Psychosocial measures reported by parents in studies of skin cancer prevention

Background. Because it is important to minimize children's sun exposure to reduce skin cancer risk, much of the extensive skin cancer prevention literature consists of studies of children's sun protection, sun avoidance and ultraviolet radiation (UVR) exposure. Little attention has been focused on the measurement of psychosocial constructs in these studies. Identification of the psychosocial correlates or determinants of children's skin cancer risk or risk-reduction behavior is critical to more fully understand and predict behavior. Furthermore, psychosocial variables may be influenced by interventions to reduce risk. Thus, it is important to examine the psychosocial measures used in studies of children's skin cancer prevention. Information on the validity and reliability of psychosocial measures may increase confidence in study findings based on these measures. In particular, self-efficacy and barriers are key constructs in several major theoretical frameworks and parental measures have been associated with children's sun protection. However, there is conceptual overlap of self-efficacy and barriers measures and little is known about the psychometric properties of these measures.^ Study Aims and Methods. The overall goal of this dissertation was to examine the measurement of psychosocial constructs relevant to children's skin cancer prevention. Because children depend primarily on their parents for skin cancer prevention, measures of parents' psychosocial constructs are the focus. Study 1 was a systematic review of parental psychosocial measures used in studies of children's sun protection, sun avoidance and UVR exposure. The specific aims of Study 1 were to (1) describe psychosocial measures reported by parents, including available information on the psychometric properties of these measures and their use in analyses and (2) provide recommendations for the development, refinement and standardized reporting of measures. ^ Study 2 examined the psychometric properties of measures of parental self-efficacy and barriers regarding children's sun protection. Melanoma patients (N=205) who were parents of children ≤ 12 years of age completed a telephone interview that included self-efficacy and barriers measures specific to sunscreen, clothing, shade and limiting time outdoors. The specific aims of Study 2 were to (1) use a confirmatory factor analytic approach to examine the factorial validity of parental self-efficacy and barriers measures, (2) examine the convergent and discriminant validity of behavior-specific measures of self-efficacy and barriers and (3) assess the reliability of item and scale measures.^ Results. In Study 1, a search of standard databases yielded 48 eligible studies. Most studies assessed only one or two psychosocial constructs. Knowledge was measured most frequently. There was little discussion of measure source, development, theoretical background or psychometric properties, besides internal consistency reliability. There was conceptual overlap of some measures. In Study 2, confirmatory factor analytic findings supported the factorial validity of the self-efficacy and barriers measures. When all eight self-efficacy and barriers measures were included in the same model, a modified eight-factor model adequately fit the data, providing preliminary evidence that the measures are distinct. Measure associations supported the convergent validity of all measures and the discriminant validity of most measures. The self-efficacy and barriers measures were reliable.^ Conclusions. Recommendations based on the literature review include developing and refining psychosocial measures based on theory. Describing a measure's theoretical basis and psychometric properties would facilitate critical evaluation. Standardized reporting of source, development, theory, construct, items and analytic role would facilitate comparison of findings, continual refinement and future applications of measures. In the validation study, self-efficacy and barriers measures were examined in a sample of parents with a personal history of melanoma. Findings suggested that these measures are valid and reliable for use in studies of children's sun protection. There was preliminary evidence that these measures are distinct but additional study is needed. ^

EVA: Laparoscopic instrument tracking based on endoscopic video analysis for psychomotor skills assessment

