Dimensionality, Reliability and Validity of the InterRAI Depression Rating Scale in a Canadian Palliative Care Population

A reliable and valid instrument is needed to screen for depression in palliative patients. The interRAI Depression Rating Scale (DRS) is based on seven items in the interRAI Palliative Care instrument. This study is the first to explore the dimensionality, reliability and validity of the DRS in a palliative population. Palliative home care patients (n = 5,175) residing in Ontario (Canada) were assessed with the interRAI Palliative Care instrument. Exploratory factor analysis and Mokken scale analysis were used to identify candidate conceptual models and evaluate scale homogeneity/performance. Confirmatory factor analysis compared models using standard goodness-of-fit indices. Convergent and divergent validity were investigated by examining polychoric correlations between the DRS and other items. The “known groups” test determined if the DRS meaningfully distinguished among client subgroups. The non-hierarchical two factor model showed acceptable fit with the data, and ordinal alpha coefficients of 0.83 and 0.82 were observed for the two DRS subscales. Omega hierarchical (ωh) was 0.78 for the bifactor model, with the general factor explaining three quarters of the common variance. Despite the multidimensionality evident in the factor analyses, bifactor modelling and the Mokken homogeneity coefficient (0.34) suggest that the DRS is a coherent scale that captures important information on sub-constructs of depression (e.g., somatic symptoms). Higher correlations were seen between the DRS and mood and psychosocial well-being items, and lower correlations with functional status and demographic variables. The DRS distinguished in the expected manner for known risk factors (e.g., social support, pain). The results suggest that the DRS is primarily unidimensional and reliable for use in screening for depression in palliative care patients.

Abordagem familiar em visita domiciliária em enfermagem de saúde mental e psiquiatria

Considerando a família como foco de atenção em enfermagem de saúde mental e psiquiatria, foi realizada a análise da prática clínica de enfermagem no âmbito da prestação de cuidados em visita domiciliária, através dos registos de enfermagem existentes nesse contexto. Partindo dos conceitos de enfermagem de saúde mental e psiquiatria, família, modelos teóricos de avaliação e intervenção familiar e visita domiciliária; procurou-se compreender que modelos de abordagem familiar emergem dos registos de enfermagem das visitas domiciliárias, assim como identificar intervenções dirigidas a utentes e familiares numa perspectiva sistémica. Embora sem identificação completa com modelos teóricos existentes, concluímos que existe, sem dúvida, atenção dada aos familiares, sendo realizada frequentemente avaliação de relacionamentos, padrões de interacção, apoios e recursos, necessitando de melhorias que permitam que seja realizada de uma forma sistematizada, criteriosa, fundamentada e claramente documentada; ABSTRACT: Considering family care central, in psychiatric mental health nursing, an analyses of nursing clinical practice in home care context, was accomplished; using the nursing notes existents in that context. Based on concepts of psychiatric mental health nursing, family, conceptual models of family assessment and intervention and home care; we tried to understand what kind of family approach emerges from the nursing notes, as well as identify what interventions are directed to patients and families in a systemic perspective. Although without clear identification of the conceptual models existents, we realise that attention giving to families, exists, without doubted, with frequent relationships assessments, interaction patterns, supports and resources, however with the need to improve in a more grounded, systematic and discerning way and clearly documented.

Factores de vulnerabilidade para a agressão sexual

A violência sexual contra mulheres e crianças é um fenómeno social e de saúde pública, transversal a diferentes culturas e épocas históricas. A consciencialização deste fenómeno ocorre porém num milénio em que a auto-determinação das mulheres e os direitos fundamentais das crianças passaram a ser considerados pelas principais estâncias políticas. Paralelamente, também a ciência tem dado o seu contributo para a compreensão e resolução destes crimes. Os estudos acerca dos mecanismos de predisposição para a agressão sexual visam a reabilitação dos indivíduos que cometeram ofensas sexuais, prevenindo a reincidência destes comportamentos. O objectivo é diminuir o número de vítimas, intervindo no agressor. O trabalho que apresentamos teve por finalidade investigar potenciais factores de predisposição para a agressão sexual em sujeitos do sexo masculino condenados por crime de violação e abuso sexual de menores, mas também em estudantes universitários com história de violência sexual. Pretendeu-se avaliar de que forma os esquemas precoces mal adaptativos, os mecanismos de inibição/excitação sexual e a personalidade intervêm nestas diferentes formas de violência sexual. Os resultados deste trabalho indicaram que as dimensões avaliadas poderão contribuir para a predisposição e/ou manutenção dos comportamentos de agressão sexual. Adicionalmente, verificou-se que as diferentes formas de violência sexual (violação, abuso sexual de menores e violência sexual em estudantes universitários) são caracterizadas por perfis distintos, e que esta especificidade poderá ser determinante na elaboração de modelos de conceptualização da agressão sexual.

