Circular piecewise regression with applications to cell-cycle data.

Applications of circular regression models appear in many different fields such as evolutionary psychology, motor behavior, biology, and, in particular, in the analysis of gene expressions in oscillatory systems. Specifically, for the gene expression problem, a researcher may be interested in modeling the relationship among the phases of cell-cycle genes in two species with differing periods. This challenging problem reduces to the problem of constructing a piecewise circular regression model and, with this objective in mind, we propose a flexible circular regression model which allows different parameter values depending on sectors along the circle. We give a detailed interpretation of the parameters in the model and provide maximum likelihood estimators. We also provide a model selection procedure based on the concept of generalized degrees of freedom. The model is then applied to the analysis of two different cell-cycle data sets and through these examples we highlight the power of our new methodology.

isocir: An R Package for Constrained Inference using Isotonic Regression for Circular Data, with an Application to Cell Biology.

In many applications one may be interested in drawing inferences regarding the order of a collection of points on a unit circle. Due to the underlying geometry of the circle standard constrained inference procedures developed for Euclidean space data are not applicable. Recently, statistical inference for parameters under such order constraints on a unit circle was discussed in Rueda et al. (2009); Fernández et al. (2012). In this paper we introduce an R package called isocir which provides a set of functions that can be used for analyzing angular data subject to order constraints on a unit circle. Since this work is motivated by applications in cell biology, we illustrate the proposed package using a relevant cell cycle data.

Prevention and Mitigation of Rural Higher Education Dropout in Colombia: A Dynamic Performance Management Approach.

Background: Dropout in higher education is a socio-educational phenomenon that has the scope to limit the benefits of education as well as to widen social disparities. For this reason, governments have implemented various public policies for its prevention and mitigation. However, in rural populations, such policies have proven to be ineffective. The aim of this paper is to simulate public policy scenarios for the treatment of school dropout in rural higher education in Colombia from a Dynamic Performance Management approach. Methodology: To achieve the aim, a parameterised simulation model was designed with data from Colombian state entities in rural higher education. Five simulations were carried out. The analysis of the results was carried out using descriptive statistics and comparison of means using the Wilcoxon Sign Rank statistic. Results: The adoption of such an approach based on simulations suggests that policies to expand the coverage of educational credits and financial support, as well as the addition of a family income subsidy, allow for a reduction in the number of dropouts. Conclusions: A dynamic, data-driven approach can be effective in preventing and mitigating dropout in these areas. It also highlights the importance of identifying the key factors contributing to dropout. The results also suggest that government policies can have a significant impact on school retention in rural areas.

Effects of the discharge plan on the caregiving load of people with chronic disease: Quasi-experimental study.

OBJECTIVE: To determine the effect of an anticipated care plan, structured around hospital discharge (PC-AH-US), regarding the caregiving load of people with NTCD residing in Colombia, 2019-2021. METHOD: This is a quasi-experimental study with pre- and post-intervention measurements. It includes 1170 participants who represented 585 chronic disease patient-caregiver pairs. We compared the PC-AH-US intervention, to the regular intervention. RESULTS: The PC-AH-US intervention group showed better results in all dimensions when compared to the regular intervention group: Awareness 8.7 (SD: 0.7) and 6.8 (SD: 1.7); Acknowledgement of their unique conditions 11.3 (SD: 1.0) and 9.4 (SD: 1.8); Capacity to fulfill care tasks 8.8 (SD: 0.7) and 7.5 (SD: 1.5); Wellbeing 11.4 (SD: 0.90) and 8.87 (SD: 2.3); Anticipation 5.88 (SD: 0.4) and 4.7 (SD: 1.1) and Support Network 11.4 (SD: 0.8) and 9.9 (SD: 2.5). CONCLUSION: The PC-AH-US intervention group showed a statistically significant decrease in the caregiving load for people with NTCD (p < 00). There were no significant institutional differences in readmissions or deaths. The PC-AH-US intervention backs institutional policies meant to care for people with NTCD.

