Distinguishing phenotypes of childhood wheeze and cough using latent class analysis

Airway disease in childhood comprises a heterogeneous group of disorders. Attempts to distinguish different phenotypes have generally considered few disease dimensions. The present study examines phenotypes of childhood wheeze and chronic cough, by fitting a statistical model to data representing multiple disease dimensions. From a population-based, longitudinal cohort study of 1,650 preschool children, 319 with parent-reported wheeze or chronic cough were included. Phenotypes were identified by latent class analysis using data on symptoms, skin-prick tests, lung function and airway responsiveness from two preschool surveys. These phenotypes were then compared with respect to outcome at school age. The model distinguished three phenotypes of wheeze and two phenotypes of chronic cough. Subsequent wheeze, chronic cough and inhaler use at school age differed clearly between the five phenotypes. The wheeze phenotypes shared features with previously described entities and partly reconciled discrepancies between existing sets of phenotype labels. This novel, multidimensional approach has the potential to identify clinically relevant phenotypes, not only in paediatric disorders but also in adult obstructive airway diseases, where phenotype definition is an equally important issue.

Productive Diversification and Sustainable Use of Complex Social-Ecological Systems: A Comparative Study of Indigenous and Settler Communities in the Bolivian Amazon

Agricultural and forest productive diversification depends on multiple socioeconomic drivers—like knowledge, migration, productive capacity, and market—that shape productive strategies and influence their ecological impacts. Our comparison of indigenous and settlers allows a better understanding of how societies develop different diversification strategies in similar ecological contexts and how the related socioeconomic aspects of diversification are associated with land cover change. Our results suggest that although indigenous people cause less deforestation and diversify more, diversification is not a direct driver of deforestation reduction. A multidimensional approach linking sociocognitive, economic, and ecological patterns of diversification helps explain this contradiction.

Organizational Assessment: An Academic Library Case Study

In this academic library case study, the concept of a multidimensional approach to organizational assessment focuses on one of Kaplan and Norton’s four Balanced Scorecard dimensions, “Learning and Growth”, as its measurement target.

Improving the Quality of Life of spousal caregivers of stroke survivors: A cost effectiveness analysis

Back ground and Purpose. There is a growing consensus among health care researchers that Quality of Life (QoL) is an important outcome and, within the field of family caregiving, cost effectiveness research is needed to determine which programs have the greatest benefit for family members. This study uses a multidimensional approach to measure the cost effectiveness of a multicomponent intervention designed to improve the quality of life of spousal caregivers of stroke survivors. Methods. The CAReS study (Committed to Assisting with Recovery after Stroke) was a 5-year prospective, longitudinal intervention study for 159 stroke survivors and their spousal caregivers upon discharge of the stroke survivor from inpatient rehabilitation to their home. CAReS cost data were analyzed to determine the incremental cost of the intervention per caregiver. The mean values of the quality-of-life predictor variables of the intervention group of caregivers were compared to the mean values of usual care groups found in the literature. Significant differences were then divided into the cost of the intervention per caregiver to calculate the incremental cost effectiveness ratio for each predictor variable. Results. The cost of the intervention per caregiver was approximately $2,500. Statistically significant differences were found between the mean scores for the Perceived Stress and Satisfaction with Life scales. Statistically significant differences were not found between the mean scores for the Self Reported Health Status, Mutuality, and Preparedness scales. Conclusions. This study provides a prototype cost effectiveness analysis on which researchers can build. Using a multidimensional approach to measure QoL, as used in this analysis, incorporates both the subjective and objective components of QoL. Some of the QoL predictor variable scores were significantly different between the intervention and comparison groups, indicating a significant impact of the intervention. The estimated cost of the impact was also examined. In future studies, a scale that takes into account both the dimensions and the weighting each person places on the dimensions of QoL should be used to provide a single QoL score per participant. With participant level cost and outcome data, uncertainty around each cost-effectiveness ratio can be calculated using the bias-corrected percentile bootstrapping method and plotted to calculate the cost-effectiveness acceptability curves.^

Modelo para la toma de decisiones sobre los contenidos curriculares de la Organización del Conocimiento en programas académicos de Bibliotecología, Documentación o Ciencia de la Información