Antecedents of loyalty to a brand : Apple clients vs. non-clients

Apple is undoubtedly a sui generis and remarkable brand in what concerns to its branding and brand experience, and remains an indisputable reference in the consumer electronics and computer industries. The aim of this study encompasses the development and empirical testing of two conceptual models that evaluate and allow to draw a comparison between Apple clients and non-clients’ perceptions, regarding brand experience, brand perceived value, price perceptions and brand trust; and that determine the antecedents of clients’ loyalty to the brand. Therefore, the contribution of this study to the literature relies on the research of the impact of brand experience on brand perceived value and on price perceptions, as well as the influence of price perceptions (positive and negative) on trust, satisfaction, and commitment to the brand. Two surveys were used to test each conceptual model, through a sample collected across the portuguese academic community. The findings prove the strong influence of the sensory and affective aspects of brand experience on both clients and non-clients. They also reveal that the negative role of price is neutralized in the presence of strong brand experience, and that the fact that Apple is viewed as an “expensive brand” may highlight its association to higher quality and prestige. Also, this study reinforces the important role of satisfaction and commitment in building customer loyalty, corroborating the existent literature. Managerial implications derived from the findings are also discussed.

Integrated coastal geoengineering approach for maritime environments

This dissertation introduces several methodological approaches which integrate a proposed coastal management model in an interdisciplinary perspective. The research presented herein is displayed as a set of publications comprising different thematic outlooks. The thesis develops an integrated coastal geoengineering approach which is intrinsically linked to the studied maritime environments. From sandy coasts and marine works to rocky platforms and sea cliffs, this study includes field work between Caminha – Figueira da Foz (NW Portugal) and Galicia (NW Spain). The research also involves an analysis and geological-geotechnical characterisation of natural rock (armourstone) and artificial units (concrete blocks) applied to coastal structures. The main goal is to contribute to the characterisation and re-evaluation of georesources and to determine armourstone suitability and availability from its source (quarry). It was also important to diagnose the geomaterials in situ concerning their degradation/deterioration level on the basis of the current status of the coastal protection works in order to facilitate more efficient monitoring and maintenance, with economic benefits. In the rocky coast approach the coastal blocks were studied along the platform, but also the geoforms were studied from a coastal morphodynamics point of view. A shoreline evolution analysis was developed for sandy coasts through Digital Shoreline Analysis System (DSAS) extension. In addition, the spatial and statistical analysis applied to sea cliffs allowed the establishment of susceptibility zones to erosion and hazardous areas. All of these studies have different purposes and results however, there is a common denominator – GIS mapping. Hence, apart from the studied coastal environment, there is an integrated system which includes a sequence of procedures and methodologies that persisted during the research period. This is a step forward in the study of different coastal environments by using almost the same methodologies. This will allow the characterisation, monitoring and assessment of coastal protection works, rocky coasts, and shore platforms. With such data, it is possible to propose or recommend strategies for coastal and shoreline management based on several justifications in terms of social, economic, and environmental questions, or even provide a GIS-based planning support system reinforced by geocartographic decisions. Overall the development of the applied cartography embraces six stages which will allow the production of detailed maps of the maritime environment: (1) high-resolution aerial imagery surveys; (2) visual inspection and systematic monitoring; (3) applied field datasheet; (4) in situ evaluation; (5) scanline surveying; and (6) GIS mapping. This thesis covers fundamental matters that were developed over the course of scientific publication and as a consequence they represent the results obtained and discussed. The subjects directly related to the thesis architecture are: (i) cartography applied to coastal dynamics (including an art historical analysis as a tool to comprehend the coastal evolution and the littoral zone); (ii) georesources assessment (the role of cartography in georesources zoning, assessment and armourstone durability); (iii) coastal geoengineering applications and monitoring (Espinho pilot site in NW Portugal as an experimental field); (iv) rocky coast and shore platform studies and characterisation; (v) sandy and mixed environment approaches; (vi) coastal geosciences GIS mapping and photogrammetric surveying (coastal geoengineering); and (vii) shoreline change mapping and coastal management strategies (the CartGalicia Project as an example – NW Spain). Finally, all of these thematic areas were crucial to generate the conceptual models proposed and to shape the future of integrated coastal coastal geoengineering management.