Experiences and Perceptions in Dyads about Ostomy Care. Meta-synthesis of Qualitative Studies.

OBJECTIVES: To understand the experiences and perceptions of care dyads (person and caregiver) when having a permanent discharge ostomy. METHODS: Meta-synthesis that followed the ENTREQ standards and was registered in PROSPERO CRD42020221755; It was developed in three phases: (i). Search for studies in academic search engines, with MeSH terms: [(Patients) AND (Ostomy)) AND (Caregivers)], including qualitative primary studies published between 2000 and 2020; (ii). Assessment of the methodological quality with the CORE-Q instrument and the credibility of qualitative findings under the guidelines of the Johanna Briggs Institute; and (iii). Comparative analysis according to the guidelines by Sandelowski and Barroso. RESULTS: The work identified 664 studies; in screening, 35 passed to full-text analysis; 22 to methodological quality evaluation; and 10 to meta-synthesis. The study found 43 qualitative findings that constituted four categories: dyads perform instrumental and emotional care; ambivalent family caregiving feelings and actions; assertive and effective family care; and rejection of bodily changes and sexual dysfunction. These categories constitute the central meta-theme: "The dyads experience a life rupture, which is restored in a sea of ambivalent emotions and learning; at the same time, affective, instrumental and assertive care is constructed". CONCLUSIONS: People who experience having a permanent discharge ostomy express their rejection to the change in bodily image, alterations in sexual life and as a couple. Caregivers and families are the main source of support by being facilitators in self-care, through relationships of mutuality and reciprocity.

Clinical efficacy of a combined acceptance and commitment therapy, dialectical behavioural therapy, and functional analytic psychotherapy intervention in patients with borderline personality disorder.

OBJECTIVE: Borderline personality disorder (BPD) consists of a persistent pattern of instability in affective regulation, impulse control, interpersonal relationships, and self-image. Although certain forms of psychotherapy are effective, their effects are small to moderate. One of the strategies that have been proposed to improve interventions involves integrating the therapeutic elements of different psychotherapy modalities from a contextual behavioural perspective (ACT, DBT, and FAP). METHODS: Patients (n = 65) attending the BPD Clinic of the Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz in Mexico City who agreed to participate in the study were assigned to an ACT group (n = 22), a DBT group (n = 20), or a combined ACT + DBT + FAP therapy group (n = 23). Patients were assessed at baseline and after therapeutic trial on measures of BPD symptom severity, emotion dysregulation, experiential avoidance, attachment, control over experiences, and awareness of stimuli. RESULTS: ANOVA analyses showed no differences between the three therapeutic groups in baseline measures. Results of the MANOVA model showed significant differences in most dependent measures over time but not between therapeutic groups. CONCLUSIONS: Three modalities of brief, contextual behavioural therapy proved to be useful in decreasing BPD symptom severity and emotional dysregulation, as well as negative interpersonal attachment. These changes were related to the reduction of experiential avoidance and the acquisition of mindfulness skills in all treatment groups, which may explain why no differences between the three different intervention modalities were observed. PRACTITIONER POINTS: Brief adaptations of acceptance and commitment therapy and dialectical behavioural therapy are effective interventions for BPD patients, in combined or isolated modalities, and with or without the inclusion of functional analytic psychotherapy. The reduction of experiential avoidance and the acquisition of mindfulness skills are related with the diminution of BPD symptoms severity, including emotional dysregulation and negative interpersonal attachment.

Changes in facial emotion expression during a psychotherapeutic intervention for patients with borderline personality disorder.

