859 resultados para Research design
Resumo:
Background. Research into methods for recovery from fatigue due to exercise is a popular topic among sport medicine, kinesiology and physical therapy. However, both the quantity and quality of studies and a clear solution of recovery are lacking. An analysis of the statistical methods in the existing literature of performance recovery can enhance the quality of research and provide some guidance for future studies. Methods: A literature review was performed using SCOPUS, SPORTDiscus, MEDLINE, CINAHL, Cochrane Library and Science Citation Index Expanded databases to extract the studies related to performance recovery from exercise of human beings. Original studies and their statistical analysis for recovery methods including Active Recovery, Cryotherapy/Contrast Therapy, Massage Therapy, Diet/Ergogenics, and Rehydration were examined. Results: The review produces a Research Design and Statistical Method Analysis Summary. Conclusion: Research design and statistical methods can be improved by using the guideline from the Research Design and Statistical Method Analysis Summary. This summary table lists the potential issues and suggested solutions, such as, sample size calculation, sports specific and research design issues consideration, population and measure markers selection, statistical methods for different analytical requirements, equality of variance and normality of data, post hoc analyses and effect size calculation.^
Resumo:
This dissertation develops and tests through path analysis a theoretical model to explain how socioeconomic, socioenvironmental, and biologic risk factors simultaneously influence each other to further produce short-term, depressed growth in preschoolers. Three areas of risk factors were identified: child's proximal environment, maturational stage, and biological vulnerability. The theoretical model represented both the conceptual framework and the nature and direction of the hypotheses. Original research completed in 1978-80 and in 1982 provided the background data. It was analyzed first by nested-analysis of variance, followed by path analysis. The study provided evidence of mild iron deficiency and gastrointestinal symptomatology in the etiology of depressed, short-term weight gain. Also, there was evidence suggesting that family resources for material and social survival significantly contribute to the variability of short-term, age-adjusted growth velocity. These results challenge current views of unifocal intervention, whether for prevention or control. For policy formulations, though, the mechanisms underlying any set of interlaced relationships must be decoded. Theoretical formulations here proposed should be reassessed under a more extensive research design. It is suggested that studies should be undertaken where social changes are actually in progress; otherwise, nutritional epidemiology in developing countries operates somewhere between social reality and research concepts, with little grasp of its real potential. The study stresses that there is a connection between substantive theory, empirical observation, and policy issues. ^
Resumo:
This cross-sectional study is based on the qualitative and quantitative research design to review health policy decisions, their practice and implications during 2009 H1N1 influenza pandemic in the United States and globally. The “Future Pandemic Influenza Control (FPIC) related Strategic Management Plan” was developed based on the incorporation of the “National Strategy for Pandemic Influenza (2005)” for the United States from the U.S. Homeland Security Council and “The Canadian Pandemic Influenza Plan for the Health Sector (2006)” from the Canadian Pandemic Influenza Committee for use by the public health agencies in the United States as well as globally. The “global influenza experts’ survey” was primarily designed and administered via email through the “Survey Monkey” system to the 2009 H1N1 influenza pandemic experts as the study respondents. The effectiveness of this plan was confirmed and the approach of the study questionnaire was validated to be convenient and the excellent quality of the questions provided an efficient opportunity to the study respondents to evaluate the effectiveness of predefined strategies/interventions for future pandemic influenza control.^ The quantitative analysis of the responses to the Likert-scale based questions in the survey about predefined strategies/interventions, addressing five strategic issues to control future pandemic influenza. The effectiveness of strategies defined as pertinent interventions in this plan was evaluated by targeting five strategic issues regarding pandemic influenza control. For the first strategic issue pertaining influenza prevention and pre pandemic planning; the confirmed effectiveness (agreement) for strategy (1a) 87.5%, strategy (1b) 91.7% and strategy (1c) 83.3%. The assessment of the priority level for strategies to address the strategic issue no. (1); (1b (High Priority) > 1a (Medium Priority) > 1c (Low Priority) based on the available resources of the developing and developed countries. For the second Strategic Issue encompassing the preparedness and communication regarding pandemic influenza control; the confirmed effectiveness (agreement) for the strategy (2a) 95.6%, strategy (2b) 82.6%, strategy (2c) 91.3% and Strategy (2d) 87.0%. The assessment of the priority level for these strategies to address the strategic issue no. (2); (2a (highest priority) > 2c (high priority) >2d (medium priority) > 2b (low priority). For the third strategic issue encompassing the surveillance and detection of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (3a) 90.9% and strategy (3b) 77.3%. The assessment of the priority level for theses strategies to address the strategic Issue No. (3) (3a (high priority) > 3b (medium/low priority). For the fourth strategic issue pertaining the response and containment of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (4a) 63.6%, strategy (4b) 81.8%, strategy (4c) 86.3%, and strategy (4d) 86.4%. The assessment of the priority level for these strategies to address the strategic issue no. (4); (4d (highest priority) > 4c (high priority) > 4b (medium priority) > 4a (low priority). The fifth strategic issue about recovery from influenza and post pandemic planning; the confirmed effectiveness (agreement) for the strategy (5a) 68.2%, strategy (5b) 36.3% and strategy (5c) 40.9%. The assessment of the priority level for strategies to address the strategic issue no. (5); (5a (high priority) > 5c (medium priority) > 5b (low priority).^ The qualitative analysis of responses to the open-ended questions in the study questionnaire was performed by means of thematic content analysis. The following recurrent or common “themes” were determined for the future implementation of various predefined strategies to address five strategic issues from the “FPIC related Strategic Management Plan” to control future influenza pandemics. (1) Pre Pandemic Influenza Prevention, (2) Seasonal Influenza Control, (3) Cost Effectiveness of Non Pharmaceutical Interventions (NPI), (4) Raising Global Public Awareness, (5) Global Influenza Vaccination Campaigns, (6)Priority for High Risk Population, (7) Prompt Accessibility and Distribution of Influenza Vaccines and Antiviral Drugs, (8) The Vital Role of Private Sector, (9) School Based Influenza Containment, (10) Efficient Global Risk Communication, (11) Global Research Collaboration, (12) The Critical Role of Global Public Health Organizations, (13) Global Syndromic Surveillance and Surge Capacity and (14) Post Pandemic Recovery and Lessons Learned. The future implementation of these strategies with confirmed effectiveness to primarily “reduce the overall response time’ in the process of ‘early detection’, ‘strategies (interventions) formulation’ and their ‘implementation’ to eventually ensure the following health outcomes: (a) reduced influenza transmission, (b) prompt and effective influenza treatment and control, (c) reduced influenza related morbidity and mortality.^
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The aim of this study was to examine the role of the Internet in Internal Homonegativity (IH) among Non gay identifying men who have sex with men (NGI-MSM). This study at University of Texas School of Public Health (UTSPH) had a mixed method research design and consisted of men 18 years of age and older who were residents of the US and Canada. The data were collected using an online survey called 'Men's Sexual Health Survey' which was developed in collaboration with Boston University School of Public Health and Denver Public Health. These surveys were administered in English, which took 30-minutes to complete, and were placed on gay oriented websites and chat rooms. 141 participants were presented with the module relating to IH. A Principal Component Analysis with varimax rotation on the nine questions that asked the participants about their feelings about gay men produced three factors of IH identified as (1) public identification as gay; (2) perception of stigma associated with being gay; and (3) social comfort with gay men. The factors significantly correlated with age, grade completed in school, income, openness about being gay and socializing with gay people, meeting partners online, dating on the Internet, attitude toward condom usage, alcohol and drug use before sex and having unprotected sex with Internet partners. These findings point toward the role of the Internet in determining IH and sexual behavior. Despite the risks, the Internet's popularity and outreach in NGI-MSM makes it an effective medium to spread public health programs.^
Resumo:
The findings of this study suggest that while child welfare workers are consistently distracted by competing priorities from unexpected events, most are committed, and to understand perspectives is more inclusive and may improve retention rates. Notably, while it is recognized that permanency decisions are not made in an intellectual, legal or clinical vacuum and certain traditional aspects of the bureaucratic structure do not impact decision making, this study advances the body of knowledge on child welfare decision making. Examined in this study are child welfare case workers’ perceptions of the extent to which the organizational environment influences the permanency decisions they make to reunify or terminate parental rights of children placed out-of-home. This study includes a sample of 95 child welfare social workers employed in three public child welfare agencies in the Baltimore and Washington, DC metropolitan area. It used a cross-sectional research design, employing a survey instrument to examine bureaucratic distraction, role conflict, and supervisory adequacy as contextual factors in the organizational environment's influence on permanency outcome decisions. Implications are made for child welfare policy, practice, and research.