Maturidade vocacional e auto-estima em adolescentes institucionalizados

Dissertação de Mestrado, Psicologia da Educação, Especialização em Necessidades Educativas Especiais, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2009

A psicologia da construção da vida : incursões no conceito da adaptabilidade para o estudo da influência parental na construção de carreira em adolescentes

Tese de doutoramento, Psicologia (Psicologia do Desenvolvimento e Aconselhamento de Carreira), Universidade de Lisboa, Faculdade de Psicologia, 2016

Supporting conceptualisation processes in collaborative networks: a case study on an R&D project

The development of new products or processes involves the creation, re-creation and integration of conceptual models from the related scientific and technical domains. Particularly, in the context of collaborative networks of organisations (CNO) (e.g. a multi-partner, international project) such developments can be seriously hindered by conceptual misunderstandings and misalignments, resulting from participants with different backgrounds or organisational cultures, for example. The research described in this article addresses this problem by proposing a method and the tools to support the collaborative development of shared conceptualisations in the context of a collaborative network of organisations. The theoretical model is based on a socio-semantic perspective, while the method is inspired by the conceptual integration theory from the cognitive semantics field. The modelling environment is built upon a semantic wiki platform. The majority of the article is devoted to developing an informal ontology in the context of a European R&D project, studied using action research. The case study results validated the logical structure of the method and showed the utility of the method.

Post-MAPS: An interactive acquisition platform for gastroenterology

Post-MAPS is a web platform that collects gastroenterological exam data from several european hospital centers, to be used in future clinical studies and was developed in partnership with experts from the gastroenterological area and information technology (IT) technicians. However, although functional, this platform has some issues that are crucial for its functioning, and can render user interaction unpleasant and exhaustive. Accordingly, we proposed the development of a new web platform, in which we aimed for an improvement in terms of usability, data uni cation and interoperability. Therefore, it was necessary to identify and study different ways of acquiring clinical data and review some of the existing clinical databases in order to understand how they work and what type of data they store, as well as their impact and contribution to clinical knowledge. Closely linked to the data model is the ability to share data with other systems, so, we also studied the concept of interoperability and analyzed some of the most widely used international standards, such as DICOM, HL7 and openEHR. As one of the primary objectives of this project was to achieve a better level of usability, practices related to Human Computer-Interaction, such as requirement analysis, creation of conceptual models, prototyping, and evaluation were also studied. Before we began the development, we conducted an analysis of the previous platform, from a functional point of view, which allowed us to gather not only a list of architectural and interface issues, but also a list of improvement opportunities. It was also performed a small preliminary study in order to evaluate the platform's usability, where we were able to realize that perceived usability is different between users, and that, in some aspects, varies according to their location, age and years of experience. Based on the information gathered during the platform's analysis and in the conclusions of the preliminary study, a new platform was developed, prepared for all potential users, from the inexperienced to the most comfortable with technology. It presents major improvements in terms of usability, also providing several new features that simplify the users' work, improving their interaction with the system, making their experience more enjoyable.

