The risk-taking and self-harm inventory for adolescents: Development and psychometric evaluation

In this study, we report on the development and psychometric evaluation of the Risk-Taking (RT) and Self-Harm (SH) Inventory for Adolescents (RTSHIA), a self-report measure designed to assess adolescent RT and SH in community and clinical settings. 651 young people from secondary schools in England ranging in age from 11.6 years to 18.7 years and 71 young people referred to mental health services for SH behavior in London between the ages of 11.9 years and 17.5 years completed the RTSHIA along with standardized measures of adolescent psychopathology. Two factors emerged from the principal axis factoring, and RT and SH were further validated by a confirmatory factor analysis as related, but different, constructs, rather than elements of a single continuum. Inter-item and test–retest reliabilities were high for both components (Cronbach's α = .85, rtt = .90; Cronbach's α .93, rtt = .87), and considerable evidence emerged in support of the measure's convergent, concurrent, and divergent validity. The findings are discussed with regard to potential usefulness of the RTSHIA for research and clinical purposes with adolescents.

Do responsible real estate companies outperform their peers?

This paper investigates the relationship between corporate social and environmental performance and financial performance for a sample of publicly traded US real estate companies. Using the MSCI ESG (formerly KLD) database on seven Environmental, Social & Governance dimensions in the 2003-2010 period, and weighting the dimensions according to prominence in the real estate sector, we model Tobin's Q and annual total return in a panel data framework. The results indicate a positive relationship between ESG rating and Tobin's Q but this effect is driven by ESG concerns rather than strengths. Consistently across all model specifications, overall ESG ratings are associated with lower returns. Negative scores appear to result in higher returns in the short run but positive scores have no significant impact on returns.

A conceptual framework of patient satisfaction with a pharmacy adherence service

Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

Validation of the NANA (Novel Assessment of Nutrition and Ageing) touch screen system for use at home by older adults

Prospective measurement of nutrition, cognition, and physical activity in later life would facilitate early detection of detrimental change and early intervention but is hard to achieve in community settings. Technology can simplify the task and facilitate daily data collection. The Novel Assessment of Nutrition and Ageing (NANA) toolkit was developed to provide a holistic picture of an individual's function including diet, cognition and activity levels. This study aimed to validate the NANA toolkit for data collection in the community. Forty participants aged 65 years and over trialled the NANA toolkit in their homes for three 7-day periods at four-week intervals. Data collected using the NANA toolkit were compared with standard measures of diet (four-day food diary), cognitive ability (processing speed) and physical activity (self-report). Bland–Altman analysis of dietary intake (energy, carbohydrates, protein fat) found a good relationship with the food diary and cognitive processing speed and physical activity (hours) were significantly correlated with their standard counterparts. The NANA toolkit enables daily reporting of data that would otherwise be collected sporadically while reducing demands on participants; older adults can complete the daily reporting at home without a researcher being present; and it enables prospective investigation of several domains at once

Comparing species and measures of landscape structure as indicators of conservation importance

P>1. The use of indicators to identify areas of conservation importance has been challenged on several grounds, but nonetheless retains appeal as no more parsimonious approach exists. Among the many variants, two indicator strategies stand out: the use of indicator species and the use of metrics of landscape structure. While the first has been thoroughly studied, the same cannot be said about the latter. We aimed to contrast the relative efficacy of species-based and landscape-based indicators by: (i) comparing their ability to reflect changes in community integrity at regional and landscape spatial scales, (ii) assessing their sensitivity to changes in data resolution, and (iii) quantifying the degree to which indicators that are generated in one landscape or at one spatial scale can be transferred to additional landscapes or scales. 2. We used data from more than 7000 bird captures in 65 sites from six 10 000-ha landscapes with different proportions of forest cover in the Atlantic Forest of Brazil. Indicator species and landscape-based indicators were tested in terms of how effective they were in reflecting changes in community integrity, defined as deviations in bird community composition from control areas. 3. At the regional scale, indicator species provided more robust depictions of community integrity than landscape-based indicators. At the landscape scale, however, landscape-based indicators performed more effectively, more consistently and were also more transferable among landscapes. The effectiveness of high resolution landscape-based indicators was reduced by just 12% when these were used to explain patterns of community integrity in independent data sets. By contrast, the effectiveness of species-based indicators was reduced by 33%. 4. Synthesis and applications. The use of indicator species proved to be effective; however their results were variable and sensitive to changes in scale and resolution, and their application requires extensive and time-consuming field work. Landscape-based indicators were not only effective but were also much less context-dependent. The use of landscape-based indicators may allow the rapid identification of priority areas for conservation and restoration, and indicate which restoration strategies should be pursued, using remotely sensed imagery. We suggest that landscape-based indicators might often be a better, simpler, and cheaper strategy for informing decisions in conservation.

