Development and preliminary validation of the cancer family impact scale for colorectal cancer

This study aimed to develop and validate The Cancer Family Impact Scale (CFIS), an instrument for use in studies investigating relationships among family factors and colorectal cancer (CRC) screening when family history is a risk factor. We used existing data to develop the measure from 1,285 participants (637 families) across the United States who were in the Johns Hopkins Colon Cancer Genetic Testing study. Participants were 94% white with an average age of 50.1 years, and 60% were women. None had a personal CRC history, and eighty percent had 1 FDR with CRC and 20% had more than one FDR with CRC. The study had three aims: (1) to identify the latent factors underlying the CFIS via exploratory factor analysis (EFA); (2) to confirm the findings of the EFA via confirmatory factor analysis (CFA); and (3) to assess the reliability of the scale via Cronbach's alpha. Exploratory analyses were performed on a split half of the sample, and the final model was confirmed on the other half. The EFA suggested the CFIS was an 18-item measure with 5 latent constructs: (1) NEGATIVE: negative effects of cancer on the family; (2) POSITIVE: positive effects of cancer on the family; (3) COMMUNICATE: how families communicate about cancer; (4) FLOW: how information about cancer is conveyed in families; and (5) NORM: how individuals react to family norms about cancer. CFA on the holdout sample showed the CFIS to have a reasonably good fit (Chi-square = 389.977, df = 122, RMSEA= 0.058 (.052-.065), CFI=.902, TLI=.877, GF1=.939). The overall reliability of the scale was α=0.65. The reliability of the subscales was: (1) NEGATIVE α = 0.682; (2) POSITIVE α = 0.686; (3) COMMUNICATE α = 0.723; (4) FLOW α = 0.467; and (5) NORM α = 0.732. ^ We concluded the CFIS to be a good measure with most fit levels over 0.90. The CFIS could be used to compare theoretically driven hypotheses about the pathways through which family factors could influence health behavior among unaffected individuals at risk due to family history, and also aid in the development and evaluation of cancer prevention interventions including a family component. ^

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. ^

Parental influence on adolescent smoking initiation among Mexican origin youth

Smoking is often initiated in adolescence through trying or experimenting with cigarettes. Smoking initiation is the beginning critical stage in the smoking trajectory often resulting in addiction. This dissertation examined the effect of parenting variables on smoking initiation behavior among 11–14 year old Mexican origin adolescents, a largely understudied group. The participants in this study were part of a population-based cohort of Mexican origin adolescents residing in Houston, Texas. ^ Aim 1 of this study assessed the appropriateness of the Family Life Questionnaire (FLQ) among Mexican origin adolescents. Second order confirmatory factor analysis (CFA) was performed to examine the factor structure of the FLQ and measurement invariance testing was conducted to evaluate the cross-cultural validity of this scale. Aim 2 analyzed cross-sectional associations between parenting variables and adolescent ever tried smoking behavior while aim 3 focused on prospective examination of changes in parenting variables from baseline to final follow-up on ever tried smoking behavior among never smokers. ^ Overall, the results of the CFA indicated that the original factor structure of the FLQ, with alterations, was a good fit for the Mexican origin adolescents. The measurement invariance analysis of the modified FLQ scale indicated adequate measurement invariance. The aim 2 cross-sectional analyses indicated that family cohesion was significantly associated with lower odds of ever tried smoking. Authoritarian parenting was significantly associated with smoking initiation only at the baseline while family conflict was significantly associated with smoking initiation only at the two-year final home visit. The findings from the aim 3 prospective analysis indicated that changes in levels of family cohesion and conflict are important predictors of smoking initiation among those who have never tried smoking. Specifically, perceiving low levels of family cohesion and a decrease in the family cohesion over two years, as well as perceiving high levels of family conflict and an increase in conflict over two years was associated with smoking initiation among never smokers. ^ In general, the findings of this study provide important insights on the links between parenting and adolescent smoking and assist in designing prevention and intervention programs that emphasize the role of family bonding to prevent adolescent smoking behavior. Family education programs for Mexican culture could also highlight the positive effects of authoritarian practices and good family communication to prevent family conflict and subsequent smoking behavior.^

