Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

BACKGROUND: In northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facilitator, lowered the neonatal mortality rate by 50% during the last intervention year compared with control sites. This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members. METHODS: Four focus group discussions (FGDs) were conducted with all facilitators at different occasions and 12 FGDs with 6 intervention groups at 2 occasions. Fifteen FGDs were audio recorded, transcribed verbatim, translated into English, and analysed using thematic analysis. RESULTS: Four themes and 17 sub-themes emerged from the 3 FGDs with facilitators, and 5 themes and 18 sub-themes were identified from the 12 FGDs with the intervention groups mirroring the process of, and the barriers to, the intervention. Facilitators and intervention group members concurred that having groups representing various organisations was beneficial. Facilitators were considered important in assembling the groups. The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups. However, the facilitators' lack of health knowledge was regarded as a deficit for assisting the groups' assignments. FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public, however, they found that the intervention was a slow and time-consuming process. Perceived facilitation barriers were lack of money, inadequate support, and the function of the intervention groups. CONCLUSIONS: This qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project. The used knowledge translation intervention, where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes, has low costs and potential for being scaled-up within existing healthcare systems.

Medical students are afraid to include abortion in their future practices : in-depth interviews in Maharastra, India

BACKGROUND: Unsafe abortions are estimated to cause eight per-cent of maternal mortality in India. Lack of providers, especially in rural areas, is one reason unsafe abortions take place despite decades of legal abortion. Education and training in reproductive health services has been shown to influence attitudes and increase chances that medical students will provide abortion care services in their future practice. To further explore previous findings about poor attitudes toward abortion among medical students in Maharastra, India, we conducted in-depth interviews with medical students in their final year of education. METHOD: We used a qualitative design conducting in-depth interviews with twenty-three medical students in Maharastra applying a topic guide. Data was organized using thematic analysis with an inductive approach. RESULTS: The participants described a fear to provide abortion in their future practice. They lacked understanding of the law and confused the legal regulation of abortion with the law governing gender biased sex selection, and concluded that abortion is illegal in Maharastra. The interviewed medical students' attitudes were supported by their experiences and perceptions from the clinical setting as well as traditions and norms in society. Medical abortion using mifepristone and misoprostol was believed to be unsafe and prohibited in Maharastra. The students perceived that nurse-midwives were knowledgeable in Sexual and Reproductive Health and many found that they could be trained to perform abortions in the future. CONCLUSIONS: To increase chances that medical students in Maharastra will perform abortion care services in their future practice, it is important to strengthen their confidence and knowledge through improved medical education including value clarification and clinical training.

Violence and reproductive health preceding flight from war : accounts from Somali born women in Sweden

Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden. Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied. Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war. Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and

The hand of God is over their hands (Q. 48:10) : on the notion of covenant in al-Ṭabarī’s account of Karbalāʾ

This article is an analysis of the story of the killing of Ḥusayn b. ʿAlī at Karbalāʾ in 61/680, as it is presented by Abū Jaʿfar Muḥammad b. Jarīr al-Ṭabarī (d. 310/923). The main argument is that the notion of the divine covenant, which permeates the Qur’an, constitutes a framework through which al-Ṭabarī views this event. The Qur’anic idea of the covenant is read in structural/thematic continuity with the Hebrew Bible account of the covenant between Yahweh and the Hebrew people, which has, in turn, been traced back in its basic form to Late Bronze Era treaties between rulers and their vassals.   The present study focusses on four speeches ascribed to Ḥusayn during the encounter he and his group had with the vanguard of the Kūfan army led by al-Ḥurr. These are analysed in accordance with their use of Qur’anic covenant vocabulary. They are also categorised within the broader framework of the eight standard characteristics of Ancient West Asian and Biblical covenants, as presented by George Mendenhall and Gary Herion, which have recently been developed in a Qur’anic context by Rosalind Ward Gwynne. This article argues that al-Ṭabarī’s Karbalāʾ narrative presents the pact of loyalty to Ḥusayn as a clear extension of the divine covenant.

Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Literary Love Making in Nicholas Sparks Novels: Finding the Balance Between the Writer's Life and Writer's Work in Bestselling Romantic Love

For almost a decade now Nicholas Sparks has been writing love stories. Not only has he been publishing his stories, but they have received high acclaim in each of their installments. Several of his novels have been made into major motion pictures and increased his popularity quite significantly. His status as a successful romantic fiction writer is undeniable, but the question is, why? What is it about Nicholas Sparks that makes his novels so engaging, and personally, what do I need to do as an aspiring novelist to try and acquire the same literary status? Sparks’s novels reach readers at a number of different levels, thus giving them appeal no matter the intellectual intent of the reader. Theoretically, Sparks engages reader response techniques as well as formalist processes such as “habitualization” and “defamiliarization,” while also developing engaging plot lines that represent many of the experiences from his own life. His writing is not only academically redeemable, but it is also creatively stimulating; between the two, Sparks represents the thunder and lightning combination all writers strive for while trying to achieve literary success. This project also offers a creative element in which I attempt to exemplify many of the traits discussed in the analytical sections of this document, by recreating them in a creative, fictitious fashion. Themes such as: motion versus stasis, life versus death, and the ordinary versus the extraordinary all exist within the narrative structure of my short story “Trip to Fall.” Besides these thematic elements, the creative section strives to represent the balance Sparks achieves between the experiences of his own life and the fictitious world he creates. Overall, this project delves into the life of Nicholas Sparks to better understand the inspiration for his writing at the level of form as well as content, while also paying tribute to Sparks’s style through a representation of his work in my own words.

Literary love making in Nicholas Sparks novels: Finding the balance between the writer’s life and the writer’s work in bestselling Romantic Literature

For almost a decade now Nicholas Sparks has been writing love stories. Not only has he been publishing his stories, but they have received high acclaim in each of their installments. Several of his novels have been made into major motion pictures and increased his popularity quite significantly. His status as a successful romantic fiction writer is undeniable, but the question is, why? What is it about Nicholas Sparks that makes his novels so engaging, and personally, what do I need to do as an aspiring novelist to try and acquire the same literary status? Sparks’s novels reach readers at a number of different levels, thus giving them appeal no matter the intellectual intent of the reader. Theoretically, Sparks engages reader response techniques as well as formalist processes such as “habitualization” and “defamiliarization,” while also developing engaging plot lines that represent many of the experiences from his own life. His writing is not only academically redeemable, but it is also creatively stimulating; between the two, Sparks represents the thunder and lightning combination all writers strive for while trying to achieve literary success. This project also offers a creative element in which I attempt to exemplify many of the traits discussed in the analytical sections of this document, by recreating them in a creative, fictitious fashion. Themes such as: motion versus stasis, life versus death, and the ordinary versus the extraordinary all exist within the narrative structure of my short story “Trip to Fall.” Besides these thematic elements, the creative section strives to represent the balance Sparks achieves between the experiences of his own life and the fictitious world he creates. Overall, this project delves into the life of Nicholas Sparks to better understand the inspiration for his writing at the level of form as well as content, while also paying tribute to Sparks’s style through a representation of his work in my own words.

Fire Hazard in Coconino County, Arizona

Fire is a major management issue in the southwestern United States. Three spatial models of fire risk for Coconino County, Northern Arizona. These models were generated using thematic data layers depicting vegetation, elevation, wind speed and direction, and precipitation for January (winter), June (summer), and July (start of monsoon season). ArcGIS 9.0 was used to weight attributes in raster layers to reflect their influence on fire risk and to interpolate raster data layers from point data. Final models were generated using the raster calculator in the Spatial Analyst extension of ArcGIS 9.0. Ultimately, the unique combinations of variables resulted in three different models illustrating the change in fire risk during the year.