Noninvasive Evaluation of Oral Lesions Using Depth-sensitive Optical Spectroscopy

BACKGROUND: Optical spectroscopy is a noninvasive technique with potential applications for diagnosis of oral dysplasia and early cancer. In this study, we evaluated the diagnostic performance of a depth-sensitive optical spectroscopy (DSOS) system for distinguishing dysplasia and carcinoma from non-neoplastic oral mucosa. METHODS: Patients with oral lesions and volunteers without any oral abnormalities were recruited to participate. Autofluorescence and diffuse reflectance spectra of selected oral sites were measured using the DSOS system. A total of 424 oral sites in 124 subjects were measured and analyzed, including 154 sites in 60 patients with oral lesions and 270 sites in 64 normal volunteers. Measured optical spectra were used to develop computer-based algorithms to identify the presence of dysplasia or cancer. Sensitivity and specificity were calculated using a gold standard of histopathology for patient sites and clinical impression for normal volunteer sites. RESULTS: Differences in oral spectra were observed in: (1) neoplastic versus nonneoplastic sites, (2) keratinized versus nonkeratinized tissue, and (3) shallow versus deep depths within oral tissue. Algorithms based on spectra from 310 nonkeratinized anatomic sites (buccal, tongue, floor of mouth, and lip) yielded an area under the receiver operating characteristic curve of 0.96 in the training set and 0.93 in the validation set. CONCLUSIONS: The ability to selectively target epithelial and shallow stromal depth regions appeared to be diagnostically useful. For nonkeratinized oral sites, the sensitivity and specificity of this objective diagnostic technique were comparable to that of clinical diagnosis by expert observers. Thus, DSOS has potential to augment oral cancer screening efforts in community settings. Cancer 2009;115:1669-79. (C) 2009 American Cancer Society.

Activist Women's Voices Oral History Collection, 1995-2000 Finding Aid

The Activist Women's Voices Oral History Project, funded by AT&T, the Ford Foundation, the Ms. Foundation for Education and Communication, and the New York Council for Humanities, is committed to documenting the voices of unheralded activist women in community-based organizations in New York City. The archive was established in 1995 under the direction of Professors Joyce Gelb and Patricia Laurence with the aim of creating linkages between activist women in the New York City community and student and faculty researchers at the City University of New York.

Trycksår : – undersköterskors kunskaper om att förebygga trycksår

Background and aims: The population of older people in our society is increasing. Agerelated changes in the skin results in a diminished perception of pain and pressure and a decreased microcirculation in the skin affects its ability to adapt to injury. Occurrence of pressure sore on geriatrikal clinics are 5-10%, witch means that between five and ten thousand patients gets daily treat for pressure sores. When the patient gets a pressure sore the need for help increases. A common apprehension is that if the patient’s affects with pressure sores it’s because of deficiency in care. According to the law, all nursing interventions should be performed according to scientific and evidence and the nurse’s assistants are responsible for how they perform. The aim of this study was to examine how much knowledge the nurses assistants in community care services has about preventing, predicting and locate riskfactors for pressure sores and if they get the right education. Methods: A questionnaire based on 20 questions was maid and used for this purpose. Out of 99 persons the questionnaires was answered bye 65 nurses assistants working in community care service in a small town in Sweden. Results: The results shown that the nurses assistants don’t use risk assessment scales in attempt to identify patients vulnerable to pressure sores and they are not well associated with the riskfactors. The study even shows that they have little knowledge in how to prevent pressure sores from appearing. The nursing model are some times out of date and the nurses assistants personal view attends to decide witch care they will perform instead of scientific and evidenced based nursing.

Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

Hälsofrämjande arbete på SSAB i Borlänge : Hälsofrämjande processer i arbetslivet och ledarskapets betydelse för medarbetarens hälsa

Problem: Arbetsmiljön är viktig för människors välbefinnande. Hälsofrämjande faktorer antas inte bara styrka individens fysiska och psykiska hälsa, utan även företagets konkurrenskraft och lönsamhet. I uppsatsen undersöker vi hur företaget SSAB i Borlänge arbetar med hälsa genom att tillämpa ett hälsofrämjande perspektiv och utgå från teorin om Känslan av sammanhang (KASAM). Ledarskapsvärderingar har betydelse för medarbetares hälsa (Hanson, 2004) och vi undersöker vilken uppfattning ett antal chefer har om sina roller i det hälsofrämjande arbetet och deras syn på medarbetarundersökningen HälsoSAM som företagshälsovården på SSAB bedriver. Arbetsbelastningen på medarbetare och chefer ökar till följd av sparkrav, samtidigt som resurserna minskar (Gatu, 2003). Följden blir en större risk för ohälsa och ett sätt att minska sjukfrånvaron är att genomföra hälsofrämjande insatser (Prevent, 2001). Syfte: Syftet med studien är att utifrån ett hälsofrämjande perspektiv förklara vad chefer har för möjligheter att skapa förutsättningar för att främja medarbetarnas hälsa på SSAB i Borlänge. Metod: Den metod som ligger till grund för uppsatsen baseras på ett kvalitativt angreppssätt där semistrukturerade intervjuer samt litteraturstudier genomförts för att samla information. Analys: Ledarens beteende påverkar medarbetarna. Hög arbetsbelastning på SSABs chefer leder till lägre närvaro bland medarbetarna, vilket i sin tur ger sämre förutsättningar för att främja hälsan. HälsoSAM kartlägger medarbetarnas hälsoläge, både välbefinnande och arbetskapacitet. Resultaten är vägledande i det hälsofrämjande arbetet men överbelastning, tidsbrist och kunskapsbrist hos cheferna bidrar till att uppföljningen inte blir systematisk. För ett väl fungerande hälsoarbete krävs systematik. Slutsats: Hälsofrämjande processer i arbetslivet skapas genom balans mellan krav och resurser. På SSAB i Borlänge hindras hälsoarbetet av tidsbrist och kunskapsbrist hos cheferna. Kostnadsbesparingar påverkar hälsoarbetet negativt och systematiken i uppföljningsarbetet blir lidande. Ansvaret för hälsoarbetet läggs på företagshälsovården, men utan stöd från chefer blir inte hälsoarbetet en naturlig del i verksamheten. Det är viktigt att i rådande situation se vad främjande av hälsa kan ge tillbaka till företaget i både ekonomiska och kvalitativa termer. Insikt om detta ökar chefernas incitament att prioritera hälsofrämjande processer och organisera arbetet så att människor har förutsättningar att hantera, kontrollera och klara av sina uppgifter.

Inclusão social e atividades culturais: o Centro Cultural Banco do Brasil no Rio de Janeiro

The aim of this study is to look into the benefits provided to social inclusion by cultural activities carried out in a cultural place with great seriousness at Rio de Janeiro. To accomplish that, the author attempt to deepen into the social exclusion/inclusion in brazilian urban context, spotlighting the historic reality of the urban process of the city. Afterwards, by means of a quality research, document files from the cultural spot were consulted and looked into the view of customers, trustees and managers. For customers were applied questionnaires with open and close questions, with trustees and managers were made interviews, and also a documentary research with opinions available in mass media. This study fits into public politics, cultural and institutional marketing, for presenting examples of how cultural activities are essential tools for completely social inclusion of people in community, demonstrating that often marketing enterprises in culture area can result in benefits for society, even no being these their main purposes.

Agricultura ecológica : do engajamento possível à retribuição esperada : um estudo dos agricultores ecologistas de Antônio Prado e Ipê-RS

