Vocabulary and expressive morpho-syntax in individuals with Down syndrome: Links to narration.

BACKGROUND: Narrative ability is crucial for social participation in everyday and school life but involves different language abilities such as vocabulary and morpho-syntax. This is particularly difficult for individuals who display both language and cognitive impairments. Previous research has identified productive vocabulary as a possible key factor for narrative performance in individuals with Down syndrome. Considering a close connection between lexical and morpho-syntactic performance within language acquisition and the distinct impairments that individuals with Down syndrome display concerning their morpho-syntactic skills, the nature of a relation between vocabulary and narrative skills under the influence of grammatical deficits requires further investigation. METHODS: Narrations were obtained from 28 children and adolescents with Down syndrome (aged 10;0-20;1) using a non-verbal picture book. Narrative abilities were rated using the Narrative Scoring Scheme across seven narrative aspects (including macro- and microstructure). Vocabulary analyses and morpho-lexical context analyses including verb and conjunction enumerations, evaluation of verb position and MLU were conducted. Findings from the transcript analysis have been supplemented with data from standardized language measures evaluating expressive lexical and morpho-syntactic development. A multiple regression analysis was conducted to identify significant predictors for narrative outcome in the participants with Down syndrome. RESULTS: Lexical analyses revealed a high heterogeneity in production of subordinating conjunctions as a link between lexical and morpho-syntactic abilities. Comparisons of standardized and narrative data demonstrated differences in subordinate clause production depending on the elicitation setting. A multiple regression analysis identified the number of different verbs in the narrative task as the most significant predictor for narrative performance in individuals with Down syndrome. DISCUSSION AND IMPLICATIONS: The findings of this study contribute to the knowledge regarding factors that influence narrative performance in individuals with language impairment. A differentiated verb lexicon can be identified as the key ability for reaching advanced narrative skills in participants with Down syndrome. These findings are of clinical relevance for therapeutic and educational support and contribute to an understanding of the relation between strengths in vocabulary and morpho-syntactic weaknesses in individuals with Down syndrome within communicative participation.

Anticipated benefits and challenges of implementing group care in Suriname's maternity and child care sector: a contextual analysis.

BACKGROUND: Suriname is a uppermiddle-income country with a relatively high prevalence of preventable pregnancy complications. Access to and usage of high-quality maternity care services are lacking. The implementation of group care (GC) may yield maternal and child health improvements. However, before introducing a complex intervention it is pivotal to develop an understanding of the local context to inform the implementation process. METHODS: A context analysis was conducted to identify local needs toward maternity and postnatal care services, and to assess contextual factor relevant to implementability of GC. During a Rapid Qualitative Inquiry, 63 online and face-to-face semi-structured interviews were held with parents, community members, on-and off-site healthcare professionals, policy makers, and one focus group with parents was conducted. Audio recordings were transcribed in verbatim and analysed using thematic analysis and Framework Method. The Consolidated Framework for Implementation Research served as a base for the coding tree, which was complemented with inductively derived codes. RESULTS: Ten themes related to implementability, one theme related to sustainability, and seven themes related to reaching and participation of the target population in GC were identified. Factors related to health care professionals (e.g., workload, compatibility, ownership, role clarity), to GC, to recipients and to planning impact the implementability of GC, while sustainability is in particular hampered by sparse financial and human resources. Reach affects both implementability and sustainability. Yet, outer setting and attitudinal barriers of health professionals will likely affect reach. CONCLUSIONS: Multi-layered contextual factors impact not only implementability and sustainability of GC, but also reach of parents. We advise future researchers and implementors of GC to investigate not only determinants for implementability and sustainability, but also those factors that may hamper, or facilitate up-take. Practical, attitudinal and cultural barriers to GC participation need to be examined. Themes identified in this study will inspire the development of adaptations and implementation strategies at a later stage.

Contextualizing critical thinking about health using digital technology in secondary schools in Kenya: a qualitative analysis.

