Assessing Difficulties in Career Decision Making Among Swiss Adolescents with the German My Vocational Situation Scale

Assessing problems in career decision making among adolescents is important for career guidance and research. The present study is the first to investigate among Swiss adolescents the factor structure and convergent validity in relation to personality of the German-language adaptation of the My Vocational Situation Scale. Two preliminary studies (N = 217) suggested that using a 5-point Likert scale response format would increase scale reliability. The confirmatory factor analyses in the main study with two cohorts (n = 341, eighth grade; n = 303, eleventh grade) confirmed that four main factors, which assess problems with identity, decision making, information, and perceived barriers, underlie the data. The barriers factor was differentiated into aspired vocation and personal situation. Construct validity was supported by significant relationships between favorable personality characteristics (emotional stability, extraversion, agreeableness, conscientiousness, generalized self-efficacy, and internal locus of control) and fewer problems. The results suggest that the vocational identity and barriers scales can be fruitfully applied to research on and the practice of career counseling with adolescents.

Measuring Intensity of End of Life Care: A Systematic Review.

BACKGROUND Many studies have measured the intensity of end of life care. However, no summary of the measures used in the field is currently available. OBJECTIVES To summarise features, characteristics of use and reported validity of measures used for evaluating intensity of end of life care. METHODS This was a systematic review according to PRISMA guidelines. We performed a comprehensive literature search in Ovid Medline, Embase, The Cochrane Library of Systematic Reviews and reference lists published between 1990-2014. Two reviewers independently screened titles, abstracts, full texts and extracted data. Studies were eligible if they used a measure of end of life care intensity, defined as all quantifiable measures describing the type and intensity of medical care administered during the last year of life. RESULTS A total of 58 of 1590 potentially eligible studies met our inclusion criteria and were included. The most commonly reported measures were hospitalizations (n = 44), intensive care unit admissions (n = 39) and chemotherapy use (n = 27). Studies measured intensity of care in different timeframes ranging from 48 hours to 12 months. The majority of studies were conducted in cancer patients (n = 31). Only 4 studies included information on validation of the measures used. None evaluated construct validity, while 3 studies considered criterion and 1 study reported both content and criterion validity. CONCLUSIONS This review provides a synthesis to aid in choosing intensity of end of life care measures based on their previous use but simultaneously highlights the crucial need for more validation studies and consensus in the field.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group

Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking. Keywords: national final examination, licensing examination, summative assessment, OSCE, action research

Entwicklung und Validierung einer Skala der Bereitschaft zu verzeihen (SBV)

Verzeihen dient der Bewältigung von Kränkungen und zwischenmenschlichen Konflikten. Es werden Definitionen und Operationalisierungen aus dem englischen Sprachraum vorgestellt. Die Entwicklung eines deutschsprachigen szenarienbasierten Instruments zur Erhebung der Bereitschaft zu verzeihen wird beschrieben. Es wird eine Differenzierung des Konstruktes in zwei Komponenten vorgeschlagen: (a) die Bereitschaft, anderen Menschen zu verzeihen, wenn diese ihre Tat bedauern, (b) die Bereitschaft, anderen Menschen zu verzeihen, wenn diese ihre Tat nicht bedauern. Die Messeigenschaften der neu entwickelten Skala wurden in fünf Studien an insgesamt 1824 Probanden untersucht. Die Ergebnisse zeigen, dass das Instrument gute psychometrische Eigenschaften besitzt. Die theoretische Differenzierung des Konstrukts wird empirisch bestätigt. Hinweise auf die Konstruktvalidität der Skala ergeben sich aus Zusammenhängen mit theoretisch einschlägigen Referenzkonstrukten: der habituellen Ärgerneigung, der Wahrnehmung und Klarheit über eigene und fremde Gefühle, positiver und negativer Affektivität, den fünf Persönlichkeitsfaktoren und sozialer Erwünschtheit. Für die Konstruktvalidität der Skala sprechen ferner konvergente Korrelationen mit anderen Maßen der Bereitschaft zu verzeihen.