Behavioral decision making and the levels of change: An application of the transtheoretical model to prenatal smoking in low -income women

Despite continued research and public health efforts to reduce smoking during pregnancy, prenatal cessation rates in the United States have decreased and the incidence of low birth weight has increased from 1985 to 1991. Lower socioeconomic status women who are at increased risk for poor pregnancy outcomes may be resistant to current intervention efforts during pregnancy. The purpose of this dissertation was to investigate the determinants of continued smoking and quitting among low-income pregnant women.^ Using data from cross-sectional surveys of 323 low-income pregnant smokers, the first study developed and tested measures of the pros and cons of smoking during pregnancy. The original decisional balance measure for smoking was compared with a new measure that added items thought to be more salient to the target population. Confirmatory factor analysis using structural equation modeling showed neither the original nor new measure fit the data adequately. Using behavioral science theory, content from interviews with the population, and statistical evidence, two 7-item scales representing the pros and cons were developed from a portion (n = 215) of the sample and successfully cross-validated on the remainder of the sample (n = 108). Logistic regression found only pros were significantly associated with continued smoking. In a discriminant function analysis, stage of change was significantly associated with pros and cons of smoking.^ The second study examined the structural relationships between psychosocial constructs representing some of the levels of and the pros and cons of smoking. The cross-sectional design mandates that statements made regarding prediction do not prove causation or directionality from the data or methods analysis. Structural equation modeling found the following: more stressors and family criticism were significantly more predictive of negative affect than social support; a bi-directional relationship was found between negative affect and current nicotine addiction; and negative affect, addiction, stressors, and family criticism were significant predictors of pros of smoking.^ The findings imply reversing the trend of decreasing smoking cessation during pregnancy may require supplementing current interventions for this population of pregnant smokers with programs addressing nicotine addiction, negative affect, and other psychosocial factors such as family functioning and stressors. ^

Modelo multifactorial para optimización de la productividad en el proceso de generación de energía eléctrica : aplicación al caso de las centrales hidroeléctricas venezolanas

