Background: Feeding and swallowing difficulties (FSD) are found in typically developing children and children with complex medical and developmental conditions. These difficulties may have negative health consequences which can be stressful for caregivers as they are required to provide care for their children in the home environment. The Feeding and Swallowing Impact Survey (FS-IS) is a subjective rating scale used to determine the health-related quality of life (HRQoL) of caregivers of children diagnosed with FSD. However, this scale is not yet available in any of the official South African languages (except for English), and has not yet been culturally or linguistically adapted for the South African context. Research aims: The study aimed to cross culturally adapt and validate the FS-IS for the South African context by 1) describing the content validity of the FS-IS in a South African context; 2) describing the cultural and linguistic appropriateness of the English, isiXhosa and Afrikaans versions of the FS-IS; and 3) describing the experiences caregivers of children have in caring for their child with FSD using the FS-IS, in a pilot study. Methodology: A descriptive exploratory design was used to cross-culturally adapt and pilot the FS-IS, which consists of 3 subsections related to daily activities, worrying and problems with feeding. Five expert speech-language therapist (SLT) participants were identified to review the FS-IS for content validity. The FS-IS was then translated into Afrikaans and isiXhosa using the forward and back translation process. Caregivers (n=15) were identified at feeding clinics to determine the cultural and linguistic appropriateness of the FS-IS in English (n=5), Afrikaans (n=5) and isiXhosa (n=5). Their recommendations were taken into consideration and changes made. The pilot study included caregivers of children with FSD attending feeding clinics at two institutions (n=32) who completed the FS-IS. The participants in the pilot study included parents as primary caregivers (n=28; 88%), grandparents (n=2; 6%), as well as foster parents (n=2; 6%). Thirty-one participants were female with 14 English speaking, 9 isiXhosa and 9 Afrikaans speaking. The caregivers were the primary caregivers of children with a variety of FSD including non-oral feeds, oral feeds with specific modifications and picky or selective eaters. Results: The FS-IS was found to have content validity as experts and caregiver participants judged it to be contextually relevant for the South African context. Caregivers considered the items on the FSIS important, clear and appropriate for speakers of their native language as well as for fellow South African families, with minor changes suggested for the isiXhosa translated version. The tool has high internal consistency (Cronbach's alpha = 0.827) as well as excellent intra and inter-rater reliability (100% agreement). Daily activities that caregiver participants found most difficult included getting help from others (50%, n=16) and leaving their child in the care of others as they are scared to have others feed or take care of their child (62.5%, n=19). The majority of caregiver participants reported concerns related to their child's general health (84%, n=27) and whether they were doing enough to help with their child's FSD (50%, n=16). Few caregivers reported difficulties with feeding, with 87.5% (n=28) reporting no difficulties as a result of the time taken to prepare meals and 72% (n=23) reported no difficulty due to professionals or family having differing opinions about how to feed their child with FSD. Conclusion: The results confirm that the FS-IS is a reliable and valid tool for the identification of caregivers with reduced HRQoL related to caring for their child with FSD in a South African context. The adapted and translated FS-IS can therefore be used to identify caregivers who may need additional support or referral for further management from the multidisciplinary team. The results highlighted the complexity of caring for a child with FSD and the effects of the burden of care on caregivers. Early identification of the HRQoL of caregivers will not only benefit the caregivers but also the child they are caring for as the HRQoL of caregivers impacts on the QoL of the child with FSD.