Translation and cultural adaptation of the Stigma-Devaluation scale for use among family caregivers of mentally ill relatives in Jordan

Background/significance. Mental illness stigma is a matter of great concern to family caregivers. Few research studies have been conducted in the Arab World on family caregivers' perception of stigma associated with caring for a mentally ill relative. Review of the literature on measurement of the concept of stigma related to caring for a mentally ill relative yielded no instrument appropriate for use in a Jordanian sample. Reliable and valid instruments to measure stigma perception among family caregivers are needed for research and practice, particularly in Arabic speaking populations. ^ Purpose. The purposes of this study were: (1) translate the Stigma-Devaluation scale (SDS) into Arabic, modifying it to accurately reflect the cultural parameters specific to Jordan, and (2) test the reliability, the content and construct validity of the Arabic version of the SDS for use among a sample of family members of mentally ill relatives in Jordan. ^ Design. Methodologic, cross-sectional. ^ Methods. The SDS was translated into Arabic language, modified and culturally adapted to the Jordanian culture by a translation model which incorporates a cultural adaptation process. The Arabic SDS was evaluated in a sample of 164 family caregivers in the outpatient mental health clinic in Irbid-Jordan. Cronbach's alpha estimation of internal consistency was used to assess the reliability of the SDS. Construct validity was determined by confirmatory factor analysis (CFA). Measurements of content validity and reading level of the Arabic SDS were included. ^ Findings. Content Validity Index was determined to be 1.0. Reading level of the Arabic SDS was considered at a 6th grade or lower Cronbach's alpha coefficient of the modified Arabic SDS total scale was .87. Initial results of CFA did not fully support the proposed factor structures of the SDS or its subscales. After modifications, the indices indicated that the modified model of each subscale had satisfactory fit. ^ Conclusion. This study provided psychometric evidence that the modified Arabic SDS translated and culturally adapted instrument, is valid and conceptually consistent with the content of the original English SDS in measuring stigma perception among families of mentally ill relatives in Jordan. ^

An epidemiologic evaluation of a worksite based intervention

The healthcare industry spends billions on worker injury and employee turnover. Hospitals and healthcare settings have one of the highest rates of lost days due to injuries. The occupational hazards for healthcare workers can be classified into biological, chemical, ergonomic, physical, organizational, and psychosocial. Therefore, interventions addressing a range of occupational health risks are needed to prevent injuries and reduce turnover and reduce costs. ^ The Sacred Vocation Program (SVP) seeks to change the content of work, i.e., the meaningfulness of work, to improve work environments. The SVP intervenes at both the individual and organizational level. First the SVP attempts to connect healthcare workers with meaning from their work through a series of 5 self-discovery group sessions. In a sixth session the graduates take an oath recommitting them to do their work as a vocation. Once motivated to connect with meaning in their work, a representative employee group meets in a second set of five meetings. This representative group suggests organizational changes to create a culture that supports employees in their calling. The employees present their plan in the twelfth session to management beginning a new phase in the existing dialogue between employees and management. ^ The SVP was implemented in a large Dallas hospital (almost 1000 licensed beds). The Baylor University Medical Center (BUMC) Pastoral Care department invited front-line caregivers (primarily Patient Care Assistants, PCAs, or Patient Care Technicians, PCTs) to participate in the SVP. Participants completed SVP questionnaires at the beginning and following SVP implementation. Following implementation, employer records were collected on injury, absence and turnover to further evaluate the program's effectiveness on metrics that are meaningful to managers in assessing organizational performance. This provided an opportunity to perform an epidemiological evaluation of the intervention using the two sources of information: employee self-reports and employer administrative data. ^ The ability to evaluate the effectiveness of the SVP on program outcomes could be limited by the strength of the measures used. An ordinal CFA performed on baseline SVP questionnaire measurements examined the construct validity and reliability of the SVP scales. Scales whose item-factor structure was confirmed in ordinal CFA were evaluated for their psychometric properties (i.e., reliability, mean, ceiling and floor effects). CFA supported the construct validity of six of the proposed scales: blocks to spirituality, meaning at work, work satisfaction, affective commitment, collaborative communication, and MHI-5. Five of the six scales confirmed had acceptable measures of reliability (all but MHI-5 had α>0.7). All six scales had a high percentage (>30%) of the scores at the ceiling. These findings supported the use of these items in the evaluation of change although strong ceiling effects may hinder discerning change. ^ Next, the confirmed SVP scales were used to evaluate whether the intervention improved program constructs. To evaluate the SVP a one group pretest-posttest design compared participants’ self-reports before and after the intervention. It was hypothesized that measurements of reduced blocks to spirituality (α = 0.76), meaning at work (α = 0.86), collaborative communication (α = 0.67) and SVP job tasks (α = 0.97) would improve following SVP implementation. The SVP job tasks scale was included even though it was not included in the ordinal CFA analysis due to a limited sample and high inter-item correlation. Changes in scaled measurements were assessed using multilevel linear regression methods. All post-intervention measurements increased (increases <0.28 points) but only reduced blocks to spirituality was statistically significant (0.22 points on a scale from 1 to 7, p < 0.05) after adjustment for covariates. Intensity of the intervention (stratifying on high participation units) strengthened effects; but were not statistically significant. The findings provide preliminary support for the hypothesis that meaning in work can be improved and, importantly, lend greater credence to any observed improvements in the outcomes. (Abstract shortened by UMI.)^

