Anàlisi factorial confirmatòria per a variables categòriques: Aplicació al qüestionari de discapacitat WHODAS-II

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.

Trauma et mémoire - quand la douleur infiltre le corps et l'âme: un regard sur les toxicodépendances graves

This article describes the long-lasting psychological after-effects of a traumatic experience. There is growing lmowledge of the biomedical underpinnings of these phenomena: the underlying mechanisms belong to an implicit learning process whereby the victim remains under the influence of painful past experiences. One of these mechanisms concerns the development of a traumatic bonding which Iioticeably impedes the establishment of interpersona! relationships. The other mechanism, called "contextualisation deficit", is the difficulty of adjusting a person's emotional and behavioural reactivity to the context of present day !ife. This capacity of a traumatic experience to become incrusted long-termina human being's mind, and to haunt the victim with various forms of psychological and physical suffering, can be compared with the presence of a tumour or an abscess in somatic medicine. Th us, severe drug addiction can be conceptualised as a disorder in which the patient tries - in most cases ineffectively - to soothe the pain of today's world in cmmection with the trauma of the past. In conclusion, this article urges the development of psychiatrie care programmes which operate at the centre of the suffering encountered by the se patients, as a complement to the already well-established offers such as harm reduction, substitution therapy and social support.

La qualité des soins dans les consultations ambulatoires pédopsychiatriques du canton de Vaud: résultats d'une enquête de satisfaction

It is common knowledge that patients' satisfaction influences their compliance with the proposed treatment and their future use of health services, and that the therapeutic alliance represents a recognised factor in the success of psychotherapeutic management. In May and June 2011 we conducted an enquiry in all the paedopsychiatric outpatient units of the Canton of Vaud in Switzerland, from which we gathered 1261 questionnaires from consulting children and their parents. The questions covered inter alia overall satisfaction concerning the quality of the care on off er, perception of the therapeutie alliance and the helpfulness of the varions types of treatment. The instruments used are recognised and validated internationally (HAQII and CSQS). The results reve al a high degree of satisfaction and a good perception of the therapeutic alliance's quality: an average of 4.9 for children and 5.9 for parents concerning the therapeutic alliance, on a scale from 1 (totally disagree) to 6 (totally agree), and concerning patient satisfaction an average of 3.2 for children and 3.4 for parents on a scale of 1 to 4. Regarding perception of the benefit derived from different forms of treatment, individual and family interviews were overwhel~ningly approved (3.2 out of 4), while compliance with drug treatment was less recognised as helpful to children (2.3 out of 4).

Emergenssistä

Keskustelua. Kommentti artikkeliin: Kokonaisuus on vähemmän kuin osiensa summa / Kari Enqvist. Tieteessä tapahtuu 16 (1998) : 7

[Illustrations de Le Diable boiteux.] / Dubercelle, grav. ; Alain-René Lesage, aut. du texte

Comprend : Tome 1. Frontispice copié d'après le frontispice réalisé par Magdeleine Horthemels de l'édition originale de 1707 :Le Diable boiteux.] El Diablo Coivelo. [Cote : microfilm R.61628] ; [Pl.] Tom.1 Pag. 25 : Dans quel endroit le Diable Boiteux transporta l'Ecolier et des premières choses qu'il lui fit voir. [Le Diable boiteux, en compagnie de l'Ecolier Zambullo, jette un sort sur la ville de Madrid et fait disparaître les toits d ; [Pl.] Tom.1 Pag. 52 : Histoire des amours du Comte de Belflor et de Léonor de Cespedes. [Cote : microfilm R.61628] ; [Pl.] Tom.1 Pag. 164 : Des Prisonniers. [Cote : microfilm R.61628] ; [Tome 1. Pl. en reg p. 244 :] Des foux enfermez. [Cote : microfilm R.61628] ; [Pl.] Tom.1 Pag. 311 : [Querelle de rue opposant des musiciens et quatre hommes armés.] [Cote : microfilm R.61628] ; [Pl.] Tom.1 Pag. 316 : De l'Incendie, et de ce que fit Asmodée en cette occasion par amitiépour Don Cléofas. [Cote : microfilm R.61628] ; [Pl.] Tom.2 Pag. 3 : Des Tombeaux, des Ombres et de la Mort. [Cote : microfilm R.61628] ; [Pl.] Tom.2 Pag. 29 : La force de l'amitié. [Cote : microfilm R.61628] ; [Pl.] Tom.2 Pag. 91 : Du Démêlé d'un Poëte Tragique avec un Auteur Comique. [Cote : microfilm R.61628] ; [Pl.] Tom.2 Pag. 181 : Des Songes. [Cote : microfilm R.61628] ; [Pl.] Tom.2 Pag. 220 : Ce que le Diable fit encore remarquer à Don Cléofas. [Cote : microfilm R.61628] ; [Pl.] Tom.2 Pag. 291 : De ce que fit Don Cléofas après que le Diable Boiteux se fut éloigné de lui; et de quelle façon l'Auteur de cet Ouvrage a jugé à propos de le finir. [Don Cléofas donne la main de sa fille Séraphine au cavalier Léandr

