984 resultados para Per Opportunity Measures
Resumo:
Objective: To describe the methodology of Confirmatory Factor Analyis for categorical items and to apply this methodology to evaluate the factor structure and invariance of the WHO-Disability Assessment Schedule (WHODAS-II) questionnaire, developed by the World HealthOrganization.Methods: Data used for the analysis come from the European Study of Mental Disorders(ESEMeD), a cross-sectional interview to a representative sample of the general population of 6 european countries (n=8796). Respondents were administered a modified version of theWHODAS-II, that measures functional disability in the previous 30 days in 6 differentdimensions: Understanding and Communicating; Self-Care, Getting Around, Getting Along withOthers, Life Activities and Participation. The questionnaire includes two types of items: 22severity items (5 points likert) and 8 frequency items (continuous). An Exploratory factoranalysis (EFA) with promax rotation was conducted on a random 50% of the sample. Theremaining half of the sample was used to perform a Confirmatory Factor Analysis (CFA) inorder to compare three different models: (a) the model suggested by the results obtained in theEFA; (b) the theoretical model suggested by the WHO with 6 dimensions; (c) a reduced modelequivalent to model b where 4 of the frequency items are excluded. Moreover, a second orderfactor was also evaluated. Finally, a CFA with covariates was estimated in order to evaluatemeasurement invariance of the items between Mediterranean and non-mediterranean countries.Results: The solution that provided better results in the EFA was that containing 7 factors. Twoof the frequency items presented high factor loadings in the same factor, and one of thempresented factor loadings smaller than 0.3 with all the factors. With regard to the CFA, thereduced model (model c) presented the best goodness of fit results (CFI=0.992,TLI=0.996,RMSEA=0.024). The second order factor structure presented adequate goodness of fit (CFI=0.987,TLI=0.991, RMSEA=0.036). Measurement non-invariance was detected for one of the items of thequestionnaire (FD20 ¿ Embarrassment due to health problems).Conclusions: AFC confirmed the initial hypothesis about the factorial structure of the WHODAS-II in 6factors. The second order factor supports the existence of a global dimension of disability. The use of 4of the frequency items is not recommended in the scoring of the corresponding dimensions.
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Given a compact pseudo-metric space, we associate to it upper and lower dimensions, depending only on the pseudo-metric. Then we construct a doubling measure for which the measure of a dilated ball is closely related to these dimensions.
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L'actual crisi econòmica, del model de producció i les greus conseqüències que està tenint en el teixit industrial, productiu, econòmic, de consum, de diferents sectors, així com la pèrdua de competitivitat i el descens de la nostra productivitat com quasi la més baixa d'Europa, ens porta a cercar solucions i alternatives en la gestió empresarial i a la direcció de les organitzacions públiques i privades,com un dels factors estratègics que podrien ajudar a col·laborar a la sortida de la crisi.
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Ten years of demographic and genetic monitoring of Stachys maritima in Catalonia (2001-2010). Implications for a recovery plan.- Stachys maritima is a species typical of the coastal dunes, with a wide distribution within the Mediterranean Basin. In spite of this, the species shows a clear regression. In Catalonia, it has been observed an important reduction of its populations since early 20th century, where it has disappeared from several localities in which it was relatively common (Tarragonès, Barcelonès). Herein we present the results of the demographic monitoring of the species during the last 10 years (2001-2010) in the known localities in Catalonia. Besides corroborating the disappearance (northern Sant Martí d'Empúries), the re-discovering (Llobregat Delta beach) and the detection of new populations (inner dunes of the Montgrí), a large year-to-year fluctuation of the monitored populations is stated; the possible reasons are discussed. In addition, the present work also includes the results of the allozyme diversity analysis of the new detected populations as well as the rediscoveries of the period 2004-2008, which were not included in a former study of genetic diversity carried out in 2002-2003. It is necessary to emphasize that the contribution of the new populations to the genetic diversity of Stachys maritima is very small, which can be attributed to their limited population size and /or to founder effects. Despite that the species is included in the Annex 2 ('En Perill d'Extinció') within the Catàleg de Flora Amenaçada de Catalunya (Catalogue of Endangered Flora of Catalonia), and some 'soft' conservation measures have been applied at local level (signposting of the beach accesses, environmental education, etc.) coupled with other more significant measures (e.g. translocation of individuals discovered in an artificial sandbank), it would be necessary the coordinated action and the scientific support of any initiative of conservation that could be carried out. The general frame to initiate actions of conservation should be the recovery plan of Stachys maritima, whose draft and application is mandatory in accordance to the Catàleg.