Resumo:
Objective. In 2009, the International Expert Committee recommended the use of HbA1c test for diagnosis of diabetes. Although it has been recommended for the diagnosis of diabetes, its precise test performance among Mexican Americans is uncertain. A strong “gold standard” would rely on repeated blood glucose measurement on different days, which is the recommended method for diagnosing diabetes in clinical practice. Our objective was to assess test performance of HbA1c in detecting diabetes and pre-diabetes against repeated fasting blood glucose measurement for the Mexican American population living in United States-Mexico border. Moreover, we wanted to find out a specific and precise threshold value of HbA1c for Diabetes Mellitus (DM) and pre-diabetes for this high-risk population which might assist in better diagnosis and better management of patient diabetes. ^ Research design and methods. We used CCHC dataset for our study. In 2004, the Cameron County Hispanic Cohort (CCHC), now numbering 2,574, was established drawn from randomly selected households on the basis of 2000 Census tract data. The CCHC study randomly selected a subset of people (aged 18-64 years) in CCHC cohort households to determine the influence of SES on diabetes and obesity. Among the participants in Cohort-2000, 67.15% are female; all are Hispanic. ^ Individuals were defined as having diabetes mellitus (Fasting plasma glucose [FPG] ≥ 126 mg/dL or pre-diabetes (100 ≤ FPG < 126 mg/dL). HbA1c test performance was evaluated using receiver operator characteristic (ROC) curves. Moreover, change-point models were used to determine HbA1c thresholds compatible with FPG thresholds for diabetes and pre-diabetes. ^ Results. When assessing Fasting Plasma Glucose (FPG) is used to detect diabetes, the sensitivity and specificity of HbA1c≥ 6.5% was 75% and 87% respectively (area under the curve 0.895). Additionally, when assessing FPG to detect pre-diabetes, the sensitivity and specificity of HbA1c≥ 6.0% (ADA recommended threshold) was 18% and 90% respectively. The sensitivity and specificity of HbA1c≥ 5.7% (International Expert Committee recommended threshold) for detecting pre-diabetes was 31% and 78% respectively. ROC analyses suggest HbA1c as a sound predictor of diabetes mellitus (area under the curve 0.895) but a poorer predictor for pre-diabetes (area under the curve 0.632). ^ Conclusions. Our data support the current recommendations for use of HbA1c in the diagnosis of diabetes for the Mexican American population as it has shown reasonable sensitivity, specificity and accuracy against repeated FPG measures. However, use of HbA1c may be premature for detecting pre-diabetes in this specific population because of the poor sensitivity with FPG. It might be the case that HbA1c is differentiating the cases more effectively who are at risk of developing diabetes. Following these pre-diabetic individuals for a longer-term for the detection of incident diabetes may lead to more confirmatory result.^
Resumo:
PURPOSE: In United States, the percentage of Extremely Low Birth Weight (ELBW) born for year 2006 was 0.8% (approximately 32,000 babies) & Very Low Birth Weight (VLBW) 1.48% (1). ELBW babies account for nearly half (49%) of the infant mortality for United States. Very Low birth weight infants are at a significant risk for high mortality and morbidity due to their multi system involvement and predisposition to lung prematurity and impaired immune function. One of the common causes cited is Vitamin A deficiency (2, 3).The purpose of this study is to look at published literature on Vitamin A supplementation in very low birth weight (VLBW) infants. ^ RESEARCH DESIGN: Systematic review of literature of published articles meeting the pre-defined criteria. ^ PROCEDURE: Studies included in this review were those which looked at very low birth weight infants defined as birth weight<1500gms. All experimental studies were reviewed. Studies looking at the effect of Vitamin A supplementation in comparison with a placebo or by itself in varying dosing regimens as an intervention were reviewed. Vitamin A deficiency and its manifestations were of interest. We used key words such as "very low birth weight", "mortality", "Vitamin A", "retinol" and "supplementation" in our search. ^ RISKS & POTENTIAL BENEFITS: We do not see any potential risks associated with this study. The potential benefit is recommendation for future studies based on the review of literature available currently. ^ IMPORTANCE OF KNOWLEDGE THAT MAY REASONABLY BE EXPECTED TO RESULT: The systematic review of literature of all experimental studies in VLBW infants showed uniform correlation of parenteral Vitamin A dosing and high plasma concentrations achieved. The recommended dosage for use is 5000 IU 3 times/week given intramuscularly for 4 weeks to prevent CLD. Higher doses have not shown benefit, with a potential for toxicity, while lower doses are inadequate. There is no role of use of Vitamin A in closure of patent ductus arteriosus & reducing mortality. However, it is important to state that the number of studies done so far is limited with small sample sizes. There is a need in the future for experimental studies to ascertain the role of Vitamin A to improve outcomes in VLBW. Atleast, one more RCT should be conducted using the dosage recommended above to make this a standard practice.^
