839 resultados para cross-over study


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This study examined the influence of organizational justice perceptions on employee work outcome relationships as moderated by individual differences that are influenced by societal culture. Power distance, but not country or individualism, moderated the relationships between perceived justice and satisfaction, performance, and absenteeism. The effects of perceived justice on these outcomes were stronger among individuals scoring lower on power distance index, and most of these study participants were in the U.S. (versus Hong Kong) sample. Limitations of the study and the implications of the findings for managing cross-culturally are discussed.

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This research is the leading brand for purchase of assets, and analyzing the factors based on brand asset components and the relationship between the brand and brand assets assets impact factors and purchase intent on uncovering the relationship between components and trademarks centered on South Korea and the United Kingdom, by comparing the asset management plan would generate. The study, information navigation product knowledge affects of constant (+), brand attitudes and knowledge of the brand loyalty and brand value to the constant trademark (+). Brand value and brand loyalty and purchase intent-(+) in the United Kingdom, on the other hand, of the impact that do not affect that.

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OBJECTIVE: To assess the effect of using different risk calculation tools on how general practitioners and practice nurses evaluate the risk of coronary heart disease with clinical data routinely available in patients' records. DESIGN: Subjective estimates of the risk of coronary heart disease and results of four different methods of calculation of risk were compared with each other and a reference standard that had been calculated with the Framingham equation; calculations were based on a sample of patients' records, randomly selected from groups at risk of coronary heart disease. SETTING: General practices in central England. PARTICIPANTS: 18 general practitioners and 18 practice nurses. MAIN OUTCOME MEASURES: Agreement of results of risk estimation and risk calculation with reference calculation; agreement of general practitioners with practice nurses; sensitivity and specificity of the different methods of risk calculation to detect patients at high or low risk of coronary heart disease. RESULTS: Only a minority of patients' records contained all of the risk factors required for the formal calculation of the risk of coronary heart disease (concentrations of high density lipoprotein (HDL) cholesterol were present in only 21%). Agreement of risk calculations with the reference standard was moderate (kappa=0.33-0.65 for practice nurses and 0.33 to 0.65 for general practitioners, depending on calculation tool), showing a trend for underestimation of risk. Moderate agreement was seen between the risks calculated by general practitioners and practice nurses for the same patients (kappa=0.47 to 0.58). The British charts gave the most sensitive results for risk of coronary heart disease (practice nurses 79%, general practitioners 80%), and it also gave the most specific results for practice nurses (100%), whereas the Sheffield table was the most specific method for general practitioners (89%). CONCLUSIONS: Routine calculation of the risk of coronary heart disease in primary care is hampered by poor availability of data on risk factors. General practitioners and practice nurses are able to evaluate the risk of coronary heart disease with only moderate accuracy. Data about risk factors need to be collected systematically, to allow the use of the most appropriate calculation tools.

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The burgeoning research into altruism and helping behaviour has examined the effect of many variables that enhance or inhibit helpfulness, but little attention has been given to the influence of culture. In the present research, data on various aspects of helping behaviour were collected in both the UK and the Sudan so that the importance of cultural influences could be investigated. In addition this research also tested the validity of current models of helping. In a repertory grid study, urgency and cost emerged as the main constructs people in the two countries use to distinguish between various helpful situations. A laboratory experiment designed to test existing models of intervention behaviour found significant main effects of country, group, size, cost and urgency; and a group size/urgency interaction. Subjects in the Sudan intervened faster than subjects in the UK; lone subjects intervened faster than subjects in small and large groups; subjects in low cost intervened faster than subjects in high cost conditions; and subjects in high urgency intervened faster than subjects in low urgency conditions. Group size effect was stronger in low than in high urgency conditions. Two field studies further investigated the effect of urgency and cost in urban-nonurban context. Significant main effects of urgency and cost were found in cities but not in towns; and people in cities were less helpful than people in towns. A questionnaire survey found that in both countries there were significant urban-nonurban differences in the incidence of reported social contacts and exchange of helpful acts between acquaintances, neighbours and strangers. However, there were no urban-nonurban differences between relatives and close friends. Finally, attitudes to altruism and helpfulness did not differ between the two countries or between urban and nonurban residents. The results highlight the need to incorporate urgency and cultural variables in theoretical models of helping behaviour.