Nesta dissertação, analiso as lógicas de engajamento dos agricultores ecologistas na agricultura ecológica em Antônio Prado e Ipê, ambos municípios da Encosta Superior do Nordeste do Rio Grande do Sul, Brasil. Os diferentes graus de engajamento dos agricultores estão relacionados à heterogeneidade na estrutura e volume de capitais acumulados por esses agentes durante suas trajetórias e às distintas expectativas de retribuição com relação a este referencial de agricultura. O referencial foi construído ou socializado neste cenário, principalmente, pelos técnicos do Centro Ecológico, constituindo-se num conjunto de práticas agrícolas alternativas que pretendem viabilizar avanços sustentáveis na produção agrícola. Na busca destes “avanços”, a agricultura ecológica é construída sob uma dimensão simbólica, orientada “pela filosofia da preservação ambiental e da justiça social”, e uma dimensão econômica caracterizada pelo objetivo de viabilizar econômica e socialmente a agricultura familiar. Assim, os agricultores, ao se engajarem, fazem suas releituras do referencial e, pela socialização, vão incorporando os limites impostos as suas ações pelas representações dominantes (legítimas) da “prática” e pelas normas que vão se institucionalizando ao longo do tempo, resultando na estrutura objetiva do espaço de relações da agricultura ecológica na região. Essas releituras resultam em distintos graus de engajamento. As distintas tomadas de posições e estratégias desenvolvidas pelos agricultores ecologistas possibilitam a formação de uma hierarquia normativa neste espaço social, permitindo que alguns agricultores, devido às disposições incorporadas durante suas trajetórias e ao tipo de relação estabelecida com os técnicos, se tornem novos mediadores.

Investimento em treinamento e seus impacto nos conhecimentos e o retorno financeiro para a empresa: o Caso da Aracruz Celulose S. A.

The main purpose of this work is to show how the investments in training influence the financial returns of Aracruz Celulose S.A., in the period from january/1998 to december/2000. The data will be treated using quantitative and qualitative parameters. Our analyses will be based on the practical elements. In order to study the idea of investment return in terms of training and questions involving motivation, a knowledge of learning, which is in itself complex because of the varieties of learning theories which don¿t fit into the cultural models being studied, we direct our attention to the necessity of a model which understands the problems of existing conditions. For so much, the most appropriate method for the treatment of data relative to motivation, to knowledge and to learning, will be the ex post facto, because this refers to facts abready known and the researcher would be unable to control or manipulate the variables.

Fusões e aquisições da indústria de petróleo e gás natural na América do Sul: um estudo qualitativo de 5 eventos

Este trabalho tem como objetivo contextualizar as Fusões e Aquisições realizadas, na América do Sul, na indústria de petróleo, pela análise qualitativa de cinco eventos, utilizando a metodologia de estudo de eventos e a influência nas cotações das ações. A partir dessa análise, foi possível associar os períodos de aumento das atividades de F&A com a evolução da indústria mundial de petróleo, e mostrar que os processos de F&A possuem um caráter estratégico frente à economia mundial. Os resultados, todavia, apresentam indícios de não geração de valor. Dentre os cinco eventos, quatro apresentaram retornos anormais acumulados negativos. Um único evento obteve retorno positivo e foi somente para a empresa adquirida. Quanto ao método de integração, a amostra de cinco eventos apresentou evidências de destruição de valor para as firmas em todas as três formas estudadas. O retorno médio na janela pós-evento – 180 dias após o anúncio – divergiu do retorno anormal acumulado na janela de evento. As influências de um determinado evento podem ser negligenciadas devido a limitações, tanto operacionais quanto metodológicas.

Ceticismo ou reputação nas recompras de ações?

Este trabalho investiga as recompras de ações no Brasil pelo prisma da reputação das empresas anunciadoras. Por meio de uma base de dados ainda inexplorada, o formulário de referência anual, que possibilita a diferenciação dos anúncios de recompras pelas quantidades efetivamente compradas. Com metodologia de estudo de evento e regressão, foram analisados os anúncios de recompras de ações da própria companhia em mercado aberto para o período compreendido entre os anos de 2007 a 2014. Os principais resultados encontrados foram à existência de reputação para empresas que apresentam uma taxa efetiva de recompra mais elevada e uma penalização para as empresas que apresentam baixas taxas efetivas de recompra em anúncios anteriores, quanto mais próximo de zero a taxa efetiva de recompra do anuncio anterior, menor é o efeito de um novo anúncio. Por fim, foi encontrado retorno anormal acumulado significativo no mercado acionário brasileiro para empresas que anunciam recompra de ações próprias no mercado aberto de 1,12% no primeiro dia, 1,56% no quinto dia e 1,97% ao final do primeiro mês. Para eventos com histórico, foi de 0,98% no primeiro dia, 1,33% no quinto dia e 1,38% ao final do primeiro mês. Já para o caso nos quais os eventos foram antecedidos imediatamente por anúncios de recompra com taxas efetivas de recompras de no mínimo 70%, foi de 1,42% no primeiro dia, 2,70% no quinto dia e 5,09% ao final do primeiro mês.