Cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence

To examine whether the widely used Strengths and Difficulties Questionnaire (SDQ) can validly be used to compare the prevalence of child mental health problems cross nationally. We used data on 29,225 5- to 16-year olds in eight population-based studies from seven countries: Bangladesh, Brazil, Britain, India, Norway, Russia and Yemen. Parents completed the SDQ in all eight studies, teachers in seven studies and youth in five studies. We used these SDQ data to calculate three different sorts of "caseness indicators" based on (1) SDQ symptoms, (2) SDQ symptoms plus impact and (3) an overall respondent judgement of 'definite' or 'severe' difficulties. Respondents also completed structured diagnostic interviews including extensive open-ended questions (the Development and Well-Being Assessment, DAWBA). Diagnostic ratings were all carried out or supervised by the DAWBA's creator, working in conjunction with experienced local professionals. As judged by the DAWBA, the prevalence of any mental disorder ranged from 2.2% in India to 17.1% in Russia. The nine SDQ caseness indicators (three indicators times three informants) explained 8-56% of the cross-national variation in disorder prevalence. This was insufficient to make meaningful prevalence estimates since populations with a similar measured prevalence of disorder on the DAWBA showed large variations across the various SDQ caseness indicators. The relationship between SDQ caseness indicators and disorder rates varies substantially between populations: cross-national differences in SDQ indicators do not necessarily reflect comparable differences in disorder rates. More generally, considerable caution is required when interpreting cross-cultural comparisons of mental health, particularly when these rely on brief questionnaires.

Processo de formação de tenistas talentosos

O objetivo do presente estudo foi obter informações a respeito do processo de formação de tenistas talentosos e os consequentes fatores que contribuíram para o alcance do profissionalismo. Para tanto, se utilizou uma amostra de cinco tenistas brasileiros profissionais, caracterizados por terem pontos na ATP (Associação dos Tenistas Profissionais). A pesquisa foi constituída através de um delineamento qualitativo, que utilizou como instrumento uma entrevista composta por três perguntas abertas, elaboradas para explorar o contexto de formação do talento. Para a análise dos resultados foi utilizado o “Discurso do Sujeito Coletivo”. De acordo com os resultados, pode-se observar a importância que os professores tiveram no desenvolvimento destes tenistas talentosos, tanto na iniciação como no treinamento. No que se diz respeito ao planejamento dos treinos, o presente estudo demonstra a falta de profissionalismo nas fases iniciais do processo de formação, e a posterior preocupação apenas quando este atleta demonstra possuir algum potencial para seguir carreira profissional.

Prediction of the Temperature Distribution of Partially Submersed Umbilical Cables

The objective of this work is to predict the temperature distribution of partially submersed umbilical cables under different operating and environmental conditions. The commercial code Fluent (R) was used to simulate the heat transfer and the air fluid flow of part of a vertical umbilical cable near the air-water interface. A free-convective three-dimensional turbulent flow in open-ended vertical annuli was solved. The influence of parameters such as the heat dissipating rate, wind velocity, air temperature and solar radiation was analyzed. The influence of the presence of a radiation shield consisting of a partially submersed cylindrical steel tube was also considered. The air flow and the buoyancy-driven convective heat transfer in the annular region between the steel tube and the umbilical cable were calculated using the standard k-epsilon turbulence model. The radiative heat transfer between the umbilical external surface and the radiation shield was calculated using the Discrete Ordinates model. The results indicate that the influence of a hot environment and intense solar radiation may affect the umbilical cable performance in its dry portion.

Pediatric pain: prevalence, assessment, and management in a teaching hospital

The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients’ pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child’s pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.

Prediction of the temperature distribution of partially submersed umbilical cables

The objective of this work is to predict the temperature distribution of partially submersed umbilical cables under different operating and environmental conditions. The commercial code Fluent® was used to simulate the heat transfer and the air fluid flow of part of a vertical umbilical cable near the air-water interface. A free-convective three-dimensional turbulent flow in open-ended vertical annuli was solved. The influence of parameters such as the heat dissipating rate, wind velocity, air temperature and solar radiation was analyzed. The influence of the presence of a radiation shield consisting of a partially submersed cylindrical steel tube was also considered. The air flow and the buoyancydriven convective heat transfer in the annular region between the steel tube and the umbilical cable were calculated using the standard k-ε turbulence model. The radiative heat transfer between the umbilical external surface and the radiation shield was calculated using the Discrete Ordinates model. The results indicate that the influence of a hot environment and intense solar radiation may affect the umbilical cable performance in its dry portion.