Las organizaciones son sistemas o unidades sociales, compuestas por personas que interactúan entre sí, para lograr objetivos comunes. Uno de sus objetivos es la productividad. La productividad es un constructo multidimensional en la que influyen aspectos tecnológicos, económicos, organizacionales y humanos. Diversos estudios apoyan la influencia de la motivación de las personas, de las habilidades y destrezas de los individuos, de su talento para desempeñar el trabajo, así como también del ambiente de trabajo presente en la organización, en la productividad. Por esta razón, el objetivo general de la investigación, es analizar la influencia entre los factores humanos y la productividad. Se hará énfasis en la persona como factor productivo clave, para responder a las interrogantes de la investigación, referidas a cuáles son las variables humanas que inciden en la productividad, a la posibilidad de plantear un modelo de productividad que considere el impacto del factor humano y la posibilidad de encontrar un método para la medición de la productividad que contemple la percepción del factor humano. Para resolver estas interrogantes, en esta investigación se busca establecer las relaciones entre las variables humanas y la productividad, vistas desde la perspectiva de tres unidades de análisis diferentes: individuo, grupo y organización, para la formulación de un modelo de productividad humana y el diseño de un instrumento para su medida. Una de las principales fuente de investigación para la elección de las variables humanas, la formulación del modelo, y el método de medición de la productividad, fue la revisión de la literatura disponible sobre la productividad y el factor humano en las organizaciones, lo que facilitó el trazado del marco teórico y conceptual. Otra de las fuentes para la selección fue la opinión de expertos y de especialistas directamente involucrados en el sector eléctrico venezolano, lo cual facilitó la obtención de un modelo, cuyas variables reflejasen la realidad del ámbito en estudio. Para aportar una interpretación explicativa del fenómeno, se planteó el modelo de los Factores Humanos vs Productividad (MFHP), el cual se analizó desde la perspectiva del análisis causal y fue conformado por tres variables latentes exógenas denominadas: factores individuales, factores grupales y factores organizacionales, que estaban relacionadas con una variable latente endógena denominada productividad. El MFHP se formuló mediante la metodología de los modelos de ecuaciones estructurales (SEM). Las relaciones inicialmente propuestas entre las variables latentes fueron corroboradas por los ajustes globales del modelo, se constataron las relaciones entre las variables latentes planteadas y sus indicadores asociados, lo que facilitó el enunciado de 26 hipótesis, de las cuales se comprobaron 24. El modelo fue validado mediante la estrategia de modelos rivales, utilizada para comparar varios modelos SEM, y seleccionar el de mejor ajuste, con sustento teórico. La aceptación del modelo se realizó mediante la evaluación conjunta de los índices de bondad de ajuste globales. Asimismo, para la elaboración del instrumento de medida de la productividad (IMPH), se realizó un análisis factorial exploratorio previo a la aplicación del análisis factorial confirmatorio, aplicando SEM. La revisión de los conceptos de productividad, la incidencia del factor humano, y sus métodos de medición, condujeron al planteamiento de métodos subjetivos que incorporaron la percepción de los principales actores del proceso productivo, tanto para la selección de las variables, como para la formulación de un modelo de productividad y el diseño de un instrumento de medición de la productividad. La contribución metodológica de este trabajo de investigación, ha sido el empleo de los SEM para relacionar variables que tienen que ver con el comportamiento humano en la organización y la productividad, lo cual abre nuevas posibilidades a la investigación en este ámbito. Organizations are social systems or units composed of people who interact with each other to achieve common goals. One objective is productivity, which is a multidimensional construct influenced by technological, economic, organizational and human aspects. Several studies support the influence on productivity of personal motivation, of the skills and abilities of individuals, of their talent for the job, as well as of the work environment present in the organization. Therefore, the overall objective of this research is to analyze the influence between human factors and productivity. The emphasis is on the individual as a productive factor which is key in order to answer the research questions concerning the human variables that affect productivity and to address the ability to propose a productivity model that considers the impact of the human factor and the possibility of finding a method for the measurement of productivity that includes the perception of the human factor. To consider these questions, this research seeks to establish the relationships between human and productivity variables, as seen from the perspective of three different units of analysis: the individual, the group and the organization, in order to formulate a model of human productivity and to design an instrument for its measurement. A major source of research for choosing the human variables, model formulation, and method of measuring productivity, was the review of the available literature on productivity and the human factor in organizations which facilitated the design of the theoretical and conceptual framework. Another source for the selection was the opinion of experts and specialists directly involved in the Venezuelan electricity sector which facilitated obtaining a model whose variables reflect the reality of the area under study. To provide an interpretation explaining the phenomenon, the model of the Human Factors vs. Productivity Model (HFPM) was proposed. This model has been analyzed from the perspective of causal analysis and was composed of three latent exogenous variables denominated: individual, group and organizational factors which are related to a latent variable denominated endogenous productivity. The HFPM was formulated using the methodology of Structural Equation Modeling (SEM). The initially proposed relationships between latent variables were confirmed by the global fits of the model, the relationships between the latent variables and their associated indicators enable the statement of 26 hypotheses, of which 24 were confirmed. The model was validated using the strategy of rival models, used for comparing various SEM models and to select the one that provides the best fit, with theoretical support. The acceptance of the model was performed through the joint evaluation of the adequacy of global fit indices. Additionally, for the development of an instrument to measure productivity, an exploratory factor analysis was performed prior to the application of a confirmatory factor analysis, using SEM. The review of the concepts of productivity, the impact of the human factor, and the measurement methods led to a subjective methods approach that incorporated the perception of the main actors of the production process, both for the selection of variables and for the formulation of a productivity model and the design of an instrument to measure productivity. The methodological contribution of this research has been the use of SEM to relate variables that have to do with human behavior in the organization and with productivity, opening new possibilities for research in this area.

