Factors influencing Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction

The purpose of this study was to identify, through in-depth interview, factors that influenced 27 Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction (AMI). The median delay time from the onset of symptoms to arrival at the hospital was 15.6 hours for men and 53.7 hours for women. Three major categories emerged from the data: (a) becoming aware of the threat, (b) maintaining a sense of normality, and (c) struggling to mobilize resources. A variety of decisions were made by patients from the onset of chest Pain to seeking help. These decisions were heavily influenced by healthcare factors (access to emergency medical service (EMS) and treatment), personal factors (cognitive interpretations of symptoms), sociocultural factors (family situation, cultural beliefs, and practices), and coping strategies. (c) 2006 Wiley Periodicals, Inc.

Tourism crisis and disasters: Enhancing understanding of system effects

This paper examines the definitions and conceptual foundations of crises and distinguishes between crises and disasters. It takes a systems view of these concepts and uses the perspective of systems as organizational networks to examine implications for tourism managers. A tourism destination is perceived as consisting of a network of interacting organizations. This perspective questions the boundaries that should be used to study crisis and disasters. The paper also discusses the possibility of a crisis having a positive outcome for a destination.

BEM-ESTAR NO TRABALHO E PERCEPÇÃO DE SUCESSO NA CARREIRA COMO ANTECEDENTES DE INTENÇÃO DE ROTATIVIDADE.

O objetivo geral deste estudo foi analisar, interpretar e discutir as relações entre as percepções de sucesso na carreira, bem-estar no trabalho e a intenção de rotatividade em trabalhadores da Região Sudeste do Brasil. Participaram desta pesquisa 500 trabalhadores que atuam no estado de São Paulo em organizações não governamentais, públicas e privadas. Como instrumento para coleta de dados foi utilizado um questionário de autopreenchimento composto de cinco escalas que mediram as variáveis da pesquisa. A presente pesquisa se propôs a apresentar, interpretar e discutir as relações entre as variáveis, como também, testar as hipóteses referentes ao modelo conceitual proposto, por meio de uma pesquisa de natureza transversal com abordagem quantitativa, cujos dados coletados foram analisados por aplicação de técnicas estatísticas paramétricas (cálculos de estatísticas descritivas: médias, desvio padrão, teste t e correlações; cálculos de estatísticas multivariadas: análise de regressão linear múltipla stepwise e teste da normalidade das variáveis, por meio do teste de Kolmogorov-Smirnov). O tratamento e análise dos dados foram realizados pelo software estatístico Statistical Package for the Social Science SPSS, versão 18.0 para Windows. Os resultados obtidos demonstraram que as dimensões de bem-estar no trabalho exercem forte e significativo impacto sobre a intenção de rotatividade dos profissionais, enquanto que a percepção de sucesso na carreira contribuiu com valores baixos neste impacto, devido ao formato do modelo hipotético. A pesquisa possibilitou concluir que quanto mais a empresa se preocupa em proporcionar um ambiente de trabalho que seja animador, interessante e que cause entusiasmo, menos os profissionais pensarão em deixá-la.

DROGAS E ALUNOS USUÁRIOS DE DROGAS NA ESCOLA: ESTUDO DE REPRESENTAÇÕES SOCIAIS DE PROFESSORES DO ENSINO MÉDIO DA REDE ESTADUAL DE SÃO PAULO

Este estudo apresenta uma discussão a respeito de drogas e de alunos usuários de drogas na escola, explorando as Representações Sociais manifestadas por professores que atuam na Rede Estadual de São Paulo, no ensino Médio. O estudo resgata aspectos históricos e sociais que influenciaram representações sociais sobre drogas em diferentes contextos da sociedade, na perspectiva de buscar compreender a maneira como atualmente elas se apresentam. Discute aspectos conceituais da Teoria das Representações Sociais a partir de Moscovici, considerando contribuições de Jodelet, e outros autores. Os dados coletados por meio de questionários e entrevistas foram analisados com o auxílio de dois softwares, o ALCESTE para análise lexical e o EVOC para análise de associação de palavras ou expressões, em articulação com uma análise de conteúdo clássica sugerida por Maria Laura Puglisi Barbosa Franco. O resultado identificou que as representações sociais sobre drogas na escola e alunos usuários estão ancoradas no modo como a grande mídia trata o tema, de forma alarmista e sensacionalista, influenciando grande parte dos professores que associa drogas na escola à violência. Verificou-se ainda que objetivação do aluno usuário de drogas é simbolizada como doença e que o grupo pesquisado segue as representações sociais há muito tempo estruturadas na sociedade, tendo a normalidade como sinônimo de saúde e a drogadição como condição desviante, decorrente de patologias. Assim, espera-se estar contribuindo para a reflexão sobre o uso e abuso de drogas nas escolas, um tema indispensável e que precisa ser enfrentado para construir-se uma via que leve a uma Educação justa e democrática.(AU)