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Manuscript 1: “Conceptual Analysis: Externalizing Nursing Knowledge” We use concept analysis to establish that the report tool nurses prepare, carry, reference, amend, and use as a temporary data repository are examples of cognitive artifacts. This tool, integrally woven throughout the work and practice of nurses, is important to cognition and clinical decision-making. Establishing the tool as a cognitive artifact will support new dimensions of study. Such studies can characterize how this report tool supports cognition, internal representation of knowledge and skills, and external representation of knowledge of the nurse. Manuscript 2: “Research Methods: Exploring Cognitive Work” The purpose of this paper is to describe a complex, cross-sectional, multi-method approach to study of personal cognitive artifacts in the clinical environment. The complex data arrays present in these cognitive artifacts warrant the use of multiple methods of data collection. Use of a less robust research design may result in an incomplete understanding of the meaning, value, content, and relationships between personal cognitive artifacts in the clinical environment and the cognitive work of the user. Manuscript 3: “Making the Cognitive Work of Registered Nurses Visible” Purpose: Knowledge representations and structures are created and used by registered nurses to guide patient care. Understanding is limited regarding how these knowledge representations, or cognitive artifacts, contribute to working memory, prioritization, organization, cognition, and decision-making. The purpose of this study was to identify and characterize the role a specific cognitive artifact knowledge representation and structure as it contributed to the cognitive work of the registered nurse. Methods: Data collection was completed, using qualitative research methods, by shadowing and interviewing 25 registered nurses. Data analysis employed triangulation and iterative analytic processes. Results: Nurse cognitive artifacts support recall, data evaluation, decision-making, organization, and prioritization. These cognitive artifacts demonstrated spatial, longitudinal, chronologic, visual, and personal cues to support the cognitive work of nurses. Conclusions: Nurse cognitive artifacts are an important adjunct to the cognitive work of nurses, and directly support patient care. Nurses need to be able to configure their cognitive artifact in ways that are meaningful and support their internal knowledge representations.
Resumo:
Hospital districts (HD) that serve the uninsured and the needy face new challenges with the implementation of Medicaid managed. The potential loss of Medicaid patients and revenues may affect the ability to cost-shift and subsequently decrease the ability of the HD to meet its legal obligation of providing care for the uninsured. ^ To investigate HD viability in the current market, the aims of this study were to: (1) describe HD's environment, (2) document the HDs strategic response, (3) document changes in the HD's performance (patient volume) and financial status, and (4) determine whether relationships or trends exist between HD strategy, performance and financial status. ^ To achieve these aims, three Texas HDs (Fort Worth, Lubbock, and San Antonio) were selected to be evaluated. For each HD four types of strategic responses were documented and evaluated for change. In addition, the ability of each HD to sustain operations was evaluated by documenting performance and financial status changes (patient volume and financial ratios). A pre-post case study design method was used in which the Medicaid managed care “rollout'” date, at each site, was the central date. First, a descriptive analysis was performed which documented the environment, strategy, financial status, and patient volume of each hospital district. Second, to compare hospital districts, each hospital district was: (i) classified by a risk index, (ii) classified by its strategic response profile, and (iii) given a performance score based upon pre-post changes in patient volume and financial indicators. ^ Results indicated that all three HDs operate in a high risk environment compared to the rest of the nation. Two HDs chose the “Status