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.

Marketing and Sales organization in a “Brand-Focused Professional” multinational

This article tests a multidimensional model of the marketing and sales organizational interface, based on a previous one tested for European companies (Homburg et al., 2008), in a specific taxonomical configuration: a brand focused professional multinational, in three successful Latin American branches. Factor reliability and hypotheses were studied through a confirmatory factor analysis. Results show the existence of a positive relationship between formalization, joint planning, teamwork, information sharing, trust and interface quality. Interface quality and business performance show also a positive relationship. This empirical study contributes to the knowledge of the organizational enhancement of interactions in emerging markets

El perfil de los consumidores de productos de comercio justo. Análisis de las variables que influyen en su intención de compra

El consumo mundial, impulsor del desarrollo y crecimiento económico de los pueblos, no ha sido igual para todas las naciones, ya que sus efectos han sido diferentes para los ciudadanos de los países del Norte y los del Sur, principalmente por dos razones: una, porque han originado complejos y diferentes estilos de vida y aspiraciones, lo que ha originado grandes diferencias entre los individuos de unos y otros países, y, dos, por su falta de valores sociales y éticos. Ante esta situación, la sociedad en su conjunto debe tomar conciencia de este hecho, y a través de un consumo responsable y de un mayor conocimiento de las relaciones comerciales entre los pueblos, debe optar por consumir productos elaborados bajo criterios de justicia y equidad. Para ayudar a alcanzar estos objetivos de equidad, solidaridad, justicia y ética, nació el Comercio Justo, que, en el caso de España, llegó con veinte años de retraso en la década de los ochenta. Aunque a día de hoy sus ventas crecen a un buen ritmo, siguen siendo inferiores al resto de los países europeos, por cuatro razones: (1) el desconocimiento que la mayoría de los potenciales consumidores tienen de este movimiento social; (2) la dificultad de acceder a los productos que comercializan; (3) el poco impulso que se ofrece desde las Administraciones Públicas; y, (4) porque hay pocas investigaciones en las que se haya analizado el Comercio Justo desde la perspectiva de la demanda, lo que ha implicado que no haya un conocimiento profundo sobre los consumidores de este tipo de productos y sobre sus motivaciones de compra. En base a todo lo expuesto, el presente trabajo se concibe como un estudio exploratorio, que tiene como objetivo principal analizar el perfil de los consumidores y no consumidores de productos de Comercio Justo, sus motivaciones de compra y no compra, así como las variables que influyen en la intención de compra futura, tanto en el segmento de consumidores actuales, como en el segmento de no consumidores de este tipo de productos. Para la realización de este trabajo, se ha utilizado, por una parte, una metodología cualitativa, que ha permitido acceder a la información sobre las opiniones y actitudes que intervienen en los procesos de decisión de compra; y, por otra, una metodología cuantitativa, a través de una encuesta online dirigida a 6.500 individuos, que ha permitido tener información, a través de sendos análisis descriptivos univariante y bivariante, de los individuos encuestados sobre el objeto del estudio. Para validar los modelos y contrastar las hipótesis planteadas, se ha utilizado el análisis de fiabilidad y validación de las escalas de medición seleccionadas (Alpha de Cronbach); el análisis factorial exploratorio, para comprobar la dimensionalidad y validez convergente de las escalas de medida; el análisis factorial confirmatorio, para validar la idoneidad de los modelos de medida propuestos; la regresión logística, para comprobar la validez del modelo general de la probabilidad de la compra o no compra de productos de Comercio Justo; y la regresión lineal múltiple, para comprobar la validez de los modelos específicos de intención de compra futura en los segmentos de compradores y de no compradores. Para realizar todos estos análisis, se han utilizado las herramientas informáticas SPSS v21 y AMOS. Las principales conclusiones del trabajo son: (1) que se deben establecer unos criterios claros que definan quién es quién en el movimiento de Comercio Justo, sus fines, sus objetivos, los productos que comercializan, así como su funcionamiento y desarrollo en España; (2) que, a pesar de las grandes ventajas y posibilidades del Comercio Justo, hay una falta de demanda de estos productos por parte de los consumidores responsables, debido principalmente