Harold Pinter, cinema e literatura : os limites da realidade

Partindo de duas questões teóricas preliminares, uma, da representação (literária e cinematográfica)do real e do imaginário, tanto no ângulo da produção como no da sua recepção e, a outra, da articulação entre formas de expressão artísticas distintas, ou seja, da interdisciplinaridade, este trabalho examina a presença do tema relativo aos limites entre realidade e fantasia no teatro, no cinema e na literatura, centrando sua atenção na obra de Harold Pinter. Consta de duas partes, cada uma com três capítulos. Na primeira, "Os pressupostos," discute-se as questões que fornecem seu substrato teórico. A segunda é dedicada ao corpus, identificando em seu título o tema investigado: "Os limites da realidade." Quanto à questão da representação, procura-se refutar "a afirmação de que a arte seja uma imitação da realidade. Uma releitura da Poética, de Aristóteles, reforçada pela opinião de diversos estudiosos da mesma, permite afirmar que a mÍmese corresponde, isto sim, a uma representação que envolve uma construção em que elementos da realidade são organizados segundo uma verdade criada pela própria obra, de acordo com critérios inerentes a ela. Além disso, através de uma leitura de Kathryn Hume, procura-se afirmar a interação sinestésica quase que permanente dos impulsos realista e da fantasiana literatura, identificando os tipos com que a fantasia se manifesta e as técnicas usadas para sua criação. A primeira parte encerra-se com um exame do relacionamento da literatura com as artes visuais e dramáticas, relações inter-disciplinares que situam este trabalho na literatura comparada.Dentre vários autores cujas obras contribuem para tal fim, destaca-se Martin Esslin, que estabelece os limitesde cada uma das artes dramáticas, identifica contatos delas com a literatura e permite, através de uma leitura de seu estudo sobre o teatro do absurdo, seja estabelecida a evolução que liga Aristóteles a Pinter. O corpus centra-se na obra de Pinterpara o teatro e para o cinema, sem limitar-se a ela,pois são também analisadas obras de outros escritores e cineastas, estabelendo-se aproximações ou contrastes entre elas. No quarto capítulo estão agrupadas obras nas quais desponta a imposição de verdades pela força fisica ou verbal. A luta pelo poder, a expulsão de elementos estranhos, dúvidas sobre a identidade e a inter-penetrablidade arte-vida caracterizam o capítulo seguinte. A ênfase temática do sexto capítulo recai sobre as limitações impostas pela condição humana. Praticamente todas as obras expressam a impossibilidade da existência de certezas absolutas e de uma perfeita distinção dos limites da realidade. Com isso, é possível afirmar não ser o objetivo da arte reproduzir a realidade. Mesmo que o fosse, tal tentativa resultaria infrutífera devido às limitações humanas.

Com a palavra mate com angu: uma intervenção estética no município de Duque de Caxias

Nas sociedades contemporâneas a cidadania cultural é um tema a ser enfrentado ao lado da defesa por uma melhor qualidade de vida material, ambiental, econômica e social. Assim, o direito à liberdade de criação, informação, expressão da diversidade entre outros, apresentam-se como desafios e fundamentos para uma verdadeira democracia cultural.O presente trabalho encontra-se inserido no campo dos estudos de novas práticas de cidadania exercidas particularmente por movimentos culturais. Nosso objeto de pesquisa foi o cineclube Mate com Angu, localizado na Baixada Fluminense.Por meio de entrevistas temáticas, buscamos aferir como cinco integrantes do grupo formulam e realizam sua proposta de intervenção social e estética, e interagem com sua comunidade Duque de Caxias utilizando a linguagem audiovisual.Os argumentos e as práticas do Mate com Angu revelaram que embora o compromisso central do grupo seja no campo estético, suas atividades trazem implicações também nos campos político e social, influenciando a vida e a cultura da comunidade caxiense. Desse modo constatamos que suas intervenções contribuem para a ampliação do conceito de cidadania, e particularmente para a construção dos direitos culturais.