Quo” response whereas one HD chose the “Competitive Proactive” response. Medicaid patient volume decreased in two of three HDs whereas indigent patient volume increased in two of the three (an indication of increasing financial risk). Total patient revenues for all HDs increased over the study period; however, the rate of increase slowed for all three after the Medicaid rollout date. All HDs experienced a decline in financial status between pre-post periods with the greatest decline observed in the HD that saw the greatest increase in indigent patient volume. ^ The pre-post case study format used and the lack of control study sites do not allow for assignment of causality. However, the results suggest possible adverse effects of Medicaid managed care and the need for a larger study, based on a stronger evaluation research design. ^
Resumo:
Se toma como punto de partida el modelo de diseño de investigación cualitativa desarrollado por Joseph Maxwell, cuya concepción sobre el diseño de una investigación es el de una estructura subyacente basada en la interconexión de los componentes del estudio y las implicancias que estos tienen sobre otros, para analizar, si es posible, la corriente neorrealista, considerada como la escuela predominante en el estudio de las relaciones internacionales. El propósito de este trabajo -sustentado en el paradigma interpretativo, que conlleva como supuesto fundacional la necesaria comprensión del sentido de la acción social en el contexto del mundo de la vida y desde la perspectiva de los participantes- es el de relevar el aporte testimonial de quienes han conducido o participado activamente, es decir, los Ministros de Relaciones Exteriores, en la formación de la política exterior del país a partir de la vuelta de la democracia.
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Esta tesis, que integra los estudios de la Sociología del Arte, se centra en la vinculación de la poética del artista Edgardo Antonio Vigo (1928 - 1997) con la política y lo político, así como con los procesos sociales más generales entre 1968 y 1975. Vigo ocupó una posición emergente en el desarrollo del arte platense y desplegó producciones que emprendieron una poética rupturista con lo establecido por algunos de los cánones tradicionales del arte y sus instituciones, y elaboró propuestas estéticas innovadoras que abarcaban las artes visuales en sus diversas formas. Se analizan en esta tesis los modos por los que Vigo al mismo tiempo que apunta a cuestionar las estructuras y manifestaciones de las Bellas Artes, lo hace con las formas dominantes de la cultura a través de obras y textos que tendían a desestabilizar los roles de autor, espectador y obra, así como a involucrarse de distintos modos en los acontecimientos políticos de la época. Se estudian, además, las producción de acciones artísticas en el espacio público, que Vigo llamó señalamientos, la utilización y apropiación del discurso y aspectos materiales de lo judicial-administrativo y la edición de la revista ensamblada Hexágono '71 (1971 -1975). En estas zonas de la poética de Vigo se consideran las diversas relaciones entre arte y política, las cuales no han sido lineales ni unidireccionales, sino modos de distorsionar y disentir con las jerarquías, lugares y funciones de los sujetos y objetos del entramado social. Para la realización de la tesis se produjo un diseño metodológico cualitativo, se utilizaron fuentes documentales y entrevistas. Se desarrolla un análisis de las obras del artista, más que remitiéndolas a una corriente artística particular, haciendo foco en su relación con la situación social y política, especialmente en sus vinculaciones con el particular proceso de subjetivación política de la época. Se procuró para ello realizar una investigación que se detenga de manera pormenorizada en el trabajo artístico y sus particularidades (materiales, técnicas, formas, estrategias de intervención), así como en sus discursos escritos, plasmados en ensayos, artículos y otros textos, para avanzar desde allí hacia un análisis interpretativo y comprensivo de las conexiones y de los efectos que perseguía tal trabajo con los procesos políticos. Se presentan en los Anexos matrices de datos de los señalamientos y de Hexágono '71, así como un índice razonado de la misma
Resumo:
En el marco de una continua reestructuración de las empresas trasnacionales productoras de maquinaria agrícola a nivel mundial, se observa una, significativa tendencia a la concentración de las mismas y a la oligopolización de la oferta mundial, situación que sin lugar a dudas impacta en nuestro país. El trabajo analiza la dinámica del comercio mundial de maquinaria agrícola, vinculada al desempeño del sector en Argentina. Para ello, se examina el comportamiento de las firmas nacionales y extranjeras (radicadas y no radicadas en el país) a partir de su inserción internacional. Para mejorar el nivel de las observaciones, el amplio espectro del sector de maquinaria agrícola es dividido en diferentes subsectores según producto. Este diseño de investigación pone en evidencia las estrategias seguidas por el entramado de empresas locales y multinacionales, en el territorio local y regional, y se observan, de acuerdo a ello, variadas ventajas en los diferentes subsectores
