Qualités psychométriques du Consumer satisfaction questionnaire (CSQ-8) et du Helping alliance questionnaire (HAQ) [Psychometric properties of the Consumer Satisfaction Questionnaire (CSQ-8) and the Helping Alliance Questionnaire (HAQ)].

BACKGROUND: This study was based on data from a quality of care assessment survey conducted in 2011 in outpatient polyclinics of the Vaud Canton in Switzerland, comprising questionnaires completed by 568 children over the age often and 672 parents of children of all ages. The objective of this study was to evaluate the psychometric qualities of the eight-item French versions for children of the Helping Alliance Questionnaire (HAQ) and the Consumer Satisfaction Questionnaire (CSQ-8) to allow formal validation and clinical application of these tools in the context of French-speaking child psychiatry. METHODOLOGY: Responses from children over the age often to the HAQ and CSQ-8 questionnaires were submitted to confirmatory factorial analysis (CFA) for ordinal data to verify their good fit with the original long versions. Construct validity (correspondence between scores on the scales and other external criteria considered to evaluate similar concepts) of the child questionnaires was tested by Spearman's correlation with the parents' responses and their feeling of being reassured or in agreement with respect to the first visit, and with the perception of the help provided by individual and family interviews. RESULTS: CFA showed an acceptable fit with the one-dimensional model of the original scales, both for the HAQ and the CSQ-8. Significant positive correlations of the scales with the parents' responses and with other convergent external criteria confirmed the good construct validity. CONCLUSIONS: These psychometric analyses provide a basis for the validation and clinical application of the abridged French versions of the HAQ and CSQ-8 in quality of care assessment in child psychiatry.

La dysménorrhée: un problème pour le pédiatre [Dysmenorrhea: a problem for the pediatrician?].

Dysmenorrhea is common in adolescent years, especially after the onset of ovulatory cycles, usually 2 to 3 years after menarche. Pain and symptoms are responsible for school absenteeism and interruption of sports and social activities. OBJECTIVES: This study aims to measure the prevalence of severe dysmenorrhea and its consequences on adolescent girls in Switzerland. Treatment of dysmenorrhea is discussed and recommendations for clinical practice are given. STUDY DESIGN: Cross sectional survey (SMASH 02) on a nationally representative sample of adolescents (n=7548; 3340 females), aged 16 to 20 years who attended post-mandatory education. A self-administered questionnaire was used to assess the severity of dysmenorrhea and its consequences on daily life pursuit of medical help and medications used. RESULTS: Among 3340 girls, 86.6% suffered from dysmenorrhea-related symptoms: 12.4% described having severe dysmenorrhea and 74.2% moderate dysmenorrhea. Girls with severe dysmenorrhea described heavier consequences on daily activities compared with girls without dysmenorrhea: 47.8% of girls with severe dysmenorrhea reported staying at home and 66.5% declared reducing their sportive activities. Yet, fewer than half have consulted a physician for this complaint and even fewer were treated properly. RECOMMENDATION: The pediatrician has a pivotal role in screening young patients for dysmenorrhea, as well as, educating and effectively treating adolescent girls with menstruation-associated symptoms. Non-steroidal anti-inflammatory drugs are considered the first-line of treatment for dysmenorrhea, and adolescents with symptoms that do not respond to this treatment for 3 menstrual periods should be offered combined oestroprogestative contraception and must be followed up, as non-responders may have an underlying organic pathology. CONCLUSION: Dysmenorrhea is a frequent health problem in adolescent years and adolescent care providers should be able to care for these patients in an efficient way.

Optimum power allocation for parallel Gaussian channels with arbitrary input distributions

The mutual information of independent parallel Gaussian-noise channels is maximized, under an average power constraint, by independent Gaussian inputs whose power is allocated according to the waterfilling policy. In practice, discrete signalling constellations with limited peak-to-average ratios (m-PSK, m-QAM, etc) are used in lieu of the ideal Gaussian signals. This paper gives the power allocation policy that maximizes the mutual information over parallel channels with arbitrary input distributions. Such policy admits a graphical interpretation, referred to as mercury/waterfilling, which generalizes the waterfilling solution and allows retaining some of its intuition. The relationship between mutual information of Gaussian channels and nonlinear minimum mean-square error proves key to solving the power allocation problem.