Perspektiv på revision : tankemönster, förväntningsgap och dilemman

Auditing is an important activity in today’s society and is characterised by several dilemmas. The assumption underlying this thesis is that auditing is influenced in prac-tice by the thought patterns of auditors. These patterns are shaped in an environment that is both regulated and self-regulated. The purpose of the thesis is to describe, analyse and compare the thought patterns of Swedish auditors and important stake-holders with regard to the way in which auditors audit information provided by listed companies and how they make statements about this information. The purpose is also to make some suggestions about how the auditing activity can be modified in order to reduce conflicting interests. The methodological approach combines the use of the repertory grid technique and open-ended interview questions. Interviews were carried out with 82 auditors and 73 stakeholders. To validate the findings, four focus groups, consisting of auditors, investors and creditors, were consulted. The findings indicate that auditors devote a relatively large amount of time and considerable effort to objects that can be verified satisfactorily, but not to objects that they perceive as being of primary importance to investors and creditors. A similar gap is found in the thought patterns of investors and creditors. Moreover, several expec-tation gaps are found, in particular regarding auditors’ statements. On the one hand, the auditors studied were reluctant to make statements about any other information than information obtained according to current practice; on the other hand, the inves-tors and creditors expressed a need for additional information about the outcome of the audit and the choice of auditing objects. The concluding suggestions concern measures that can reduce the discrepancies identi-fied, including (i) the introduction of a mandatory primary audit and a market-oriented secondary audit, (ii) extended information about the outcome of the audit and the choice of auditing objects that will benefit the stakeholders, (iii) a somewhat less expo-sed position of the auditors, and (iv) the importance of a changed balance of power in the auditing arena and the need for an integrated and dynamic approach to auditing. Keywords: auditing, accounting information, auditors, stakeholders, agency theory, thought patterns, expectation gap, repertory grid.

Essays in policy evaluation

This dissertation consists of three empirical studies that aim at providing new evidence in the field of public policy evaluation. In particular, the first two chapters focus on the effects of the European cohesion policy, while the third chapter assesses the effectiveness of Italian labour market incentives in reducing long-term unemployment. The first study analyses the effect of EU funds on life satisfaction across European regions , under the assumption that projects financed by structural funds in the fields of employment, education, health and environment may affect the overall quality of life in recipient regions. Using regional data from the European Social Survey in 2002-2006, it resorts to a regression discontinuity design, where the discontinuity is provided by the institutional framework of the policy. The second study aims at estimating the impact of large transfers from a centralized authority to a local administration on the incidence of white collar crimes. It merges a unique dataset on crimes committed in Italian municipalities between 2007 and 2011 with information on the disbursement of EU structural funds in 2007-2013 programming period, employing an instrumental variable estimation strategy that exploits the variation in the electoral cycle at local level. The third study analyses the impact of an Italian labour market policy that allowed firms to cut their labour costs on open-ended job contracts when hiring long-term unemployed workers. It takes advantage of a unique dataset that draws information from the unemployment lists in Veneto region and it resorts to a regression discontinuity approach to estimate the effect of the policy on the job finding rate of long-term unemployed workers.