BACKGROUND: Good health decisions depend on one's ability to think critically about health claims and make informed health choices. Young people can learn these skills through school-based interventions, but learning resources need to be low-cost and built around lessons that can fit into existing curricula. As a first step to developing and evaluating digital learning resources that are feasible to use in Kenyan secondary schools, we conducted a context analysis to explore interest in critical thinking for health, map where critical thinking about health best fits in the curriculum, explore conditions for introducing new learning resources, and describe the information and communication technology (ICT) infrastructure available for teaching and learning. METHODS: We employed a qualitative descriptive approach. We interviewed 15 key informants, carried out two focus group discussions, observed ICT conditions in five secondary schools, reviewed seven documents, and conducted an online catalog of ICT infrastructure in all schools (n=250) in Kisumu County. Participants included national curriculum developers, national ICT officers, teachers, and national examiners. We used a framework analysis approach to analyze data and report findings. FINDINGS: Although critical thinking is a core competence in the curriculum, critical thinking about health is not currently taught in Kenyan secondary schools. Teachers, health officials, and curriculum developers recognized the importance of teaching critical thinking about health in secondary schools. Stakeholders agreed that Informed Health Choices learning resources could be embedded in nine subjects. The National Institute of Curriculum Development regulates resources for learning; the development of new resources requires collaboration and approval from this body. Most schools do not use ICT for teaching, and for those few that do, the use is limited. Implementation of Kenya's ICT policy framework for schools faces several challenges which include inadequate ICT infrastructure, poor internet connectivity, and teachers' lack of training and experience. CONCLUSION: Teaching critical thinking about health is possible within the current Kenyan lower secondary school curriculum, but the learning resources will need to be designed for inclusion in and across existing subjects. The National ICT Plan and Vision for 2030 provides an opportunity for scale-up and integration of technology in teaching and learning environments, which can enable future use of digital resources in schools. However, given the current ICT condition in schools in the country, digital learning resources should be designed to function with limited ICT infrastructure, unstable Internet access, and for use by teachers with low levels of experience using digital technology.

Continued use of retracted papers: Temporal trends in citations and (lack of) awareness of retractions shown in citation contexts in biomedicine.

We present the first database-wide study on the citation contexts of retracted papers, which covers 7,813 retracted papers indexed in PubMed, 169,434 citations collected from iCite, and 48,134 citation contexts identified from the XML version of the PubMed Central Open Access Subset. Compared with previous citation studies that focused on comparing citation counts using two time frames (i.e., preretraction and postretraction), our analyses show the longitudinal trends of citations to retracted papers in the past 60 years (1960-2020). Our temporal analyses show that retracted papers continued to be cited, but that old retracted papers stopped being cited as time progressed. Analysis of the text progression of pre- and postretraction citation contexts shows that retraction did not change the way the retracted papers were cited. Furthermore, among the 13,252 postretraction citation contexts, only 722 (5.4%) citation contexts acknowledged the retraction. In these 722 citation contexts, the retracted papers were most commonly cited as related work or as an example of problematic science. Our findings deepen the understanding of why retraction does not stop citation and demonstrate that the vast majority of postretraction citations in biomedicine do not document the retraction.

Contextual factors influencing physicians' perception of antibiotic prescribing in primary care in Germany - a prospective observational study.

BACKGROUND: Antimicrobial resistance is a worldwide challenge for health services and systems alike. To reduce the overuse of antibiotics, multifaceted interventions are often used to achieve sustainable effects. It can be assumed that these effects are influenced by contextual factors. Embedded in the cluster randomized trial ARena (Sustainable reduction of antibiotic-induced antimicrobial resistance), the aim of this present study was to identify contextual factors associated with practitioners' perceptions of antibiotic prescribing in German primary health care. METHODS: In a prospective observational study, data were generated in a three-wave survey study between January 2018 and July 2019. Analysis was performed using logistic regression models. The outcome of interest was the physician perceived impact of participating in the ARena project on decision-making regarding antibiotic prescribing, the independent variables of interest included individual characteristics, intervention arm allocation, primary care network (PCN) environment and characteristics of the medical practice. RESULTS: Forty Six point eight percent (n = 126) of participants indicated to have perceived an impact on their decision-making regarding antibiotic prescribing by participating in the ARena project. Bivariate logistic regression analyses indicated that work experience (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.006-1.103), PCN environment (OR 2.06, 95% CI 1.256-3.363), structural conditions (OR 1.66, 95% CI 1.161-2.371), environment of existing processes (OR 1.46, 95% CI 1.011-2.094), and externally defined general conditions (OR 1.57, 95% CI 1.035-2.378) were associated with physicians' perceived impact of participating in the ARena project on decision-making regarding antibiotic prescribing. In the multivariable logistic regression analysis, only work experience OR 1.05 (95% CI 1.001-1.104) continuously showed a significant influence. CONCLUSIONS: This study indicates that contextual factors at individual, practice, and system level influence physicians' perceptions of antibiotic prescribing. Longer work experience appeared to be a significant influencing factor to be considered in antimicrobial stewardship programs. TRIAL REGISTRATION: ISRCTN, ISRCTN58150046 (registered 13.09.2017).