PROFESSORES COM DEFICIÊNCIA FÍSICA NO ENSINO SUPERIOR: ESTUDO DE TRAJETÓRIAS ESCOLARES

Convivemos natural e socialmente com as diferenças, mesmo que de forma não apreendida, não aparente. Nesse contexto surge o estigma do deficiente, parte integrante de um grupo que foge aos padrões normais da sociedade e da natureza. E no convívio escolar essa diferença torna-se mais evidente gerando um desequilíbrio social, que as práticas pedagógicas tentam minimizar com a proposta da inclusão. As pesquisas acerca da educação inclusiva apontam experiências de professores(as) normais com alunos(as) com e sem deficiência que freqüentam o mesmo ambiente escolar. Observando essa realidade de outro ângulo, como se apresentam essas relações quando o(a) professor(a) é deficiente? Existem poucos trabalhos documentando essas experiências. Esta pesquisa pretende preencher essa lacuna, tendo como base a trajetória formativa de um professor com deficiência física, atuando no ensino superior, em conjunto com entrevistas de outros dois professores do ensino superior, também com deficiência física por meio das seguintes categorias: trajetórias no ensino básico, acesso e permanência no ensino superior, acesso ao mercado de trabalho, acesso e atuação como professor de ensino superior e inclusão. Objetivou-se assim, estabelecer uma reflexão sobre a inclusão profissional frente às dificuldades enfrentadas diariamente na escola. Na tentativa de explicitar as características e os atributos dos indivíduos com deficiência, em convívio com pessoas normais, utilizou-se como base teórica o apoio da estatística, especificamente da curva normal, em conjunto com a trajetória histórica e legislativa acerca do tema. Portanto, o estudo visa contribuir para o desenvolvimento de uma cultura inclusiva promovendo a normalidade das diferenças.(AU)

A UTILIZAÇÃO DO LASER DE BAIXA INTENSIDADE NA MOVIMENTAÇÃO DENTÁRIA E NA SENSIBILIDADE DOLOROSA APÓS APLICAÇÃO DE FORÇA ORTODÔNTICA

O presente estudo objetivou avaliar a eficácia do Laser de Baixa Intensidade (LBI) na aceleração da movimentação dentária e na diminuição da dor frente à aplicação de força ortodôntica. A amostra foi composta por 19 pacientes, sendo doze do sexo feminino e sete do sexo masculino, com idade inicial média de 14,69 anos, todos com indicação para extrações de primeiros pré-molares. Destes, 66 caninos foram submetidos à retração inicial, sendo que 33 receberam aplicação de laser e 33 foram considerados controle. Utilizou-se o Laser de Baixa Intensidade de arseneto de gálio e alumínio, com comprimento de onda de 780nm, na dosimetria de 40mW;10J/cm2;10s/ponto, aplicado apenas uma vez ao mês em dez pontos, sendo cinco por vestibular e cinco por lingual/palatino. Modelos de gesso foram confeccionados durante todos os meses de retração dos caninos, que teve duração de quatro meses, sendo, posteriormente, digitalizados para se mensurar a quantidade de movimentação de um lado em relação ao outro, utilizando-se como referência as papilas incisivas. Para a avaliação da dor experimentada pelos pacientes, os mesmos foram orientados a preencher uma escala analógica visual (VAS) que variava de 0 a 10 , em que zero significava nenhuma dor e dez significava dor insuportável, nos intervalos de 12, 24, 48 e 72 horas após a aplicação da força ortodôntica. Foi mensurado o apinhamento de todas as hemiarcadas dos pacientes na fase inicial, medindo-se a distância entre os pontos de contato de cada dente. Para a verificação do padrão de normalidade, empregou-se o teste de Kolmogorov-Smirnov, sendo que para comparar o lado irradiado com o lado não irradiado foi utilizado o teste t pareado, exceto para a variável razão caninos/molares , analisada pelo teste não paramétrico de Wilcoxon (p<0,05). Os resultados mostraram que em relação ao apinhamento dentário, os lados irradiado e não irradiado apresentaram-se compatíveis. Além disso, não houve diferença estatisticamente significante entre a quantidade de retração dos caninos irradiados comparados aos não irradiados, o mesmo acontecendo com a sensibilidade dolorosa experimentada pelos pacientes. Concluiu-se assim que o LBI na dosimetria e forma como foi utilizado não foi eficiente na aceleração da movimentação dentária nem na redução da dor experimentada pelos pacientes frente às forças ortodônticas.