Zielvereinbarungsgespräch und Leitungsaufgabe von katholischen Priestern

Die großen christlichen Kirchen in Deutschland befinden sich in einem strukturellen Umbruch, der sich zunehmend auf die Pastoral der örtlichen Pfarreien und Kirchengemeinden auswirkt. Durch die Einführung von Verfahren aus dem New Public Management erhoffen sich Kirchenleitungen beider Konfessionen eine innerkirchliche Personalentwicklung, die vor allem das hauptberufliche Seelsorgepersonal neu motivieren soll. Insbesondere in der katholischen Kirche soll so - in Verbindung mit einem möglichst missionarisch wirksamen Neuaufbruch - die Transformation der ehemals volkskirchlich geprägten Pfarrgemeinden in eine sich neu abzeichnende Sozialgestalt von Kirche als Netzwerk größerer pastoraler Einheiten unterstützt werden. Die vorliegende Arbeit untersucht an der interdisziplinären Schnittstelle von Organisationforschung und praktischer Theologie, inwieweit die Einführung von Zielvereinbarungsgesprächen (ZVG) führungsverantwortliche Priester in der Wahrnehmung ihrer Leitungsaufgabe stärkt. Über 300 leitende Priester aus den Erzbistümern Freiburg und Paderborn hatten an der empirischen Studie mit zwei Messzeitpunkten teilgenommen. 73 Priester waren an beiden Messzeitpunkten A (2007) und B (2008) beteiligt. Unmittelbar nach dem Zeitpunkt A besuchten die befragten Priester der Erzdiözese Freiburg eine ZVG-Einführungsschulung, der sich eine einjährige Gesprächspraxis anschloss. Die in der Erzdiözese Paderborn befragten Priester bildeten die Vergleichsgruppe (ohne entsprechendes Treatment).rn rnWesentliches Ergebnis der Studie sind empirische Hinweise auf signifikante Zusammenhänge zwischen dem priesterlichem Leitungsselbstverständnis, der ZVG-Umsetzung und der Einschätzung der eigenen Führungsqualität.rnrnIn den Selbsteinschätzungen der leitenden Priester (z.B. im Hinblick auf Leitungszufriedenheit, Bedeutung bzw. Gelingen von einzelnen Leitungs- und Gesprächsaspekten, etc.) zeigten sich zum Zeitpunkt A im Vergleich zwischen beiden Diözesen nur geringe Unterschiede. Dies gilt auch für die in A erfolgte Auswertung offener Fragen zum priesterlichen Selbstverständnis, welches als leitungs-amtliche Handlungs- und Objektorientierung in beiden Diözesen am wenigsten stark ausgeprägt war.Zum Zeitpunkt B verdeutlichte die Untersuchung des Tätigkeitsfelds Gemeindeleitung, dass dessen Bedeutung in Freiburg größer war als in Paderborn. Der hierfür erbrachte Kraft- bzw. Zeitaufwand war in Freiburg jedoch niedriger als in Paderborn, was als eine Frucht der verbindlichen ZVG-Einführung in Freiburg interpretiert werden kann. Deutlich wird auch, dass Priester, die der ZVG-Einführung eine hohe Bedeutung beimessen, mit ihren Mitarbeitern viele Gespräche planen. Weil Folgegespräche zum Zeitpunkt B im gleichen Umfang wie schon zum Zeitpunkt A geplant wurden, müssen die konkreten Gesprächserfahrungen in der A-Phase hinreichend positiv gewesen sein. Die Umsetzung zum Zeitpunkt B war jedoch nicht in dem zum Zeitpunkt A geplanten Maß erfolgt, was sich mit Prioritätsverschiebungen erklären lässt. Interessanterweise korreliert die Anzahl der geführten Zielvereinbarungsgespräche mit dem Dienst- und Lebensalter der Priester. Erfahrene Priester, die sich auf eine Mitarbeiterführung durch Zielvereinbarung einlassen, machen demnach gute Erfahrungen mit diesem Personalentwicklungsinstrument. rnrnInsgesamt können die Ergebnisse der Studie zu einer weiteren Kultivierung der Zielvereinbarungsgespräche im kirchlichen Dienst ermutigen. Bistümern, die noch keine Zielvereinbarungsgespräche eingeführt haben, kann eine Implementierung angeraten werden. rn

Problems in functioning from the patient perspective using the International Classification of Functioning, Disability and Health (ICF) as a reference

We conducted a qualitative, multicenter study using a focus group design to explore the lived experiences of persons with any kind of primary sleep disorder with regard to functioning and contextual factors using six open-ended questions related to the International Classification of Functioning, Disability and Health (ICF) components. We classified the results using the ICF as a frame of reference. We identified the meaningful concepts within the transcribed data and then linked them to ICF categories according to established linking rules. The six focus groups with 27 participants yielded a total of 6986 relevant concepts, which were linked to a total of 168 different second-level ICF categories. From the patient perspective, the ICF components: (1) Body Functions; (2) Activities & Participation; and (3) Environmental Factors were equally represented; while (4) Body Structures appeared poignantly less frequently. Out of the total number of concepts, 1843 concepts (26%) were assigned to the ICF component Personal Factors, which is not yet classified but could indicate important aspects of resource management and strategy development of those who have a sleep disorder. Therefore, treatment of patients with sleep disorders must not be limited to anatomical and (patho-)physiological changes, but should also consider a more comprehensive view that includes patient's demands, strategies and resources in daily life and the contextual circumstances surrounding the individual.