A methodologic study of pain assessment in Anglo and Hispanic children with cancer

There is growing clinical evidence that even young children experience pain and accompanying anxiety. Few instruments have been validated to assess pain characteristics in children. The study of related demographic, illness, psychologic and parental factors in children has also been limited. This study examines the reliability and validity of pain assessment tools in an outpatient pediatric cancer population. A total of 78 children from three to fifteen years of age were observed and interviewed about the pain of invasive procedures. The effect of cultural factors and the stress of acculturation were examined by comparing data from two cultural groups, Anglo and Hispanic.^ Spielberger State-Trait Anxiety Scales were administered to children and parents prior to an invasive procedure. The Procedure Behavioral Checklist (PBCL) was used for observation of the child's response during the procedure. The Children's Procedural Interview (CPI) which contains items on the PBCL and visual analogues (scales of faces indicating varying degrees of pain and anxiety) was administered following the procedure.^ Reliability coefficients for Anglos were.78 on the PBCL,.79 on the CPI and.85 on the visual analogue scales. For Hispanics, the reliability for the PBCL was.54, while the CPI had a reliability of.72 and the visual analogue scales,.87. Construct validity was demonstrated by high correlations between the PBCL and CPI scores for both ethnic groups (.66 for Anglos and.64 for Hispanics) and by the significant correlation of State anxiety scores with both PBCL and CPI scores. Age was inversely correlated with PBCL and CPI scores for both ethnic groups. Hispanic parents' anxiety scores were higher than Anglo parents, but were not highly correlated with their child's PBCL, CPI or State-Trait anxiety scores. Caregivers' ratings were correlated with the PBCL scores for Anglos but not for Hispanics.^ The findings of this study indicate that pain responses may be reliably assessed using both observational and self-report methods in children, though differences in Anglo and Hispanic cultures exist. Differences in pain symptomatology and assessment in the two cultural groups warrant further study. ^

Self -management behavior in patients with cystic fibrosis

Self-management is being promoted in cystic fibrosis (CF). However, it has not been well studied. Principal aims of this research were (1) to evaluate psychometric properties of a CF disease status measure, the NIH Clinical Score; (2) to develop and validate a measure of self-management behavior, the SMQ-CF scale, and (3) to examine the relation between self-management and disease status in CF patients over two years.^ In study 1, NIH Clinical Scores for 200 patients were used. The scale was examined for internal consistency, interrater reliability, and content validity using factor analysis. The Cronbach's alpha (.81) and interrater reliability (.90) for the total scale were high. General scale items were less reliable. Factor analysis indicated that most of the variance in disease status is accounted for by Factor 1 which consists of pulmonary disease items.^ The SMQ-CF measures the performance of CF self-management. Pilot testing was done with 98 CF primary caregivers. Internal consistency reliability, social desirability bias, and content validity using factor analysis were examined. Internal consistency was good (alpha =.95). Social desirability correlation was low (r =.095). Twelve factors identified were consistent with conceptual groupings of behaviors. Around two hundred caregivers from two CF centers were surveyed and multivariate analysis of variance was used to assess construct validity. Results confirmed expected relations between self-management, patient age, and disease status. Patient age accounted for 50% and disease status 18% of the variance in the SMQ-CF scale.^ It was hypothesized that self-management would positively affect future disease status. Data from 199 CF patients (control and education intervention groups) were examined. Models of hypothesized relations were tested using LISREL structural equation modeling. Results indicated that the relations between baseline self-management and Time 1 disease status were not significant. Significant relations were observed in self-management behaviors from time 1 to time 2 and patterns of significant relations differed between the two groups.^ This research has contributed to refinements in the ability to measure self-management behavior and disease status outcomes in cystic fibrosis. In addition, it provides the first steps in exploratory behavioral analysis with regard to self-management in this disease. ^

