851 resultados para Retrospective pre-test


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Banco del conocimiento

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The Web played a role in the burst of economic activity that occurred in the late 1990s that saw company values dramatically rise and fall, business and government processes reshaped, traditional marketing media challenged, and much written concerning the benefits to customers from the adoption of what was initially termed e-commerce. Initial empirical studies of Australian and New Zealand business and government use of the Web found that while the Web was used for marketing communication, it was not as favoured as trade press reports suggested as a marketing transaction channel, nor for relationship management. This paper, which reports the findings of a pre-test of the self-administered online questionnaire stage of a three-phase study, suggests that little has changed in organisational use of the Web in Australia and New Zealand since the late 1990s, even among high network traffic organisations. The pre-test findings reported do not present a clear picture concerning the influence of strategic use of traditional and online marketing mix elements on organisational performance. Analysis employing a Marketing Readiness of Website Indicator (MRWI) content analysis tool is shown not to predict organisational performance as hypothesised.

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Objective
The use of then-test (retrospective pre-test) scores has frequently been proposed as a solution to potential confounding of change scores because of response shift, as it is assumed that then-test and post-test responses are provided from the same perspective. However, this assumption has not been formally tested using robust quantitative methods. The aim of this study was to compare the psychometric performance of then-test/post-test with traditional pre-test/post-test data and assessing whether the resulting data structures support the application of the then-test for evaluations of chronic disease self-management interventions.

Study Design and Setting
Pre-test, post-test, and then-test data were collected from 314 participants of self-management courses using the Health Education Impact Questionnaire (heiQ). The derived change scores (pre-test/post-test; then-test/post-test) were examined for their psychometric performance using tests of measurement invariance.

Results
Few questionnaire items were noninvariant across pre-test/post-test, with four items identified and requiring removal to enable an unbiased comparison of factor means. In contrast, 12 items were identified and required removal in then-test/post-test data to avoid biased change score estimates.

Conclusion
Traditional pre-test/post-test data appear to be robust with little indication of response shift. In contrast, the weaker psychometric performance of then-test/post-test data suggests psychometric flaws that may be the result of implicit theory of change, social desirability, and recall bias.

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Objectives Program evaluations are frequently based on ‘then-test’ data, i.e., pre-test collected in retrospect. While the application of the then-test has practical advantages, little is known about the validity of then-test data. Because of the collection of then-test in close proximity to post-test questions, this study was aimed at exploring whether the presence of then-test questions in post-test questionnaires influenced subjects’ responses to post-test.
Patients and methods To test the influence of then-test questions, we designed a randomized three-group study in the context of chronic disease self-management programs. Interventions had comparable goals and philosophies, and all 949 study participants filled out identical Health Education Impact Questionnaires (heiQ) at pre-test. At post-test, participants were then randomized to one of the following three groups: Group A responded to post-test questions only (n = 331); Group B filled out transition questions in addition to post-test (n = 304); and Group C filled out then-test questions in addition to post-test (n = 314).
Results Significant post-test differences were found in six of eight heiQ scales, with respondents who filled out then test questions reporting significantly higher post-test scores than respondents of the other groups.
Conclusions This study provides evidence that the inclusion of then-test questions alters post-test responses,
suggesting that change scores based on then-test data be interpreted with care.

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Transient test facilities offer the potential for the simultaneous study of turbine aerodynamic performance, unsteady flow phenomena and the heat transfer characteristics of a turbine stage. This paper describes the development of aerodynamic performance measurement techniques in the Oxford Rotor Facility (ORF). The solutions to the technological issues involved with transient testing presented in this paper are expected to achieve levels of precision uncertainty comparable with traditional steady flow test rigs. The theoretical background to the measurement of aerodynamic performance is presented together with a comprehensive pre-test uncertainty analysis. The instrumentation scheme for the measurement of stage mass flow rate is discussed in detail, the measurements of shaft power, total inlet enthalpy, and stage pressure ratio are also outlined. The current working section features a 62% scale, 1-1/2 stage, high-pressure shroudless transonic turbine. The required inlet flow conditions are provided by an Isentropic Light Piston Tunnel (ILPT) with a quasi-steady state run time of approximately 70ms. The testing is conducted at engine representative specific speed, pressure ratio, gas-to-wall temperature ratio, Mach number and Reynolds number.