Se presenta un modelo para decidir los contenidos curriculares de la Organización del Conocimiento en carreras de Bibliotecología, Documentación y Ciencia de la Información, orientado principalmente al Mercosur. Para el diseño del modelo se tuvieron en cuenta los contenidos mínimos recomendados por los encuentros de directores y docentes de escuelas de Bibliotecología del Mercosur, la llamada corriente de ISKO y los aportes de distintos autores relacionados con ambas fuentes. El modelo consta de tres categorías primarias: fundamentos, aplicaciones y ética de la Organización del Conocimiento. Los fundamentos se consideran desde un abordaje multidimensional. Las aplicaciones se dividen en tres categorías primarias: a) construcción de sistemas de organización del conocimiento, b) descripción de contenido y c) gestión de calidad de la Organización del Conocimiento. La ética también se divide en tres categorías secundarias: compromiso ético, valores éticos y problemas éticos. El modelo debe entenderse como un molde vacío que necesita llenarse con los contenidos que decida cada carrera o cada espacio curricular y se espera que facilite la evaluación, actualización y comparación de esos contenidos. Tiene la limitación de basarse en las recomendaciones del Mercosur y la corriente de ISKO, que no son aceptadas por todos los especialistas

Modelo para la toma de decisiones sobre los contenidos curriculares de la Organización del Conocimiento en programas académicos de Bibliotecología, Documentación o Ciencia de la Información

Se presenta un modelo para decidir los contenidos curriculares de la Organización del Conocimiento en carreras de Bibliotecología, Documentación y Ciencia de la Información, orientado principalmente al Mercosur. Para el diseño del modelo se tuvieron en cuenta los contenidos mínimos recomendados por los encuentros de directores y docentes de escuelas de Bibliotecología del Mercosur, la llamada corriente de ISKO y los aportes de distintos autores relacionados con ambas fuentes. El modelo consta de tres categorías primarias: fundamentos, aplicaciones y ética de la Organización del Conocimiento. Los fundamentos se consideran desde un abordaje multidimensional. Las aplicaciones se dividen en tres categorías primarias: a) construcción de sistemas de organización del conocimiento, b) descripción de contenido y c) gestión de calidad de la Organización del Conocimiento. La ética también se divide en tres categorías secundarias: compromiso ético, valores éticos y problemas éticos. El modelo debe entenderse como un molde vacío que necesita llenarse con los contenidos que decida cada carrera o cada espacio curricular y se espera que facilite la evaluación, actualización y comparación de esos contenidos. Tiene la limitación de basarse en las recomendaciones del Mercosur y la corriente de ISKO, que no son aceptadas por todos los especialistas

Modelo para la toma de decisiones sobre los contenidos curriculares de la Organización del Conocimiento en programas académicos de Bibliotecología, Documentación o Ciencia de la Información

Se presenta un modelo para decidir los contenidos curriculares de la Organización del Conocimiento en carreras de Bibliotecología, Documentación y Ciencia de la Información, orientado principalmente al Mercosur. Para el diseño del modelo se tuvieron en cuenta los contenidos mínimos recomendados por los encuentros de directores y docentes de escuelas de Bibliotecología del Mercosur, la llamada corriente de ISKO y los aportes de distintos autores relacionados con ambas fuentes. El modelo consta de tres categorías primarias: fundamentos, aplicaciones y ética de la Organización del Conocimiento. Los fundamentos se consideran desde un abordaje multidimensional. Las aplicaciones se dividen en tres categorías primarias: a) construcción de sistemas de organización del conocimiento, b) descripción de contenido y c) gestión de calidad de la Organización del Conocimiento. La ética también se divide en tres categorías secundarias: compromiso ético, valores éticos y problemas éticos. El modelo debe entenderse como un molde vacío que necesita llenarse con los contenidos que decida cada carrera o cada espacio curricular y se espera que facilite la evaluación, actualización y comparación de esos contenidos. Tiene la limitación de basarse en las recomendaciones del Mercosur y la corriente de ISKO, que no son aceptadas por todos los especialistas

The Weakness of Post-Communist Civil Society Reassessed. CES Papers - Open Forum #11, 2012

During the last two decades, scholars from a variety of disciplines have argued that civil society is structurally deficient in post-communist countries. Yet why have the seemingly strong, active and mobilized civic movements of the transition period become so weak after democracy was established? And why have there been diverging political trajectories across the post-communist space if civil society structures were universally weak? This paper uses a wide range of data from various available sources to show that civil societies in Central and Eastern European countries are not as feeble as is commonly assumed. Some post-communist countries possess vigorous public spheres, and active civil society organizations strongly connected to transnational civic networks able to shape domestic policies. Following the calls by Anheier (2004) and Bernhard and Karakoç (2007) we adopt a multidimensional approach to the measurement of civil society. In a series of cross-section timeseries models, we show that our broader measures of civic and social institutions are able to predict the diverging transition paths among post-communist regimes, and in particular the growing gap between democratic East Central Europe and the increasingly authoritarian post-Soviet space.