Telehealth readiness and its influencing factors among Chinese clinical nurses: A cross-sectional study.

AIM/OBJECTIVE: This study aimed to assess telehealth readiness among clinical nurses in China and explore the factors that affect their telehealth readiness and the relationships of telehealth readiness and telehealth practice-related variables. BACKGROUND: Telehealth is a new service model that uses information and communication technology to provide professional health care services for resource-poor areas. With the global spread of COVID-19, nurses urgently need to adapt and apply telehealth technology to replace conventional face-to-face treatment. However, nurse-led telehealth services in China are currently only in the pilot phase and the readiness of clinical nurses needs to be assessed to facilitate successful telehealth implementation. DESIGN: A cross-sectional, multicentre study was undertaken with the questionnaire survey method. METHODS: Data were collected in October-December 2020 used online questionnaires. A convenience sample of 3386 nurses from 19 hospitals in China completed the Chinese version of Telehealth Readiness Assessment Tools. RESULTS: The mean score of the telehealth readiness was in the category between 61 and 80 points (mean 61.23, SD 11.61). The percentages of nurses meeting the following levels of telehealth readiness were as follows: low (49.9%), moderate (42.0%) and high (8.1%). Significantly higher domain scores were recorded for nurses in the unmarried, head of responsible nursing group. Moreover, there were positive correlations between telehealth readiness level and service experience, service willingness, mode cognition, manpower allocation and policy guidance. CONCLUSIONS: There are still many factors hindering the successful implementation of telehealth. Nursing educators should formulate telehealth education curriculum and service standards to improve the telehealth readiness of nurses.

Políticas públicas sobre violencia feminicida y feminicidio en México: una mirada desde las unidades de análisis y contexto / Políticas públicas sobre violência feminicida e feminicídio no México: um olhar das unidades de análise e contexto / Public policies on feminicide violence and femicide in Mexico: a look at the analysis and context units

El feminicidio es el asesinato de una mujer ­ o niña ­ por el hecho de ser mujer, es decir por razones de género. El término expresa la violencia extrema que se manifiesta en este acto, muchas veces perpetrado con particular crueldad, precedido de maltratos, secuestro, tortura sexual y seguido de la exposición del cadáver en el espacio público. Este texto tiene como objetivo reflexionar respecto al funcionamiento de las Unidades de Análisis y Contexto para la investigación de feminicidios, ­ creadas en el marco de las Declaratorias de Alerta de Violencia de Género en México (art. 22, LGAMVLV) ­, para observar las características jurídico-normativas, técnicas y de recursos que tienen y deberían tener de acuerdo con las recomendaciones internacionales. Sostenemos que las unidades de inteligencia y de análisis de contextos son una herramienta para la investigación criminal, que pueden funcionar para comprener el feminicidio y las violencias interseccionales en el país. A través de un análisis descriptivo y documental, privilegiamos los informes oficiales de las Unidades de Análisis y Contexto sobre violencia contra las mujeres, analizamos los principales obstáculos para la implementación de dichas unidades, y desde la perspectiva de género y pertinencia cultural, la forma y estrategias en cómo se capta la información para distinguir entre homicidio y feminicidio, y mujeres indígenas y/o afromexicanas, en un contexto de violencias estructurales y del crimen organizado

