des résultats au niveau du cas d’étude autant qu’au niveau théorique. La recherche valide l’importance de prendre en compte le paysage culturel dans les situations post-catastrophes, (en particulier) dans la mesure où il s’agit d’un élément souvent négligé par les urbanistes et les acteurs locaux. En effet, les éléments constitutifs du paysage culturel tels que l’attachement au lieu et les réseaux sociaux, participent d’un sentiment d'appartenance (« home ») et d’une volonté, pour les résidents, de reconstruire leurs habitations, leur communauté ainsi que leur quartier. Toutefois, il faut reconnaître que ces éléments ne suffisent pas à retrouver ce qu’ils ont perdu. Ainsi, l’étude du paysage culturel permet non seulement de mieux comprendre la complexité de la résilience, mais démontre également que cette dernière est une construction sociale.

Community satisfaction with indoor residue spraying for Malaria control in Karonga, Northern Malawi

Background The Malawi National Malaria Control Program conducted Indoor Residual Spraying (IRS) in 2010 and 2013 in selected hot districts along the valleys including Karonga, but no study has been done to measure community satisfaction levels in these areas. Aim To assess satisfaction levels of community with IRS in both rural and urban settings, in Karonga district. Methods A cross-sectional study was conducted in urban village of Mwahimba and rural village of Fundi. Qualitative and quantitative data was collected from households’ representatives through Focus Group Discussions (FGDs) using De Wets’s Schutte tool. Qualitative data was analysed using thematic analysis while numbers and percentages were generated using Microsoft excel. Results Overall level of satisfaction in Fundi was estimated at 69% while that of Mwahimba was at 60.9%. In Fundi village, 66.1 % (37) of the household representatives were satisfied while in Mwahimba village, 60.7 % (34) were satisfied with the IRS programme. Factors that led to satisfaction were minimal adverse effects of the chemical on people after spraying, killing of other insects, sprayer’ courtesy and good communication. Factors behind dissatisfaction include: short residual effect of the chemical used, over-dilution of the chemical and minimal community involvement. Conclusion Despite finding high satisfaction levels in rural village than in an urban village, overall all the villages reported low levels of satisfaction with IRS due to various factors some of which common to both villages. Karonga District Health Office needs to involve the community in the process of spraying by recruiting sprayers from the target area and also explaining the purpose of dilution and the dilution factor to community members.

The quality of care of diabetic patients in rural Malawi: A case of Mangochi district

Background Diabetes mellitus is a global public health problem. In Malawi, the prevalence of diabetes is 5.6% but the quality of care has not been well studied. Objective The aim of this study was to assess the quality of care offered to diabetic patients in Mangochi district. Methods This was a cross sectional descriptive study. Quantitative data were collected using a questionnaire from a sample of 75 diabetic patients (children and adults) who attended the Diabetes Clinic at Mangochi District Hospital between 20012 and 2013. Qualitative data were also collected using semi-structured interviews with eight Key Informants from among the District Health Management Team. Frequencies and cross-tabulation were obtained from the quantitative data. Patients’ master cards were checked to validate results. Clinical knowledge about diabetes, care practices and resources were the themes analysed from the qualitative data. Results Among the 75 participants interviewed, 46 were females and 29 males. The overall mean age was 48.3 years (45.6 for females and 53.3 for males). More than half of patients had little or no information about diabetes (40.0 % (n=30) and 22.7 (n=17) respectively. The majority of patients were taking their medicines regularly 98.7% (n=74). Only 17.3% (n=13) reported having their feet inspected regularly. Fifty-six percent of patients were satisfied about services provision. Some nurses and clinicians were trained on diabetes care but most of them left. Guidelines on diabetes management were not accessible. There were shortages in medicines (e.g. soluble insulin) and reagents. Information Education and Communication messages were offered through discussions, experiences sharing and posters. Conclusion Quality of diabetes care provided to diabetic patients attended to Mangochi hospital was sub-optimal due to lack of knowledge among patients and clinicians and resources. More efforts are needed towards retention of trained staff, provision of pharmaceutical and laboratory resources and health education.