Beyond power:unbridging Foucault and Weber

Today, very few would doubt that there are plenty of reasons to liken Weber’s and Foucault’s theories of power. Nevertheless, their respective works have divergent ethical and ontological preoccupations which should be reconsidered. This paper explores Foucault’s account of a historical episode in Discipline and Punish and Weber’s theory of life spheres, uncovering evidence that there is a need to reassess the conceptual bridges which have been built so far. The exploration reveals a radical difference between a monological theory of power (Foucault) and a multidimensional approach to power (Weber). Yet by unbridging the two thinkers and focusing on other aspects of their theories along with their ideas about power, we also find that alternative links between the two frameworks may offer a more promising critical theory.

O ser idoso estomizado sob o olhar complexo: uma proposta de gerontotecnologia educativa

Na presença da estomia, o idoso pode apresentar maior grau de complicações e dificuldades no processo de adaptação, talvez porque a estomia envolva significados que dizem respeito à auto-imagem e à presença/aumento de dependência. Resgatar a necessidade do autocuidado do idoso em relação à saúde é fundamental para que, no cuidado, se obtenha sua participação e mobilização diária quanto à formulação do processo educativo em saúde. Este estudo tem como objetivos identificar as características do idoso estomizado, atendido em um serviço de estomaterapia e propor uma gerontotecnologia educativa que venha a contribuir no cuidado de idosos estomizados, à luz da Complexidade, de Edgar Morin. Foi realizada uma pesquisa, com abordagem qualitativa, do tipo estudo de caso, tendo como local um serviço de estomaterapia, o qual possibilitou contato com fichas cadastrais e via telefone com os sujeitos e, depois, com o domicílio do idoso, no Rio Grande, Rio Grande do Sul, Brasil. Os sujeitos do estudo totalizaram 4 (quatro) idosos, sendo três mulheres e um homem. Foram utilizados, como instrumento, o formulário e o ecomapa, e como técnicas, a entrevista, a observação assistemática e a gravação. Foram respeitadas as normas éticas. A análise dos dados deu-se por: 1) leitura exaustiva dos dados; 2) apresentação dos casos e seus ecomapas tendo como suporte a Complexidade de Edgar Morin; 3) redescoberta de conceitos, a priori, que ilustraram a visão do idoso com estomia: ser humano idoso estomizado complexo, saúde complexa do idoso estomizado, cuidado complexo ao idoso estomizado e sua família. Por fim, elaborou-se uma cartilha educativa, junto ao idoso, como facilitadora para o autocuidado. Quanto aos resultados, verificou-se que cada idoso estomizado está permeado por situações pontuais e, a partir disso, percebeu-se diferentes concepções recursivas e formas de enfrentamento na adaptação. A aceitação da mudança corporal e psicológica mostrou-se mais fácil, quando se verificou apoio familiar, instrução técnica anterior ou presença de pessoas conhecidas. O enfrentamento da doença e a possibilidade da morte são aspectos presentes para os idosos e que limitam suas atividades de vida diária. Assim, surgiram conceitos que contemplaram o ser humano em sua totalidade, com incertezas e significados. A visão que transcende a complexidade da estomia engloba um cuidado que busca integrar a família do idoso com estomia, estimulando-o ao autocuidado e ao acolhimento diário, reforçando a auto-estima, como estratégia de recomeço em meio a desafios permanentes: ser idoso e ter uma estomia. Lançar um novo olhar sobre a temática idoso estomizado é complexo, exigindo abordagem multidimensional das características que o envolvem. Acreditase que mudanças favoráveis poderão advir após implementação de um programa de educação em saúde que contemple a singularidade das questões que envolvem o idoso estomizado e suas necessidades.