INTRODUCTION: The EVA (Endoscopic Video Analysis) tracking system a new tracking system for extracting motions of laparoscopic instruments based on non-obtrusive video tracking was developed. The feasibility of using EVA in laparoscopic settings has been tested in a box trainer setup. METHODS: EVA makes use of an algorithm that employs information of the laparoscopic instrument's shaft edges in the image, the instrument's insertion point, and the camera's optical centre to track the 3D position of the instrument tip. A validation study of EVA comprised a comparison of the measurements achieved with EVA and the TrEndo tracking system. To this end, 42 participants (16 novices, 22 residents, and 4 experts) were asked to perform a peg transfer task in a box trainer. Ten motion-based metrics were used to assess their performance. RESULTS: Construct validation of the EVA has been obtained for seven motion-based metrics. Concurrent validation revealed that there is a strong correlation between the results obtained by EVA and the TrEndo for metrics such as path length (p=0,97), average speed (p=0,94) or economy of volume (p=0,85), proving the viability of EVA. CONCLUSIONS: EVA has been successfully used in the training setup showing potential of endoscopic video analysis to assess laparoscopic psychomotor skills. The results encourage further implementation of video tracking in training setups and in image guided surgery.

Relevance of motion-related assessment metrics in laparoscopic surgery

INTRODUCTION: Motion metrics have become an important source of information when addressing the assessment of surgical expertise. However, their direct relationship with the different surgical skills has not been fully explored. The purpose of this study is to investigate the relevance of motion-related metrics in the evaluation processes of basic psychomotor laparoscopic skills, as well as their correlation with the different abilities sought to measure. METHODS: A framework for task definition and metric analysis is proposed. An explorative survey was first conducted with a board of experts to identify metrics to assess basic psychomotor skills. Based on the output of that survey, three novel tasks for surgical assessment were designed. Face and construct validation study was performed, with focus on motion-related metrics. Tasks were performed by 42 participants (16 novices, 22 residents and 4 experts). Movements of the laparoscopic instruments were registered with the TrEndo tracking system and analyzed. RESULTS: Time, path length and depth showed construct validity for all three tasks. Motion smoothness and idle time also showed validity for tasks involving bi-manual coordination and tasks requiring a more tactical approach respectively. Additionally, motion smoothness and average speed showed a high internal consistency, proving them to be the most task-independent of all the metrics analyzed. CONCLUSION: Motion metrics are complementary and valid for assessing basic psychomotor skills, and their relevance depends on the skill being evaluated. A larger clinical implementation, combined with quality performance information, will give more insight on the relevance of the results shown in this study.

Brain tissue segmentation on Diffusion Weighted Magnetic Resonance data

Introduction Diffusion weighted Imaging (DWI) techniques are able to measure, in vivo and non-invasively, the diffusivity of water molecules inside the human brain. DWI has been applied on cerebral ischemia, brain maturation, epilepsy, multiple sclerosis, etc. [1]. Nowadays, there is a very high availability of these images. DWI allows the identification of brain tissues, so its accurate segmentation is a common initial step for the referred applications. Materials and Methods We present a validation study on automated segmentation of DWI based on the Gaussian mixture and hidden Markov random field models. This methodology is widely solved with iterative conditional modes algorithm, but some studies suggest [2] that graph-cuts (GC) algorithms improve the results when initialization is not close to the final solution. We implemented a segmentation tool integrating ITK with a GC algorithm [3], and a validation software using fuzzy overlap measures [4]. Results Segmentation accuracy of each tool is tested against a gold-standard segmentation obtained from a T1 MPRAGE magnetic resonance image of the same subject, registered to the DWI space. The proposed software shows meaningful improvements by using the GC energy minimization approach on DTI and DSI (Diffusion Spectrum Imaging) data. Conclusions The brain tissues segmentation on DWI is a fundamental step on many applications. Accuracy and robustness improvements are achieved with the proposed software, with high impact on the application’s final result.

Behavior of Ad Hoc routing protocols, analyzed for emergency and rescue scenarios, on a real urban area

A mobile Ad Hoc network (MANET) is a collection of wireless mobile nodes that can dynamically configure a network without a fixed infrastructure or central administration. This makes it ideal for emergency and rescue scenarios, where sharing information is essential and should occur as soon as possible. This article discusses which of the routing strategies for mobile MANETs: proactive, reactive or hierarchical, has a better performance in such scenarios. By selecting a real urban area for the emergency and rescue scenario, we calculated the density of nodes and the mobility model needed for the validation study of AODV, DSDV and CBRP in the routing model. The NS2 simulator has been used for our study. We also show that the hierarchical routing strategies are better suited for this type of scenarios.