Recommendation of soil fertility levels for willow in the southern highlands of Santa Catarina

The species Salix x rubens is being grown on the Southern Plateau of Santa Catarina since the 1940s, but so far the soil fertility requirements of the crop have not been assessed. This study is the first to evaluate the production profile of willow plantations in this region, based on the modified method of Summer & Farina (1986), for the recommendation of fertility levels for willow. By this method, based on the law of Minimum and of Maximum for willow production for the conditions on the Southern Plateau of Santa Catarina, the following ranges could be recommended: pH: 5.0-6.5; P: 12-89 mg dm-3; Mg: 3.2-7.5 mg; Zn: 5.0-8.3 mg dm-3; Cu: 0.8-4.6 mg dm-3; and Mn; 20-164 mg dm-3. The Ca/Mg ratio should be between 1.2 and 2.9. For K and Ca only the lower (sufficiency level), but not the upper threshold (excess) was established, with respectively 114 mg dm-3 and 5.3 cmol c dm-3. It was also possible to determine the upper threshold for Al and the Al/Ca ratio, i.e., 1.7 cmol c dm-3 and 0.28, respectively. For maximum yields, the clay in the soil surface layer should be below 320 g dm-3.

Fitomassa e decomposição de resíduos de plantas de cobertura puras e consorciadas

O cultivo de plantas de cobertura, no outono/inverno, na região do Planalto do Rio Grande Sul contribui para o sucesso do sistema plantio direto. No entanto, informações relativas à produção de fitomassa e decomposição de resíduos dessas espécies ainda são escassas para a região, sobretudo para espécies consorciadas. O experimento foi conduzido em Não-Me-Toque, RS, em um Latossolo Vermelho distrófico típico, avaliando-se nove tratamentos, sendo quatro constituídos por plantas de cobertura em culturas puras [centeio (Secale cereale L.), aveia-preta (Avena strigosa Schreb), ervilha forrageira (Pisum sativum subesp. arvense) e nabo forrageiro (Raphanus sativus L. var. oleiferus Metzg)] e cinco por consórcios [(centeio + ervilha forrageira, centeio + nabo forrageiro, aveia + nabo forrageiro, centeio + ervilhaca (Vicia sativa L.) e aveia + ervilhaca)]. A dinâmica de decomposição dos resíduos culturais das plantas de cobertura foi avaliada em bolsas de decomposição, as quais foram distribuídas na superfície do solo e coletadas aos sete, 14, 21, 28, 57, 117 e 164 dias. O consórcio entre leguminosas e crucífera com gramíneas resultou em maior produção de fitomassa em relação ao cultivo destas em culturas puras. O nitrogênio (N) acumulado na parte aérea dos consórcios formados por ervilha forrageira e nabo com centeio e aveia foi semelhante ao da leguminosa e da crucífera em culturas puras e superou em 220,4 % os valores de N observados para as gramíneas em culturas puras. Por meio do consórcio entre as espécies de cobertura foi possível reduzir a taxa de decomposição dos resíduos culturais, em comparação com as culturas puras da leguminosa e da crucífera.