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We examined the spelling acquisition in children up to late primary school of a consistent orthography (Italian) and an inconsistent orthography (English). The effects of frequency, lexicality, length, and regularity in modulating spelling performance of the two groups were examined. English and Italian children were matched for both chronological age and number of years of schooling. Two-hundred and seven Italian children and 79 English children took part in the study. We found greater accuracy in spelling in Italian than English children: Italian children were very accurate after only 2 years of schooling, while in English children the spelling performance was still poor after 5 years of schooling. Cross-linguistic differences in spelling accuracy proved to be more persistent than the corresponding ones in reading accuracy. Orthographic consistency produced not only quantitative, but also qualitative differences, with larger frequency and regularity effects in English than in Italian children.

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OBJECTIVE—The purpose of this study was to compare prevalence and risk factors for diabetic retinopathy among U.K. residents of South Asian or white European ethnicity. RESEARCH DESIGN AND METHODS—This was a community-based cross-sectional study involving 10 general practices; 1,035 patients with type 2 diabetes were studied: 421 of South Asian and 614 of white European ethnicity. Diabetic retinopathy, sight-threatening retinopathy, maculopathy, and previous laser photocoagulation therapy were assessed after grading of retinal photographs. Data were collected on risk factors including age, duration, and treatment of diabetes, blood pressures, serum total cholesterol, and A1C. RESULTS—Patients of South Asian ethnicity had significantly higher systolic (144 vs. 137 mmHg, P < 0.0001) and diastolic (84 vs. 74 mmHg, P < 0.0001) blood pressure, A1C (7.9 vs. 7.5%, P < 0.0001), and total cholesterol (4.5 vs. 4.2 mmol/l, P < 0.0001). Diabetic retinopathy was detected in 414 (40%) patients (189 South Asian [45%] versus 225 white European [37%]; P = 0.0078). Sight-threatening retinopathy was detected in 142 (14%) patients (68 South Asian [16%] versus 74 white European [12%]; P = 0.0597). After adjustment for confounders, there were significantly elevated risks of any retinopathy and maculopathy for South Asian versus white European patients. CONCLUSIONS—Patients of South Asian ethnicity had a significantly higher prevalence of diabetic retinopathy and maculopathy, with significantly elevated systolic and diastolic blood pressure, A1C, and total cholesterol; lower attained age; and younger age at diagnosis. Earlier onset of disease and higher levels of modifiable risk factors make early detection of diabetes, annual referral for retinal screening, and intensive risk factor control key elements in addressing this health inequality.

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Introduction - Rheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mortality, attributed to both traditional and novel cardiovascular risk factors. The metabolic syndrome, a cluster of classical cardiovascular risk factors, including hypertension, obesity, glucose intolerance, and dyslipidaemia, is highly prevalent in RA. Reports suggest that long-term glucocorticoid (GC) use may exacerbate individual cardiovascular risk factors, but there have been no studies in RA to assess whether it associates with the metabolic syndrome. We examined whether GC exposure associates with the presence of metabolic syndrome in patients with RA. Methods - RA patients (n = 398) with detailed clinical and laboratory assessments were categorised into three groups according to GC exposure: no/limited (<3 months) exposure (NE), low-dose (<7.5 mg/day) long-term exposure (LE), and medium-dose (greater than or equal to 7.5 mg to 30 mg/day) long-term exposure (ME). The metabolic syndrome was defined using the National Cholesterol Education Programme III guidelines. The association of GC exposure with the metabolic syndrome was evaluated using binary logistic regression. Results - The metabolic syndrome was present in 40.1% of this population and its prevalence did not differ significantly between the GC exposure groups (NE 37.9% versus LE 40.7% versus ME 50%, P = 0.241). Binary logistic regression did not demonstrate any increased odds for the metabolic syndrome when comparing ME with LE (odds ratio = 1.64, 95% confidence interval 0.92 to 2.92, P = 0.094) and remained non significant after adjusting for multiple potential confounders. Conclusions - Long-term GC exposure does not appear to associate with a higher prevalence of the metabolic syndrome in patients with RA. The components of the metabolic syndrome may already be extensively modified by other processes in RA (including chronic inflammation and treatments other than GCs), leaving little scope for additive effects of GCs.