Desarrollo de un modelo integral de evaluación para instituciones de educación superior y análisis de su impacto en la planificación y gestión institucional

El propósito de esta tesis doctoral es el desarrollo de un modelo integral de evaluación de la gestión para instituciones de educación superior (IES), fundamentado en valorar la gestión de diferentes subsistemas que la integran, así como estudiar el impacto en la planificación y gestión institucional. Este Modelo de Evaluación Institucional fue denominado Modelo Integral de Evaluación de Gestión de las IES (MIEGIES), que incorpora la gestión de la complejidad, los aspectos gerenciales, el compromiso o responsabilidad social, los recursos, además de los procesos propios universitarios con una visión integral de la gestión. Las bases conceptuales se establecen por una revisión del contexto mundial de la educación superior, pasando por un análisis sobre evaluación y calidad en entornos universitarios. La siguiente reflexión conceptual versó sobre la gestión de la complejidad, de la gestión gerencial, de la gestión de responsabilidad social universitaria, de la gestión de los recursos y de la gestión de los procesos, seguida por un aporte sobre modelaje y modelos. Para finalizar, se presenta un resumen teórico sobre el alcance de la aplicación de ecuaciones estructurales para la validación de modelos. El desarrollo del modelo conceptual, dimensiones e indicadores, fue efectuado aplicando los principios de la metodología de sistemas suaves –SSM. Para ello, se identifica la definición raíz (DR), la razón sistémica de ser del modelo, para posteriormente desarrollar sus componentes y principios conceptuales. El modelo quedó integrado por cinco subsistemas, denominados: de la Complejidad, de la Responsabilidad Social Universitaria, Gerencial, de Procesos y de Recursos. Los subsistemas se consideran como dimensiones e indicadores para el análisis y son los agentes críticos para el funcionamiento de una IES. Los aspectos referidos a lo Epistemetodológico, comenzó por identificar el enfoque epistemológico que sustenta el abordaje metodológico escogido. A continuación se identifican los elementos clásicos que se siguieron para llevar a cabo la investigación: Alcance o profundidad, población y muestra, instrumentos de recolección de información y su validación, para finalizar con la explicación procedimental para validar el modelo MIEGIES. La población considerada para el estudio empírico de validación fueron 585 personas distribuidas entre alumnos, docentes, personal administrativo y directivos de una Universidad Pública Venezolana. La muestra calculada fue de 238 individuos, número considerado representativo de la población. La aplicación de los instrumentos diseñados y validados permitió la obtención de un conjunto de datos, a partir de los cuales se validó el modelo MIEGIES. La validación del Modelo MIGEIES parte de sugerencias conceptuales para el análisis de los datos. Para ello se identificaron las variables relevantes, que pueden ser constructos o conceptos, las variables latentes que no pueden ser medidas directamente, sino que requiere seleccionar los indicadores que mejor las representan. Se aplicó la estrategia de modelación confirmatoria de los Modelos de Ecuaciones Estructurales (SEM). Para ello se parte de un análisis descriptivo de los datos, estimando la fiabilidad. A continuación se aplica un análisis factorial exploratorio y un análisis factorial confirmatorio. Para el análisis de la significancia del modelo global y el impacto en la planificación y gestión, se consideran el análisis de coeficientes de regresión y la tabla de ANOVA asociada, la cual de manera global especifica que el modelo planteado permite explicar la relación entre las variables definidas para la evaluación de la gestión de las IES. Así mismo, se encontró que este resultado de manera global explica que en la evaluación institucional tiene mucha importancia la gestión de la calidad y las finanzas. Es de especial importancia destacar el papel que desarrolla la planificación estratégica como herramienta de gestión que permite apoyar la toma de decisiones de las organizaciones en torno al quehacer actual y al camino que deben recorrer en el futuro para adecuarse a los cambios y a las demandas que les impone el entorno. El contraste estadístico de los dos modelos ajustados, el teórico y el empírico, permitió a través de técnicas estadísticas multivariables, demostrar de manera satisfactoria, la validez y aplicación del modelo propuesto en las IES. Los resultados obtenidos permiten afirmar que se pueden estimar de manera significativa los constructos que definen la evaluación de las instituciones de educación superior mediante el modelo elaborado. En el capítulo correspondiente a Conclusiones, se presenta en una de las primeras instancias, la relación conceptual propuesta entre los procesos de evaluación de la gestión institucional y de los cinco subsistemas que la integran. Posteriormente se encuentra que los modelos de ecuaciones estructurales con base en la estrategia de modelación confirmatoria es una herramienta estadística adecuada en la validación del modelo teórico, que fue el