Metas de vida de adolescentes argentinos

El objetivo principal de esta Tesis es construir un instrumento de evaluación psicológica válido para examinar las metas de vida de las adolescencias argentinas. Para arribar a su construcción se realizan distintos estudios: un primer Estudio Exploratorio, del que surge evidencia empírica acerca de diferencias en las posibles elecciones de metas según las distintas variables: género, región geográfica y contexto sociocultural de pertenencia. Del mismo estudio provienen las categorías de análisis que se emplean para la selección de ítems a incluir en la versión preliminar del instrumento. A lo largo de la investigación se realizan tres versiones del Inventario Metas Vitales [MV], luego de la aplicación de la prueba correspondiente a cada versión, se hacen los ajustes y se somete a valoración de jueces expertos [validez del constructo]. Finalmente se establece la ESCALA MV defintiva sometida a análisis estadístico confirmatorio. Dado el caudal de datos obtenidos en la muestra definitiva, se decide incluir un análisis complementario de los mismos en función de las variables diferenciales seleccionadas. Para llevar a cabo el objetivo enunciado, se trata de articular una investigación acerca de la población adolescente de nuestro país tomando como referentes a sujetos de entre 17 y 19 años, de ambos sexos, escolarizados en contextos educativos públicos y privados, de distintas provincias del norte, centro y sur de Argentina. Se parte de considerar dos dimensiones conceptuales: la primera refiere a una concepción de Adolescencia no tradicional y desde allí se pone énfasis en la segunda dimensión que comprende una tarea integradora para conocer y comprender las Metas que orientan las vidas de las adolescencias hoy

Metas de vida de adolescentes argentinos

El objetivo principal de esta Tesis es construir un instrumento de evaluación psicológica válido para examinar las metas de vida de las adolescencias argentinas. Para arribar a su construcción se realizan distintos estudios: un primer Estudio Exploratorio, del que surge evidencia empírica acerca de diferencias en las posibles elecciones de metas según las distintas variables: género, región geográfica y contexto sociocultural de pertenencia. Del mismo estudio provienen las categorías de análisis que se emplean para la selección de ítems a incluir en la versión preliminar del instrumento. A lo largo de la investigación se realizan tres versiones del Inventario Metas Vitales [MV], luego de la aplicación de la prueba correspondiente a cada versión, se hacen los ajustes y se somete a valoración de jueces expertos [validez del constructo]. Finalmente se establece la ESCALA MV defintiva sometida a análisis estadístico confirmatorio. Dado el caudal de datos obtenidos en la muestra definitiva, se decide incluir un análisis complementario de los mismos en función de las variables diferenciales seleccionadas. Para llevar a cabo el objetivo enunciado, se trata de articular una investigación acerca de la población adolescente de nuestro país tomando como referentes a sujetos de entre 17 y 19 años, de ambos sexos, escolarizados en contextos educativos públicos y privados, de distintas provincias del norte, centro y sur de Argentina. Se parte de considerar dos dimensiones conceptuales: la primera refiere a una concepción de Adolescencia no tradicional y desde allí se pone énfasis en la segunda dimensión que comprende una tarea integradora para conocer y comprender las Metas que orientan las vidas de las adolescencias hoy

Methodological Proposal for Teamwork Evaluation in the field of training Project Management.

Teamwork, is one of the abilities that today is highly valued in the professional arena with a great importance for various personal and interpersonal skills associated with it. In this context, the Technical University of Madrid, is developing a coordinated educational innovation project, which main objective is to develop methodological and assessment tools for the acquisition of personal skills necessary to improve the employability of graduates and their skills for project management. Within this context, this paper proposes a methodology composed of various activities and indicators, as well as specific assessment instruments linked to the teamwork competence. Through a series of systematic steps it was allowed the design of an instrument and construction of a scale for measuring the competence of teamwork. The practical application of the methodology has been carried out in Projects lectures from different Schools of Engineering at the Technical University of Madrid, which results are presented in this document as a pilot experience. Results show the various aspects and methods that teachers should consider in evaluating the competence of the work, including analysis of the quality of results, through reliability and construct validity. On the other hand, show the advantages of applying this methodology in the field of project management teaching.

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.