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OBJECTIVE: To determine overall and disease-related accuracy of the clinical/imagiological evaluation for pulmonary infiltrates of unknown aetiology, compared with the pathological result of the surgical lung biopsy (SLB) and to evaluate the need for the latter in this setting. METHODS: We conducted a retrospective review of the experiences of SLB in 366 consecutive patients during the past 5 years. The presumptive diagnosis was based on clinical, imagiological and non-invasive or minimally invasive diagnostic procedures and compared with the gold standard of histological diagnosis by SLB. We considered five major pathological groups: diffuse parenchymal lung disease (DPLD), primitive neoplasms, metastases, infectious disease and other lesions. Patients with previous histological diagnosis were excluded. RESULTS: In 56.0% of patients (n=205) clinical evaluation reached a correct diagnosis, in 42.6% a new diagnosis was established (n=156) by the SLB, which was inconclusive in 1.4% (n=5). The pre-test probability for each disease was 85% for DPLD, 75% for infectious disease, 64% for primitive neoplasms and 60% for metastases. Overall sensitivity, specificity, positive and negative predictive values for the clinical/radiological diagnosis were 70%, 90%, 62% and 92%, respectively. For DPLD: 67%, 90%, 76% and 85%; primitive neoplasms: 47%, 90%, 46% and 90%; metastases: 99%, 79%, 60% and 99%; infectious disease 38%, 98%, 53% and 96%. CONCLUSIONS: Despite a high sensitivity and specificity of the clinical and imagiological diagnosis, the positive predictive value was low, particularly in the malignancy group. SLB should be performed in pulmonary infiltrates of unknown aetiology because the clinical/imagiological assessment missed and/or misdiagnosed an important number of patients.

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INTRODUCCIÓN: El diagnóstico de Tromboembolismo Pulmonar (TEP) ha sido un reto clínico a pesar de los avances en modalidades diagnósticas y opciones terapéuticas, el TEP permanece como una entidad sub diagnosticada y letal. La medición en sangre del Dímero D, con punto de corte de 500 mcg/L, por lo tanto es una excelente prueba de tamizaje para los pacientes en el departamento de urgencias . Esta evaluación inicial debe ser complementada con la realización de angioTAC de tórax, decisión que debe ser tomada precozmente con el fin de evitar complicaciones que amenacen la vida METODOLOGIA: Se realizo un estudio de prueba diagnóstica retrospectivo donde se revisaron las historias clínicas de 109 pacientes adultos de la Fundación Santa Fe de Bogotá en quienes se realizo angioTAC de tórax con protocolo para TEP, con probabilidad diagnóstica de Tromboembolismo Pulmonar Baja o Intermedia por criterios de Wells y que además tengan Dímero D. Se calculo la sensibilidad y especificidad del Dímero D teniendo en cuenta la probabilidad clínica pre test calculada por criterios de Wells, y se calcularon likelihood ratio positivo y negativo para cada punto de corte de Dímero D. RESULTADOS: El estudio mostro una sensibilidad del 100% para valores de Dímero D menores de 1100 mcg/L, en pacientes con baja probabilidad, y sensibilidad de 100% para valores menores de 700 mcg/L en pacientes con probabilidad intermedia. DISCUSIÓN: Pacientes con baja probabilidad pre test por criterios de Wells con valores de Dímero D menores de 1100 mcg/L y de probabilidad intermedia con valores menores de 700 mcg/L no requieren estudios adicionales, lo cual disminuye de manera importante la toma de angioTAC y reduce costos de atención.

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Estudiar cuales son los 'esquemas alternativos' o 'preconceptos' que los alumnos traen consigo al llegar a la Enseñanza Secundaria, en relación a los cambios de estado de agregación de la materia. 33 alumnos/as del IB Carles Riba (pruebas pilotos). 103 alumnos/as de 14-16 años, 33 pertenecientes al IB Bernat Metge y 70 pertenecientes al IB Carles Riba (pre-test). Se prepara un primer cuestionario como fuente inicial de recogida de datos. Posteriormente se elaboran tres pruebas piloto que contienen básicamente preguntas abiertas (OEQ) y de elección múltiple (MCQ). Las variables que aparecen son q (muestra el rendimiento global) y m (explica la certeza global en los MCQ), además de 11 combinaciones más. De la evaluación de las preguntas cerradas del primer test se confecciona un pretest. A continuación se analizan las preguntas abiertas, para finalizar con un estudio global del test con datos de las partes I (MCQ) y II (OEQ). Pruebas con preguntas abiertas y de elección múltiple. Entrevistas. Cuestionarios. Tablas de contingencia. Fórmula 20 de Kuder-Richardson. Test de Chi-cuadrado. Análisis en porcentajes. Escala de Likert. 1) No se dan diferencias significativas entre escuelas según los valores del Chi-cuadrado, ni en número de aciertos ni en la certeza manifestada. Tampoco se han encontrado diferencias significativas entre clases. 2) Sólamente un 5 por ciento del total de casos posibles resultan asociaciones. 3) Menos de un 10 por ciento de asociaciones son atribuibles al simple azar. Se prevé de gran importancia el intento de encontrar: asociaciones entre ideas expresadas por los alumnos con su lenguaje; explicación a las aparentes deficiencias de homogeneidad que ya se reflejan entre partes similares, aunque en contextos diferentes, de los tests distribuidos hasta el momento. Se intentará aprovechar la clasificación iniciada en diferentes modelos, hecho que implica la existencia de ciertas hipótesis ocultas.