Mother-Child Spiritual Discourse: A Mixed Methods Study

Parents and children, starting at very young ages, discuss religious and spiritual issues¿where we come from, what happens to us after we die, is there a God, and so on. Unfortunately, few studies have analyzed the content and structure of parent-child conversation about religion and spirituality (Boyatzis & Janicki, 2003; Dollahite & Thatcher, 2009), and most studies have relied on self-report with no direct observation. The current study examined mother-child (M-C) spiritual discourse to learn about its content, structure, and frequency through a survey inventory in combination with direct video observation using a novel structured task. We also analyzed how mothers¿ religiosity along several major dimensions related to their communication behaviors within both methods. Mothers (N = 39, M age = 40) of children aged 3-12 completed a survey packet on M-C spiritual discourse and standard measures of mothers¿ religious fundamentalism, intrinsic religiosity, sanctification of parenting (how much the mother saw herself as doing God¿s work as a parent), and a new measure of parental openness to children¿s spirituality. Then, in a structured task in our lab, mothers (N = 33) and children (M age = 7.33) watched a short film or read a short book that explored death in an age-appropriate manner and then engaged in a videotaped conversation about the movie or book and their religious or spiritual beliefs. Frequency of M-C spiritual discourse was positively related to mothers¿ religious fundamentalism (r = .71, p = .00), intrinsic religiosity (r = .77, p = .00), and sanctification of parenting (r = .79, p = .00), but, surprisingly, was inversely related to mothers¿ v openness to child¿s spirituality (r = -.52, p = .00). Survey data showed that the two most common topics discussed were God (once a week) and religion as it relates to moral issues (once a week). According to mothers their children¿s most common method of initiating spiritual discourse was to repeat what he or she has heard parents or family say about religious issues (M = 2.97; once a week); mothers¿ most common method was to describe their own religious/spiritual beliefs (M = 2.92). Spiritual discourse most commonly occurred either at bedtime or mealtime as reported by 26% of mothers, with the most common triggers reported as daily routine/random thoughts (once a week) and observations of nature (once a week). Mothers¿ most important goals for spiritual discourse were to let their children know that they love them (M = 3.72; very important) and to help them become a good and moral person (M = 3.67; very important). A regression model showed that significant variance in frequency of mother-child spiritual discourse (R2 = .84, p = .00) was predicted by the mothers¿ importance of goals during discourse (ß = 0.46, p = .00), frequency that the mother¿s spirituality was deepened through spiritual discourse (ß = 0.39, p = .00), and the mother¿s fundamentalism (ß = 0.20, p = .05). In a separate regression, the mother¿s comfort in the structured task (ß = 0.70, p = .00), and the number of open-ended questions she asked (ß = -0.26, p = .03) predicted the reciprocity between mother and child (R2 = .62, p = .00). In addition, the mother¿s age (ß = 0.22, p = .059) and comfort during the task (ß = 0.73, p = .00) predicted the child¿s engagement within the structured task. Other findings and theoretical and methodological implications will be discussed.

Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia

Background It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable. This paper compares the health-seeking behavior of households from rural Andean communities at a Peruvian and a Bolivian study site. The main research question was whether the increased presence of biomedicine led to a displacement of Andean indigenous medical practices or to coexistence of the two healing traditions. Methodology Open-ended interviews and free listing exercises were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification of households’ therapeutic strategies and use of remedies was carried out by means of content analysis of interview transcriptions and inductive interference. Furthermore, a quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories was performed. Results Our findings indicate that the health-seeking behavior of the Andean households in this study is independent of the degree of availability of biomedical facilities in terms of quality of services provided, physical accessibility, and financial affordability, except for specific practices such as childbirth. Preference for natural remedies over pharmaceuticals coexists with biomedical healthcare that is both accessible and affordable. Furthermore, our results show that greater access to biomedicine does not lead to less prevalence of Andean indigenous medical knowledge, as represented by the levels of knowledge about culture-bound illnesses. Conclusions The take-home lesson for health policy-makers from this study is that the main obstacle to use of biomedicine in resource-poor rural areas might not be infrastructural or economic alone. Rather, it may lie in lack of sufficient recognition by biomedical practitioners of the value and importance of indigenous medical systems. We propose that the implementation of health care in indigenous communities be designed as a process of joint development of complementary knowledge and practices from indigenous and biomedical health traditions.