Family-centred service (FCS), which acknowledges the importance of family engagement in therapeutic processes and focuses on needs of all family members, is increasingly being recognized as an optimal care delivery model for families of children with developmental disabilities. However, services for families are oftentimes ‘child-centric’, wherein family members are seen as partners in therapy or care delivery only, while their own or family needs are not addressed. This arises from the lack of awareness of complex and highly individual family needs by professionals with whom they interact, but also from a significant lack of services oriented toward parent-specific needs in current delivery models. This thesis aims to address this knowledge gap and provides solutions for parental support in the context of pediatric developmental rehabilitation, which might also be applicable to other settings (e.g., community, education). The objectives of this thesis were: (a) to conduct a systematic review synthesizing randomized controlled trials aiming to address parents’ physical, psychological and socioeconomic well-being; (b) to perform cross-cultural and language adaptation and proof-of-concept pilot exploration of an innovative, strengths-based support program ‘ENabling VISions And Growing Expectation’ (ENVISAGE) for parents of children with neurodevelopmental disabilities in Croatia; (c) to refine the Croatian version of the program according to the pilot study results; (d) to run the first set of ENVISAGE workshops and evaluate their impact on Croatian parents’ perception of self, their child with a disability and their family; and (e) to learn about participants’ experience with the program. The findings show that interventions aiming to improve parents’ well-being have limited but promising effectiveness on parents’ health and well-being outcomes. ENVISAGE has proven to be a comprehensive, acceptable, usable, feasible and impactful program for parents of children with developmental disabilities in Croatia. / Dissertation / Doctor of Science (PhD) / Parents raising children with developmental disabilities have unique challenges in their parenting role, which might impact their health and well-being. However, there has been very little focus on parental and family needs in the context of pediatric developmental rehabilitation. Parents are often expected to focus on their child’s issues when their own support needs are usually also significant. This thesis aimed to address this research and practice gap through: a) evaluating best quality evidence on how to support parental well-being; and b) piloting a novel ‘early intervention’ support program for parents of children with disabilities, ‘ENabling VISions And Growing Expectation’ (ENVISAGE), in a new culture and language setting, Croatia. These findings have implications for spreading awareness of innovative programs to improve well-being of parents of children with developmental disabilities in various sectors (e.g., healthcare, community).

Conflict Related Sexual Violence (CRSV) is a persistent and pervasive humanitarian issue, exacerbated by complexities inherent in global conflicts. Recognising the widespread character of CRSV, the need for comprehensive measures to combat it becomes apparent. In the Democratic Republic of Congo (DRC), where CRSV remains a prevalent element in the conflict, Panzi Hospital stands out for its specialisation in assisting survivors. The hospital has developed a holistic care model known as the Panzi Model, which serves as a guiding framework for their efforts. In an increasingly interconnected world, characterised by blurred borders and interdependence among societies, the importance of knowledge transfer (KT), especially while acknowledging the importance of an intersectional approach, becomes evident. This study aimed to assess stakeholders' perceptions of the transferability of the Panzi Model, with a specific focus on its transfer from the DRC to Ukraine, facilitated by the Mukwege Foundation. Employing a qualitative mixed-methods approach, empirical data was collected through interviews and document analysis. The analysis was guided by a theoretical framework—a process model for KT developed within the scope of this research, integrating intersectionality into all its phases. Key findings reveal optimism regarding the model's adaptability, but significant challenges persist, including cultural barriers and a lack of conscious decision-making processes of KT. While efforts have been made to raise awareness and provide support services in Ukraine, challenges remain, including a disproportionate focus on advocacy efforts, leaving limited space for tangible medical and psychological support efforts––both key components of the Panzi Model. Findings also revealed the complexities of deciding whether to establish one-stop-centres (OSCs) or to work through referral systems. In conclusion, the study suggests that while the philosophy of the Panzi Model can be transferred, its full implementation requires nuanced adaptations. Recommendations include transparent disclosure of adaptations and a focus on underlying principles rather than rigid methods. Additionally, the study advocates for fostering international civil society collaboration and prioritising long-term aid for sustainable development. Overall, successful application of these concepts requires contextual sensitivity and ongoing collaboration among stakeholders.