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OBJECTIVE: To examine the incremental cost effectiveness of the five first line pharmacological smoking cessation therapies in the Seychelles and other developing countries. DESIGN: A Markov chain cohort simulation. SUBJECTS: Two simulated cohorts of smokers: (1) a reference cohort given physician counselling only; (2) a treatment cohort given counselling plus cessation therapy. INTERVENTION: Addition of each of the five pharmacological cessation therapies to physician provided smoking cessation counselling. MAIN OUTCOME MEASURES: Cost per life-year saved (LYS) associated with the five pharmacotherapies. Effectiveness expressed as odds ratios for quitting associated with pharmacotherapies. Costs based on the additional physician time required and retail prices of the medications. RESULTS: Based on prices for currently available generic medications on the global market, the incremental cost per LYS for a 45 year old in the Seychelles was 599 US dollars for gum and 227 dollars for bupropion. Assuming US treatment prices as a conservative estimate, the incremental cost per LYS was significantly higher, though still favourable in comparison to other common medical interventions: 3712 dollars for nicotine gum, 1982 dollars for nicotine patch, 4597 dollars for nicotine spray, 4291 dollars for nicotine inhaler, and 1324 dollars for bupropion. Cost per LYS increased significantly upon application of higher discount rates, which may be used to reflect relatively high opportunity costs for health expenditures in developing countries with highly constrained resources and high overall mortality. CONCLUSION: Pharmacological cessation therapy can be highly cost effective as compared to other common medical interventions in low mortality, middle income countries, particularly if medications can be procured at low prices.
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Background: A hospitalised patient infected with MRSA was found to harbour a VISA strain after 6 weeks of treatment with vancomycin. Additional contact measures were reinforced according to CDCs recommendations. We decide to evaluate if these applied control measures were effective. Objective: To evaluate the efficacy of strict additional contact measures to contain the dissemination of VISA from an infected patient. Methods: All patients from the unit were screened weekly for MRSA during a 6-week period, whereas health care workers (HCW) were screened only once. Screening specimen included nose, throat, groin, and clinical specimens for patients, and only nose and throat for HCW. Broth enrichment and chromogenic agar (MRSA-select) were used for MRSA detection. All MRSA isolates were tested on Van screen plates, and growing colonies were tested for MIC of vancomycin. MIC was performed using Etest. Population analysis was done for VISA confirmation. One strain per person was typed by Double Locus Sequence Typing (based on clfB and spa sequencing). Results: 66 patients hospitalized in the same service during the 6 weeks and 55 HCW were screened for MRSA and VISA. MRSA was found in 16/66 (24%) patients and 1/55 (2%) HCW. 16/17 MRSA from patients belonged to the same genotype that the VISA strain. The remaining patient had a MRSA identical to the HCW isolate. Among the 16 MRSA isolates sharing the same genotype than the VISA strain, two showed Etests vancomycin MIC of only 4 mg/L. MIC results were confirmed by the population analysis. They were not considered as VISA, but as MRSA with increased vancomycin MICs. Both isolates were obtained from two roommates. Conclusion: Strict additional contact measures were found to be effective to contain VISA dissemination. However, the identification of two isolates with increased vancomycin MIC (4 mg/L) in two roommates raised the question of the need to routinely test this susceptibility and of adequate control measures for patients harbouring such isolates.
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El projecte es basa en el desenvolupament d'un aplicació web amb l'objectiu de facilitar l’intercanvi de llibres mitjançant una manera ràpida i eficaç alhora que es redueixen els costos fins a ser mínims o inexistents. També inclou la funcionalitat d'afegir relats d'autors aficionats amb la finalitat de compartir aquests amb la resta d'usuaris, els quals tenen la possibilitat de comentar tant els llibres com els relats.