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Purpose: To evaluate the influence of heat treatment (HT) procedures of a pre-hydrolyzed silane on bond strength of resin cement to a feldspathic ceramic.Materials and Methods: Ceramic and composite blocks (N = 30) were divided into six groups (n = 5) and subjected to the following conditioning procedures: G1: 9.6% hydrofluoric acid (HF) for 20 s + silane (RelyX Ceramic Primer, 3M ESPE) + resin cement (Panavia F2.0, Kuraray) (control); G2: HF (20 s) + silane + heat treatment in furnace (HTF) (100 degrees C, 2 min) + resin cement; G3: silane + HTF + resin cement; G4-HF (20 s) + silane + heat treatment with hot air (HTA) (50 +/- 5 degrees C for 1 min) + resin cement; G5: silane + HTA + resin cement; G6: silane + resin cement. The microtensile bond strength (MTBS) test was performed using a universal testing machine (1 mm/min). After debonding, the substrate and adherent surfaces were analyzed using a stereomicroscope and SEM to categorize the failure types. The data were statistically evaluated using one-way ANOVA and Tukey's test (5%).Results: The control group (G1) showed no pre-test failures and presented significantly higher mean MTBS (16.01 +/- 1.12 MPa) than did other groups (2.63 +/- 1.05 to 12.55 +/- 1.52 MPa) (p = 0.0001). In the groups where HF was not used, HTF (G3: 12.55 +/- 1.52 MPa) showed significantly higher MTBS than did HTA (G5: 2.63 +/- 1.05 MPa) (p < 0.05). All failure types were mixed, ie, adhesive between the resin cement and ceramic accompanied by cohesive failure in the cement.Conclusion: Heat treatment procedures for the pre-hydrolyzed silane either in a furnace or with the application of hot air cannot replace the use of HF gel for the adhesion of resin cement to feldspathic ceramic. Yet when mean bond strengths and incidence of pre-test failures are considered, furnace heat treatment delivered the second best results after the control group, being considerably better than hot air application.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Oxytocin (OT) is known to be involved in anxiety, as well as cardiovascular and hormonal regulation. The objective of this study was to assess the acute effect of intranasally administered OT on subjective states, as well as cardiovascular and endocrine parameters, in healthy volunteers (n = 14) performing a simulated public speaking test. OT or placebo was administered intranasally 50 min before the test. Assessments were made across time during the experimental session: (1) baseline (-30 min); (2) pre-test (-15 min); (3) anticipation of the speech (50 min); (4) during the speech (1:03 h), post-test time 1 (1:26 h), and post-test time 2 (1:46 h). Subjective states were evaluated by self-assessment scales. Cortisol serum and plasma adrenocorticotropic hormone (ACTH) were measured. Additionally, heart rate, blood pressure, skin conductance, and the number of spontaneous fluctuations in skin conductance were measured. Compared with placebo, OT reduced the Visual Analogue Mood Scale (VAMS) anxiety index during the pre-test phase only, while increasing sedation at the pre-test, anticipation, and speech phases. OT also lowered the skin conductance level at the pre-test, anticipation, speech, and post-test 2 phases. Other parameters evaluated were not significantly affected by OT. The present results show that OT reduces anticipatory anxiety, but does not affect public speaking fear, suggesting that this hormone has anxiolytic properties.