Feminicídio é o assassinato de uma mulher ­ ou menina ­ pelo fato de ser mulher, ou seja, por razões de gênero. O termo expressa a extrema violência que se manifesta neste ato, muitas vezes perpetrado com particular crueldade, precedido de maus tratos, sequestro, tortura sexual e seguido da exposição do cadáver em espaço público. O objetivo deste texto é refletir sobre o funcionamento das unidades de análise e contexto, criadas no contexto das Declarações de Alerta de Gênero no México, para observar as características jurídico-normativas, técnicas e de recursos que elas têm ou deveriam ter segundo as recomendações internacionais. Sustentamos que as unidades de inteligência e análise de contexto são uma ferramenta de investigação criminal, que pode servir para compreender o feminicídio e a violência interseccional no país. Através de uma análise descritiva e documental, privilegiamos os relatórios oficiais das unidades de análise e contexto sobre a violência contra a mulher, analisamos os principais entraves à implementação das referidas unidades e, na perspectiva da relevância cultural e de gênero, a forma e as estratégias em como as informações são coletadas para distinguir entre homicídio e feminicídio e mulheres indígenas e/ou afro-mexicanas, em um contexto de violência estrutural e crime organizado

Femicide is the murder of a woman ­ or girl ­ due to the fact of being a woman, that is, for reasons of gender. The term expresses the extreme violence that is manifested in this act, often perpetrated with particular cruelty, preceded by mistreatment, kidnapping, sexual torture and followed by the exposition of the corpse in public space. Objective: This text aims to reflect on the functioning of the Analysis and Context Units that have been created in Mexico, to observe the legal-regulatory, technical and resource characteristics that they have and should have in accordance with international recommendations. We sustain that the intelligence and context analysis units are a tool for criminal investigation, which can work to understand intersectional violence in Mexico. Through a descriptive and documentary analysis, we privilege the official reports of the Analysis and Context Units on violence against women, we analyze, based on the main obstacles to the implementation of said units, from the perspective of gender and relevance culture, as well as the way and strategies in how information is collected to distinguish between homicide and femicide, and to identify indigenous and/or Afro-Mexican women, and in a context of other structural violence and organized crime

Supporting children who have a parent with a mental illness in Tyrol: a situational analysis for informing co-development and implementation of practice changes.

BACKGROUND: A research project, which aims to improve the situation of children of parents with a mental illness (COPMI) is currently underway in the Austrian region of Tyrol. The project aims to strengthen formal and informal support structures around the child, through enhancing their village of collaborative support. Understanding the current situation in the region is vital for implementing practice change. This paper aims to gain knowledge regarding the Tyrolean societal and service provision context. METHODS: We collected qualitative (17 interviews among stakeholder and people with lived experience) and quantitative data (e.g. health insurance data) regarding overall societal characteristics, epidemiology of mental illness, currently existing services, uptake of services, and current practices and challenges of identifying and supporting COPMIs. We analysed data along eight external context dimensions: 1) professional influences, 2) political support, 3) social climate, 4) local infrastructure, 5) policy and legal climate, 6) relational climate, 7) target population, and 8) funding and economic climate. RESULTS: We identified that there is awareness of potential challenges related to COPMIs at both a professional and planning level. Additionally, there is a lack of installed support processes and standards to meet these children's needs across Tyrol. A variety of services are available both for unwell parents, as well as for families and individual family members. Yet, only one small service addresses COPMIs directly. Services fall into different sectors (education, health, social affairs) and are funded from different sources, making coordination difficult. Access varies from universal to rather restricted (i.e. through referral). The potential number of parents which could be reached in order to identify their children via adult mental health, differs considerably by setting. Societal structures indicate that the informal and voluntary sector may be a realistic source for supporting COPMIs. CONCLUSIONS: The societal structures and the current services provide a rich resource for improving identification and support of COPMIs, however considerable coordination and behaviour change efforts will be required due to the fragmentation of the system and professional cultures. The insights into the context of supporting COPMIs have been of high value for developing and implementing practice changes in the local organizations.

Telemonitoring readiness among Austrian diabetic patients: A cross-sectional validation study.

Digitalized healthcare services offer remote and cost-effective treatment of diabetes patients. Thus, the present online study analyzed the readiness to use telemonitoring among Austrian diabetes patients. We developed and validated a German version of the patient telehealth readiness assessment tool and performed quantitative context analysis of free-text comments on perceived barriers and benefits of telemonitoring. Participants (n = 41, 42.6% females) achieved a medium average readiness level for telemonitoring. The three top benefits were intensified care, shorter travel and waiting times, and better therapy adjustment. The top three barriers were data privacy issues, loss of personal communication and focus on blood sugar, and teledoctor competence. Diabetes patients represent a suitable target group for remote treatment opportunities. However, a shift from traditional face-to-face medical care to exclusive telemonitoring treatment from diagnosis to consultation and treatment requires fundamental new legal framework conditions.