procedimiento propuesto en el marco de la investigación. En cuanto al análisis del impacto del Modelo en la Planificación y la Gestión, se concluye que ésta es una herramienta útil para cerrar el círculo de evaluación institucional. La planificación y la evaluación institucional son procesos inherentes a la filosofía de gestión. Es por ello que se recomienda su práctica como de necesario cumplimiento en todas las instancias funcionales y operativas de las Instituciones de Educación Superior. ABSTRACT The purpose of this dissertation is the development of a comprehensive model of management evaluation for higher education institutions (HEIs), based on evaluating the management of different subsystems and study the impact on planning and institutional management. This model was named Institutional Assessment Comprehensive Evaluation Model for the Management of HEI (in Spanish, MIEGIES). The model incorporates the management of complexity, management issues, commitment and social responsibility and resources in addition to the university's own processes with a comprehensive view of management. The conceptual bases are established by a review of the global context of higher education, through analysis and quality assessment in university environments. The following conceptual discussions covered the management of complexity, management practice, management of university social responsibility, resources and processes, followed by a contribution of modeling and models. Finally, a theoretical overview of the scope of application of structural equation model (SEM) validation is presented. The development of the conceptual model, dimensions and indicators was carried out applying the principles of soft systems methodology (SSM). For this, the root definition (RD), the systemic rationale of the model, to further develop their components and conceptual principles are identified. The model was composed of five subsystems, called: Complexity, University Social Responsibility, Management, Process and Resources. The subsystems are considered as dimensions and measures for analysis and are critical agents for the functioning of HEIs. In matters relating to epistemology and methodology we began to identify the approach that underpins the research: Scope, population and sample and data collection instruments. The classic elements that were followed to conduct research are identified. It ends with the procedural explanation to validate the MIEGIES model. The population considered for the empirical validation study was composed of 585 people distributed among students, faculty, staff and authorities of a public Venezuelan university. The calculated sample was 238 individuals, number considered representative of the population. The application of designed and validated instruments allowed obtaining a data set, from which the MIEGIES model was validated. The MIGEIES Model validation is initiated by the theoretical analysis of concepts. For this purpose the relevant variables that can be concepts or constructs were identified. The latent variables cannot be measured directly, but require selecting indicators that best represent them. Confirmatory modeling strategy of Structural Equation Modeling (SEM) was applied. To do this, we start from a descriptive analysis of the data, estimating reliability. An exploratory factor analysis and a confirmatory factor analysis were applied. To analyze the significance of the overall models the analysis of regression coefficients and the associated ANOVA table are considered. This comprehensively specifies that the proposed model can explain the relationship between the variables defined for evaluating the management of HEIs. It was also found that this result comprehensively explains that for institutional evaluation quality management and finance are very important. It is especially relevant to emphasize the role developed by strategic planning as a management tool that supports the decision making of organizations around their usual activities and the way they should evolve in the future in order to adapt to changes and demands imposed by the environment. The statistical test of the two fitted models, the theoretical and the empirical, enabled through multivariate statistical techniques to demonstrate satisfactorily the validity and application of the proposed model for HEIs. The results confirm that the constructs that define the evaluation of HEIs in the developed model can be estimated. In the Conclusions section the conceptual relationship between the processes of management evaluation and the five subsystems that comprise it are shown. Subsequently, it is indicated that structural equation models based on confirmatory modeling strategy is a suitable statistical tool in validating the theoretical model, which was proposed in the framework of the research procedure. The impact of the model in Planning and Management indicates that this is a useful tool to complete the institutional assessment. Planning and institutional assessment processes are inherent in management philosophy. That is why its practice is recommended as necessary compliance in all functional and operational units of HEIs.