<p dir="ltr">Since the 2000s, there has been a growing interest in qualitative research in the field of Japanese language education, including life story research (e.g., Miyo, 2015). One of the purposes of life story research in Japanese language education is to pay attention to, listen to, and describe the voices of people to whom Japanese language education has so far paid little attention (Miyo, 2014, 2015a). Many studies have listened to the voices of Japanese language learners living in Japan and described their experiences (e.g., Miyo, 2009; Sato, 2015; Maruyama & Ozawa, 2018). However, many studies have not paid particular attention to the region where the learners are staying. One gets the impression that the place could be anywhere as long as the learners are in Japan. Further, cross-cultural adaptation research often focuses on international cross-cultural contact. However, in recent years, it has been pointed out that cross-cultural contact also involves regional differences within a single country (Gui et al., 2012; Berry, 2016). In other words, foreigners staying in a host country experience not only intercultural contact between their own country and the host country but also intercultural contact arising from regional differences within the host country, making the adaptation process complex.</p><p dir="ltr">This narrative case study focused on one American learner of Japanese, Kevin (pseudonym), and his experience on Futaba Island (pseudonym) and analyzed his process of cross-cultural adaptation. Data was collected from his diary and semi-structured interviews with him over six months. The collected data were then graphically represented using the method of Trajectory Equifinality Modeling (TEM) (Sato et al., 2009; Sato et al., 2014). The data obtained in this study showed that Kevin’s back-and-forth between Futaba Island and the mainland impeded and facilitated his cross-cultural adaptation in different ways. Unlike people in large cities on the mainland, people on Futaba Island stare at Kevin and treat him as a special guest, which made him aware of cultural barriers, leading him to construct an identity as an outsider and feel, “I will never fully integrate into Japanese society.” Furthermore, when he traveled to the mainland, he experienced reverse culture shock by encountering many American tourists that he cannot see on Futaba Island. Seeing American tourists behaving incompatibly with Japanese cultural norms made Kevin realize that he was more integrated into Japanese society than he had thought. All of this suggests that when considering the cross-cultural adaptation of foreigners staying in Japan, it is essential to take a place-based perspective on where they are in Japan and where they have been during their stay. Furthermore, just because a person is staying in the host country does not mean that cross-cultural adaptation is influenced by factors that are exclusive to the host country. While staying in the host country, one’s cross-cultural adaptation may be influenced by people from or by events in their home country. It is necessary to take into account home country-related factors as well.</p>

Les troubles musculo-squelettiques du membre supérieur (TMS-MS) peuvent avoir un impact négatif sur l'autonomie d’une personne. À ce jour, il n’existe pas d’outils en français évaluant les limitations d'activités et les restrictions de participation, disposant de bonnes propriétés métrologiques et d'applicabilité dans un contexte clinique marqué par des contraintes de temps. L’Upper Limb Functional Index (ULFI), qui présente de bonnes qualités métrologiques et applicabilité clinique adéquate, s'avère un outil intéressant pour les ergothérapeutes de par son approche centrée sur la personne. Toutefois, il n'était disponible qu'en anglais et en espagnol. La présente recherche, constituée de deux études, visait à adapter l’ULFI à la population canadienne française et à évaluer ses propriétés métrologiques et son applicabilité clinique. La première étude a examiné sa cohérence interne, sa validité convergente et son applicabilité clinique auprès de 50 patients bilingues atteints de TMS-MS. La seconde étude visait à analyser sa fidélité test-retest et sa sensibilité au changement auprès de 60 patients francophones. Les résultats ont révélé que l'ULFI-CF possède des propriétés métrologiques solides : une cohérence interne élevée (α de Cronbach = 0,93), une excellente fidélité test-retest (CCI = 0,87-0,95), une excellente validité convergente (r = 0,70-0,85) et une sensibilité au changement de bonne à excellente (tailles d'effet = 0,49-0,88 et r = 0,64 pour la section 1). L'ULFI-CF démontre également une bonne applicabilité clinique. En conclusion, l’ULFI-CF s’avère un outil pertinent pour les cliniciens œuvrant auprès d’une clientèle canadienne française souffrant d'un TMS-MS dans un contexte clinique marqué par des contraintes de temps. / Upper limb musculoskeletal disorders (UL-MSD) can negatively impact on patients' autonomy. There are no existing outcome measures available in French to assess activity limitations and participation restrictions caused by UL-MSD that have sound metrological properties and are applicable in a clinical context where clinicians have limited assessment time for each patient. The Upper Limb Functional Index (ULFI), having good metrological qualities and clinical applicability, is a relevant tool for clinicians since it promotes a patient-centered approach. However, the tool was only available in English and Spanish until now. This research project included two studies and aimed at adapting the ULFI to the French Canadian population and to assess the metrological properties of the adapted version (ULFI-FC) and its clinical applicability. The first study examined its internal consistency, convergent validity and clinical applicability among 50 bilingual patients with UL-MSD. The second study aimed to analyse its test-retest reliability and responsiveness among 60 French-speaking patients. The findings revealed that the ULFI-FC possesses sound metrological properties: a high internal consistency (Cronbach α = 0.93 for Part 1), an excellent test-retest reliability (ICC = 0.87-0.95), an excellent convergent validity (r = 0.70-0.85), and good to excellent responsiveness (effect size = 0.49-0.88; and r = 0.64 for Part 1), as well as good clinical applicability in a context where assessment time devoted to each patient is limited. In conclusion, the ULFI-CF is a relevant and attractive tool assessing activity limitations and participation restrictions for clinicians working with French Canadian UL-MSD patients in a busy clinical setting.