Non-normally distributed data and non-parametric statistics

Different types of numerical data can be collected in a scientific investigation and the choice of statistical analysis will often depend on the distribution of the data. A basic distinction between variables is whether they are ‘parametric’ or ‘non-parametric’. When a variable is parametric, the data come from a symmetrically shaped distribution known as the ‘Gaussian’ or ‘normal distribution’ whereas non-parametric variables may have a distribution which deviates markedly in shape from normal. This article describes several aspects of the problem of non-normality including: (1) how to test for two common types of deviation from a normal distribution, viz., ‘skew’ and ‘kurtosis’, (2) how to fit the normal distribution to a sample of data, (3) the transformation of non-normally distributed data and scores, and (4) commonly used ‘non-parametric’ statistics which can be used in a variety of circumstances.

Development of a near activity visual questionnaire to assess accommodating intraocular lenses

Purpose: To develop a questionnaire that subjectively assesses near visual function in patients with 'accommodating' intraocular lenses (IOLs). Methods: A literature search of existing vision-related quality-of-life instruments identified all questions relating to near visual tasks. Questions were combined if repeated in multiple instruments. Further relevant questions were added and item interpretation confirmed through multidisciplinary consultation and focus groups. A preliminary 19-item questionnaire was presented to 22 subjects at their 4-week visit post first eye phacoemulsification with 'accommodative' IOL implantation, and again 6 and 12 weeks post-operatively. Rasch Analysis, Frequency of Endorsement, and tests of normality (skew and kurtosis) were used to reduce the instrument. Cronbach's alpha and test-retest reliability (intraclass correlation coefficient, ICC) were determined for the final questionnaire. Construct validity was obtained by Pearson's product moment correlation (PPMC) of questionnaire scores to reading acuity (RA) and to Critical Print Size (CPS) reading speed. Criterion validity was obtained by receiver operating characteristic (ROC) curve analysis and dimensionality of the questionnaire was assessed by factor analysis. Results: Rasch Analysis eliminated nine items due to poor fit statistics. The final items have good separation (2.55), internal consistency (Cronbach's α = 0.97) and test-retest reliability (ICC = 0.66). PPMC of questionnaire scores with RA was 0.33, and with CPS reading speed was 0.08. Area under the ROC curve was 0.88 and Factor Analysis revealed one principal factor. Conclusion: The pilot data indicates the questionnaire to be internally consistent, reliable and a valid instrument that could be useful for assessing near visual function in patients with 'accommodating' IOLS. The questionnaire will now be expanded to include other types of presbyopic correction. © 2007 British Contact Lens Association.

Statnote 1: is the data normal?

Testing whether an observed distribution of observations deviates from normality is a common type of statistical test available in statistics software. Most software offer two ways of judging whether there are significant deviations of the observed from the expected distributions, viz., chi-square and the KS test. These tests have different sensitivities and problems and often give conflicting results. The results of these tests together with observations of the shape of the observed distribution should be used to judge normality.

Statnote 4: what if the data are not normal?

When testing the difference between two groups, if previous data indicate non-normality, then either transform the data if they comprise percentages, integers or scores or use a non-parametric test. If there is uncertainty whether the data are normally distributed, then deviations from normality are likely to be small if the data are measurements to three significant figures. Unless there is clear evidence that the distribution is non-normal, it is more efficient to use the conventional t-tests. It is poor statistical practice to carry out both the parametric and non-parametric tests on a set of data and then choose the result that is most convenient to the investigator!

Statnote 5: Is one set of data more variable than another?

There may be circumstances where it is necessary for microbiologists to compare variances rather than means, e,g., in analysing data from experiments to determine whether a particular treatment alters the degree of variability or testing the assumption of homogeneity of variance prior to other statistical tests. All of the tests described in this Statnote have their limitations. Bartlett’s test may be too sensitive but Levene’s and the Brown-Forsythe tests also have problems. We would recommend the use of the variance-ratio test to compare two variances and the careful application of Bartlett’s test if there are more than two groups. Considering that these tests are not particularly robust, it should be remembered that the homogeneity of variance assumption is usually the least important of those considered when carrying out an ANOVA. If there is concern about this assumption and especially if the other assumptions of the analysis are also not likely to be met, e.g., lack of normality or non additivity of treatment effects then it may be better either to transform the data or to carry out a non-parametric test on the data.