Resumo:
Esta tesis, que integra los estudios de la Sociología del Arte, se centra en la vinculación de la poética del artista Edgardo Antonio Vigo (1928 - 1997) con la política y lo político, así como con los procesos sociales más generales entre 1968 y 1975. Vigo ocupó una posición emergente en el desarrollo del arte platense y desplegó producciones que emprendieron una poética rupturista con lo establecido por algunos de los cánones tradicionales del arte y sus instituciones, y elaboró propuestas estéticas innovadoras que abarcaban las artes visuales en sus diversas formas. Se analizan en esta tesis los modos por los que Vigo al mismo tiempo que apunta a cuestionar las estructuras y manifestaciones de las Bellas Artes, lo hace con las formas dominantes de la cultura a través de obras y textos que tendían a desestabilizar los roles de autor, espectador y obra, así como a involucrarse de distintos modos en los acontecimientos políticos de la época. Se estudian, además, las producción de acciones artísticas en el espacio público, que Vigo llamó señalamientos, la utilización y apropiación del discurso y aspectos materiales de lo judicial-administrativo y la edición de la revista ensamblada Hexágono '71 (1971 -1975). En estas zonas de la poética de Vigo se consideran las diversas relaciones entre arte y política, las cuales no han sido lineales ni unidireccionales, sino modos de distorsionar y disentir con las jerarquías, lugares y funciones de los sujetos y objetos del entramado social. Para la realización de la tesis se produjo un diseño metodológico cualitativo, se utilizaron fuentes documentales y entrevistas. Se desarrolla un análisis de las obras del artista, más que remitiéndolas a una corriente artística particular, haciendo foco en su relación con la situación social y política, especialmente en sus vinculaciones con el particular proceso de subjetivación política de la época. Se procuró para ello realizar una investigación que se detenga de manera pormenorizada en el trabajo artístico y sus particularidades (materiales, técnicas, formas, estrategias de intervención), así como en sus discursos escritos, plasmados en ensayos, artículos y otros textos, para avanzar desde allí hacia un análisis interpretativo y comprensivo de las conexiones y de los efectos que perseguía tal trabajo con los procesos políticos. Se presentan en los Anexos matrices de datos de los señalamientos y de Hexágono '71, así como un índice razonado de la misma
Resumo:
En el marco de una continua reestructuración de las empresas trasnacionales productoras de maquinaria agrícola a nivel mundial, se observa una, significativa tendencia a la concentración de las mismas y a la oligopolización de la oferta mundial, situación que sin lugar a dudas impacta en nuestro país. El trabajo analiza la dinámica del comercio mundial de maquinaria agrícola, vinculada al desempeño del sector en Argentina. Para ello, se examina el comportamiento de las firmas nacionales y extranjeras (radicadas y no radicadas en el país) a partir de su inserción internacional. Para mejorar el nivel de las observaciones, el amplio espectro del sector de maquinaria agrícola es dividido en diferentes subsectores según producto. Este diseño de investigación pone en evidencia las estrategias seguidas por el entramado de empresas locales y multinacionales, en el territorio local y regional, y se observan, de acuerdo a ello, variadas ventajas en los diferentes subsectores
Resumo:
Se toma como punto de partida el modelo de diseño de investigación cualitativa desarrollado por Joseph Maxwell, cuya concepción sobre el diseño de una investigación es el de una estructura subyacente basada en la interconexión de los componentes del estudio y las implicancias que estos tienen sobre otros, para analizar, si es posible, la corriente neorrealista, considerada como la escuela predominante en el estudio de las relaciones internacionales. El propósito de este trabajo -sustentado en el paradigma interpretativo, que conlleva como supuesto fundacional la necesaria comprensión del sentido de la acción social en el contexto del mundo de la vida y desde la perspectiva de los participantes- es el de relevar el aporte testimonial de quienes han conducido o participado activamente, es decir, los Ministros de Relaciones Exteriores, en la formación de la política exterior del país a partir de la vuelta de la democracia.