Emotional dysregulation is one of the main features of Borderline Personality Disorder (BPD). Therefore, it constitutes a central therapeutic objective of the interventions that have proven to be effective for these patients, including the Acceptance and Commitment Therapy (ACT). However, benefits on emotional regulation have been evaluated through self-report instruments, and an anatomically based, objective, and precise measurement of the ability to change the type, duration and frequency of emotions is still needed. OBJECTIVE: To assess facial emotion expression, valence and arousal during an ACT based intervention, between initial, middle and final therapeutic sessions for BPD patients. METHOD: Using the FaceReader 7.0, 29 recordings of individual therapeutic sessions for BPD patients during an ACT intervention trial were analyzed. RESULTS: Happiness and fear intensity increase from the beginning to the end of the sessions, while sadness decreases. Emotional valence exhibits a significant decrease in its negative value during sessions from -0.13 (S.D. = 0.12) at the initial part of the sessions to -0.06 (S.D. = 0.08) by the end of the sessions, with a moderate effect size (Cohen d = 0.69). Emotional arousal increased from the beginning to the end of sessions and whole intervention. CONCLUSION: The emotional valence and arousal differed according to the psychotherapeutically process involved during ACT intervention, suggesting that the systematic analysis of facial expressions allows a rigorously examination of the relations between emotions, physiological processes, and instrumental behavior experimented though a psychotherapeutically process.

Facilitadores y barreras para el uso de la práctica basada en evidencia / Facilitators and barriers to the use of evidence-based practice / Facilitadores e barreiras ao uso de práticas baseadas em evidências

Objetivo: Conocer los facilitadores y barreras para el uso de la práctica basada en evidencia (PBE) en profesionales de enfermería que laboran en el área clínica. Método: Estudio cuali-tativo de tipo exploratorio descriptivo, con análisis de discurso, se realizaron 6 grupos focales conformados por 3 a 7 participantes para un total de 32 personas, se utilizó un muestreo inten-cional; en promedio fueron grabados entre 60 a 90 minutos por grupo focal. Para el análisis se empleó la fragmentación, codificación y categorización de las entrevistas obteniendo categorías temáticas, subcategorías y códigos a partir del uso del programa Atlas Ti versión 8. Resultados: El 69 % de los entrevistados respondió que el pregrado o posgrado habían recibido algún tipo de formación en PBE, la principal fuente de información cuando tienen alguna duda en la práctica clínica son los protocolos institucionales o los compañeros con más experiencia. Los facilitado-res identificados en este estudio fueron: tiempo para investigar, formación en PBE, iniciativa, grupos de investigación y compañeros; las barreras fueron: falta de apoyo institucional, poca formación en PBE, falta de tiempo, idioma, desmotivación profesional y el rechazo frente al cambio. Conclusiones: Se describen los facilitadores y barreras que presentan los profesionales de enfermería que laboran en el área clínica. Sin embargo se requieren investigaciones adicion-ales que permitan reconocer el fenómeno desde otras perspectivas en el contexto Colombiano y latinoamericano

Objective: To find out the facilitators and barriers to the use of evidence-based practice (EBP) in nursing professionals working in the clinical area. Method: Qualitative descrip-tive exploratory study, with discourse analysis, 6 focus groups were carried out with 3 to 7 participants for a total of 32, a purposive sampling was used; an average of 60 to 90 minutes were recorded per focus group. For the analysis we used the fragmentation, coding and cate-gorisation of the interviews obtaining thematic categories, subcategories and codes from the use of Atlas Ti version 8. Results: 69 % of the interviewees responded that the undergraduate or postgraduate had received some kind of training in EBP, the main source of information when they have any doubt in clinical practice are the institutional protocols or colleagues with more experience. Facilitators identified in this study were: time to investigate, training in EBP, initiative, research groups and peers; barriers were: lack of institutional support, little training in EBP, lack of time, language, professional demotivation and rejection in the face of change. Conclusions: The facilitators and barriers presented by nursing professionals working in the clinical area are described. However, further research is needed to recognise the phenomenon from other perspectives in the Colombian and Latin American context.