INTRODUÇÃO: O modelo \'prática baseada em evidência na tecnologia assistiva\', possui como objetivo agregar os objetivos dos clientes integrando a experiência dos profissionais às melhores evidências disponíveis da pesquisa sistemática para a escolha do produto. Para o campo da tecnologia assistiva (TA), isso implica uma ênfase na pesquisa de resultados que discute sobre as contribuições dos dispositivos e os serviços relacionados à vida diária dos usuários. No Brasil, existe uma falta de modelos que articulem o uso da TA, diminuindo o abandono dos dispositivos. Com os modelos e os instrumentos de medida, é possível obter dados, comparar os resultados entre populações distintas, adquirir medidas de resultado confiáveis e válidas, de forma econômica e eficaz, e transformar medidas subjetivas em dados objetivos, que podem ser quantificados e analisados. Isso possibilita que se verifiquem os impactos nos processos de intervenção em saúde e se comparem os produtos com menos recursos financeiros. OBJETIVO: Este estudo tem dois objetivos distintos, mas que se entrelaçam ao dar suporte à sua justificativa e que aqui são chamados de Fase A e Fase B. O primeiro, consiste em identificar através da realização de uma revisão sistemática da literatura os diferentes questionários utilizados para selecionar itens de TA. O segundo, realizar o processo de adaptação transcultural do quadro de estruturação para a modelagem conceitual de resultados de dispositivos de TA (QEMCRDTA) para ser utilizado no Brasil. MÉTODO: Para selecionar e escolher o modelo utilizado nesta pesquisa, visando alcançar os objetivos descritos, foram efetuados dois estudos, divididos aqui em fase A e B. Na Fase A, procedeu-se a uma revisão sistemática da literatura nacional e internacional, com o objetivo de identificar os diferentes questionários utilizados para selecionar itens de TA, descrever e avaliar os procedimentos adotados para fazer a adaptação transcultural, com as características e os domínios temáticos de cada artigo, avaliar o processo de adaptação cultural adotado e descrever as propriedades psicométricas encontradas nos trabalhos. A Fase B compreendeu as etapas de: 1) tradução/síntese das traduções; 2) retrotradução (back translation); 3) Análise pelo comitê de especialistas; 4) Teste da versão pré-final conforme diretrizes internacionais. CONCLUSÕES: Os resultados da fase A mostraram que dentre os 560 artigos encontrados, Apenas 05 pesquisas foram incluídas na síntese qualitativa atendendo os critérios de inclusão. O QUEST pode ser considerado o instrumento mais traduzido e adaptado para outras culturas. Os achados da Fase B, expõem um alto índice da validade do conteúdo certificando a qualidade dos itens que representam o conceito mensurado. Todos os itens que passaram pelo processo de adaptação transcultural foram classificados como de fácil entendimento e nenhum item foi acrescentado ou retirado do Quadro de Estruturação para a Modelagem Conceitual de Resultados de Dispositivos de TA (QEMCRDTA) / INTRODUCTION: The model is based on assistive technology, whose main objective is to choose the professionals for the best results of the systematic research to choose the product. For the TA field, this implies an emphasis on researching results on applications and services related to users\' daily life. In Brazil, there is a lack of models that address the use of assistive technology, reducing the abandonment of devices. With models and measuring instruments, it is possible to obtain data, to compare results between distinctions, to obtain expected and variable measures of results, on a temporary and efficient basis, and to carry out the application of objective data, which can be quantified and analyzed. This enables the results of health and health process studies to be compared with other financial resources. PURPOSE: This study has two distinct objectives, but they are intertwined with support for its justification and are called Phase A and Phase B. The first is to identify through the systematic review of the literature the different questionnaires