977 resultados para Cognitive validation questionnaires
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The Experiences in Close Relationships Inventory permits to evaluate attachment in close relationships during adulthood based on two dimensions able to be present in this kind of relationships: the avoidance of proximity and the anxiety related with to abandonment. It is a self-report 7- points likert scale composed by 36 items. The Portuguese version was administered to a sample of 551 university students (60% female), the majority with ages between 19 and 24 years old (88%) in a dating relationship (86%). The principal components analysis with oblimin rotation was performed. The total scale has good internal consistency (α=.86), as also has the 2 sub-scales: anxiety (α=.86) and avoidance (α=.88). The two dimensions evaluated are significantly correlated with socio-demographics, relational characteristics (jealousy, relationship distress, and compromise), wishes (enmeshment versus differentiation) and fears (abandonment versus control) related to attitudes in significant relationships, which testify the construct validity of the instrument. The results obtained are coherent with the original version and other ECR‘s adaptations. Practitioners and researchers in the context of clinical psychology and related areas have now at their disposal the Portuguese version of the ECR inventory, which has shown its very high usefulness in the study of close relationships, and specifically attachment in adulthood.
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This paper presents a model predictive current control applied to a proposed single-phase five-level active rectifier (FLAR). This current control strategy uses the discrete-time nature of the active rectifier to define its state in each sampling interval. Although the switching frequency is not constant, this current control strategy allows to follow the reference with low total harmonic distortion (THDF). The implementation of the active rectifier that was used to obtain the experimental results is described in detail along the paper, presenting the circuit topology, the principle of operation, the power theory, and the current control strategy. The experimental results confirm the robustness and good performance (with low current THDF and controlled output voltage) of the proposed single-phase FLAR operating with model predictive current control.
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The job of health professionals, including nurses, is considered inherently stressful (Lee & Wang, 2002; Rutledge et al., 2009), and thus it is important to improve and develop specific measures that are sensitive to the demands that health professionals face. This study analysed the psychometric properties of three instruments that focus on the professional experiences of nurses in aspects related to occupational stress, cognitive appraisal, and mental health issues. The evaluation protocol included the Stress Questionnaire for Health Professionals (SQHP; Gomes, 2014), the Cognitive Appraisal Scale (CAS; Gomes, Faria, & Gonçalves, 2013), and the General Health Questionnaire-12 (GHQ-12; Goldberg, 1972). Validity and reliability issues were considered with statistical analysis (i.e. confirmatory factor analysis, convergent validity, and composite reliability) that revealed adequate values for all of the instruments, namely, a six-factor structure for the SQHP, a five-factor structure for the CAS, and a two-factor structure for the GHQ-12. In conclusion, this study proposes three consistent instruments that may be useful for analysing nurses’ adaptation to work contexts.
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OBJECTIVE: To assess the Dixtal DX2710 automated oscillometric device used for blood pressure measurement according to the protocols of the BHS and the AAMI. METHODS: Three blood pressure measurements were taken in 94 patients (53 females 15 to 80 years). The measurements were taken randomly by 2 observers trained to measure blood pressure with a mercury column device connected with an automated device. The device was classified according to the protocols of the BHS and AAMI. RESULT: The mean of blood pressure levels obtained by the observers was 148±38/93±25 mmHg and that obtained with the device was 148±37/89±26 mmHg. Considering the differences between the measurements obtained by the observer and those obtained with the automated device according to the criteria of the BHS, the following classification was adopted: "A" for systolic pressure (69% of the differences < 5; 90% < 10; and 97% < 15 mmHg); and "B" for diastolic pressure (63% of the differences < 5; 83% < 10; and 93% < 15 mmHg). The mean and standard deviation of the differences were 0±6.27 mmHg for systolic pressure and 3.82±6.21 mmHg for diastolic pressure. CONCLUSION: The Dixtal DX2710 device was approved according to the international recommendations.