Show me, help me, let me : supporting teachers' changing conceptions of reading assessment and reading instruction

This qualitative inquiry used case study methodology to explore the change processes of 3 primary-grade teachers throughout their participation in 7 -month professional learning initiative focused on reading assessment and instruction. Participants took part in semimonthly inquiry-based professional learning community sessions, as well as concurrent individualized classroom-based literacy coaching. Each participant's experiences were first analyzed as a single case study, followed by cross-case analyses. While their patterns of professional growth differed, findings documented how all participants altered their understandings of the roles and relevancy of individual components of reading instruction (e.g., comprehension, decoding) and instructional approaches to scaffold students' growth (e.g., levelled text, strategy instruction), and experienced some form of conceptual change. Factors identified as affecting their change processes included; motivation, professional knowledge, professional beliefs (self-efficacy and theoretical orientation), resources (e.g., time, support), differentiated professional learning with associated goal-setting, and uncontrollable influences, with the affect of each factor compounded by interaction with the others. Comparison of participants' experiences to the Cognitive-Affective Model of Conceptual Change (CAMCC) and the Interconnected Model of Teacher Professional Growth (IMTPG) demonstrated the applicability of using both conceptual models, with the IMTPG providing macrolevel insights over time and the CAMCC microlevel insights at each change intervaL Recommendations include the provision of differentiated teacher professional learning opportunities, as well as research documenting the effects of teacher mentorship programs and the professional growth of teacher educators. ii

Examining the incremental validity of psychopathy versus antisocial personality disorder in understanding patterns of criminal behavior

La psychopathie et le trouble de personnalité antisociale sont deux syndromes reliés qui ont été identifiés comme prédicteurs importants de comportements violents et de criminalité. Cependant, la recherche indique que les facteurs de la psychopathie centrés sur la personnalité ne sont pas des prédicteurs fiables de récidive violente chez les personnes atteintes de maladies mentales. Toutefois, peu d’études se sont centrées sur l’identification des facteurs associés au patron des antécédents criminels. Les 96 hommes de l’étude ont été déclarés non criminellement responsables en raison de troubles mentaux. Ils ont été évalués quant au trouble de la personnalité antisociale ainsi qu’à la psychopathie. Les dossiers criminels de la Gendarmerie Royale du Canada ont également été consultés afin de reconstituer l’histoire criminelle. Les résultats suggèrent que ni les traits de personnalité antisociaux, ni les facteurs de la psychopathie ne démontrent une validité prédictive incrémentielle les uns sur les autres quant au nombre ou à la sévérité des délits. La présence d’un grand nombre de traits antisociaux est associée à un plus grand nombre et à une plus importante sévérité d’actes criminels non-violents. Les résultats sont discutés en termes de l’utilité d’une classification du trouble de personnalité antisociale, et de la pertinence du construit de la psychopathie pour les personnes atteintes de maladies mentales graves.

Entre les connaissances et la pratique de santé publique : un monde de collaborations

La santé publique n’échappe pas au courant actuel qui valorise le développement d’une culture de décision et d’action axée sur l’utilisation des données probantes. Des études qui portent sur les services de santé et les politiques publiques en lien avec les services de santé proposent diverses stratégies interactives entre les producteurs et les utilisateurs de connaissances pour favoriser le passage de la théorie vers la pratique. Dans ce contexte, une place importante est accordée aux activités de partage et d’utilisation des connaissances (PUC) au sein des organisations de santé. Or, la mise en œuvre de ces stratégies est peu documentée dans le cadre particulier de la pratique de la santé publique. Pour dégager les processus qui œuvrent au cœur du phénomène dans la pratique de la santé publique sur le territoire montréalais, des cadres au niveau de la direction régionale ont été interrogés sur leurs expériences et leurs perceptions relatives aux activités de PUC. L’analyse du corpus par théorisation ancrée a permis l’émergence de certains concepts clés qui ont été intégrés de manière à formuler une théorie substantive du partage et de l’utilisation des connaissances. La synergie entre le savoir, le savoir-faire et le savoir être se traduit par un savoir agir complexe des acteurs et des organisations qui implique avant tout un climat propice à la collaboration. L’importance accordée à la dimension relationnelle au cœur des activités de PUC témoigne de la volonté de mettre en place des structures collaboratives et de s’éloigner graduellement d’une gestion hiérarchique des savoirs dans la pratique de la santé publique à Montréal. Cette analyse démontre que les défis relatifs à la mise en œuvre d’activités de PUC dépassent les préoccupations reliées aux étapes du processus de transfert des connaissances tel que présenté par la plupart des modèles conceptuels traditionnels.