A implementação de ações de integração na segurança pública: o caso das polícias civil e militar do Rio Grande do Norte

The research aimed to understand the challenges for the implementation of the proposed integration between the Civil Police and the Military Police in Rio Grande do Norte to the proposals of the SUSP. This study aimed to explore the gap with regard to the deepening of the possible causes that may hinder the implementation of integrated working between the police in public security, through a specific analysis on the state of Rio Grande do Norte. Was based on a theoretical framework that includes policies: general concepts, the steps of a public policy, the implementation stage , public security : conceptual definitions, policies on security in Brazil, the structure of public security in Brazil and systems police, Military Police x Civil Police: Roles and conflicts , integrating public security: the challenges to be overcome, the Unified public Safety (SUSP) and the main difficulties in the integration of the police. Being classified as to the purposes as an exploratory research on how to approach ranks as qualitative. The research unit was the Center for Integrated Operations Public Safety (CIOSP) through three subjects who were the chief CIOSP, the representative of the military police acting with the CIOSP, and representative civil police also active with the CIOSP. These subjects were chosen because of the understanding that individuals occupying senior positions would have more ability to respond to questions that guide the research problem. Data were collected through a set of interviews, qualitative data analysis was performed based content analysis, based on the definition of categories of analysis, gated time cross. With the results, it was revealed that the main problems of integration between the state police are treatment protocols, lack of political will and lack of infrastructure. The relationship between the Military Police and Civil Police in Rio Grande do Norte has differing cultural aspect, but can be considered as good value, professionalism and integrated operations. The implementation of CIOSP-RN followed the characteristics of the top-down model, the main difficulties in implementing the proposals of the SUSP, lack of own resources, the lack of standardization in public safety and the lack of professional training of public safety. It was concluded that with respect to the challenges to the implementation of the proposed integration between the Civil Police and the Military Police in Rio Grande do Norte to the proposals of the SUSP, the actions follow the characteristics of the top-down model, with no autonomy of administrators public to say in decisions, which restricts the view of the public safety of the state

Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation the medical profession and other health-related occupations. In this paper we address this gap by considering the experience of newly instituted general practitioners (family physicians) with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and GPs—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.

FERTILISER CREDIT AND AGROECOLOGICAL USE OF ORGANIC SOIL AMENDMENTS IN NORTHERN GHANA

Contemporary African agricultural policy embodies the African Green Revolution’s drive towards modernisation and commercialisation. Agroecologists have criticised this movement on ecological, social and political grounds. Northern Ghanaian fertiliser credit schemes provide a good example through which these critiques can be examined in a context where agricultural policy reflects the African Green Revolution’s ideals. This study aimed to determine the relationship of such credit schemes to farmers’ use of organic amendments, elucidate other factors related to organic amendment use, and comment on the relevance of this modernisation policy and its relationship to agroecology. A first research phase employed semi-structured key informant interviews. Qualitative data from these informed construction of a semi-structured questionnaire that was used in a survey of 205 farmers. Multistage sampling purposively identified five villages and selected farmers within who had joined government and donor-funded fertiliser credit schemes. The use of organic and inorganic amendments was compared to that of peers who had not taken part in such schemes. Quantitative data were used in binomial logistic regression, inferential and descriptive statistics. Qualitative data were content analysed. Credit group membership was associated with higher fertiliser application and yield, but had little influence on the extent of commercialisation. Farmers who applied organic amendments were 40% less likely to belong to a fertiliser credit scheme than not, indicating substitution between organic and inorganic fertilisers. Organic amendments were 40% more likely to be applied to compound farms than outfields and six times more likely to be applied by household heads than other household members. However, household heads also preferentially joined credit groups. This was part of an agroecological soil fertility management strategy. Household heads appreciated the soil moisture retention properties of organic amendments, and applied them to compound farms to reduce risk to their household food supply in a semi-arid environment. They simultaneously accessed fertiliser to enhance this household provisioning strategy. They appreciated the increased yields this achieved, yet complained that the repayment terms of credit schemes were unfair, fertiliser did not enhance yields in dry conditions and fertilisers were supplied late. Farmers’ use of credited fertiliser alongside their existing agroecological strategy is helpful to the extent that it raises yields, yet is problematic in that it conflicts with risk-reduction strategies based on organics. There is some potential for modernised and agroecological management paradigms to coexist. For fertiliser credit to play a role in this, schemes must use fairer repayment terms and involve a focus on simultaneous use of organic amendments.

Análise bioética do uso de artes expressivas no cuidado oncológico infantil em hospital público de Pernambuco

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Bioética, 2015.

A importância da figura paterna na Relação mãe-bebé

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

O acesso e a qualidade do ensino primário público em Angola (2002-2012) : estudo de caso das províncias de Benguela, Huambo, Bié e Moxico

Doutoramento em Estudos de Desenvolvimento