Objetivo: Descobrir os facilitadores e as barreiras ao uso da prática baseada em evidências (PBE) em profissionais de enfermagem que atuam na área clínica. Método: Estudo exploratório descritivo qualitativo, com análise de discurso; foram realizados 6 grupos focais com 3 a 7 participantes, totalizando 32; foi usada uma amostragem intencional; foi registrada uma média de 60 a 90 minutos por grupo focal. Para a análise utilizou-se a fragmentação, codificação e categorização das entrevistas obtendo-se categorias temáticas, subcategorias e códigos a partir da utilização do Atlas Ti versão 8. Resultados: 69% dos entrevistados responderam que a grad-uação ou pós-graduação havia recebido algum tipo de treinamento em PBE, a principal fonte de informação quando têm alguma dúvida na prática clínica são os protocolos institucionais ou colegas com mais experiência. Os facilitadores identificados neste estudo foram: tempo para in-vestigar, treinamento em PBE, iniciativa, grupos de pesquisa e colegas; as barreiras foram: falta de apoio institucional, pouco treinamento em PBE, falta de tempo, idioma, desmotivação profis-sional e rejeição diante de mudanças. Conclusões: São descritos os facilitadores e as barreiras apresentados pelos profissionais de enfermagem que trabalham na área clínica. No entanto, são necessárias mais pesquisas para reconhecer o fenômeno de outras perspectivas no contexto co-lombiano e latino-americano

Entorno laboral de los enfermeros de un hospital público de Colombia / Work environment of nurses in a public colombian hospital

Introducción: El entorno laboral de los profesionales de enfermería hospitalarios y su impacto en resultados no ha sido explorado en Colombia. Esta investigación busca describir las características del entorno laboral de los profesionales de enfermería de un hospital público universitario colombiano y determinar su asociación con las características sociodemográficas y con resultados para el enfermero, el paciente y la institución. Método: Estudio descriptivo exploratorio. Se invitó a participar a los 139 enfermeros clínicos de la institución. Se remitió el formulario por RedCap, con preguntas sociodemográficas y laborales, el instrumento ENLASA-Enfermería y preguntas de resultados. De los datos sociodemográficos y laborales se obtuvieron frecuencias y porcentajes. Se empleó el método de Dalenius-Hodges para determinar el puntaje en el cual se consideraba el entorno laboral saludable. Para analizar las asociaciones entre las características sociodemográficas y laborales, los puntajes de ENLASA-Enfermería y los resultados se usaron coeficiente de contingencia, Phi y V de Cramer. Resultados: La tasa de respuesta fue 84%. El puntaje global sugiere que el entorno laboral es saludable. La dimensión de componentes estructurales organizacionales es considerada no saludable (58,3048/100); mientras la de procesos organizaciones es considerada saludable (68,1256/100). Las subdimensiones con más bajos puntajes fueron: políticas de recursos humanos (62,2960/100), planeación de recursos de enfermería (42,9487), y remuneración (52,7778). En la dimensión de procesos organizacionales la autonomía clínica obtuvo el más bajo y el único puntaje que la clasifica como aspecto no saludable (52,6709). Conclusiones: Se plantea la necesidad de promover entornos laborales saludables, trabajar en políticas y planeación del recurso humano en enfermería y avanzar en la investigación en torno a este asunto, para apoyar decisiones de políticas públicas y organizacionales. (AU)

Introduction: The work environment of hospital nurses and its impact on results have not been explored in Colombia. This research seeks to describe the characteristics of the work environment of nurses in a Colombian public hospital and to determine their association with sociodemographic characteristics and with results for the nurse, the patient and the institution. Method: Exploratory descriptive study. The 139 clinical nurses from the institution were invited to participate. The form was sent by RedCap, with sociodemographic and employment questions, the ENLASA-Nursing instrument, and results questions. Frequencies and percentages were obtained from the sociodemographic and employment data. The Dalenius-Hodges method was used to determine the score in which the healthy work environment was considered. To analyze the associations between sociodemographic and occupational characteristics, ENLASA-Nursing scores, and outcomes, the contingency coefficient, Phi, and Cramer's V were used. Results: The response rate was 84%. The overall score suggests that the work environment is healthy. The dimension of organizational structural components is considered unhealthy (58.3048/100); that of organizational processes is considered healthy (68.1256/100). The subdimensions with the lowest scores were: human resources policies (62.2960/100), nursing resource planning (42.9487), and remuneration (52.7778). In the organizational process dimension, clinical autonomy obtained the lowest and the only score that classifies it as an unhealthy aspect (52.6709). Conclusions: There is a need to promote healthy work environments, work on policies and planning of human resources in nursing, and advance research on this matter, to support national and organizational policy decisions. (AU)

