PACIC Instrument: disentangling dimensions using published validation models.

OBJECTIVE: To better understand the structure of the Patient Assessment of Chronic Illness Care (PACIC) instrument. More specifically to test all published validation models, using one single data set and appropriate statistical tools. DESIGN: Validation study using data from cross-sectional survey. PARTICIPANTS: A population-based sample of non-institutionalized adults with diabetes residing in Switzerland (canton of Vaud). MAIN OUTCOME MEASURE: French version of the 20-items PACIC instrument (5-point response scale). We conducted validation analyses using confirmatory factor analysis (CFA). The original five-dimension model and other published models were tested with three types of CFA: based on (i) a Pearson estimator of variance-covariance matrix, (ii) a polychoric correlation matrix and (iii) a likelihood estimation with a multinomial distribution for the manifest variables. All models were assessed using loadings and goodness-of-fit measures. RESULTS: The analytical sample included 406 patients. Mean age was 64.4 years and 59% were men. Median of item responses varied between 1 and 4 (range 1-5), and range of missing values was between 5.7 and 12.3%. Strong floor and ceiling effects were present. Even though loadings of the tested models were relatively high, the only model showing acceptable fit was the 11-item single-dimension model. PACIC was associated with the expected variables of the field. CONCLUSIONS: Our results showed that the model considering 11 items in a single dimension exhibited the best fit for our data. A single score, in complement to the consideration of single-item results, might be used instead of the five dimensions usually described.

Content validation of the dimensions constituting non-adherence to treatment of arterial hypertension

The objective of the study was to validate the content of the dimensions that constituted nonadherence to treatment of arterial systemic hypertension. It was a methodological study of content validation. Initially an integrative review was conducted that demonstrated four dimensions of nonadherence: person, disease/treatment, health service, and environment. Definitions of these dimensions were evaluated by 17 professionals, who were specialists in the area, including: nurses, pharmacists and physicians. The Content Validity Index was calculated for each dimension (IVCi) and the set of the dimensions (IVCt), and the binomial test was conducted. The results permitted the validation of the dimensions with an IVCt of 0.88, demonstrating reasonable systematic comprehension of the phenomena of nonadherence.

The discourse of health managers on aspects related to the delay in tuberculosis diagnosis

The aim of this study was to analyze the discourse of health managers on aspects related to delay in tuberculosis diagnosis. This was a qualitative research study, conducted with 16 Family Health Unit managers. The empirical data were obtained through semi-structured interviews. The analysis was based on the theoretical framework of the French school of discourse analysis. According to the managers’ statements, the delay in tuberculosis diagnosis is related to patient and health service aspects. As for patient aspects, managers report fear, prejudice and lack of information as factors that may promote a delayed diagnosis. Regarding health service aspects, structural problems and lack of professional skills were reported. The discourse of managers should be considered to qualify tuberculosis control actions and to prevent delays in diagnosis.

‘A tiger that wants to become a lion’: Violent forms of agency among youth in Cape Verde

Cape Verdean prison population raised 100% in the last ten years: in this paper I offer an interpretation of this disturbing figure, addressing the issue of young offenders and children in conflict with the law, the perception of youth crime in Cape Verde, and how the government has recently dealt with these issues. Cape Verde currently deploys a repressive approach to the issue of youth crime: in this draconian context, I will follow the application of policies and laws targeting juvenile delinquents as well as the public and media discourse on the issue. At the same time, through interviews with younger inmates in prisons and institutions, I will relocate young offenders’ behavior and activity within their wider social context, providing urgently needed data on the cultural and social dimensions of juvenile offending and violence.

The art and learning patterns of knowing in nursing

Objective To identify the perception of the students about the use of art as a pedagogical strategy in learning the patterns of knowing in nursing; to identify the dimensions of each pattern valued in the analysis of pieces of art. Method Descriptive mixed study. Data collection used a questionnaire applied to 31 nursing students. Results In the analysis of the students’ discourse, it was explicit that empirical knowledge includes scientific knowledge, tradition and nature of care. The aesthetic knowledge implies expressiveness, subjectivity and sensitivity. Self-knowledge, experience, reflective attitude and relationships with others are the subcategories of personal knowledge and the moral and ethics support ethical knowledge. Conclusion It is possible to learn patterns of knowledge through art, especially the aesthetic, ethical and personal. It is necessary to investigate further pedagogical strategies that contribute to the learning patterns of nursing knowledge.

Dimensions of national culture and the accounting environment -The Spanish case-

Gray (1988) has put forward a hypothesis on how a national accountingenvironment might reflect the cultural dimensions identified by Hofstede (1980, 1983). A number of studies have tested Gray's hypothesis, including one by Pourjalali and Meek (1995) which identified a match between changes in cultural dimensions and the accounting environment in Iran following the revolution. In this paper we replicate this work in the context of Spain following the death of Franco in 1975 and the emergence of a democratic constitution in 1978. Specifically, we: 1) Consider Gray's hypothesis built on Hofstede's cultural dimensions and review some empirical tests of the hypotheses.2) Building on the work of Hofstede and Gray, we: put forward some hypotheses on how we would expect cultural dimensions to change in Spain with the transition to democracy.3) Review developments in accounting in Spain following the transition to democracy, in order to identify how well these fit with our hypotheses.

The discourse on political pluralism in early eighteenth-century England : a conceptual study with special reference to terminology of religious origin

Doctoral dissertation, University of Jyväskylä

Variations in fathers' discourse on fatherhood and in family alliances during infancy

The aim of this pilot study is to analyse the discourse of fathers of toddlers concerning fatherhood and the link between some particularities in the discourse and family alliance. The sample consists of 13 Swiss first time fathers (5 fathers of girls and 8 of boys). In order to evaluate the paternal discourse, the fathers were given a semi-structured interview, which was later analysed using the research package Alceste. The family alliance, i.e., the degree of coordination among the partners when executing a task together, was assessed through the Lausanne Trilogue Play (Fivaz-Depeursinge & Corboz-Warnery, 1999). The main results indicated an interesting link between classes of paternal discourse grouped around the following themes "affective relationship", "daily routine" and "educational goals", and the family alliance (defined in two major categories; functional and problematic alliances). Finally, clinical perspectives on links between paternal representations and family functioning at an interactive level are discussed