L’émission des comportements inadaptés au travail : adaptation ou explication quant à la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail

La présente thèse de doctorat porte sur la relation entre la perception de la justice organisationnelle, l’émission de comportements inadaptés au travail et la santé psychologique des individus au travail. En plus de développer un outil de mesure des comportements inadaptés au travail et d’entreprendre un processus de validation de celui-ci, le présent travail propose que les comportements inadaptés au travail puissent occuper un rôle soit protecteur ou explicatif dans la relation qui unit la perception de la justice organisationnelle avec la santé psychologique des individus au travail. Au sein de cette thèse, le premier article recense la documentation scientifique quant aux variables de la perception de la justice organisationnelle, de l’émission des comportements inadaptés au travail et de la santé psychologique des individus au travail, ainsi que les liens qui unissent ces variables. Aussi, les modèles conceptuels des rôles modérateur et médiateur des comportements inadaptés au travail sont proposés au sein de la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. Le deuxième article a pour objectif de développer un outil de mesure des comportements inadaptés au travail et de tester ses propriétés psychométriques. Ainsi, des analyses statistiques exploratoires et confirmatoires ont été effectuées. Afin d’appuyer la valeur critériée de l’outil proposé, une analyse corrélationnelle a été réalisée avec le critère de l’adaptation. Certaines valeurs psychométriques de l’outil sont validées par les résultats obtenus. Le troisième article examine empiriquement les modèles conceptuels des rôles anticipés des comportements inadaptés au travail dans la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. La perception de la justice organisationnelle a été vue sous les composantes distributive, procédurale, informationnelle et interpersonnelle. De son côté, la santé psychologique des individus a été observée par le biais des éléments du bien-être et de la détresse psychologique au travail. Les différentes analyses de régressions multiples hiérarchiques ont permis d’observer l’absence du rôle modérateur des comportements inadaptés au travail. Pour sa part, l’utilisation du test de Sobel a démontré la présence du rôle médiateur des comportements inadaptés au travail dans certaines relations. Plus exactement, celles-ci sont la relation entre la justice interpersonnelle et le bien-être psychologique au travail, la relation entre la justice interpersonnelle et la détresse psychologique au travail, ainsi que la relation entre la justice distributive et la détresse psychologique au travail. Finalement, la conclusion de la thèse présente une synthèse des résultats et expose les limites et pistes de recherches futures.

Les politiques en matière de drogue : une question de valeur?

Dans le domaine des drogues actuellement illicites, deux courants politiques opposés s'affrontent: un mouvement en faveur de la répression fait face à ce que l'on nomme bien souvent l'anti-prohibitionnisme. Comment, à partir de la réalité actuelle, en arrive-t-on à prendre des positions tellement opposées? L'objectif de cet article consiste à analyser les valeurs dominantes qui sont à la base de chacun de ces discours. La méthode privilégiée pour atteindre cet objectif consiste en une recension des écrits scientifiques des 20 dernières années. Quatre bases de données furent consultées: NCJRS, Socio-file, Psyclitt, et Current Content. De cette interrogation, 200 textes furent retenus pour analyse. L'analyse des écrits scientifiques traitant des politiques répressives envers les drogues et de la position anti-prohibitionniste a permis de faire ressortir trois valeurs principales: la gestion optimale des ressources humaines et sociales, la promotion et la santé, et la liberté individuelle vs la protection de l'état. Ces valeurs ne sont pas mutuellement exclusives puisque certaines idées invoquées en vue de justifier la position défendue peuvent s'appliquer à l'une ou l'autre des valeurs identifiées, démontrant combien ceux-ci sont fortement inter-reliées. Enfin, mentionnons que l'ensemble de ces écrits sur le thème étudié présente des faiblesses majeures - elles sont discutées en conclusion.