a la falta de información-comunicación sobre el propio movimiento, y, muy especialmente, a la falta de información sobre los productos, los canales de comercialización, las políticas de precios, las políticas de comunicación, etc., y a la necesidad de que estos productos estén accesibles en los lugares donde los consumidores hacen su compra habitual; y (3) que el Comercio Justo español debe afrontar una serie de desafíos, como son la coordinación entre las diferentes organizaciones que participan en su desarrollo; la sensibilización de los consumidores; la creación de una imagen de marca que defina de una manera clara y sencilla qué es el Comercio Justo; la orientación al cliente y no al producto; y extender la red de comercialización de productos de Comercio Justo a los canales donde los consumidores hacen su compra habitualmente. ABSTRACT Global consumption, the driver of economic growth and development of nations, is not the same for all countries, since its effects have been different on people coming from the North or the South. This is due mainly to two reasons: firstly, because they have developed complex and different lifestyles and aspirations, which have led to significant differences between individuals of one country and another and secondly, because they lack social and ethical values. Given this situation, society as a whole should be aware of this fact, and through responsible consumption and a greater knowledge of trade relations between countries, should opt for consuming products produced with criteria of justice and equity. Fair Trade began as a way to help reach these goals of equity, solidarity, justice and ethics. In the case of Spain it did not start until 20 years later, in the eighties. Although today sales of Fair Trade products are growing at a good rate, they are still below that of other European countries, for four reasons: (1) unawareness of this social movement; (2) the difficult access to these products; (3) insufficient government support; (4) the limited research carried out to analyse Fair Trade from the perspective of demand, resulting in a lack of knowledge about this type of consumer and their purchasing motivations. Based on the above, the present study is designed as an exploratory investigation, aimed at analyzing the profile of consumers and non-consumers of Fair Trade, their motivations for buying and not buying, as well as the variables which influence future purchase intention in both the current consumer segment, and the non-user segment of such products. To carry out this study we have used, on the one hand, a qualitative methodology, to obtain information about the views and attitudes involved in the purchase decision process; and on the other, a quantitative methodology, through an online survey of 6,500 individuals, which provided information through two separate univariate and bivariate descriptive analysis, of the individuals interviewed about the object of this study. To validate the models and contrast hypotheses, we have used the reliability analysis and validation of the selected measurement scales (Cronbach's Alpha); exploratory factor analysis to verify the dimensionality and convergent validity of the measurement scales; confirmatory factor analysis to validate the adequacy of the models of measurement proposed; logistic regression, to verify the validity of the general model of the probability of buying or not buying Fair Trade products; and multiple linear regression to test the validity of specific models in future purchase intention in the segments of buyers and non-buyers. To carry out these analyses, we used SPSS v21 software tools and AMOS. The principal conclusions of the investigation are: (1) the need to establish clear criteria which define who is who in the Fair Trade movement, its goals, objectives, the products they sell, as well as its operation and development in Spain; (2) that despite the great advantages and possibilities of Fair Trade, there is a lack of demand for these products by responsible consumers, mainly due to the lack of information-communication about the movement itself, and especially on the range of products, sales channels, pricing policies, communication policies, etc., and the need for these products to be available in places where consumers make their usual purchase; and (3) that Spanish Fair Trade must address a number of challenges such as: coordination between the different organizations involved in trade development; consumer awareness; creation of a brand image that defines in a clear and simple way what Fair Trade is; focus on the customer rather than the product; and expansion of the network of Fair Trade sales outlets to include the channels where consumers usually make their purchases.