Percepciones e implicaciones en personas con ostomías de eliminación. Revisión narrativa / Perceptions and implications in people with elimination ostomies. Narrative review / Percepções e implicações em pessoas com estomias de eliminação. Revisão narrativa

Introducción: Las personas que experimentan el tener una ostomía de eliminación como parte de un tratamiento clínico enfrentan cambios que impactan su calidad de vida, a nivel familiar, social, laboral y económico. Metodología: Revisión narrativa, que incluyó artículos de todos los diseños metodológicos en español, inglés y portugués, disponibles en las bases de datos Scopus, Ovid Nursing, Pubmed, Web of Science, Lilacs, Sage, Sciencedirect, Scielo, Google Scholar y repositorios universitarios, con términos de búsqueda MeSH "Ostomy and Rural Population and caregivers", de los últimos 10 años. Estos artículos surtieron análisis teórico para la construcción de categorías temáticas afines. Resultados: Las categorías temáticas obtenidas son: 1) significado de tener una ostomía: destino, estigma, cambio; 2) afectaciones en la calidad de vida: cambios físicos y de roles; 3) estrategias de afrontamiento: intervenciones integrales; 4) impacto de las intervenciones educativas: en el preoperatorio y para el cuidado; 5) importancia del autocuidado: facilita la adaptación; y 6) rol de los cuidadores: asumen la carga de cuidado. Conclusiones: Las personas con ostomías, sus cuidadores y familias experimentan diferentes cambios en las dinámicas y roles de vida, por lo cual requieren soporte en salud con apoyo emocional, en habilidades cognitivas e instrumentales.

Introduction: People who experience having an elimination ostomy as part of a clinical treatment face changes that impact their quality of life, at a family, social, work and economic level. Methodology: Narrative review, which included articles of all methodological designs in Spanish, English and Portuguese, available in the Scopus, Ovid Nursing, Pubmed, Web of Science, Lilacs, Sage, Sciencedirect, Scielo, Google Scholar and repository databases. university students, with MeSH search terms "Ostomy and Rural Population and caregivers", from the last 10 years. These articles provided theoretical analysis for the construction of re-lated thematic categories. Results: The thematic categories obtained are: 1) meaning of hav-ing an ostomy: fate, stigma, change; 2) effects on quality of life: physical and role changes; 3) coping strategies: comprehensive interventions; 4) impact of educational interventions: in the preoperative period and for care; 5) importance of self-care: it facilitates adaptation; and 6) role of caregivers: they assume the burden of care. Conclusions: People with ostomies, their caregivers and families experience different changes in life dynamics and roles, which is why they require health support with emotional support, cognitive and instrumental skills.

Introdução: As pessoas que experienciam uma ostomia de eliminação no âmbito de um trata-mento clínico deparam-se com alterações que impactam a sua qualidade de vida, a nível familiar, social, laboral e económico. Metodologia: Revisão narrativa, que incluiu artigos de todos os desenhos metodológicos em espanhol, inglês e português, disponíveis nas bases de dados Scop-us, Ovid Nursing, Pubmed, Web of Science, Lilacs, Sage, Sciencedirect, Scielo, Google Scholar e repositório. , com os termos de busca MeSH "Ostomia e população rural e cuidadores", dos últimos 10 anos. Esses artigos forneceram análises teóricas para a construção das categorias temáticas relacionadas.Resultados: As categorias temáticas obtidas são: 1) significado de ter uma estomia: destino, estigma, mudança; 2) efeitos na qualidade de vida: mudanças físicas e de papéis; 3) estratégias de coping: intervenções integrais; 4) impacto das intervenções educativas: no pré-operatório e no cuidado; 5) importância do autocuidado: facilita a adaptação; e 6) papel de cuidador: assumem o ônus do cuidado. Conclusões: As pessoas com ostomias, seus cuidadores e familiares vivenciam diferentes mudanças na dinâmica e nos papéis da vida, pelo que requerem apoio de saúde com suporte emocional, habilidades cognitivas e instrumentais.