used to select Assistive Technology items. The second was the process of cross-cultural adaptation of the framework for a conceptual modeling of assistive technology resources for use in Brazil. METHOD: To obtain the number of sequential actions, the index was corrected in two years, divided into two years, divided into stages A and B. In Phase A, a systematic review of the national and international literature was carried out, with the Abstract Keywords of different questions for users to change such as trends, the as described and assessor of the evaluation of adaptive studies to discover the cross-cultural characteristics, and the psychiatric strategies processes to adaptability in the works. Phase B comprised the steps of: 1) translation / synthesis of translations; 2) back translation (reverse translation); 3) Analysis by the committee of experts; 4) Testing the pre-final relationship according to international guidelines. CONCLUSIONS: the results of the phase A change that are among the 560 articles found, only 05 were inserted in the qualitative synthesis in proposing inclusion. QUEST can be considered the most translated and adapted instrument for other cultures. The findings of Phase B, expose a high index of content validity, certifying the quality of the items that represent the concept measured. All cases that received the cross-cultural adaptation process were classified as easy to understand and no item was included or removed from the Structuring Framework for a Conceptual Modeling of Assistive Technology Devices Results

Introdução: O comprometimento cognitivo (CC) na Esclerose Múltipla (EM) possui taxas de prevalência de 43% a 70% e pode surgir desde a Síndrome Clinicamente Isolada (CIS) aos estágios iniciais da EM. O CC na EM pode evoluir independentemente dos sinais e sintomas motores, dos resultados do EDSS e ausência de lesões ativas (captantes) na Ressonância Magnética. Neste contexto, o Multiple Sclerosis National Questionaire (MSNQ) e o protocolo Brief International Cognitive Assesment for Multiple Sclerosis (BICAMS) são instrumentos internacionais empregados para a triagem e o monitoramento nos centros de atendimento para os pacientes com EM. Estudos posteriores e reuniões do mesmo comitê concluíram que o MSNQ possui várias limitações por ser uma medida não objetiva e a triagem única pelo Symbol Digit Modalities Test (SDMT) por si só não é capaz de acessar outras áreas que podem estar comprometidas na EM. Com a segunda revisão do MMSE, e na falta de instrumentos de triagem objetivos capazes de triar os pacientes que precisassem ser melhor acompanhados pelo BICAMS, buscou-se no presente estudo criar a partir do BICAMS e do MMSE-2 uma medida rápida para triagem, que tivesse medidas de memória episódica, velocidade de processamento, atenção e memória operacional. Objetivo: Para obter uma ferramenta de triagem para este propósito (MMSE-MS) foram conduzidos estudos de adaptação segundo o estímulo: estudo de protótipos, estudo de adaptação, propriedades psicométricas e normas do MMSE-2 (como a nossa ferramenta experimental) e estudo preliminar de desenvolvimento de uma ferramenta objetiva de triagem para EM, com base no MMSE-3. Métodos: Todos os estudos de tradução e adaptação foram conduzidos seguindo um mesmo método, já amplamente utilizado pela literatura. O primeiro estudo consistiu no estudo convencional e de protótipos para verificar qual possuía melhor estimativa de equivalência entre as culturas. O segundo estudo consistiu em adaptar, verificar as propriedades psicométricas e estabelecer normas para o MMSE-2. Similarmente ao estudo anterior, um juiz internacional discutiu os resultados do estudo de adaptação para estabelecimento dos parâmetros de transculturalidade. O último estudo foi realizado com o objetivo de obter uma ferramenta com estimativas de sensibilidade e especificidade similares ao BICAMS, mas que fosse designada à triagem dos pacientes que são elegíveis para ser acompanhados pelo BICAMS. Para tal participaram do primeiro estudo, 374 voluntários da comunidade e 25 pacientes com