Communication channels role in measles vaccination in São Paulo city, Brazil.

Fatores associados com falhas na cobertura da vacinação contra o sarampo na cidade de São Paulo foram estudados por meio de entrevistas com pais ou responsáveis por 122 crianças de até cinco anos. Observou-se que a população conhece a doença e identifica a vacina com a idéia de proteção, mas não cumpre o calendário de vacinação e atrasa as doses da vacina contra o sarampo. Idade, região de origem ou de residência, status familiar ou nível educacional não mostraram associação com o cumprimento do calendário obrigatório (uma dose da vacina contra o sarampo deve ser aplicada dos 9 aos 11 meses e a segunda, aos 15 meses). A televisão é o meio de comunicação que mais informa os entrevistados sobre as Campanhas Nacionais de Multivacinação e o cartão de vacinação foi identificado como uma das vias de comunicação utilizadas para informar sobre a vacinação fora das Campanhas, na rotina. No entanto, nenhum meio de comunicação identificado no estudo pôde, significativamente, promover a mudança de comportamento da indife rença para o compromisso com o cumprimento do calendário, ou seja, adesão. A única variável significativamente relacionada com o atraso na vacinação, de até 20 dias, foi o sentimento de dó de aplicar injeções nas crianças (p = 0,08). Crianças brasileiras têm de visitar o posto de saúde para receber, até cinco anos de idade, 19 vacinas, 12 até o primeiro ano. O estudo deixa claro que não há adesão ao calendário proposto para vacinação contra o sarampo, apesar de ser esta a proposição das Campanhas Nacionais de Multivacinação e da vacinação de rotinaRisk factors associated with failure to receive measles vaccine were studied in eight districts of São Paulo city, Brazil. Parents or carers of 122 children were interviewed about their perception and understanding about the disease anda about measles vaccination, a kind of knowledge that can be acquired through vaccination communication campaigns or from personal communication (from the doctors, nurses of the health care center or friends). Population description factors were also identified. Results analysis shows that neither age, region of origin or residence, marital status nor educational level were related to taking or not taking measles vaccines adequately. Most of the people remembered about having being informed about the last annual vaccination campaign by television, but no communication channel was significantly associated with vaccination status. Answers to questions about knowing the disease or not or knowing the vaccine or not, when analysed alone, did not show any association with taking measles vaccines at the time indicated by health agencies. However, the results showed that when parents felt pity for their children receiving shots, they delayed the vaccination for at least 20 days. Since families visit the health center at least seven times before children complete five years of age and since most of the children does not take the measles vaccine in the exactly recommended day, but delay or anticipate the shots, it is clear that there is no compliance to the recommended government\'s measles vaccination schedule (first dose at 9 and second at 15 months of age), although this is the message that annual communication campaigns and interpersonal communication try to pas

Communication channels role in measles vaccination in São Paulo city, Brazil.

Fatores associados com falhas na cobertura da vacinação contra o sarampo na cidade de São Paulo foram estudados por meio de entrevistas com pais ou responsáveis por 122 crianças de até cinco anos. Observou-se que a população conhece a doença e identifica a vacina com a idéia de proteção, mas não cumpre o calendário de vacinação e atrasa as doses da vacina contra o sarampo. Idade, região de origem ou de residência, status familiar ou nível educacional não mostraram associação com o cumprimento do calendário obrigatório (uma dose da vacina contra o sarampo deve ser aplicada dos 9 aos 11 meses e a segunda, aos 15 meses). A televisão é o meio de comunicação que mais informa os entrevistados sobre as Campanhas Nacionais de Multivacinação e o cartão de vacinação foi identificado como uma das vias de comunicação utilizadas para informar sobre a vacinação fora das Campanhas, na rotina. No entanto, nenhum meio de comunicação identificado no estudo pôde, significativamente, promover a mudança de comportamento da indife rença para o compromisso com o cumprimento do calendário, ou seja, adesão. A única variável significativamente relacionada com o atraso na vacinação, de até 20 dias, foi o sentimento de dó de aplicar injeções nas crianças (p = 0,08). Crianças brasileiras têm de visitar o posto de saúde para receber, até cinco anos de idade, 19 vacinas, 12 até o primeiro ano. O estudo deixa claro que não há adesão ao calendário proposto para vacinação contra o sarampo, apesar de ser esta a proposição das Campanhas Nacionais de Multivacinação e da vacinação de rotinaRisk factors associated with failure to receive measles vaccine were studied in eight districts of São Paulo city, Brazil. Parents or carers of 122 children were interviewed about their perception and understanding about the disease anda about measles vaccination, a kind of knowledge that can be acquired through vaccination communication campaigns or from personal communication (from the doctors, nurses of the health care center or friends). Population description factors were also identified. Results analysis shows that neither age, region of origin or residence, marital status nor educational level were related to taking or not taking measles vaccines adequately. Most of the people remembered about having being informed about the last annual vaccination campaign by television, but no communication channel was significantly associated with vaccination status. Answers to questions about knowing the disease or not or knowing the vaccine or not, when analysed alone, did not show any association with taking measles vaccines at the time indicated by health agencies. However, the results showed that when parents felt pity for their children receiving shots, they delayed the vaccination for at least 20 days. Since families visit the health center at least seven times before children complete five years of age and since most of the children does not take the measles vaccine in the exactly recommended day, but delay or anticipate the shots, it is clear that there is no compliance to the recommended government\'s measles vaccination schedule (first dose at 9 and second at 15 months of age), although this is the message that annual communication campaigns and interpersonal communication try to pas