Attention to Diversity from an Interdisciplinary Perspective: Results from the Final Graduation Project from a Group of Students Majoring in Preschool Education and Special Education

Nowadays, the topic of diversity is being studied, particularly in the field of the formation of future educators, where it is clearly evident in each one of the students. In order to understand this concept and meet the challenges it demands, this investigation, through the experience of action research, looks for a real picture of how this diversity is served in Guanacaste’s rural contexts. This is accomplished by identifying those ways to guide a better teachers’ work, and by taking into account the educational planning and the participation of the different sectors involved in the process of teaching and learning.

Characterization approach to modified glassy carbon electrode-nanofilm system within multidimensional scaling

The aim of this work is to characterize the nanofilm consisting of the benzoic acid-modified glassy carbon (GC) electrode system through multidimensional scaling space analysis. The surface modification is based on the electrochemical reaction between the GC electrode and benzoic acid-diazonium salt (BA-DAS). As a result, the nonofilms regarding the benzoic acid-glassy carbon (BA-GC) electrode surface was obtained. For the analysis of the naonfilm of BC-GC electrode system, the IR spectra of the modified BA-GC electrode surface, GC surface and BA-DAS were recorded in the spectral range of 599.84 – 3996.34 [cm–1]. The IR data vectors of the above three forms were processed by the using the multidimensional scaling space approach to demonstrate the existence of a nanofilm on the modified BA-GC electrode system. Two- and three-dimensional MDS profiles obtained by application of multidimensional scaling approach to the data sets {CG1,...,CG10}, {BA-GC1,...,BA-GC10} and {FILM1,...,FILM10} allow a good recognition of the nanofilm on the modified glassy carbon (GC) electrode system.

A multidimensional measurement approach and analysis of children's motivation for reading, attributional style, and reading achievement

The present study investigates the usefulness of a multi-method approach to the measurement of reading motivation and achievement. A sample of 127 elementary and middle-school children aged 10 to 14 responded to measures of motivation, attributions, and achievement both longitudinally and in a challenging reading context. Novel measures of motivation and attributions were constructed, validated, and utilized to examine the relationship between ~ motivation, attributions, and achievement over a one-year period (Study I). The impact of classroom contexts and instructional practices was also explored through a study of the influence of topic interest and challenge on motivation, attributions, and persistence (Study II), as well as through interviews with children regarding motivation and reading in the classroom (Study III). Creation and validation of novel measures of motivation and attributions supported the use of a self-report measure of motivation in situation-specific contexts, and confirmed a three-factor structure of attributions for reading performance in both hypothetical and situation-specific contexts. A one-year follow up study of children's motivation and reading achievement demonstrated declines in all components of motivation beginning at age 10 through 12, and particularly strong decreases in motivation with the transition to middle school. Past perceived competence for reading predicted current achievement after controlling for past achievement, and showed the strongest relationships with reading-related skills in both elementary and middle school. Motivation and attributions were strongly related, and children with higher motivation Fulmer III displayed more adaptive attributions for reading success and failure. In the context of a developmentally inappropriate challenging reading task, children's motivation for reading, especially in terms of perceived competence, was threatened. However, interest in the story buffered some ofthe negative impacts of challenge, sustaining children's motivation, adaptive attributions, and reading persistence. Finally, children's responses during interviews outlined several emotions, perceptions, and aspects of reading tasks and contexts that influence reading motivation and achievement. Findings revealed that children with comparable motivation and achievement profiles respond in a similar way to particular reading situations, such as excessive challenge, but also that motivation is dynamic and individualistic and can change over time and across contexts. Overall, the present study outlines the importance of motivation and adaptive attributions for reading success, and the necessity of integrating various methodologies to study the dynamic construct of achievement motivation.

Multidimensional Measures of Firm Competitiveness: a Model-Based Approach

The concept of competitiveness, for a long time considered as strictly connected to economic and financial performances, evolved, above all in recent years, toward new, wider interpretations disclosing its multidimensional nature. The shift to a multidimensional view of the phenomenon has excited an intense debate involving theoretical reflections on the features characterizing it, as well as methodological considerations on its assessment and measurement. The present research has a twofold objective: going in depth with the study of tangible and intangible aspect characterizing multidimensional competitive phenomena by assuming a micro-level point of view, and measuring competitiveness through a model-based approach. Specifically, we propose a non-parametric approach to Structural Equation Models techniques for the computation of multidimensional composite measures. Structural Equation Models tools will be used for the development of the empirical application on the italian case: a model based micro-level competitiveness indicator for the measurement of the phenomenon on a large sample of Italian small and medium enterprises will be constructed.