Adaptação cultural e validação da Compliance with Standard Precautions Scale (CSPS) para enfermeiros brasileiros

Introdução: As precauções-padrão (PP) constituem um conjunto de medidas que têm como finalidade minimizar o risco de transmissão ocupacional de patógenos, sendo indispensável sua utilização por profissionais de saúde, sobretudo pelos enfermeiros. No entanto, a não adesão às PP constitui problemática amplamente discutida em todo o mundo. Embora haja diversos estudos brasileiros que visem avaliar a adesão às PP , ainda tem-se observado grande fragilidade no processo de construção e de validação dos instrumentos utilizados para avaliação deste construto. Objetivo: Realizar a adaptação cultural e validação da Compliance with Standard Precautions Scale (CSPS) para enfermeiros brasileiros. Metodologia: Trata-se de um estudo metodológico para a adaptação e validação da CSPS. Essa escala é composta por 20 itens com quatro opções de respostas, e destina-se a avaliar a adesão às PP. O processo de adaptação consistiu em Tradução, Consenso entre Juízes, Retrotradução e Validação Semântica. A primeira etapa foi a tradução do idioma original para o português do Brasil. Após foi realizado um comitê composto por sete juízes, a versão de consenso obtida na etapa anterior foi traduzida novamente para o idioma de origem. Foram avaliadas as propriedades psicométricas do instrumento, considerando-se as validades de face e de conteúdo, a validade de construto e a confiabilidade. A versão para o Português do Brasil da CSPS (CSPS-PB) foi aplicada em uma amostra de 300 enfermeiros que atuam na assistência a pacientes em um hospital localizado na cidade de São Paulo/SP. A confiabilidade foi avaliada por meio da consistência interna (alfa de Cronbach) e teste reteste (coeficiente de correlação intraclasse - ICC). Para a validação de construto, foi utilizada a comparação entre grupos diferentes, análise fatorial exploratória e análise fatorial confirmatória, segundo o Modelo de Equações Estruturais (SEM). Utilizou-se o software IBM® SPSS, 19.0. Para a análise fatorial confirmatória foi utilizado o módulo específico Analysis of Moment Structures (IBM® SPSS AMOS). Para a análise paralela utilizou-se o programa RanEigen Syntax. O nível de significância adotado foi ? = 0,05. Todos os aspectos éticos foram contemplados. Resultados: A tradução realizada por tradutores juramentados garantiu qualidade a esse processo. A validação de face e de conteúdo possibilitou a realização de modificações pertinentes e imperativas a fim de atender aos critérios de equivalências conceituais, idiomáticas, culturais e semânticas. Obteve-se ?=0,61 na avaliação da consistência interna, indicando confiabilidade satisfatória. O ICC indicou uma correlação de 0,87 quase perfeita para o teste reteste duas semanas após a primeira abordagem, conferindo estabilidade satisfatória. A validade de construto mostrou que a CSPS-PB foi capaz de discriminar as médias de adesão às PP entre grupos distintos referente à idade (F=5,15 p<=0,01), ao tempo de experiência clínica (F = 8,9 p<= 0,000) e a ter recebido treinamento (t = 2,48 p<=0,01). Na análise fatorial confirmatória, o modelo foi subidentificado. A análise fatorial exploratória indicou que todos os itens apresentaram cargas fatoriais adequadas (>=0,30), sendo identificados quatro fatores pela análise paralela. O total de variância explicada foi de 35,48%. Conclusão: A CSPS-PB, trata-se de um instrumento adequado, confiável e válido para medir a adesão às PP entre enfermeiros brasileiros