A Glimpse of the First Eight Months of the COVID-19 Literature on Microsoft Academic Graph: Themes, Citation Contexts, and Uncertainties.

As scientists worldwide search for answers to the overwhelmingly unknown behind the deadly pandemic, the literature concerning COVID-19 has been growing exponentially. Keeping abreast of the body of literature at such a rapidly advancing pace poses significant challenges not only to active researchers but also to society as a whole. Although numerous data resources have been made openly available, the analytic and synthetic process that is essential in effectively navigating through the vast amount of information with heightened levels of uncertainty remains a significant bottleneck. We introduce a generic method that facilitates the data collection and sense-making process when dealing with a rapidly growing landscape of a research domain such as COVID-19 at multiple levels of granularity. The method integrates the analysis of structural and temporal patterns in scholarly publications with the delineation of thematic concentrations and the types of uncertainties that may offer additional insights into the complexity of the unknown. We demonstrate the application of the method in a study of the COVID-19 literature.

Mapping key stakeholders' position towards interdisciplinary transgender healthcare: A stakeholder analysis.

Trans individuals experience an incongruence between their sex characteristics and their gender which might cause significant distress called gender dysphoria. Gender dysphoria is commonly treated using transition-related healthcare services, like sex hormones and surgeries, ideally in interdisciplinary settings. The stakeholder environment of an interdisciplinary transgender healthcare centre (ITHC) is considered key in delivering high-quality healthcare. Therefore, a stakeholder analysis was performed seeking to improve stakeholder relationships and service quality through an evidence-based approach. Quantitative data were collected using a questionnaire administered cross-sectionally, and covering attitude towards the ITHC, influence of and influence on stakeholders, level of knowledge about the ITHC, importance of the ITHC for stakeholders and types of interests. The analysis used primary data, collected July to August 2015. N = 79 key stakeholders were identified and n = 42 (53.2%) participated in the survey. Participants were categorised analytically into four stakeholder groups: trans groups, trans health experts, healthcare system and admin departments of the ITHC. Although participants reported low values (e.g. average values on a 5-point Likert scale; importance: 2.54; influence on the ITHC: 2.43), the attitude of the four stakeholder groups towards the ITHC were positive overall. The attitudes varied, however, depending on the group, for example trans health experts and trans groups reported the highest values for most items. The results demonstrate the importance of systematically analyzing stakeholder positions in order to make appropriate policy decisions, improving stakeholder relationships and assuring long-term high-quality healthcare provision. Subsequently, an action plan was developed, focusing on the two groups with the highest values (trans health experts, trans groups). Selected measures are discussed. If stakeholders are to play their part in providing high-quality, interdisciplinary trans healthcare, they need regular information on the latest developments and recurring feedback of their interests and requirements for the ITHC.

Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs).

BACKGROUND: Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making. METHOD: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997-2018). RESULTS: Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels. CONCLUSIONS: The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed planning.

Visualizing the context of citations referencing papers published by Eugene Garfield: a new type of keyword co-occurrence analysis.

During Eugene Garfield's (EG's) lengthy career as information scientist, he published about 1500 papers. In this study, we use the impressive oeuvre of EG to introduce a new type of bibliometric networks: keyword co-occurrences networks based on the context of citations, which are referenced in a certain paper set (here: the papers published by EG). The citation context is defined by the words which are located around a specific citation. We retrieved the citation context from Microsoft Academic. To interpret and compare the results of the new network type, we generated two further networks: co-occurrence networks which are based on title and abstract keywords from (1) EG's papers and (2) the papers citing EG's publications. The comparison of the three networks suggests that papers of EG and citation contexts of papers citing EG are semantically more closely related to each other than to titles and abstracts of papers citing EG. This result accords with the use of citations in research evaluation that is based on the premise that citations reflect the cognitive influence of the cited on the citing publication.