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In 2004, the National Institutes of Health made available the Patient-Reported Outcomes Measurement Information System – PROMIS®, which is constituted of innovative item banks for health assessment. It is based on classical, reliable Patient-Reported Outcomes (PROs) and includes advanced statistical methods, such as Item Response Theory and Computerized Adaptive Test. One of PROMIS® Domain Frameworks is the Physical Function, whose item bank need to be translated and culturally adapted so it can be used in Portuguese speaking countries. This work aimed to translate and culturally adapt the PROMIS® Physical Function item bank into Portuguese. FACIT (Functional Assessment of Chronic Illness Therapy) translation methodology, which is constituted of eight stages for translation and cultural adaptation, was used. Fifty subjects above the age of 18 years participated in the pre-test (seventh stage). The questionnaire was answered by the participants (self-reported questionnaires) by using think aloud protocol, and cognitive and retrospective interviews. In FACIT methodology, adaptations can be done since the beginning of the translation and cultural adaption process, ensuring semantic, conceptual, cultural, and operational equivalences of the Physical Function Domain. During the pre-test, 24% of the subjects had difficulties understanding the items, 22% of the subjects suggested changes to improve understanding. The terms and concepts of the items were totally understood (100%) in 87% of the items. Only four items had less than 80% of understanding; for this reason, it was necessary to chance them so they could have correspondence with the original item and be understood by the subjects, after retesting. The process of translation and cultural adaptation of the PROMIS® Physical Function item bank into Portuguese was successful. This version of the assessment tool must have its psychometric properties validated before being made available for clinical use.

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La fin du traitement actif et le début de la phase de survie correspondent à une période de transition qui présente de nombreux défis pour la personne survivante au cancer, les soignants et le système de santé. La phase de survie au cancer est une phase distincte mais négligée du continuum de soins. Pour faciliter la transition de la fin du traitement actif vers la survie et optimiser la coordination des soins de suivi, la mise en place d’un plan de soins de suivi (PSS) est proposée. Le but de cette recherche est de développer, de mettre en place et d’évaluer si un plan de soins de suivi (PSS) permet de répondre aux besoins globaux, de diminuer la détresse émotionnelle et de favoriser les comportements d’autogestion de santé de femmes atteintes du cancer de l’endomètre (FACE) lors de la transition de la fin du traitement actif vers la survie au cancer. Elle comprend deux phases distinctes. La première phase visait d’abord le développement d’un plan de soins de suivi (PSS) pour des femmes atteintes du cancer de l’endomètre avec traitements adjuvants. La sélection du contenu du PSS a été faite à partir de la recension des écrits et des données recueillies lors d’entrevues individuelles avec 19 FACE, 24 professionnels de la santé travaillant avec cette clientèle et quatre gestionnaires de proximité en oncologie. Cette première phase avait également pour but la validation du contenu du PSS auprès de dix professionnels de la santé impliqués dans l’étude. La seconde phase consistait à évaluer la faisabilité, l’acceptabilité du PSS et à en pré-tester l’utilité à répondre aux besoins globaux, à diminuer la détresse émotionnelle (peur de la récidive) et à favoriser l’autogestion de santé auprès d’un groupe de 18 femmes atteintes du cancer de l’endomètre avec traitements adjuvants à la fin du traitement actif vers la survie. Sur le plan de la faisabilité, les résultats suggèrent que la mise en place du PSS comporte des défis en termes de temps, de ressources et de coordination pour l’infirmière pivot en oncologie (IPO). Concernant l’acceptabilité du PSS, les FACE le perçoivent comme un outil d’information utile qui favorise la communication avec le médecin de famille ou d’autres professionnels de la santé. Les IPO soutiennent sa valeur ajoutée à la fin du traitement et soulignent que la discussion du contenu du PSS fait ressortir des éléments de surveillance et de suivi essentiels à prendre en compte pour la phase de survie et permet de mettre l’emphase sur l’autogestion de sa santé. Pour les médecins de famille, le PSS est un outil d’information pour les survivantes qui favorise la réassurance, la communication et la continuité des soins entre professionnels de la santé. Enfin, pour ce qui est de l’utilité du PSS à répondre aux besoins globaux, les résultats suggèrent que l’ensemble des besoins sont plus satisfaits trois mois après la fin des traitements pour le groupe ayant reçu un PSS. Bien que la peur de récidive du cancer (PRC) s’améliore au suivi de trois mois pour le groupe exposé au PSS, 55% des FACE conservent un score cliniquement significatif de 13 à la sous-échelle de sévérité de peur de récidive à la fin du traitement et 42% au suivi de trois mois. Les comportements d’autogestion de santé s’améliorent entre la fin du traitement et le suivi de trois mois pour le groupe exposé un PSS. Considérant ces résultats, la démarche soutient la pertinence de mettre en place un PSS à la fin du traitement actif pour les FACE pour répondre à des besoins d’information, favoriser la communication et la continuité des soins avec les professionnels de la santé et les comportements d’autogestion de santé dans la phase de survie. Cependant, des contraintes de temps, de ressources et de coordination doivent être prises en compte pour sa mise en place dans le milieu clinique. Mots-clés : Transition, fin du traitement actif, besoins, survie au cancer, plan de soins de suivi.