Circular Order Aggregation and its Application to Cell-cycle Genes Expressions.

The aim of circular order aggregation is to find a circular order on a set of n items using angular values from p heterogeneous data sets. This problem is new in the literature and has been motivated by the biological question of finding the order among the peak expression of a group of cell cycle genes. In this paper, two very different approaches to solve the problem that use pairwise and triplewise information are proposed. Both approaches are analyzed and compared using theoretical developments and numerical studies, and applied to the cell cycle data that motivated the problem.

Circular Order Aggregation and its Application to Cell-cycle Genes Expressions.

The aim of circular order aggregation is to find a circular order on a set of n items using angular values from p heterogeneous data sets. This problem is new in the literature and has been motivated by the biological question of finding the order among the peak expression of a group of cell cycle genes. In this paper, two very different approaches to solve the problem that use pairwise and triplewise information are proposed. Both approaches are analyzed and compared using theoretical developments and numerical studies, and applied to the cell cycle data that motivated the problem.

Experiences and Perceptions in Dyads about Ostomy Care. Meta-synthesis of Qualitative Studies / Experiencias y percepciones en díadas sobre el cuidado con ostomías. Meta-síntesis de estudios cualitativos / Experiências e percepções em díades sobre os cuidados com a ostomia. Metassíntese de estudos qualitativos

Objective. To understand the experiences and perceptions of care dyads (person and caregiver) when having a permanent discharge ostomy. Methods. Meta-synthesis that followed the ENTREQ standards and was registered in PROSPERO CRD42020221755; It was developed in three phases: (i). Search for studies in academic search engines, with MeSH terms: [(Patients) AND (Ostomy)) AND (Caregivers)], including qualitative primary studies published between 2000 and 2020; (ii). Assessment of the methodological quality with the CORE-Q instrument and the credibility of qualitative findings under the guidelines of the Johanna Briggs Institute; and (iii). Comparative analysis according to the guidelines by Sandelowski and Barroso. Results. The work identified 664 studies; in screening, 35 passed to full-text analysis; 22 to methodological quality evaluation; and 10 to meta-synthesis. The study found 43 qualitative findings that constituted four categories: dyads perform instrumental and emotional care; ambivalent family caregiving feelings and actions; assertive and effective family care; and rejection of bodily changes and sexual dysfunction. These categories constitute the central meta-theme: "The dyads experience a life rupture, which is restored in a sea of ambivalent emotions and learning; at the same time, affective, instrumental and assertive care is constructed". Conclusions: People who experience having a permanent discharge ostomy express their rejection to the change in bodily image, alterations in sexual life and as a couple. Caregivers and families are the main source of support by being facilitators in self-care, through relationships of mutuality and reciprocity.

Objetivo. Comprender las experiencias y percepciones de las díadas del cuidado (persona y cuidador) al tener una ostomía de eliminación. Métodos. Meta-síntesis que siguió los estándares ENTREQ y contó con registro en PROSPERO CRD42020221755. Se desarrolló en tres fases: (i) Búsqueda de estudios en buscadores académicos, con términos MeSH: [(Patients) AND (Ostomy)) AND (Caregivers)], incluyendo estudios primarios cualitativos publicados entre los años 2000 al 2020; (ii) Valoración de la calidad metodológica con instrumento CORE-Q y de credibilidad de hallazgos cualitativos bajo lineamientos del JBI; y (iii) Análisis comparativo según los lineamientos los autores Sandelowski y Barroso. Resultados. Se identificaron 664 estudios; en el cribado 35 pasaron a análisis de texto completo, 22 a evaluación de calidad metodológica y 10 a meta-síntesis. Se identificaron 43 hallazgos cualitativos que constituyeron 4 categorías: las díadas desarrollan el cuidado instrumental y emocional; sentimientos y acciones de cuidado familiar ambivalentes; cuidado familiar asertivo y eficaz; y rechazo a los cambios corporales y disfunción sexual. Estas categorías constituyen el meta-tema central: "Las díadas viven una ruptura de vida, la cual se restaura en un mar de emociones y aprendizajes ambivalentes; a la vez, se construye un cuidado afectivo, instrumental y asertivo". Conclusión. Las personas que vivencian el tener una ostomía permanente de eliminación, expresan el rechazo al cambio en la imagen corporal, alteraciones en la vida sexual y de pareja. Los cuidadores y las familias se constituyen como la fuente principal de apoyo al ser facilitadores en el autocuidado, por medio de relaciones de mutualidad y reciprocidad.