Resumo:
The Universitat Oberta de Catalunya (UOC, Open University of Catalonia) is involved inseveral research projects and educational activities related to the use of Open Educational Resources (OER). Some of the discussed issues in the concept of OER are research issues which are being tackled in two EC projects (OLCOS and SELF). Besides the research part, the UOC aims at developing a virtual centre for analysing and promoting the concept of OERin Europe in the sector of Higher and Further Education. The objectives are to makeinformation and learning services available to provide university management staff,eLearning support centres, faculty and learners with practical information required to create, share and re-use such interoperable digital content, tools and licensing schemes. In the realisation of these objectives, the main activities are the following: to provide organisationaland individual e-learning end-users with orientation; to develop perspectives and useful recommendations in the form of a medium-term Roadmap 2010 for OER in Higher and Further Education in Europe; to offer practical information and support services about how to create, share and re-use open educational content by means of tutorials, guidelines, best practices, and specimen of exemplary open e-learning content; to establish a larger group ofcommitted experts throughout Europe and other continents who not only share theirexpertise but also steer networking, workshops, and clustering efforts; and to foster and support a community of practice in open e-learning content know-how and experiences.
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Un recorregut per la historia de les edicions d'artista a Catalunya a través de la cultura visual i l'art contemporani. Amb l'edició independent i la xarxa digital com dues eines fonamentals tan pels artistes -pels beneficis que l'edició pot proporcionar a la seva visibilitat i l'evolució professional- com pels diferents agents -veuen en ella l'oportunitat de generar nous formats de relació amb el públic- que tenen la voluntat de treballar amb i per aquest subsector de l'últim art contemporani. Un àmbit que avui gaudeix d'una situació creativa i productiva molt interessant i fructífera.
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OBJECTIVE: The cause precipitating intracranial aneurysm rupture remains unknown in many cases. It has been observed that aneurysm ruptures are clustered in time, but the trigger mechanism remains obscure. Because solar activity has been associated with cardiovascular mortality and morbidity, we decided to study its association to aneurysm rupture in the Swiss population. METHODS: Patient data were extracted from the Swiss SOS database, at time of analysis covering 918 consecutive patients with angiography-proven aneurysmal subarachnoid hemorrhage treated at 7 Swiss neurovascular centers between January 1, 2009, and December 31, 2011. The daily rupture frequency (RF) was correlated to the absolute amount and the change in various parameters of interest representing continuous measurements of solar activity (radioflux [F10.7 index], solar proton flux, solar flare occurrence, planetary K-index/planetary A-index, Space Environment Services Center [SESC] sunspot number and sunspot area) using Poisson regression analysis. RESULTS: During the period of interest, there were 517 days without recorded aneurysm rupture. There were 398, 139, 27, 12, 1, and 1 days with 1, 2, 3, 4, 5, and 6 ruptures per day. Poisson regression analysis demonstrated a significant correlation of F10.7 index and RF (incidence rate ratio [IRR] = 1.006303; standard error (SE) 0.0013201; 95% confidence interval (CI) 1.003719-1.008894; P < 0.001), according to which every 1-unit increase of the F10.7 index increased the count for an aneurysm to rupture by 0.63%. A likewise statistically significant relationship of both the SESC sunspot number (IRR 1.003413; SE 0.0007913; 95% CI 1.001864-1.004965; P < 0.001) and the sunspot area (IRR 1.000419; SE 0.0000866; 95% CI 1.000249-1.000589; P < 0.001) emerged. All other variables analyzed showed no significant correlation with RF. CONCLUSIONS: We found greater radioflux, SESC sunspot number, and sunspot area to be associated with an increased count of aneurysm rupture. The clinical meaningfulness of this statistical association must be interpreted carefully and future studies are warranted to rule out a type-1 error.
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One motive for behaving as the agent of another"s aggression appears to be anchored in as yet unelucidated mechanisms of obedience to authority. In a recent partial replication of Milgram"s obedience paradigm within an immersive virtual environment, participants administered pain to a female virtual human and observed her suffering. Whether the participants" response to the latter was more akin to other-oriented empathic concern for her well-being or to a self-oriented aversive state of personal distress in response to her distress is unclear. Using the stimuli from that study, this event-related fMRI-based study analysed brain activity during observation of the victim in pain versus not in pain. This contrast revealed activation in pre-defi ned brain areas known to be involved in affective processing but not in those commonly associated with affect sharing (e.g., ACC and insula). We then examined whether different dimensions of dispositional empathy predict activity within the same pre-defi ned brain regions: While personal distress and fantasy (i.e., tendency to transpose oneself into fi ctional situations and characters) predicted brain activity, empathic concern and perspective taking predicted no change in neuronal response associated with pain observation. These exploratory fi ndings suggest that there is a distinct pattern of brain activity associated with observing the pain-related behaviour of the victim within the context of this social dilemma, that this observation evoked a self-oriented aversive state of personal distress, and that the objective"reality" of pain is of secondary importance for this response. These fi ndings provide a starting point for experimentally more rigorous investigation of obedience.
