ABSTRACT
This article performs empirical research and finds a negative relationship between accidents in the workplace and financial performance. The relationship is stronger and more persistent for performance 1 year ahead than for the current year. We find no significant evidence of curvilinear U-shaped or inverted U-shaped relationships. Results are strong across different industries and samples, variable definitions and model specifications. The study contributes to the scarce extant research with reliable data and samples of a wide span of industries. The study also contributes methodologically with refined analyses of the curvilinear relationship and providing robust widespread inference for a large number of industries.
Subject(s)
Accidents, Occupational , Workplace , HumansABSTRACT
BACKGROUND: Lifestyle is one of the main determinants of people's health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors' communication skills, and more specifically the Motivational Interviewing. METHODS/DESIGN: The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire) is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. - SCOPE: Thirty-two primary care centers in Spain. -Sampling and Size: a) face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b) Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362). Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a) Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b) Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis), internal consistency (Cronbach alpha), intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology), generalizability, construct validity and sensitivity to change (Pearson product-moment correlation coefficient). DISCUSSION: The verification of the hypothesis that EVEM is a valid and reliable tool for assessing motivational interviewing would be a major breakthrough in the current theoretical and practical knowledge, as it could be used to assess if the providers put into practice a patient centered communication style and can be used both for training or researching purposes. TRIALS REGISTRATION Dislip-EM study: NCT01282190 (ClinicalTrials.gov).
Subject(s)
Clinical Competence/standards , Motivational Interviewing/standards , Physicians, Primary Care/psychology , Communication , Humans , Physician-Patient Relations , Physicians, Primary Care/standards , Prospective Studies , Psychometrics , Reproducibility of Results , SpainABSTRACT
BACKGROUND: The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. METHODS/DESIGN: An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. DISCUSSION: Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity. TRIALS REGISTRATION: ClinicalTrials.gov (NCT01282190).
Subject(s)
Dyslipidemias/therapy , General Practice , Interviews as Topic/methods , Motivation , Adult , Aged , Cholesterol/blood , Dyslipidemias/blood , Dyslipidemias/drug therapy , Female , Humans , Hypolipidemic Agents/therapeutic use , Male , Middle Aged , Surveys and Questionnaires , Triglycerides/bloodABSTRACT
Recentment s'ha fet públic el Pla Estratègic d'Ordenacióde l'Atenció de Pediatria a l'Atenció Primària elaboratper la Direcció General de Planificació i Avaluació del Departament de Salut. Aquesta aportació no pretén una discussió minuciosa del text del Pla Estratègic, sinó considerar alguns dels conceptes en què es basa per fer les seves propostes i també les raons amb les quals hi dóna suport. L'autor creu que no es pot assegurar que la seva aplicació garanteixi una atenció pediàtrica primària de qualitat
No disponible
Subject(s)
Humans , Child Health Services/organization & administration , Primary Health Care/organization & administration , Strategic Planning , Quality Indicators, Health CareABSTRACT
OBJECTIVE: To assess the degree of body image distortion in female adolescents and evaluate its association with the social esthetic model and the adoption of dietary measures. METHOD: We performed a cross sectional, observational study in a random sample of female adolescents aged 12 to 21 years old. Information was gathered via two different sources. A structured questionnaire including sociodemographic and anthropometric items was administered to determine adolescents' desire to resemble advertising models, their satisfaction with trouser size, and whether they would follow an unsupervised diet, etc. A game consisting of 9 images of female shapes of increasing size was used to evaluate self-perceived body image. The subjects chose the shape they believed most closely resembled their own. RESULTS: A sample of 401 subjects with a mean age of 17.6 (standard deviation = 2.6) years was evaluated. Seventy-five percent had normal weight, 11% were overweight, 13% were obese, and 0.8% were underweight. A total of 76.8% of the subjects had distorted body image and wished to look like advertising models (p < 0.001), 47.7% were dissatisfied with their trouser size (p < 0.001), and 15.3% were following special diets without supervision (p < 0.001). CONCLUSIONS: The majority of adolescents aged between 13 and 21 years old were dissatisfied with their body image. A distorted body image translates into wanting to resemble advertising models and dissatisfaction with trouser size, which in turn leads to following unsupervised diets.
Subject(s)
Body Image , Self Concept , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Spain , Urban PopulationABSTRACT
Objetivo. Determinar el grado de distorsión de la autoimagen corporal en adolescentes femeninas, y evaluar su asociación con el modelo estético-social y la adopción de medidas dietéticas. Método. Estudio observacional y transversal. Muestra aleatoria poblacional de adolescentes femeninas de entre 12 y 21 años de edad. La información fue recogida a través de 2 fuentes: mediante un cuestionario estructurado sobre datos sociodemográficos y antropométricos (deseo de parecerse a las modelos publicitarias, satisfacción con la talla de pantalón que usaban, si realizaban dietas sin supervisión, etc.) y valoración de la autopercepción de la propia imagen corporal mediante un juego de 9 imágenes de siluetas femeninas de anchura creciente. Resultados. Se analizaron 401 adolescentes con una media de edad de 17,6 años (desviación estándar = 2,6). En cuanto al peso, el 75,3% tenía normopeso, el 11% sobrepeso, el 13% obesidad y el 0,8% bajopeso. Respecto a la percepción de la imagen, el 76,8% presentaba distorsión de la autoimagen corporal y le gustaba parecerse a las modelos publicitarias (p < 0,001). El 47,7% no estaba de acuerdo con la talla de pantalón que usaba (p < 0,001). El 15,3% realizaba dieta sin supervisión (p < 0,001). Conclusiones. La mayoría de adolescentes en edades comprendidas entre 13 y 21 años no está conforme con su imagen corporal. La distorsión de la autoimagen corporal se traduce en querer parecerse más a las modelos publicitarias y a no estar satisfechas con sus tallas de pantalón. Esto las lleva a la realización de dietas sin supervisión
Objective. To assess the degree of body image distortion in female adolescents and evaluate its association with the social esthetic model and the adoption of dietary measures. Method. We performed a cross sectional, observational study in a random sample of female adolescents aged 12 to 21 years old. Information was gathered via two different sources. A structured questionnaire including sociodemographic and anthropometric items was administered to determine adolescents' desire to resemble advertising models, their satisfaction with trouser size, and whether they would follow an unsupervised diet, etc. A game consisting of 9 images of female shapes of increasing size was used to evaluate self-perceived body image. The subjects chose the shape they believed most closely resembled their own. Results. A sample of 401 subjects with a mean age of 17.6 (standard deviation 5 2.6) years was evaluated. Seventy-five percent had normal weight, 11% were overweight, 13% were obese, and 0.8% were underweight. A total of 76.8% of the subjects had distorted body image and wished to look like advertising models (p < 0.001), 47.7% were dissatisfied with their trouser size (p < 0.001), and 15.3% were following special diets without supervision (p < 0.001). Conclusions. The majority of adolescents aged between 13 and 21 years old were dissatisfied with their body image. A distorted body image translates into wanting to resemble advertising models and dissatisfaction with trouser size, which in turn leads to following unsupervised diets