Objetivo. Compreender as vivências e percepções das díades de cuidado (pessoa e cuidador) ao ter uma estomia de descarte. Métodos. Meta-síntese que seguiu os padrões do ENTREQ e foi registrada no PROSPERO CRD42020221755. Foi desenvolvido em três fases: (i) Busca de estudos em buscadores acadêmicos, com termos MeSH: [(Pacientes) AND (Ostomia)) AND (Cuidadores)], incluindo estudos qualitativos primários publicados entre 2000 e 2020; (ii) Avaliação da qualidade metodológica com o instrumento CORE-Q e credibilidade dos achados qualitativos sob as diretrizes do JBI; e (iii) Análise comparativa segundo as orientações dos autores Sandelowski e Barroso. Resultados. 664 estudos foram identificados; na triagem, 35 passaram para análise de texto completo, 22 para avaliação da qualidade metodológica e 10 para metassíntese. Foram identificados 43 achados qualitativos que constituíram 4 categorias: as díades desenvolvem o cuidado instrumental e emocional; sentimentos e ações ambivalentes de cuidado familiar; cuidado familiar assertivo e eficaz; e rejeição de alterações corporais e disfunção sexual. Essas categorias constituem o meta-tema central: "As díades vivem uma pausa na vida, que se restabelece em um mar de emoções e aprendizados ambivalentes; Ao mesmo tempo, constrói-se o cuidado afetivo, instrumental e assertivo". Conclusão. As pessoas que vivenciam uma estomia de remoção permanente expressam rejeição à mudança na imagem corporal, alterações na vida sexual e com o parceiro. Os cuidadores e as famílias constituem-se como principal fonte de apoio por serem facilitadores no autocuidado, por meio de relações de mutualidade e reciprocidade.

Determination of Temporal Order among the Components of an Oscillatory System.

Oscillatory systems in biology are tightly regulated process where the individual components (e.g. genes) express in an orderly manner by virtue of their functions. The temporal order among the components of an oscillatory system may potentially be disrupted for various reasons (e.g. environmental factors). As a result some components of the system may go out of order or even cease to participate in the oscillatory process. In this article, we develop a novel framework to evaluate whether the temporal order is unchanged in different populations (or experimental conditions). We also develop methodology to estimate the order among the components with a suitable notion of "confidence." Using publicly available data on S. pombe, S. cerevisiae and Homo sapiens we discover that the temporal order among the genes cdc18; mik1; hhf1; hta2; fkh2 and klp5 is evolutionarily conserved from yeast to humans.

Modelación con teoría de grafos para la unidimensionalidad de un instrumento de evaluación / Modeling with graph theory to unidimensionality for an assessment instrument