Dieta e fatores de riscos metabólicos para doença cardiovascular em adultos e idosos residentes no município de São Paulo: uma análise por modelos de equações estruturais

Introdução: As doenças cardiovasculares são a principal causa de morte no Brasil e no mundo e apresentam importante contribuição para a carga global de doenças. A dieta tem sido considerada um dos determinantes primários do estado de saúde dos indivíduos, atuando na modulação dos fatores de risco metabólicos para doença cardiovascular. Objetivos: Desenvolver um modelo conceitual para a relação entre fatores de risco metabólicos e investigar sua associação com padrões de dieta de adultos e idosos residentes no município de São Paulo. Métodos: Estudo transversal de base populacional com amostra probabilística de adultos e idosos, residentes em área urbana do município de São Paulo, que participaram do Inquérito de Saúde do Município de São Paulo, realizado em duas fases entre os anos de 2008 e 2011 (estudo ISA Capital 2008). Na primeira fase do estudo, 1.102 adultos e idosos, de ambos os sexos, foram entrevistados no domicílio, por meio da aplicação de questionário estruturado e do recordatório alimentar de 24 horas. Na segunda fase, 642 indivíduos adultos e idosos foram reavaliados quanto ao consumo alimentar por meio da aplicação, por telefone, do segundo recordatório alimentar, e, destes, 592 participaram da coleta domiciliar de amostras de sangue venoso, da medição antropométrica e da aferição da pressão arterial por técnico de enfermagem. Os alimentos relatados em ambos os recordatórios foram agrupados segundo a similaridade do valor nutricional e hábitos alimentares da população, e corrigidos pela variância intrapessoal da ingestão por procedimentos estatísticos da plataforma online Multiple Source Method. Os grupos de alimentos foram analisados por meio de análise fatorial exploratória e confirmatória (manuscrito 1) e por modelos de equações estruturais exploratórios (manuscrito 3), a fim de obter os padrões de dieta. O modelo conceitual da relação entre os fatores de risco metabólicos (leptina sérica, proteína C-reativa de alta sensibilidade sérica, pressão arterial sistólica e diastólica, razão colesterol total/lipoproteína de alta densidade, razão triacilglicerol/lipoproteína de alta densidade, glicemia de jejum plasmática, circunferência da cintura e peso corporal) foi obtido por modelos de equações estruturais estratificados por sexo (manuscrito 2). Por fim, a associação dos padrões de dieta com o modelo conceitual proposto (manuscrito 3) foi investigada por modelos de equações estruturais exploratórios. Índices de qualidade de ajuste foram estimados para avaliar a adequação de todos os modelos. As análises foram realizadas no programa Mplus versão 6.12. Resultados: No manuscrito 1, a análise fatorial exploratória revelou a existência de dois padrões de dieta, os quais apresentaram boa qualidade de ajuste na análise fatorial confirmatória quando aplicados os pontos de corte de cargas fatoriais |0,25| na rotação oblíqua Promax. No manuscrito 2, a relação entre os fatores de risco metabólicos foi diferente entre os sexos. Nas mulheres, a leptina sérica apresentou efeitos indiretos e positivos, mediados pelo peso corporal e pela circunferência da cintura, em todos os fatores de risco avaliados. Já nos homens, a leptina sérica apresentou efeitos diretos e positivos sobre a proteína C-reativa de alta sensibilidade e efeitos indiretos e positivos (mediados pelo peso corporal e pela circunferência da cintura) sobre a razão triacilglicerol/lipoproteína de alta densidade, colesterol total/lipoproteína de alta densidade e glicemia de jejum plasmática. No manuscrito 3, foram obtidos três padrões de dieta, dos quais o Tradicional apresentou relação direta e negativa com a leptina sérica e relação indireta e negativa com o peso corporal e a circunferência da cintura, bem como com os demais fatores de risco metabólicos. Já o padrão Prudente apresentou relação direta e negativa com a pressão arterial sistólica, enquanto o padrão Moderno não se associou aos fatores de risco metabólicos investigados. Conclusão: Diferenças nos padrões de dieta de acordo com o tipo de rotação fatorial empregada foram observadas. A relação entre os fatores de risco metabólicos para doença cardiovascular foi distinta entre homens e mulheres, sendo a leptina um dos possíveis hormônios envolvidos. Os padrões de dieta Tradicional e Prudente associaram-se inversamente com os fatores de risco metabólicos, desempenhando uma importante estratégia de prevenção e controle às doenças cardiovasculares no país.