An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes

Abstract Background Evidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM. Purpose To present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System. Methods A committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions. Results The development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas). Conclusions The competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM

Bootstrapped phylogram of <i>Rhodnius prolixus</i> and other aspartyl proteinases.

<p>Bootstrap values above 50% are shown on the branches. The bottom line indicates 10% amino acid sequence divergence between the proteins. <i>R. prolixus</i> sequences are shown by the notation RP followed by a unique number and have a red circle preceding their names. The <i>Triatoma infestans</i> sequences from Balczun et. al. <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002594#pntd.0002594-Balczun1" target="_blank">[2]</a> have a green marker. The remaining sequences were obtained from GenBank and are annotated with the first three letters of the genus name, followed by the first three letters of the species name, followed by their GenBank GI number. One thousand replicates were done for the bootstrap test using the neighbor joining test.</p

Bootstrapped phylogram of <i>Rhodnius prolixus</i> and other insect peritrophin annotated as Group IV peritrophin in Fig. 1.

<p>Bootstrap values above 50% are shown on the branches. The bottom line indicates 10% amino acid sequence divergence between the proteins. <i>R. prolixus</i> sequences are shown by the notation RP followed by a unique number. The remaining protein sequences were obtained from GenBank and are annotated with the first three letters of the genus name followed by the first three letters of the species name followed by their GenBank GI number. All non-<i>Rhodnius</i> sequences derive mostly from mosquitoes, with one deriving from a flea and another from a sand fly. Roman numerals indicate clades with mixed mosquito genera. Ten thousand replicates were done for the bootstrap test using the neighbor joining method.</p

Bootstrapped phylogram of <i>Rhodnius prolixus</i> midgut lectins aligned with their best matches to the NR database.

<p>Bootstrap values above 50% are shown on the branches. The bottom line indicates 10% amino acid sequence divergence between the proteins. <i>R. prolixus</i> sequences are shown by the notation RP followed by a unique number. The remaining sequences were obtained from GenBank and are annotated with the first three letters of the genus name, followed by the first three letters of the species name, followed by their GenBank GI number. One thousand replicates were done for the bootstrap test using the neighbor joining test.</p

Cladogram of insect Lysozymes from glycoside hydrolase Family 22.

<p>The <i>R. prolixus</i> sequences are shown by the notation RP- followed by a unique number. The remaining proteins were obtained from GenBank and they are annotated with accession number followed by species name. The dendrogram was generated with the UPGMA algorithm. The branches were statistically supported by bootstrap analysis (cut-off 40) based on 1,000 replicates.</p

Bootstrapped phylogram of <i>Rhodnius prolixus</i> and other cysteinyl proteinases.

<p>Bootstrap values above 50% are shown on the branches. The bottom line indicates 10% amino acid sequence divergence between the proteins. <i>R. prolixus</i> sequences are shown by the notation RP followed by a unique number and have a red circle preceding their names. The remaining sequences, obtained from GenBank, are annotated with the first three letters of the genus name, followed by the first three letters of the species name, followed by their GenBank GI number. One thousand replicates were done for the bootstrap test using the neighbor joining test.</p

Bootstrapped phylogram of <i>Rhodnius prolixus</i> midgut lipocalins aligned with their best matches to the NR database.

<p>Bootstrap values above 50% are shown on the branches. The bottom line indicates 20% amino acid sequence divergence between the proteins. <i>R. prolixus</i> sequences are shown by the notation RP followed by a unique number. The remaining sequences, obtained from GenBank, are annotated with the first three letters of the genus name, followed by the first three letters of the species name, followed by their GenBank GI number. One thousand replicates were done for the bootstrap test using the neighbor joining test.</p

Functional classification of RE-overexpressed transcripts (>10× compared to anterior + PMs) from <i>Rhodnius prolixus</i>.

<p>Functional classification of RE-overexpressed transcripts (>10× compared to anterior + PMs) from <i>Rhodnius prolixus</i>.</p