EM. No segundo e terceiro estudo, participaram 128 pacientes com EM e 602 voluntários saudáveis. Todos os estudos clínicos e com as amostras da comunidade foram realizados no período de 2013 à 2015 e contaram com a parceria em pesquisa do Instituto Brasileiro de Neuropsicologia (IBNeuro) e do Laboratório de Instrumentação e Avaliação Psicológica (LABIAP). A coleta de pacientes foi realizada no Ambulatório de Neuroimunologia do Hospital das clínicas da Faculdade de Medicina de Ribeirão Perto (FMRP-USP). Resultados: No primeiro estudo, foram mantidas 5 palavras das 15 da versão original. A razão para as modificações na lista Brasileira foram as diferenças entre a divisão silábica, extensão das palavras e presença de protótipos. Verificou-se ainda que até a quarta palavra evocada na nossa cultura em cada categoria semântica foram as mesmas que foram evocadas na língua nativa do instrumento, mas a ordem da frequência variou dentro de cada categoria, mostrando que embora existam palavras que são prototípicas às duas culturas na classificação semântica global, o contexto cultural interfere muito quando partimos para as especificidades dentro de cada classificação e categoria semântica. O MMSE-2 também apresentou estimativas de validade e precisão comum às duas culturas. No quarto estudo, as medidas do MMSE-2 que tiveram melhor relação com o BICAMS e índices de sensibilidade e especificidade parecidos foram as medidas da tarefa de evocação, atenção e cálculo, memória de histórias e codificação dígitos-símbolos. As correlações selecionadas foram aquelas classificadas em moderadas e fortes. Como segundo critério, as medidas do MMSE-2 foram comparadas às medidas do BICAMS pela curva ROC. As medidas do MMSE- 2 que tiveram especificidade e sensibilidade significativas (p<0,001) foram as elegíveis para compor o teste de triagem. Como a tarefa de codificação dígitos-símbolos é susceptível à demanda motora, optou-se pelo uso da forma oral do SDMT em conjunto. Deste modo, no nosso instrumento de triagem, normas para este instrumento foram criadas a partir da soma dos itens do MMSE-MS com o SDMT oral. Conclusão: A integração de dados desses diversos estudos evidencia cautela quanto aos procedimentos de adaptação empregados para adaptação transcultural das tarefas que são de origem verbal e semântica. Há também evidências da necessidade de instrumentos capazes de triar esses pacientes. Para tal, o MMSE-EM mostrou-se válido, preciso, com índices de sensibilidade e especificidade similares ao BICAMS, com normas ajustadas ao contexto Brasileiro. / Background: The cognitive impairment (CI) in Multiple Sclerosis (MS) has the prevalence rate from 43% to 70% and may occur from the Clinically Isolated Syndrome (CIS) to the early stages of MS. The CI in MS can advance independently of motor signs and symptoms, EDSS scores and MRI stable. In this context, the National Multiple Sclerosis Questionnaire (MSNQ) and the International Brief Cognitive Assesment for Multiple Sclerosis (BICAMS) are international tools used to screening and monitoring MS patients in care centers. Further studies and meetings provided by same committee alluded that MSNQ has several limitations for being a non-objective measure and the screening using the Symbol Digit Modalities Test (SDMT) alone is not effective because other areas that may be impaired in MS is not screened. With the second revision of the MMSE, and the lack of objective screening tools to quikly screening MS patients that needed to be monitored by BICAMS, we aimed in the presente study to create a fast measurement to screening the episodic memory, processing speed, attention and working memory from BICAMS and MMSE-2. Objective: To obtain brief a screening tool for MS (MMSE-MS) were conducted four studies using different tools: first the prototype study to development of CVLT-2 lists, adaptation, psychometric properties and normative data of BICAMS to the Braziliam context (as our gold standard), Cross cultural adaptation, psychometric properties, and normative data of MMSE-2 (the experimental tool) and the