En el marco de las políticas públicas en Colombia sobre calidad de la educación superior se encuentran los lineamientos para que el Estado reconozca los programas de pregrado como de alta calidad, entre tales lineamientos se consideran los sistemas de evaluación de los estudiantes basados en políticas institucionales claras y transparentes que propicien una identificación integral de las condiciones académicas y actitudinales de los estudiantes por lo que es imprescindible tecnificar y modernizar los procesos de evaluación para fortalecer la emisión de inferencias confiables sobre el logro académico. En este artículo se describe una aplicación de la Teoría de Grafos usando algunas de sus definiciones y teoremas básicos con la intención de potenciar su uso para el estudio del supuesto de unidimensionalidad de la Teoría de Respuesta al Ítem como alternativa para robustecer la evaluación. La unidimensional fue entendida en el sentido de la homogeneidad escalar y de criterio para las relaciones de orden definidas por la dominación tanto para ítems como para evaluados: para los ítems conforme al número de evaluados que los contestaron correctamente y a la dificultad; para los evaluados respecto al número de respuestas correctas y a la habilidad. Se aplicó la combinación de las dos teorías a un caso de estudio que contempla el instrumento de la prueba diagnóstica del Examen de Clasificación de Matemáticas Básicas en la Universidad Jorge Tadeo Lozano, con esto se ofrece un valor agregado porque se evidencian los resultados de forma algorítmica y visual con ayuda de herramientas informáticas especializadas.

In Colombia, public policies about quality of higher education involve student assessment systems as a relevant characteristic. These systems should have clear and transparent institutional policies requiring comprehensive identification of attitudinal and academic conditions about examinee performance. Consequently, on the way of continuous improvement of academic services offered by institutions of higher education, an assessment process adequately technified allowing valid inferences about academic achievement is required. In this sense, the Rasch measurement model of Item Response Theory is a modern alternative to strengthen educational measurement estimating the ability of the student and the difficulty of the item on a comparable scale. Unidimensionality, local independence and internal consistency are assumptions made in Rasch measurement model. Unidimensionality assumption has several definitions, one of them is the occurrence of a dominant factor influencing test performance. Another definition is considered in the present study. Here, unidimensionality was interpreted as scalar and criterial homogeneity for the order relations defined by domination for items and assessed applicants. Graph Theory is an ideal mathematical modelling approach to this assumption inasmuch as represent intangible interactions as required. In order to achieve this, Graph Theory and Item Response Theory were combined to examine the qualifying test for the Basic Mathematics subject at Jorge Tadeo Lozano University as a case study. This test was composed by 45 items divided in three blocks. With several combinations of these blocks, three virtual booklets were obtained each one comprising 30 of them. From the application of June 2011, a test sample of 509 responses chains was obtained. Three data bases were processed one for each booklet, the first spanned 175 responses chains, the second 170 and the third one 164. To begin with the exmination on the Rasch measurement model, the parameters reliability, separation, Cronbach Alpha and item residual correlation were estimated to gauge and determine performance test for getting acceptable values in each booklet applied. Tatsuoka was followed to undertake the path to unidimensionality from Graph Theory gathering a real case experience processed with suitable software. Additionally, the sensitivity of the order relation was verified through: 1) ordering by number of correct responses per item (1I order) and items difficulty (2I order); 2) ordering by number of correct responses per applicant (1E order) and estimated ability (2E order). Furthermore, the linear models were obtained collating these orders. In like manner, three Guttman scales and their adjacency matrices were schematized one for each booklet. Subsequently, the respective graphs were processed and represented using Gephi just as a specialized tool that enables running some algorithms like Force Atlas. Afterwards, the second power of each adjacency matrix was found using Matlab 2014b and domination matrices were calculated for both items and applicants in the aforementioned orders for a total of 12 matrices. Consistency index developed by Cliff was computed for the domination matrices. As a result, moderate consistency was observed. Significant domination for the entries of these matrices was analyzed through McNemar test in order to have an asymmetric dominance relation. Moreover, a reachable matrix was calculated for each one of these significant domination matrices as a limit ofa sequence of boolean powers. Finally, dominance hierarchies were illustrated with vertex degrees and compared with student maps by the means of Winsteps 3.73. The combination of Graph Theory and Item Response Theory allowed a deeper comprehension of unidimensionality assumption. Thereupon, universities can optimize their resources offering to applicant differential academic options per individual position in the ability scale. The results can be used to outline advantages for the applicants who can evidence their position in the ability scale and identify the different areas to improve.