"They take care of their own": healthcare professionals' constructions of Sami persons with dementia and their families' reluctance to seek and accept help through attributions to multiple contexts.

BACKGROUND: Norwegian government white papers have stated that the Sami population is reluctant to seek help from healthcare services and has traditions of self-help and the use of local networks. OBJECTIVE: In this article we explore healthcare professionals' discursive constructions of Sami persons with dementia and their families' reluctance to seek and accept help from healthcare services. DESIGN: The article is based on an analysis of focus group interviews with healthcare professionals (n = 18) in four municipalities in Northern Norway with multiethnic populations. A narrative context analysis, which involved an examination of sequences of discourse, was employed. RESULTS: Reluctance to seek and accept help among Sami service users and assumptions about self-support were recurring themes in the focus groups. The reluctance was attributed to macro contexts, such as socio-historical processes and cultural norms, and to micro contexts, such as individual and interpersonal factors including the healthcare professionals' cultural backgrounds and language competence. The healthcare professionals' positioning as insiders or outsiders (Sami or non-Sami) affected their attributions. CONCLUSIONS: Local healthcare professionals are at the front line for providing and assessing service users' needs for healthcare services. Consequently, their perceptions of service users' needs are pivotal for achieving equity in healthcare. The established opinion that Sami "take care of their own" and are reluctant to seek and accept help may lead to omissions or neglect. Healthcare professionals' awareness about how present encounters in healthcare settings are framed and shaped by the service users' previous and prevailing experiences of marginalisation and subordination is crucial to avoid omissions or neglect resulting from assumptions about cultural preferences. Discursively shaped boundaries and differences between groups may create the impression that the distance between the groups is too wide to traverse, which in turn may lead to further marginalisation of service users in healthcare encounters.

Understanding the Context of Learning in an Online Social Network for Health Professionals' Informal Learning.

Online social networks (OSN) enable health professionals to learn informally, for example by sharing medical knowledge, or discussing practice management challenges and clinical issues. Understanding the learning context in OSN is necessary to get a complete picture of the learning process, in order to better support this type of learning. This study proposes critical contextual factors for understanding the learning context in OSN for health professionals, and demonstrates how these contextual factors can be used to analyse the learning context in a designated online learning environment for health professionals.

Understanding the local context and its possible influences on shaping, implementing and running social accountability initiatives for maternal health services in rural Democratic Republic of the Congo: a contextual factor analysis.

BACKGROUND: Social accountability has to be configured according to the context in which it operates. This paper aimed to identify local contextual factors in two health zones in the Democratic Republic of the Congo and discuss their possible influences on shaping, implementing and running social accountability initiatives. METHODS: Data on local socio-cultural characteristics, the governance context, and socio-economic conditions related to social accountability enabling factors were collected in the two health zones using semi-structured interviews and document reviews, and were analyzed using thematic analysis. RESULTS: The contexts of the two health zones were similar and characterized by the existence of several community groups, similarly structured and using similar decision-making processes. They were not involved in the health sector's activities and had no link with the health committee, even though they acknowledged its existence. They were not networked as they focused on their own activities and did not have enough capacity in terms of social mobilization or exerting pressure on public authorities or providers. Women were not perceived as marginalized as they often occupied other positions in the community besides carrying out domestic tasks and participated in community groups. However, they were still subject to the local male dominance culture, which restrains their involvement in decision-making, as they tend to be less educated, unemployed and suffer from a lack of resources or specific skills. The socio-economic context is characterized by subsistence activities and a low employment rate, which limits the community members' incomes and increases their dependence on external support. The governance context was characterized by imperfect implementation of political decentralization. Community groups advocating community rights are identified as "political" and are not welcomed. The community groups seemed not to be interested in the health center's information and had no access to media as it is non-existent. CONCLUSIONS: The local contexts in the two health zones seemed not to be supportive of the operation of social accountability initiatives. However, they offer starting points for social accountability initiatives if better use is made of existing contextual factors, for instance by making community groups work together and improving their capacities in terms of knowledge and information.

The ChIP-Seq tools and web server: a resource for analyzing ChIP-seq and other types of genomic data.