Development and psychometric testing of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T): The Spanish version

Background: The Clinical Learning Environment, Supervision and Nurse Teacher scale is a reliable and valid instrument to evaluate the quality of the clinical learning process in international nursing education contexts. Objectives: This paper reports the development and psychometric testing of the Spanish version of the Clinical Learning Environment, Supervision and Nurse Teacher scale. Design: Cross-sectional validation study of the scale. Setting: 10 public and private hospitals in the Alicante area, and the Faculty of Health Sciences (University of Alicante, Spain). Participants: 370 student nurses on clinical placement (January 2011–March 2012). Methods: The Clinical Learning Environment, Supervision and Nurse Teacher scale was translated using the modified direct translation method. Statistical analyses were performed using PASW Statistics 18 and AMOS 18.0.0 software. A multivariate analysis was conducted in order to assess construct validity. Cronbach’s alpha coefficient was used to evaluate instrument reliability. Results: An exploratory factorial analysis identified the five dimensions from the original version, and explained 66.4% of the variance. Confirmatory factor analysis supported the factor structure of the Spanish version of the instrument. Cronbach’s alpha coefficient for the scale was .95, ranging from .80 to .97 for the subscales. Conclusion: This version of the Clinical Learning Environment, Supervision and Nurse Teacher scale instrument showed acceptable psychometric properties for use as an assessment scale in Spanish-speaking countries.

Programme Prevent-Teach-Reinforce : une intervention comportementale pour diminuer les comportements problématiques en milieu scolaire

Cet article a pour but de décrire le programme d’intervention Prevent-Teach-Reinforce (PTR; Dunlap et al., 2010) en mettant l’accent sur les théories béhaviorales sous-jacentes qui ont servi à son développement. Le PTR est un programme visant la diminution des comportements problématiques chez les enfants et les adolescents en milieu scolaire qui est basé sur l’évaluation fonctionnelle pour développer une intervention individualisée et intensive. Nous effectuons une analyse critique afin de proposer un protocole de validation scientifique puisque le programme n’a fait l’objet que d’une seule évaluation randomisée. Les implications pour la pratique clinique sont aussi discutées en mettant l’accent sur le rôle du psychologue dans l’implantation de ce programme.

Urinary Biomarkers Indicative of Apoptosis and Acute Kidney Injury in the Critically Ill.