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El presente estudio pretende arribar a la construcción de un modelo explicativo del comportamiento político a partir de la contribución que los marcos sociales (norma sociales, normas de ciudadanía, ideología, confianza política) y sociocognitivos (inteligencia afectiva, interés político, eficacia política, conocimiento político, sentimiento de comunidad) mostraron, en términos de relaciones entre las variables, sobre el mismo. Nuestra atención se centra no sólo al comportamiento político de la ciudadanía -que es donde se desarrollaron la mayor parte de los estudios-, sino a las elites de poder constitutivas del sistema político (jueces, legisladores provinciales y representantes de instituciones del gobierno y de organismos no gubernamentales). Asimismo, pretende establecer las diferencias que puedan evidenciarse en torno a la relación de estas variables con el comportamiento político entre los distintos colectivos estudiados en el ámbito de la ciudad de Córdoba. Para ello se realizara una primera etapa de estudio instrumental, con el objeto de analizar las propiedades psicométricas de los instrumentos a utilizar en la operacionalización de las variables. Para ello se tomara una muestra accidental de 250 personas entre 18 y 65 años de edad. Posteriormente, se realizarán dos etapas de estudio ex post facto, con la finalidad de construir los modelos planteados. En la primera de ellas, se trabajará con una muestra accidental de 100 representantes de los grupos de poder estudiados y en la segunda con una muestra probabilística de 500 ciudadanos cordobeses entre 18 y 65 años de edad.
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Identificación y caracterización del problema objeto de estudio: Diversas investigaciones señalan que el uso o consumo de alcohol comienza durante la adolescencia. En este periodo del desarrollo típicamente se han reportado deterioros asociados con el consumo de alcohol sobre diversas funciones cognitivas. Sin embargo, los hallazgos no siempre han sido concluyentes. Hipótesis: a) Existe una mayor cantidad de déficits neuropsicológicos (especialmente en los dominios asociados con la toma de decisiones) en los grupos de adolescentes que presentan patrones de consumo elevados o tipo binge y en los adolescentes bajo tratamiento; b) Existen sesgos cognitivos de tipo implícito en los adolescentes expuestos a publicidades referidas a bebidas alcohólicas; y c) Existe mayor presencia de expectativas negativas en el grupo conformado por niños, así como una mayor presencia de expectativas positivas en el grupo conformado por adolescentes. Planteo de Objetivos: se pretende lograr un perfil neuropsicológico de adolescentes de ambos sexos en función de patrones de consumo de alcohol bien diferenciados. Asimismo, se intentará determinar la presencia de sesgos cognitivos hacia estímulos asociados con el alcohol en función de las expectativas hacia el psicotrópico y el tipo de consumo del mismo que presenta la población bajo estudio. Finalmente, se buscará determinar si existen cambios evolutivos en las expectativas hacia el alcohol que pudieran indicar la presencia de mayor vulnerabilidad al consumo de alcohol. Materiales y métodos a utilizar: Se utilizarán pruebas neuropsicológicas (IGT, WCST, otras) y cognitivas (AEQ o similares). Se apelará al uso de diseños ex post facto prospectivos de tipo simple o factoriales, diseños factoriales, estudios instrumentales y estudios descriptivos de poblaciones mediante encuestas. Resultados esperados: 1) Se espera encontrar una mayor cantidad de déficits neuropsicológicos (especialmente en los dominios asociados con la toma de decisiones) en los grupos de adolescentes con patrones de consumo de alcohol elevados y binge, así como en el grupo de adolescentes bajo tratamiento. 2) Se espera encontrar la presencia de sesgos cognitivos implícitos en aquellos adolescentes expuestos a publicidades referidas a bebidas alcohólicas en contraposición a los adolescentes expuestos a publicidades de bebidas no-alcohólicas. 3) Se espera encontrar una mayor presencia de expectativas negativas en el grupo conformado por niños, y una mayor presencia de expectativas positivas en el grupo conformado por adolescentes, con lo que se verificaría el supuesto que señala que las EA se modifican a lo largo del desarrollo. Asimismo, se espera confirmar que las EA cambian en función de la experiencia de consumo de alcohol. Importancia del proyecto: En el ámbito local no se han realizado estudios sistemáticos de esta naturaleza, la información que se obtenga permitirá evaluar el impacto del uso y abuso de alcohol durante la adolescencia así como diseñar y ejecutar mejores estrategias de prevención y de rehabilitación y, al mismo tiempo, facilitará la toma de decisiones en el campo de la planificación de políticas sanitarias dirigidas a los adolescentes.