Heritage Sporting Event : An Old Recipe for a New Problem

In the last decades, the globalized competition among cities and regions made them develop new strategies for branding and promoting their territory to attract tourists, investors, companies and residents. Major sports events - such as the Olympic Games, the FIFA World Cup or World and Continental Championships - have played an integral part in these strategies. Believing, with or without evidence, in the capacity of those events to improve the visibility and the economy of the host destination, many cities, regions and even countries have engaged in establishing sports events hosting strategies. The problem of the globalized competition in the sports events "market" is that many cities and regions do not have the resources - either financial, human or in terms of infrastructure - to compete in hosting major sports events. Consequently, many cities or regions have to turn to second-tier sports events. To organise those smaller events means less media coverage and more difficulty in finding sponsors, while the costs - both financial and in terms of services - stay high for the community. This paper analyses how Heritage Sporting Events (HSE) might be an opportunity for cities and regions engaged in sports events hosting strategies. HSE is an emerging concept that to date has been under-researched in the academic literature. Therefore, this paper aims to define the concept of HSE through an exploratory research study. A multidisciplinary literature review reveals two major characteristics of HSEs: the sustainability in the territory and the authenticity of the event constructed through a differentiation process. These characteristics, defined through multiple variables, give us the opportunity to observe the construction process of a sports event into a heritage object. This paper argues that HSEs can be seen as territorial resources that can represent a competitive advantage for host destinations. In conclusion, academics are invited to further research HSEs to better understand their construction process and their impacts on the territory, while local authorities are invited to consider HSEs for the branding and the promotion of their territory.

Impact of a telenursing service on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized trial study protocol.

BACKGROUND: Pediatric rheumatic diseases have a significant impact on children's quality of life and family functioning. Disease control and management of the symptoms are important to minimize disability and pain. Specialist clinical nurses play a key role in supporting medical teams, recognizing poor disease control and the need for treatment changes, providing a resource to patients on treatment options and access to additional support and advice, and identifying best practices to achieve optimal outcomes for patients and their families. This highlights the importance of investigating follow-up telenursing (TN) consultations with experienced, specialist clinical nurses in rheumatology to provide this support to children and their families. METHODS/DESIGN: This randomized crossover, experimental longitudinal study will compare the effects of standard care against a novel telenursing consultation on children's and family outcomes. It will examine children below 16 years old, recently diagnosed with inflammatory rheumatic diseases, who attend the pediatric rheumatology outpatient clinic of a tertiary referral hospital in western Switzerland, and one of their parents. The telenursing consultation, at least once a month, by a qualified, experienced, specialist nurse in pediatric rheumatology will consist of providing affective support, health information, and aid to decision-making. Cox's Interaction Model of Client Health Behavior serves as the theoretical framework for this study. The primary outcome measure is satisfaction and this will be assessed using mixed methods (quantitative and qualitative data). Secondary outcome measures include disease activity, quality of life, adherence to treatment, use of the telenursing service, and cost. We plan to enroll 56 children. DISCUSSION: The telenursing consultation is designed to support parents and children/adolescents during the course of the disease with regular follow-up. This project is novel because it is based on a theoretical standardized intervention, yet it allows for individualized care. We expect this trial to confirm the importance of support by a clinical specialist nurse in improving outcomes for children and adolescents with inflammatory rheumatisms. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012).

ILS-ESP An efficient, simple, and parameter-free algorithm for solving the permutation flow-shop problem