preliminary study of development of MMSE-MS. Methods: All translation and adaptation studies were conducted following the same method, as widely used in the literature. The first study consisted of conventional adaptation and prototypical norms, aiming to see which had the best estimates of equivalence between the cultures. The second study with BICAMS protocol show that MS scored significantly lower on all BICAMS tests. At the end of the study, the results were discussed with a member of the international committee to confirm the evidences of transculturality between the original and Brazilian versions. The third study consisted of Adapt, to investigate the psychometric properties and stablish normative data to the MMSE-2. Similarly to the previous study, an international judge discussed the results of the study of adaptation to identify the estimatives of transculturality. The fourth and last study was conducted in order to obtain a tool with sensitivity and similar specificity estimates BICAMS, but it was designed to screen patients who are eligible to be accompanied by BICAMS. Participated of the first study, 374 healthy volunteers and 25 patients with MS. In the second and third study participated 128 MS patients and 602 healthy volunteers. All clinical studies and community samples were carried out from 2013 to 2015 and had the partnership of the Brazilian Institute of Neuropsychology (IBNeuro) and the Laboratory of Instrumentation and Psychological Assessment (LABIAP). The collection of patients was performed at the Neuroimmunology Outpatient Clinic from Ribeirão Preto Medical School (FMRP-USP). Results: In the first study, were kept 5 words of 15 from the original American version. The reason for these changes in the Brazilian list were the differences between the syllabic division, extension of the words and the presence of prototypicall words. Was also found that until the fourth word evoked in our culture, in each semantic category were the same as those mentioned in the native language, but the order of the frequency varied within each category, indicating that although there are words that are prototypically commom between the two cultures in the overall semantic classification, the cultural context changes when we analyse the specifics prototipically words inside of each classification and semantic categories. To the second study, the BICAMS showed similar estimates of reliability and validity for current use as monitoring tool for MS in the Brazilian contexto, supporting the diagnostic validity of the Brazilian-Portuguese adaptation The normative data were satisfactory (p <0.001) in relation to the vocational status. The third study, with MMSE-2 also provided good estimates of validity and precision to the both cultures. To the fourth study, the MMSE-2 was compared to the BICAMS. The MMSE-2 tasks which had similar sensitivity and specificity to the BICAMS protocol was the recalling, attention and calculation, history memory and processing speed (Symbol Digit-coding). The selected tasks were those classified as moderate and Strong correlations. The second procedure consisted on comparisions among the MMSE-2 measurements and BICAMS using ROC curve. So, the MMSE-2 measures that had significant (p <0.001) specificity and sensitivity and similar area under the curve (ROC) were eligible to composse the screening tool. As the digit-symbol coding task is susceptible to motor demand, we decided to include the oral SDMT to the task. Thus, to get our screening tool, normative data for this instrument were created from the sum of the MMSE-MS items with oral SDMT. Conclusion: The overall of the data from these studies calls attention to the necessity of the caution to the adaptation procedures used in cross-cultural adaptation of the tasks that has verbal and semantic stimuli. There is also the need of tools abel to screening MS patients. For this, these preliminar data for MMSE-MS showed evidences of validation, similar sensitivity and and specificity, with normative data culturally adjusted to the Brazilian context.