BACKGROUND Apoptosis is a key mechanism involved in ischemic acute kidney injury (AKI), but its role in septic AKI is controversial. Biomarkers indicative of apoptosis could potentially detect developing AKI prior to its clinical diagnosis. METHODS As a part of the multicenter, observational FINNAKI study, we performed a pilot study among critically ill patients who developed AKI (n = 30) matched to critically ill patients without AKI (n = 30). We explored the urine and plasma levels of cytokeratin-18 neoepitope M30 (CK-18 M30), cell-free DNA, and heat shock protein 70 (HSP70) at intensive care unit (ICU) admission and 24h thereafter, before the clinical diagnosis of AKI defined by the Kidney Disease: Improving Global Outcomes -creatinine and urine output criteria. Furthermore, we performed a validation study in 197 consecutive patients in the FINNAKI cohort and analyzed the urine sample at ICU admission for CK-18 M30 levels. RESULTS In the pilot study, the urine or plasma levels of measured biomarkers at ICU admission, at 24h, or their maximum value did not differ significantly between AKI and non-AKI patients. Among 20 AKI patients without severe sepsis, the urine CK-18 M30 levels were significantly higher at 24h (median 116.0, IQR [32.3-233.0] U/L) than among those 20 patients who did not develop AKI (46.0 [0.0-54.0] U/L), P = 0.020. Neither urine cell-free DNA nor HSP70 levels significantly differed between AKI and non-AKI patients regardless of the presence of severe sepsis. In the validation study, urine CK-18 M30 level at ICU admission was not significantly higher among patients developing AKI compared to non-AKI patients regardless of the presence of severe sepsis or CKD. CONCLUSIONS Our findings do not support that apoptosis detected with CK-18 M30 level would be useful in assessing the development of AKI in the critically ill. Urine HSP or cell-free DNA levels did not differ between AKI and non-AKI patients.

Programme Prevent-Teach-Reinforce : une intervention comportementale pour diminuer les comportements problématiques en milieu scolaire.

Cet article a pour but de décrire le programme d’intervention Prevent-Teach-Reinforce (PTR; Dunlap et al., 2010) en mettant l’accent sur les théories béhaviorales sous-jacentes qui ont servi à son développement. Le PTR est un programme visant la diminution des comportements problématiques chez les enfants et les adolescents en milieu scolaire qui est basé sur l’évaluation fonctionnelle pour développer une intervention individualisée et intensive. Nous effectuons une analyse critique afin de proposer un protocole de validation scientifique puisque le programme n’a fait l’objet que d’une seule évaluation randomisée. Les implications pour la pratique clinique sont aussi discutées en mettant l’accent sur le rôle du psychologue dans l’implantation de ce programme.

Validating the functional capacity index: A comparison of predicted versus observed total body scores

Background: The Functional Capacity Index (FCI) was designed to predict physical function 12 months after injury. We report a validation study of the FCI. Methods: This was a consecutive case series registered in the Queensland Trauma Registry who consented to the prospective 12-month telephone-administered follow-up study. FCI scores measured at 12 months were compared with those originally predicted. Results: Complete Abbreviated Injury Scale score information was available for 617 individuals, of whom 587 (95%) could be assigned at least one FCI score (range, 1-17). Agreement between the largest predicted FCI and observed FCI score was poor (kappa = 0.05; 95% confidence interval, 0.00-0.10) and explained only 1% of the variability in observed FCI. Using an encompassing model that included all FCI assignments, agreement remained poor (kappa = 0.05; 95% confidence interval, -0.02-0.12), and the model explained only 9% of the variability in observed FCI. Conclusion: The predicted functional capacity poorly agrees with actual functional outcomes. Further research should consider including other (noninjury) explanatory factors in predicting FCI at 12 months.