From a managerial point of view, the more effcient, simple, and parameter-free (ESP) an algorithm is, the more likely it will be used in practice for solving real-life problems. Following this principle, an ESP algorithm for solving the Permutation Flowshop Sequencing Problem (PFSP) is proposed in this article. Using an Iterated Local Search (ILS) framework, the so-called ILS-ESP algorithm is able to compete in performance with other well-known ILS-based approaches, which are considered among the most effcient algorithms for the PFSP. However, while other similar approaches still employ several parameters that can affect their performance if not properly chosen, our algorithm does not require any particular fine-tuning process since it uses basic "common sense" rules for the local search, perturbation, and acceptance criterion stages of the ILS metaheuristic. Our approach defines a new operator for the ILS perturbation process, a new acceptance criterion based on extremely simple and transparent rules, and a biased randomization process of the initial solution to randomly generate different alternative initial solutions of similar quality -which is attained by applying a biased randomization to a classical PFSP heuristic. This diversification of the initial solution aims at avoiding poorly designed starting points and, thus, allows the methodology to take advantage of current trends in parallel and distributed computing. A set of extensive tests, based on literature benchmarks, has been carried out in order to validate our algorithm and compare it against other approaches. These tests show that our parameter-free algorithm is able to compete with state-of-the-art metaheuristics for the PFSP. Also, the experiments show that, when using parallel computing, it is possible to improve the top ILS-based metaheuristic by just incorporating to it our biased randomization process with a high-quality pseudo-random number generator.

Tradução e adaptação cultural do Newcastle Satisfaction with Nursing Scales para a cultura brasileira

Este estudo teve por objetivos traduzir e adaptar o Newcastle Satisfaction with Nursing Scales para a cultura brasileira, bem como verificar seu uso prático. O instrumento contém duas escalas e tem como objetivo avaliar as experiências vivenciadas pelo paciente e a satisfação com o cuidado de enfermagem. Para o procedimento metodológico de adaptação cultural foram seguidas as etapas de tradução, síntese, retro-tradução, avaliação pelo comitê de especialistas e pré-teste. O processo de tradução e adaptação cultural foi considerado apropriado. A avaliação pelo comitê de especialistas resultou em modificações gramaticais simples para a maioria dos itens e, no pré-teste, participaram 40 sujeitos. A versão brasileira do Newcastle Satisfaction with Nursing Scales demonstrou adequada validade de conteúdo e facilidade de compreensão pelos sujeitos. Contudo, este é um estudo que antecede o processo de avaliação das propriedades psicométricas do instrumento, cujos resultados serão apresentados em publicação posterior.

The interaction of ownership structure and customer satisfaction as determinants of brand equity

In this paper we study the interaction between ownership structure and customer satisfaction, and their impact on a firm's brand equity. We find that customer satisfaction has a positive direct effect on brand equity but an indirect negative one, through reductions in ownership concentration. This latter effect emerges when managers are focused mainly on satisfying customers. It gives out a warning signal that highlights the perverse effect of implementing policies focused excessively on satisfying customers at the expense of shareholders, on a firm's brand equity. We demonstrate our theoretical contention, empirically, making use of an incomplete panel data comprising 69 firms from 11 different nations for the period 2002-2005.

Consumer Satisfaction with Websites of Banks - The Moderating Effect of Consumer Technology Attractiveness