Validação do protocolo de avaliação do frênulo da língua em bebês

Este estudo teve por objetivo validar o Protocolo de avaliação do frênulo da língua em bebês. Para isso, a partir do cálculo amostral, foi aplicado o protocolo em 100 bebês saudáveis, nascidos a termo, com 30 dias de vida, em amamentação exclusiva. O processo de validação consistiu da análise da validade de conteúdo, de critério e de construto, bem como da confiabilidade, sensibilidade, especificidade, valor preditivo positivo e negativo. A validade de conteúdo foi realizada por três examinadores, por meio da classificação de cada item quanto à clareza e posterior aplicação do Índice de Validação do Conteúdo. As avaliadoras sugeriram modificações no protocolo, por consenso, possibilitando obter a versão final. Para a validade de critério, comparou-se o Protocolo de avaliação do frênulo da língua em bebês com o instrumento Bristol Tongue Assessment Tool (BTAT). A validade de construto foi analisada a partir da comparação dos escores do protocolo aplicado nos bebês com 30 e 75 dias. As avaliações foram realizadas por duas fonoaudiólogas especialistas em Motricidade Orofacial (denominadas A1 e A2), devidamente treinadas e calibradas, por meio da análise das filmagens realizadas durante a aplicação do protocolo, para verificação da concordância entre examinadores, bem como definição dos valores de sensibilidade, especificidade e valores preditivos. Para a análise da concordância intra-avaliador foi realizado o teste/reteste de 20% da amostra pela A2. Quanto ao tratamento estatístico, para a análise de concordância intra e entre avaliadores, foram utilizados o Coeficiente de Correlação Intraclasse e o cálculo do erro do método. Para análise da validade de construto foram aplicados os testes de Wilcoxon e Mann-Whitney. O nível de significância adotado em todos os testes foi de 5%. Houve 100% de concordância na validação do conteúdo. A validade de critério apresentou correlações fortes dos itens correspondentes do Protocolo de avaliação do frênulo da língua em bebês e do instrumento BTAT, sendo o valor do coeficiente de correlação de Spearman igual a -0,997. Os resultados obtidos evidenciaram uma concordância muito boa intra e entre avaliadores, com valores baixos de erro casual e valores de p>0,05 (evidenciando que não há diferença entre a análise dos avaliadores) e Coeficiente de Correlação Intraclasse maior que 0,75; mostrando ainda, uma capacidade significativa do protocolo em mensurar as mudanças resultantes da frenotomia lingual, pela história clínica, avaliação anatomofuncional e avaliação da sucção não nutritiva e nutritiva (p<0,05). Quando comparados os resultados dos bebês com alteração do frênulo lingual (grupo experimental) e sem alteração (grupo controle), com 30 e 75 dias, houve diferença nos escores parciais e no escore total do exame clínico e do protocolo completo. Os índices de sensibilidade, especificidade e valores preditivos positivo e negativo foram 100%. A ocorrência das alterações do frênulo lingual nesse estudo foi de 21%. Concluiu-se, com este estudo, que o Protocolo de avaliação do frênulo da língua em bebês mostrou ser um instrumento válido e confiável de avaliação, assegurando acurácia em diagnosticar as alterações do frênulo lingual dentro dos parâmetros investigados, podendo ser aplicado por diferentes avaliadores, desde que os mesmos sejam capacitados e treinados para sua aplicação.

Comprehensive Validation Of A Measure Of Student School Engagement: A Pilot Study Of Middle School Students

Although it may sound reasonable that American education continues to be more effective at sending high school students to college, in a study conducted in 2009, The Council of the Great City Schools states that "slightly more than half of entering ninth grade students arrive performing below grade level in reading and math, while one in five entering ninth grade students is more than two years behind grade level...[and] 25% received support in the form of remedial literacy instruction or interventions" (Council of the Great City Schools, 2009). Students are distracted with technology (Lei & Zhao, 2005), family (Xu & Corno, 2003), medical illnesses (Nielson, 2009), learning disabilities and perhaps the most detrimental to academic success, the very lack of interest in school (Ruch, 1963). In a Johns Hopkins research study, Building a Graduation Nation - Colorado (Balfanz, 2008), warning signs were apparent years before the student dropped out of high school. The ninth grade was often referenced as a critical point that indicated success or failure to graduate high school. The research conducted by Johns Hopkins illustrates the problem: students who become disengaged from school have a much greater chance of dropping out of high school and not graduating. The first purpose of this study was to compare different measurement models of the Student School Engagement (SSE) using Factor Analysis to verify model fit with student engagement. The second purpose was to determine the extent to which the SSE instrument measures student school engagement by investigating convergent validity (via the SSE and Appleton, Christenson, Kim and Reschly's instrument and Fredricks, Blumenfeld, Friedel and Paris's instrument), discriminant validity (via Huebner's Student Life Satisfaction Survey) and criterion-related validity (via the sub-latent variables of Aspirations, Belonging and Productivity and student outcome measures such as achievement, attendance and discipline). Discriminant validity was established between the SSE and the Appleton, Christenson, Kim and Reschly's model and Fredricks, Blumenfeld, Friedel and Paris's (2005) Student Engagement Instruments (SEI). When confirming discriminant validity, the SSE's correlations were weak and statistically not significant, thus establishing discriminant validity with the SLSS. Criterion-related validity was established through structural equation modeling when the SSE was found to be a significant predictor of student outcome measures when both risk score and CSAP scores were used. The third purpose of this study was to assess the factorial invariance of the SSE instrument across gender to ensure the instrument is measuring the intended construct across different groups. Conclusively, configural, weak and metric invariances were established for the SSE as a non-significant change in chi-square indicating that all parameters including the error variances were invariant across groups of gender. Engagement is not a clearly defined psychological construct; it requires more research in order to fully comprehend its complexity. Hopefully, with parental and teacher involvement and a sense of community, student engagement can be nurtured to result in a meaningful attachment to school and academic success.