Technological enhancements to optometric clinical tests

A sizeable amount of the testing in eye care, requires either the identification of targets such as letters to assess functional vision, or the subjective evaluation of imagery by an examiner. Computers can render a variety of different targets on their monitors and can be used to store and analyse ophthalmic images. However, existing computing hardware tends to be large, screen resolutions are often too low, and objective assessments of ophthalmic images unreliable. Recent advances in mobile computing hardware and computer-vision systems can be used to enhance clinical testing in optometry. High resolution touch screens embedded in mobile devices, can render targets at a wide variety of distances and can be used to record and respond to patient responses, automating testing methods. This has opened up new opportunities in computerised near vision testing. Equally, new image processing techniques can be used to increase the validity and reliability of objective computer vision systems. Three novel apps for assessing reading speed, contrast sensitivity and amplitude of accommodation were created by the author to demonstrate the potential of mobile computing to enhance clinical measurement. The reading speed app could present sentences effectively, control illumination and automate the testing procedure for reading speed assessment. Meanwhile the contrast sensitivity app made use of a bit stealing technique and swept frequency target, to rapidly assess a patient’s full contrast sensitivity function at both near and far distances. Finally, customised electronic hardware was created and interfaced to an app on a smartphone device to allow free space amplitude of accommodation measurement. A new geometrical model of the tear film and a ray tracing simulation of a Placido disc topographer were produced to provide insights on the effect of tear film breakdown on ophthalmic images. Furthermore, a new computer vision system, that used a novel eye-lash segmentation technique, was created to demonstrate the potential of computer vision systems for the clinical assessment of tear stability. Studies undertaken by the author to assess the validity and repeatability of the novel apps, found that their repeatability was comparable to, or better, than existing clinical methods for reading speed and contrast sensitivity assessment. Furthermore, the apps offered reduced examination times in comparison to their paper based equivalents. The reading speed and amplitude of accommodation apps correlated highly with existing methods of assessment supporting their validity. Their still remains questions over the validity of using a swept frequency sine-wave target to assess patient’s contrast sensitivity functions as no clinical test provides the range of spatial frequencies and contrasts, nor equivalent assessment at distance and near. A validation study of the new computer vision system found that the authors tear metric correlated better with existing subjective measures of tear film stability than those of a competing computer-vision system. However, repeatability was poor in comparison to the subjective measures due to eye lash interference. The new mobile apps, computer vision system, and studies outlined in this thesis provide further insight into the potential of applying mobile and image processing technology to enhance clinical testing by eye care professionals.

Measuring employee innovation:a review of existing scales and the development of the innovative behavior and innovation support inventories across cultures

Purpose - The paper develops a model of employee innovative behavior conceptualizing it as distinct from innovation outputs and as a multi-faceted behavior rather than a simple count of ‘innovative acts’ by employees. It understands individual employee innovative behaviors as a micro-foundation of firm intrapreneurship that is embedded in and influenced by contextual factors such as managerial, organizational and cultural support for innovation. Building from a review of existing employee innovative behavior scales and theoretical considerations we develop and validate the Innovative Behavior Inventory (IBI) and the Innovation Support Inventory (ISI). Design/methodology/approach – Two pilot studies, a third validation study in the Czech Republic and a fourth cross-cultural validation study using population representative samples from Switzerland, Germany, Italy and the Czech Republic (N=2812 employees and 450 entrepreneurs) were conducted. Findings - Both inventories were reliable and showed factorial, criterion, convergent and discriminant validity as well as cross-cultural equivalence. Employee innovative behavior was supported as comprising of idea generation, idea search, idea communication, implementation starting activities, involving others and overcoming obstacles. Managerial support was the most proximal contextual influence on innovative behavior and mediated the effect of organizational support and national culture. Originality/value - The paper advances our understanding of employee innovative behavior as a multi-faceted phenomenon and the contextual factors influencing it. Where past research typically focuses on convenience samples within a particular country, we offer first robust evidence that our model of employee innovative behavior generalizes across cultures and types of samples. Our model and the IBI and ISI inventories enable researchers to build a deeper understanding of the important micro-foundation underpinning intrapreneurial behavior in organizations and allow practitioners to identify their organizations’ strengths and weaknesses related to intrapreneurship.

Construção e validação do instrumento de investigação do conhecimento de gestantes sobre sua saúde bucal e a do seu bebê: perspectiva do cuidado em saúde

INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach α ˃ 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women’s knowledge about their oral health and the oral health of their baby.

Construção e validação do instrumento de investigação do conhecimento de gestantes sobre sua saúde bucal e a do seu bebê: perspectiva do cuidado em saúde

INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach α ˃ 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women’s knowledge about their oral health and the oral health of their baby.