Sistema de informações para gestão ambiental

This Research Report presents the Environmental Management Information System, which has been planned for CEAMA - Center for Management and Environment. The System consists in the framework of data bases in the environment field, and the logic for information treatment. It has been developed to support current and future requirements of Center for Management and Environment in Escola de Administração de Empresas de São Paulo, Fundação Getulio Vargas (EAESP/FGV). The System was developed for Windows/Access environment and consists of a Main Data Base and a Thematic Data Base. The Main Data Base can store libraries, NGOs, Environmental Impact Reports, technical reports, companies and many other items. The Thematic one can contain several subjects related with environment, specifying the place or access form in which the data can be obtained. The Report also describes several environmental information systems, as a result of a survey that has been done as a part of the research project.

Data mining por meio de análise de redes, no contexto de filtro colaborativo

Tendo como motivação o desenvolvimento de uma representação gráfica de redes com grande número de vértices, útil para aplicações de filtro colaborativo, este trabalho propõe a utilização de superfícies de coesão sobre uma base temática multidimensionalmente escalonada. Para isso, utiliza uma combinação de escalonamento multidimensional clássico e análise de procrustes, em algoritmo iterativo que encaminha soluções parciais, depois combinadas numa solução global. Aplicado a um exemplo de transações de empréstimo de livros pela Biblioteca Karl A. Boedecker, o algoritmo proposto produz saídas interpretáveis e coerentes tematicamente, e apresenta um stress menor que a solução por escalonamento clássico.

Análise de redes em procedimentos de cooperação indireta: utilização no sistema de recomendações da Biblioteca Karl A. Boedecker

Sistemas de recomendação baseados cooperação indireta podem ser implementados em bibliotecas por meio da aplicação de conceitos e procedimentos de análise de redes. Uma medida de distância temática, inicialmente desenvolvida para variáveis dicotômicas, foi generalizada e aplicada a matrizes de co-ocorrências, permitindo o aproveitando de toda a informação disponível sobre o comportamento dos usuários com relação aos itens consultados. Como resultado formaram-se subgrupos especializados altamente coerentes, para os quais listas-base e listas personalizadas foram geradas da maneira usual. Aplicativos programáveis capazes de manipularem matrizes, como o software S-plus, foram utilizados para os cálculos (com vantagens sobre o software especializado UCINET 5.0), sendo suficientes para o processamento de grupos temáticos de até 10.000 usuários.

Empreendendo a aprendizagem: uma proposta de co-participação em sala de aula

Esta pesquisa pretendeu gerar pistas para situações do dia-a-dia dos alunos do curso de Administração, na disciplina de Psicologia, co-responsabilizando-os por sua produção e solução dos conflitos da classe. Nossa investigação centrou-se no grupo de discussão constituído por representantes (rodiziados) dos pequenos grupos da classe, apoiados pelo professor para discutir: a) dúvidas temáticas; b) sugestão para conflitos ocorridos intragrupos e intergrupos. Indagamos se: essa metodologia favoreceu a cooperação e a criatividade intergrupos e intragrupos? Como recursos auxiliares, utilizamos o sistema de monitoria/didática dos emergentes/devolutiva do processo grupal/confecção de textos pelos alunos.

Por uma teorização das organizações de produção artesanal: habilidades produtivas nos caminhos singulares do Rio de Janeiro

The purpose of this thesis is to support the argument that workmanship production centers don¿t represent just survival strategy of social groups marginal to economical structure. Workmanship organizations are productive schemes that survived, in a parallel way, to the industrialization process, although they don¿t have been considered by the organization theory. The knowledge reserve in administration, from the traditional approach to critical studies, increased concerns on industrial organizations and business arrangements. Nevertheless, it is possible to find in Teoria da Delimitação dos Sistemas Sociais, from Guerreiro Ramos, elements to comprehend workmanship organizations as: technology, scale and sustainability, cognition, space and relationship and time. The research methodology used was bibliographic, field and documental, regarding action-research. It comes to the conclusion that, at present time, to keep it as distinct productive schemes, workmanship organizations must be associated to tourism and culture. The production must be thematic, with territorial identity, creative and sustainable, by the management of local raw material.