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

Volunteer Engagement: Does Engagement Predict the Degree of Satisfaction among New Volunteers and the Commitment of Those who have been Active Longer?

This study examines the concept of engagement in samples of volunteers from different non-profit organisations. Study 1 analyzes the psychometric properties of the abbreviated version of the Utrecht Work Engagement Scale (UWES) (Schaufeli, Bakker, & Salanova, 2006a). Two factorial structures are examined: one-dimensional and three-dimensional structures. Based on the Three-Stage Model of Volunteers’ Duration of Service (Chacón, Vecina, & Dávila, 2007), Study 2 investigates the relationship between engagement, volunteer satisfaction, and intention to remain in a sample of new volunteers and the relationship between engagement, organisational commitment, and intention to remain in a sample of veteran volunteers. Moderated mediation analysis is provided using duration of service as a moderator in order to set a splitting point between new and veteran volunteers. The results of the confirmatory factor analysis suggest that the three-factor model fits better to the data. Regarding the structural models, the first one shows that engagement is crucial to volunteer satisfaction during the first stage, while volunteer satisfaction is the key variable in explaining intention to continue. The second structural model shows that engagement reinforces the participant’s commitment to the organisation, while organizational commitment predicts intention to continue. Both models demonstrate a notable decline when samples are changed.

Elaboração e validação de um instrumento de avaliação da transferência do Tratamento Diretamente Observado da tuberculose segundo a perspectiva de profissionais de saúde de nível médio e superior (ATP-IINFOC-TB)

Compreendendo a tuberculose enquanto problema de saúde pública, desde meados dos anos 1990 a Organização Mundial da Saúde recomenda ações de controle da doença, dentre estas a Directly Observed Treatment Short-Course (DOTS) que, junto às demais recomendações, é transferida e executada em diferentes cenários, sendo essa transferência merecedora de atenção e aprofundamento, o que deve ocorrer por meio da utilização de métodos válidos e confiáveis. Trata-se de um estudo metodológico, cujo objetivo é elaborar e validar um instrumento voltado à avaliação da transferência da política do Tratamento Diretamente Observado, segundo a perspectiva de profissionais de saúde, por meio das dimensões \"Informação\", \"Conhecimento\" e \"Inovação\". O estudo foi realizado em três fases, a saber: validação semântica, primeira fase do estudo de campo e segunda fase do estudo de campo. A validação semântica contou com 24 profissionais; a primeira fase do estudo de campo, com 101 profissionais; e a segunda fase do estudo de campo, com 401 profissionais. Na validação semântica, o instrumento foi ajustado segundo as sugestões dos entrevistados, tendo ocorrido também a retirada de dois itens dos 49 inicialmente propostos. Na primeira fase do estudo de campo, o instrumento não apresentou efeito floor and ceiling e foram retirados 8 itens com carga fatorial < 0,30 na Análise Fatorial Exploratória. O instrumento apresentou um bom alfa de Cronbach (?=0,87), e a dimensão \"Conhecimento\" apresentou alfa baixo (?=0,645). Na segunda fase do estudo de campo, o efeito floor and ceiling manteve- se ausente, com baixo coeficiente de correlação linear de Pearson (r), baixo ajuste (55%) e baixo alfa de Cronbach (?=0,61) para a dimensão \"Conhecimento\", tendo as dimensões \"Informação\" e \"Inovação\" atingido valores aceitáveis. Para o instrumento como um todo, o Alfa de Cronbach foi de 0,872. O KMO e o Teste de Esfericidade de Bartlett foram satisfatórios, permitindo a Análise Fatorial Confirmatória. Entretanto, identificou-se baixo valor de ajuste do modelo no CFI e RMSEA (0,576 e 0,088, respectivamente), com uma baixa correlação entre as dimensões propostas. Conclui-se que o instrumento elaborado é capaz de avaliar a transferência do TDO segundo a perspectiva de profissionais de saúde de nível médio e superior de forma unidimensional, sem a utilização das três dimensões inicialmente propostas