Productivity analysis and measurement

The state of the art in productivity measurement and analysis shows a gap between simple methods having little relevance in practice and sophisticated mathematical theory which is unwieldy for strategic and tactical planning purposes, -particularly at company level. An extension is made in this thesis to the method of productivity measurement and analysis based on the concept of added value, appropriate to those companies in which the materials, bought-in parts and services change substantially and a number of plants and inter-related units are involved in providing components for final assembly. Reviews and comparisons of productivity measurement dealing with alternative indices and their problems have been made and appropriate solutions put forward to productivity analysis in general and the added value method in particular. Based on this concept and method, three kinds of computerised models two of them deterministic, called sensitivity analysis and deterministic appraisal, and the third one, stochastic, called risk simulation, have been developed to cope with the planning of productivity and productivity growth with reference to the changes in their component variables, ranging from a single value 'to• a class interval of values of a productivity distribution. The models are designed to be flexible and can be adjusted according to the available computer capacity expected accuracy and 'presentation of the output. The stochastic model is based on the assumption of statistical independence between individual variables and the existence of normality in their probability distributions. The component variables have been forecasted using polynomials of degree four. This model is tested by comparisons of its behaviour with that of mathematical model using real historical data from British Leyland, and the results were satisfactory within acceptable levels of accuracy. Modifications to the model and its statistical treatment have been made as required. The results of applying these measurements and planning models to the British motor vehicle manufacturing companies are presented and discussed.

Investigation of chromatic function in the normal and abnormal eye

This study examined the use of non-standard parameters to investigate the visual field, with particular reference to the detection of glaucomatous visual field loss. Evaluation of the new perimetric strategy for threshold estimation - FASTPAC, demonstrated a reduction in the examination time of normals compared to the standard strategy. Despite an increased within-test variability the FASTPAC strategy produced a similar mean sensitivity to the standard strategy, reducing the effects of patient fatigue. The new technique of Blue-Yellow perimetry was compared to White-White perimetry for the detection of glaucomatous field loss in OHT and POAG. Using a database of normal subjects, confidence limits for normality were constructed to account for the increased between-subject variability with increase in age and eccentricity and for the greater variability of the Blue-Yellow field compared to the White-White field. Effects of individual ocular media absorption had little effect on Blue-Yellow field variability. Total and pattern probability analysis revealed five of 27 OHTs to exhibit Blue-Yellow focal abnormalities; two of these patients subsequently developed White-White loss. Twelve of the 24 POAGs revealed wider and/or deeper Blue-Yellow loss compared with the White-White field. Blue-Yellow perimetry showed good sensitivity and specificity characteristics, however, lack of perimetric experience and the presence of cataract influenced the Blue-Yellow visual field and may confound the interpretation of Blue-Yellow visual field loss. Visual field indices demonstrated a moderate relationship to the structural parameters of the optic nerve head using scanning laser tomography. No abnormalities in Blue-Yellow or Red-Green colour CS was apparent for the OHT patients. A greater vulnerability of the SWS pathway in glaucoma was demonstrated using Blue-Yellow perimetry however predicting which patients may benefit from B-Y perimetric examination is difficult. Furthermore, cataract and the extent of the field loss may limit the extent to which the integrity of the SWS channels can be selectively examined.

Variability of the permetric response in normals and in glaucoma

This study investigated the variability of response associated with various perimetric techniques, with the aim of improving the clinical interpretation of automated static threshold perirnetry. Evaluation of a third generation of perimetric threshold algorithms (SITA) demonstrated a reduction in test duration by approximately 50% both in normal subjects and in glaucoma patients. SITA produced a slightly higher, but clinically insignificant, Mean Sensitivity than with the previous generations of algorithms. This was associated with a decreased between-subject variability in sensitivity and hence, lower confidence intervals for normality. In glaucoma, the SITA algorithms gave rise to more statistically significant visual field defects and a similar between-visit repeatability to the Full Threshold and FASTPAC algorithms. The higher estimated sensitivity observed with SITA compared to Full Threshold and FASTPAC were not attributed to a reduction in the fatigue effect. The investigation of a novel method of maintaining patient fixation, a roving fixation target which paused immediately prior lo the stimulus presentation, revealed a greater degree of fixational instability with the roving fixation target compared to the conventional static fixation target. Previous experience with traditional white-white perimetry did not eradicate the learning effect in short-wavelength automated perimetry (SWAP) in a group of ocular hypertensive patients. The learning effect was smaller in an experienced group of patients compared to a naive group of patients, but was still at a significant level to require that patients should undertake a series of at least three familiarisation tests with SWAP.

Stock market efficiency before and after a financial liberalisation reform:do breaks in volatility dynamics matter?

This article focuses on the deviations from normality of stock returns before and after a financial liberalisation reform, and shows the extent to which inference based on statistical measures of stock market efficiency can be affected by not controlling for breaks. Drawing from recent advances in the econometrics of structural change, it compares the distribution of the returns of five East Asian emerging markets when breaks in the mean and variance are either (i) imposed using certain official liberalisation dates or (ii) detected non-parametrically using a data-driven procedure. The results suggest that measuring deviations from normality of stock returns with no provision for potentially existing breaks incorporates substantial bias. This is likely to severely affect any inference based on the corresponding descriptive or test statistics.