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En la investigación anterior -en la zona pampeana de la Provincia de Córdoba- se demostró teórica y empíricamente, que el desarrollo de la Sociedad Civil muchas veces libradas a su suerte y con limitaciones legales apoyan decididamente el desarrollo local, sin embargo han logrado solo parcialmente sus objetivos, por lo que es necesario comenzar un camino de fortalecimiento en los nuevos roles que deben asumir. Los gobiernos locales, a la vez, intentan trabajosamente con contados éxitos detener el procesos de descapitalización social -financiera y humana- de sus comunidades locales y regionales, peregrinando con escaso éxito a los centros concentrados del poder político y económico, para procurar los recursos financieros y humanos necesarios que no alcanzan a reponer los que se fugan desde hace décadas de sus localidades. Las empresas, con ciclos recurrentes de crecimiento y decrecimiento vinculados a los mercados en que colocan sus productos, también se debaten en la búsqueda de los escasos recursos, financieros y humanos, que les permitan consolidar un desarrollo a mediano y largo plazo. El desarrollo alcanzado en Sistemas de información, instrumentos de relevamiento, análisis y elaboración de propuestas para el Desarrollo Local, nos permite avanzar en: 1. La confirmación empírica de las hipótesis iniciales - factores exógenos y endógenos - en la zona Norte y Serrana de la provincia 2. La validación científica -mediante el Análisis de ecuaciones estructurales. de tales supuestos, para el conjunto de las poblaciones analizadas en ambas etapas. 3. La identificación de los problemas normativos que afectan el desarrollo de las Organizaciones de la Sociedad Civil (OSC). METODOLOGÍA Respecto la validación empírica en la zona norte y serrana 1. Selección de las 4 localidades a relevar de acuerdo a las categorías definidas 2. Elaboración de acuerdos con autoridades e instituciones locales. 3. Relevamiento cualitativo con líderes locales y fuentes de datos secundarias. 4. Adaptación de instrumentos de relevamiento a las realidades locales y estudios previos 5. Relevamiento cuantitativo de campo, capacitación de encuestadores y supervisores. 6. Procesamiento y elaboración de informes finales locales. Respecto de la construcción de modelos de desarrollo 1. Desarrollar las dimensiones especificas y las variables (items) de cada factor crítico. 2. Revisar el instrumento con expertos de cada una de las dimensiones. 3. Validar a nivel exploratorio por medio de un Análisis de Componentes Principales 4. Someter a los expertos la evaluación de una serie de localidades que representan cada uno. Respecto de la identificación de las normas legales que afectan a la Sociedad Civil 1.Relevamiento documental de normas 2. Relevamiento con líderes de instituciones de la Sociedad Civil 3. Análisis de las normas vigentes 4. Elaboración de Informes Finales y Transferencia a líderes e instituciones
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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2011
Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction
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Background: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. Objective: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. Methods: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. Results: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). Conclusion: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients.
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Background: Coronary artery bypass graft (CABG) is a standard surgical option for patients with diffuse and significant arterial plaque. This procedure, however, is not free of postoperative complications, especially pulmonary and cognitive disorders. Objective: This study aimed at comparing the impact of two different physiotherapy treatment approaches on pulmonary and cognitive function of patients undergoing CABG. Methods: Neuropsychological and pulmonary function tests were applied, prior to and following CABG, to 39 patients randomized into two groups as follows: Group 1 (control) - 20 patients underwent one physiotherapy session daily; and Group 2 (intensive physiotherapy) - 19 patients underwent three physiotherapy sessions daily during the recovery phase at the hospital. Non-paired and paired Student t tests were used to compare continuous variables. Variables without normal distribution were compared between groups by using Mann-Whitney test, and, within the same group at different times, by using Wilcoxon test. The chi-square test assessed differences of categorical variables. Statistical tests with a p value ≤ 0.05 were considered significant. Results: Changes in pulmonary function were not significantly different between the groups. However, while Group 2 patients showed no decline in their neurocognitive function, Group 1 patients showed a decline in their cognitive functions (P ≤ 0.01). Conclusion: Those results highlight the importance of physiotherapy after CABG and support the implementation of multiple sessions per day, providing patients with better psychosocial conditions and less morbidity.