Physicians' philosophy of care: a comparison of complementary and conventional medicine

BACKGROUND: This project is part of an evaluation of complementary and alternative medicine (CAM) aimed at providing a scientific basis for the Swiss Government to include 5 CAM methods in basic health coverage: anthroposophic medicine, homeopathy, neural therapy, phytotherapy and Traditional Chinese Medicine (TCM). OBJECTIVES: The objective was to explore the philosophy of care (convictions and values, priorities in medical activity, motivation for CAM, criteria for the practice of CAM, limits of the used methods) of conventional and CAM general practitioners (GPs) and to determine differences between both groups. MATERIALS AND METHODS: This study was a cross-sectional survey of a representative sample of 623 GPs who provide complementary or conventional primary care. A mailed questionnaire with open-ended questions focusing on the philosophy of care was used for data collection. An appropriate methodology using a combination of quantitative and qualitative approaches was developed. RESULTS: Significant differences between both groups include philosophy of care (holistic versus positivistic approaches), motivation for CAM (intrinsic versus extrinsic) and priorities in medical activity. Both groups seem to be aware of limitations of the therapeutic methods used. The study reveals that conventional physicians are also using complementary medicine. DISCUSSION: Our study provides a wealth of data documenting several aspects of physicians' philosophy of care as well as differences and similarities between conventional and complementary care. Implications of the study with regard to quality of care as well as ethical and health policy issues should be investigated further.

Formal speech stylistics and type A behavior in 38 subjects during nonstress interviews

Open-ended interviews of 90 min length of 38 patients were analyzed with respect to speech stylistics, shown by Schucker and Jacobs to differentiate individuals with type A personality features from those with type B. In our patients, Type A/B had been assessed by the Bortner Personality Inventory. The stylistics studied were: repeated words swallowed words, interruptions, simultaneous speech, silence latency (between question and answer) (SL), speed of speech, uneven speed of speech (USS), explosive words (PW), uneven speech volume (USV), and speech volume. Correlations between both raters for all speech categories were high. Positive correlations between extent of type A and SL (r = 0.33; p = 0.022), USS (r = 0.51; p = 0.002), PW (r = 0.46; p = 0.003) and USV (r = 0.39; p = 0.012) were found. Our results indicate that the speech in nonstress open-ended interviews of type A individuals tends to show a higher emotional tension (positive correlations for USS PW and USV) and is more controlled in conversation (positive correlation for SL).

Assessment of a high school geological field course

Fieldwork is supportive of students’ natural inquiry abilities. Educational research findings suggest that instructors can foster the growth of thinking skills and promote science literacy by incorporating active learning strategies (McConnel et al, 2003). Huntoon (2001) states that there is a need to determine optimal learning strategies and to document the procedure of assessing those optimal geoscience curricula. This study seeks to determine if Earth Space II, a high school geological field course, can increase students’ knowledge of selected educational objectives. This research also seeks to measure any impact Earth Space II has on students’ attitude towards science. Assessment of the Earth Space II course objectives provided data on the impact of field courses on high school students’ scientific literacy, scientific inquiry skills, and understanding of selected course objectives. Knowledge assessment was done using a multiple choice format test, the Geoscience Concept Inventory, and an open-ended format essay test. Attitude assessment occurred by utilizing a preexisting science attitude survey. Both knowledge assessments items showed a positive effect size from the pretest to the posttest. The essay exam effect size was 17 and the Geoscience Concept Inventory effect size was 0.18. A positive impact on students’ attitude toward science was observed by an increase in the overall mean Likert value from the pre-survey to the post-survey.

An ethnobotanical survey of the economic and cultural significance of non-timber forest products in the southwest Rhodope Mountain region of Bulgaria

The people of the southwestern Rhodope Mountains of Bulgaria live in small, mountainous villages and rural areas. They rely on berries, herbs, and mushrooms provided by the forest and maintain a lifestyle and culture of gathering them. This study determined the economic and landscape concentration of Non-Timber Forest Products (NTFPs) and how this has changed in the past twenty years in the region of Garmen. The objective was to gauge the cultural and economic significance of NTFPs in the lives of the people who live there. Data was collected using informal, open-ended interviews and through participant observation. Results indicate that ethnicity influence how resources are utilized. Roma people collect mushrooms for income generation; Orthodox Bulgarians gather herbs, berries, and mushrooms for medicinal purposes, to supplement their diets, and to carry on traditions. Bulgarian Muslims collect for a combination of the aforementioned reasons. Changes that occur in the forests affect each of the ethnic groups in different ways and forest management practices should include people’s knowledge and uses of NTFPs.