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.

Validez de constructo de tres escalas de satisfacción del paciente mediante la estrategia de matrices multirrasgo-multimétodo

Se emplea el diseño de las matrices multirrasgo-multimétodo (MTMM) en la evaluación de la satisfacción del paciente. La muestra, extraída al azar simple, fue de 254 pacientes ingresados en tres hospitales del Servei Valencià de Salut de la provincia de Alicante, mayores de 16 años, conscientes y orientados. Los instrumentos de medida fueron tres escalas de satisfacción, dos de carácter general y una específica con los cuidados de enfermería, todas autoinformes. Los rasgos evaluados fueron varias dimensiones de satisfacción, y los métodos tres tipos de formulación de items y escalas de respuesta. Se ha empleado el análisis factorial confirmatorio, siguiéndose la estrategia de constrastar varios modelos alternativos (Widaman, 1985; Marsh, 1989). Los resulta dos indican que: la varianza de método es elevada, superior a la de rasgos; existe validez convergente; los rasgos están altamente correlacionados, pero hay evidencia de validez discriminante; dos métodos están altamente correlacionados; y no se ha podido estimar el modelo general de matrices MTMM.

The Spanish version of the Prenatal Breast-feeding Self-efficacy Scale: Reliability and validity assessment

Background: Only a minority of infants are exclusively breastfed for the recommended 6 months postpartum. Breast-feeding self-efficacy is a mother's confidence in her ability to breastfeed and is predictive of breastfeeding behaviors. The Prenatal Breast-feeding Self-efficacy Scale (PBSES) was developed among English-speaking mothers to measure breastfeeding self-efficacy before delivery. Objectives: To translate the PBSES into Spanish and assess its psychometric properties. Design: Reliability and validity assessment. Setting: A public hospital in Yecla, Spain. Participants: A convenience sample of 234 pregnant women in their third trimester of pregnancy. Methods: The PBSES was translated into Spanish using forward and back translation. A battery of self-administered questionnaires was completed by participants, including a questionnaire on sociodemographic variables, breastfeeding experience and intention, as well as the Spanish version of the PBSES. Also, data on exclusive breastfeeding at discharge were collected from hospital database. Dimensional structure, internal consistency and construct validity of the Spanish version of PBSES were assessed. Results: Confirmatory factor analysis suggested the presence of one construct, self-efficacy, with four dimensions or latent variables. Cronbach's alpha coefficient for internal consistency was 0.91. Response patterns based on decision to breastfeed during pregnancy provided evidence of construct validity. In addition, the scores of the Spanish version of the PBSES significantly predicted exclusive breastfeeding at discharge. Conclusions: The Spanish version of PBSES shows evidences of reliability, and contrasting group and predictive validity. Confirmatory factor analysis indicated marginal fit and further studies are needed to provide new evidence on the structure of the scale. The Spanish version of the PBSES can be considered a reliable measure and shows validity evidences.