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Introductions: In the care of hypertension, it is important that health professionals possess available tools that allow evaluating the impairment of the health-related quality of life, according to the severity of hypertension and the risk for cardiovascular events. Among the instruments developed for the assessment of health-related quality of life, there is the Mini-Cuestionario of Calidad de Vida en la Hipertensión Arterial (MINICHAL) recently adapted to the Brazilian culture. Objective: To estimate the validity of known groups of the Brazilian version of the MINICHAL regarding the classification of risk for cardiovascular events, symptoms, severity of dyspnea and target-organ damage. Methods: Data of 200 hypertensive outpatients concerning sociodemographic and clinical information and health-related quality of life were gathered by consulting the medical charts and the application of the Brazilian version of MINICHAL. The Mann-Whitney test was used to compare health-related quality of life in relation to symptoms and target-organ damage. The Kruskal-Wallis test and ANOVA with ranks transformation were used to compare health-related quality of life in relation to the classification of risk for cardiovascular events and intensity of dyspnea, respectively. Results: The MINICHAL was able to discriminate health-related quality of life in relation to symptoms and kidney damage, but did not discriminate health-related quality of life in relation to the classification of risk for cardiovascular events. Conclusion: The Brazilian version of the MINICHAL is a questionnaire capable of discriminating differences on the health‑related quality of life regarding dyspnea, chest pain, palpitation, lipothymy, cephalea and renal damage.
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Background:The aging process promotes a progressive increase in chronic-degenerative diseases. The effect of these diseases on the functional capacity has been well recognized. Another health parameter concerns “quality of life related to health”. Among the elderly population, cardiovascular diseases stand out due to the epidemiological and clinical impact. Usually, these diseases have been associated with others. This set of problems may compromise both independence and quality of life in elderly patients who seek cardiologic treatment. These health parameters have not been well contemplated by cardiologists.Objective:Evaluating, among the elderly population with cardiovascular disease, which are the most relevant clinical determinants regarding dependence and quality of life.Methods:This group was randomly and consecutively selected and four questionnaires were applied: HAQ, SF-36, PRIME-MD e Mini Mental State.Results:The study included 1,020 elderly patients, 63.3% women. The group had been between 60 and 97 years-old (mean: 75.56 ± 6.62 years-old). 61.4% were independent or mild dependence. The quality of life total score was high (HAQ: 88.66 ± 2.68). 87.8% of patients had a SF-36 total score > 66. In the multivariate analysis, the association between diagnoses and high degrees of dependence was significant only for previous stroke (p = 0.014), obesity (p < 0.001), lack of physical activity (p = 0.016), osteoarthritis (p < 0.001), cognitive impairment (p < 0.001), and major depression (p < 0.001). Analyzing the quality of life, major depression and physical illness for depression was significantly associated with all domains of the SF-36.Conclusion:Among an elderly outpatient cardiology population, dependence and quality of life clinical determinants are not cardiovascular comorbidities, especially the depression.
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Social intelligence
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AbstractBackground:30-40% of cardiac resynchronization therapy cases do not achieve favorable outcomes.Objective:This study aimed to develop predictive models for the combined endpoint of cardiac death and transplantation (Tx) at different stages of cardiac resynchronization therapy (CRT).Methods:Prospective observational study of 116 patients aged 64.8 ± 11.1 years, 68.1% of whom had functional class (FC) III and 31.9% had ambulatory class IV. Clinical, electrocardiographic and echocardiographic variables were assessed by using Cox regression and Kaplan-Meier curves.Results:The cardiac mortality/Tx rate was 16.3% during the follow-up period of 34.0 ± 17.9 months. Prior to implantation, right ventricular dysfunction (RVD), ejection fraction < 25% and use of high doses of diuretics (HDD) increased the risk of cardiac death and Tx by 3.9-, 4.8-, and 5.9-fold, respectively. In the first year after CRT, RVD, HDD and hospitalization due to congestive heart failure increased the risk of death at hazard ratios of 3.5, 5.3, and 12.5, respectively. In the second year after CRT, RVD and FC III/IV were significant risk factors of mortality in the multivariate Cox model. The accuracy rates of the models were 84.6% at preimplantation, 93% in the first year after CRT, and 90.5% in the second year after CRT. The models were validated by bootstrapping.Conclusion:We developed predictive models of cardiac death and Tx at different stages of CRT based on the analysis of simple and easily obtainable clinical and echocardiographic variables. The models showed good accuracy and adjustment, were validated internally, and are useful in the selection, monitoring and counseling of patients indicated for CRT.
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Magdeburg, Univ., Fak. für Natuwiss., Diss., 2009