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L’infant ha de tenir l’oportunitat d’estar envoltat per una col·lecció de llibres que el permeti escollir les lectures que necessita a cada moment. L’escola, concretament la biblioteca escolar, ha de possibilitar aquesta trobada mitjançant un fons documental seleccionat a partir de les necessitats i els interessos d’infants i mestres. El present treball pretén recollir algunes recomanacions bàsiques per a la selecció de documents a la biblioteca escolar en un marc teòric inicial. En la segona part del projecte, s’intenta analitzar com es porta a la pràctica aquest procés en el nostre territori a partir de l’anàlisi de tres realitats concretes: la biblioteca escolar, la biblioteca pública i el Seminari de Bibliografia Infantil i Juvenil de l’Associació de Mestres Rosa Sensat.
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El Treball Final de Grau, com a punt final de l¿itinerari acadèmic dels Graus definitsformalment com a generalistes, pot esdevenir, amb les innovacions i concrecions que es presenten, una oportunitat per a un estudiant d¿estar més capacitat per a poder inserir-se en un competitiu mercat laboral, així com l¿inici de la gestió de la seva reputació en línia, incloent la presència en repositoris i xarxes socials. Mitjançant la selecció i anàlisi de les competències, es presenta el disseny i les primeres experiències del TFG en el Grau d¿Informació i Documentació de la UOC.
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Ten years of demographic and genetic monitoring of Stachys maritima in Catalonia (2001-2010). Implications for a recovery plan.- Stachys maritima is a species typical of the coastal dunes, with a wide distribution within the Mediterranean Basin. In spite of this, the species shows a clear regression. In Catalonia, it has been observed an important reduction of its populations since early 20th century, where it has disappeared from several localities in which it was relatively common (Tarragonès, Barcelonès). Herein we present the results of the demographic monitoring of the species during the last 10 years (2001-2010) in the known localities in Catalonia. Besides corroborating the disappearance (northern Sant Martí d’Empúries), the re-discovering (Llobregat Delta beach) and the detection of new populations (inner dunes of the Montgrí), a large year-to-year fluctuation of the monitored populations is stated; the possible reasons are discussed. In addition, the present work also includes the results of the allozyme diversity analysis of the new detected populations as well as the rediscoveries of the period 2004-2008, which were not included in a former study of genetic diversity carried out in 2002-2003. It is necessary to emphasize that the contribution of the new populations to the genetic diversity of Stachys maritima is very small, which can be attributed to their limited population size and /or to founder effects. Despite that the species is included in the Annex 2 (“En Perill d’Extinció”) within the Catàleg de Flora Amenaçada de Catalunya (Catalogue of Endangered Flora of Catalonia), and some “soft” conservation measures have been applied at local level (signposting of the beach accesses, environmental education, etc.) coupled with other more significant measures (e.g. translocation of individuals discovered in an artificial sandbank), it would be necessary the coordinated action and the scientific support of any initiative of conservation that could be carried out. The general frame to initiate actions of conservation should be the recovery plan of Stachys maritima, whose draft and application is mandatory in accordance to the Catàleg
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An assortment of human behaviors is thought to be driven by rewards including reinforcement learning, novelty processing, learning, decision making, economic choice, incentive motivation, and addiction. In each case the ventral tegmental area/ventral striatum (nucleus accumbens) (VTAVS) system has been implicated as a key structure by functional imaging studies, mostly on the basis of standard, univariate analyses. Here we propose that standard functional magnetic resonance imaging analysis needs to be complemented by methods that take into account the differential connectivity of the VTAVS system in the different behavioral contexts in order to describe reward based processes more appropriately. We fi rst consider the wider network for reward processing as it emerged from animal experimentation. Subsequently, an example for a method to assess functional connectivity is given. Finally, we illustrate the usefulness of such analyses by examples regarding reward valuation, reward expectation and the role of reward in addiction.