The websites are becoming the firms’ first contact interface with their clients. Hence, understanding customers’ online attitudes and behaviors have been capturing increased research attention. The extant research has pointed customers’ satisfaction with the websites as the main reason for customers’ online behaviors. This research has used mostly variables related to the characteristics of the websites as the predictors of customers’ website satisfaction. However, recent research shows that groups of individuals displaying distinctive characteristics react differently to the same context. Therefore, behavior may be considerably different among groups of customers. In this study, we develop a conceptual model of the influence of individual characteristics on the traditional website quality – website satisfaction relationship. We propose a model based on the construct of consumer technology attractiveness (CTA) to represent the genuine positive propensity of individuals toward technology. We further test the moderating effect of this construct on the commonly used predictors of customer’s website satisfaction using Hierarchical Multiple Regression. The empirical study was based on websites of banks operating in Portuguese market. The commercial banking industry is one of the Portuguese industries that better uses the Internet to establish relationships with clients. Data were collected through an online website satisfaction survey, participated by the lecturers and postgraduate students from four Portuguese Universities and Polytechnic Institutes. Our final sample comprised 276 valid questionnaires. Our study permits to conclude that the most commonly used antecedents of website overall satisfaction are still relevant for analyzing consumer’s satisfaction with the banks websites. We also conclude that CTA has a significant moderating effect on almost all customers’ website satisfaction variables used in the study. This study contributes to highlight the theoretical importance and significant influence of consumers’ personal characteristics on their online behavior. Moreover, for the practitioners, a better understanding of these individual characteristics will assist them in developing customized websites that will meet customers’ expectations. O estudo dos comportamentos dos consumidores em ambientes online tem vindo a ter um crescente interesse, uma vez que os websites estão a transformar-se num importante ponto de contacto entre as empresas e os seus clientes. A satisfação dos clientes com os websites tem sido apontada pela Literatura como o principal condicionante dos comportamentos online dos consumidores. No entanto, a investigação científica tem conseguido provar que grupos de indivíduos com características distintas reagem de forma diferente quando submetidos a contextos idênticos, o que poderá levar a diferenças significativas no comportamento online de consumidores pertencentes a diferentes grupos. Neste estudo desenvolvemos um modelo conceptual que reflecte a influência de características individuais na relação entre a qualidade e a satisfação com os websites. Propomos um modelo assente na atractividade tecnológica do consumidor (CTA), que representa a propensão genuína que os indivíduos possuem em relação à tecnologia. Testamos o efeito moderador deste conceito sobre as variáveis mais utilizadas nos estudos sobre a satisfação dos consumidores com os websites, utilizando a Regressão Múltipla Hierárquica. O estudo empírico baseou-se nos websites dos bancos que operam no mercado português, uma vez que este sector é um dos que melhor utiliza a Internet na sua relação com os clientes. Os dados foram recolhidos através de um questionário sobre satisfação com os websites, colocado online e dirigido a docentes e estudantes de programas de pós-graduações, mestrados e doutoramentos de quatro universidades e instituto politécnico portugueses, tendo resultado numa amostra final de 276 questionários validados estatisticamente. Este estudo permitiu concluir que as variáveis que são mais utilizadas como antecedentes da satisfação dos consumidores com os websites, continuam a ser igualmente válidas para a análise dos websites dos bancos. Também concluímos que a CTA tem efeitos moderadores significativos na grande maioria das variáveis utilizadas neste estudo. Assim, conseguimos realçar a importância teórica das características pessoais dos consumidores no seu comportamento online. Para os gestores, uma melhor compreensão destas características individuais permitir-lhes-á desenvolver websites customizados que irão satisfazer as expectativas dos seus clientes.

Injuries Resulted From Breastfeeding: A New Approach To A Known Problem

This study aimed at analyzing nipple trauma resulted from breastfeeding based on dermatological approach. Two integrative reviews of literature were conducted, the first related to definitions, classification and evaluation methods of nipple trauma and another about validation studies related to this theme. In the first part were included 20 studies and only one third defined nipple trauma, more than half did not defined the nipple’s injuries reported, and each author showed a particular way to assess the injuries, without consensus. In the second integrative review, no validation study or algorithm related to nipple trauma resulted from breastfeeding was found. This fact demonstrated that the nipple’s injuries mentioned in the first review did not go through validation studies, justifying the lack of consensus identified as far as definition, classification and assessment methods of nipple trauma.


Measuring professional satisfaction and nursing workload among nursing staff at a Greek Coronary Care Unit

ABSTRACT Objective To explore potential associations between nursing workload and professional satisfaction among nursing personnel (NP) in Greek Coronary Care Units (CCUs). Method A cross-sectional study was performed involving 66 members of the NP employed in 6 randomly selected Greek CCUs. Job satisfaction was assessed by the IWS and nursing workload by NAS, CNIS and TISS-28. Results The response rate was 77.6%. The reliability of the IWS was α=0.78 and the mean score 10.7 (±2.1, scale range: 0.5-39.7). The most highly valued component of satisfaction was “Pay”, followed by “Task requirements”, “Interaction”, “Professional status”, “Organizational policies” and “Autonomy”. NAS, CNIS and TISS-28 were negatively correlated (p≤0.04) with the following work components: “Autonomy”, “Professional status”, “Interaction” and “Task requirements”. Night shift work independently predicted the score of IWS. Conclusion The findings show low levels of job satisfaction, which are related with nursing workload and influenced by rotating shifts.