BACKGROUND: ChIP-seq and related high-throughput chromatin profilig assays generate ever increasing volumes of highly valuable biological data. To make sense out of it, biologists need versatile, efficient and user-friendly tools for access, visualization and itegrative analysis of such data. RESULTS: Here we present the ChIP-Seq command line tools and web server, implementing basic algorithms for ChIP-seq data analysis starting with a read alignment file. The tools are optimized for memory-efficiency and speed thus allowing for processing of large data volumes on inexpensive hardware. The web interface provides access to a large database of public data. The ChIP-Seq tools have a modular and interoperable design in that the output from one application can serve as input to another one. Complex and innovative tasks can thus be achieved by running several tools in a cascade. CONCLUSIONS: The various ChIP-Seq command line tools and web services either complement or compare favorably to related bioinformatics resources in terms of computational efficiency, ease of access to public data and interoperability with other web-based tools. The ChIP-Seq server is accessible at http://ccg.vital-it.ch/chipseq/ .

NAD homeostasis in the bacterial response to DNA/RNA damage.

In mammals, NAD represents a nodal point for metabolic regulation, and its availability is critical to genome stability. Several NAD-consuming enzymes are induced in various stress conditions and the consequent NAD decline is generally accompanied by the activation of NAD biosynthetic pathways to guarantee NAD homeostasis. In the bacterial world a similar scenario has only recently begun to surface. Here we review the current knowledge on the involvement of NAD homeostasis in bacterial stress response mechanisms. In particular, we focus on the participation of both NAD-consuming enzymes (DNA ligase, mono(ADP-ribosyl) transferase, sirtuins, and RNA 2'-phosphotransferase) and NAD biosynthetic enzymes (both de novo, and recycling enzymes) in the response to DNA/RNA damage. As further supporting evidence for such a link, a genomic context analysis is presented showing several conserved associations between NAD homeostasis and stress responsive genes.

Genome-wide search for eliminylating domains reveals novel function for BLES03-like proteins.

Bacterial phosphothreonine lyases catalyze a novel posttranslational modification involving formation of dehydrobutyrine/dehyroalanine by ß elimination of the phosphate group of phosphothreonine or phosphoserine residues in their substrate proteins. Though there is experimental evidence for presence of dehydro amino acids in human proteins, no eukaryotic homologs of these lyases have been identified as of today. A comprehensive genome-wide search for identifying phosphothreonine lyase homologs in eukaryotes was carried out. Our fold-based search revealed structural and catalytic site similarity between bacterial phosphothreonine lyases and BLES03 (basophilic leukemia-expressed protein 03), a human protein with unknown function. Ligand induced conformational changes similar to bacterial phosphothreonine lyases, and movement of crucial arginines in the loop region to the catalytic pocket upon binding of phosphothreonine-containing peptides was seen during docking and molecular dynamics studies. Genome-wide search for BLES03 homologs using sensitive profile-based methods revealed their presence not only in eukaryotic classes such as chordata and fungi but also in bacterial and archaebacterial classes. The synteny of these archaebacterial BLES03-like proteins was remarkably similar to that of type IV lantibiotic synthetases which harbor LanL-like phosphothreonine lyase domains. Hence, context-based analysis reinforced our earlier sequence/structure-based prediction of phosphothreonine lyase catalytic function for BLES03. Our in silico analysis has revealed that BLES03-like proteins with previously unknown function are novel eukaryotic phosphothreonine lyases involved in biosynthesis of dehydro amino acids, whereas their bacterial and archaebacterial counterparts might be involved in biosynthesis of natural products similar to lantibiotics.

Comparison of Disability Standards Based on ICF / 中国康复理论与实践

Objective To analyze and compare 3 Chinese standards of disability. Methods Based on the framework and terminology of International Classification of Functioning, Disability and Health (ICF), the structure and content of 3 standards of disability, i.e., Standard for Identify Work Ability- Gradation of Disability Caused by Work-related injuries and Occupational Diseases (GB/T 16180—2006), As-sessment for Body Impairment of the Injured in Road Traffic Accidents (GB 18667—2002) and Life Insurance Disability Insurance were re-viewed. Results All the standards primarily involved body structure, partly bodily functions, little activity and participation without specific assessment, but no environmental factors. Conclusion The framework and terminology of ICF can be used in the standardization of disabili-ty standards.