INTRODUÇÃO: O modelo \'prática baseada em evidência na tecnologia assistiva\', possui como objetivo agregar os objetivos dos clientes integrando a experiência dos profissionais às melhores evidências disponíveis da pesquisa sistemática para a escolha do produto. Para o campo da tecnologia assistiva (TA), isso implica uma ênfase na pesquisa de resultados que discute sobre as contribuições dos dispositivos e os serviços relacionados à vida diária dos usuários. No Brasil, existe uma falta de modelos que articulem o uso da TA, diminuindo o abandono dos dispositivos. Com os modelos e os instrumentos de medida, é possível obter dados, comparar os resultados entre populações distintas, adquirir medidas de resultado confiáveis e válidas, de forma econômica e eficaz, e transformar medidas subjetivas em dados objetivos, que podem ser quantificados e analisados. Isso possibilita que se verifiquem os impactos nos processos de intervenção em saúde e se comparem os produtos com menos recursos financeiros. OBJETIVO: Este estudo tem dois objetivos distintos, mas que se entrelaçam ao dar suporte à sua justificativa e que aqui são chamados de Fase A e Fase B. O primeiro, consiste em identificar através da realização de uma revisão sistemática da literatura os diferentes questionários utilizados para selecionar itens de TA. O segundo, realizar o processo de adaptação transcultural do quadro de estruturação para a modelagem conceitual de resultados de dispositivos de TA (QEMCRDTA) para ser utilizado no Brasil. MÉTODO: Para selecionar e escolher o modelo utilizado nesta pesquisa, visando alcançar os objetivos descritos, foram efetuados dois estudos, divididos aqui em fase A e B. Na Fase A, procedeu-se a uma revisão sistemática da literatura nacional e internacional, com o objetivo de identificar os diferentes questionários utilizados para selecionar itens de TA, descrever e avaliar os procedimentos adotados para fazer a adaptação transcultural, com as características e os domínios temáticos de cada artigo, avaliar o processo de adaptação cultural adotado e descrever as propriedades psicométricas encontradas nos trabalhos. A Fase B compreendeu as etapas de: 1) tradução/síntese das traduções; 2) retrotradução (back translation); 3) Análise pelo comitê de especialistas; 4) Teste da versão pré-final conforme diretrizes internacionais. CONCLUSÕES: Os resultados da fase A mostraram que dentre os 560 artigos encontrados, Apenas 05 pesquisas foram incluídas na síntese qualitativa atendendo os critérios de inclusão. O QUEST pode ser considerado o instrumento mais traduzido e adaptado para outras culturas. Os achados da Fase B, expõem um alto índice da validade do conteúdo certificando a qualidade dos itens que representam o conceito mensurado. Todos os itens que passaram pelo processo de adaptação transcultural foram classificados como de fácil entendimento e nenhum item foi acrescentado ou retirado do Quadro de Estruturação para a Modelagem Conceitual de Resultados de Dispositivos de TA (QEMCRDTA) / INTRODUCTION: The model is based on assistive technology, whose main objective is to choose the professionals for the best results of the systematic research to choose the product. For the TA field, this implies an emphasis on researching results on applications and services related to users\' daily life. In Brazil, there is a lack of models that address the use of assistive technology, reducing the abandonment of devices. With models and measuring instruments, it is possible to obtain data, to compare results between distinctions, to obtain expected and variable measures of results, on a temporary and efficient basis, and to carry out the application of objective data, which can be quantified and analyzed. This enables the results of health and health process studies to be compared with other financial resources. PURPOSE: This study has two distinct objectives, but they are intertwined with support for its justification and are called Phase A and Phase B. The first is to identify through the systematic review of the literature the different questionnaires used to select Assistive Technology items. The second was the process of cross-cultural adaptation of the framework for a conceptual modeling of assistive technology resources for use in Brazil. METHOD: To obtain the number of sequential actions, the index was corrected in two years, divided into two years, divided into stages A and B. In Phase A, a systematic review of the national and international literature was carried out, with the Abstract Keywords of different questions for users to change such as trends, the as described and assessor of the evaluation of adaptive studies to discover the cross-cultural characteristics, and the psychiatric strategies processes to adaptability in the works. Phase B comprised the steps of: 1) translation / synthesis of translations; 2) back translation (reverse translation); 3) Analysis by the committee of experts; 4) Testing the pre-final relationship according to international guidelines. CONCLUSIONS: the results of the phase A change that are among the 560 articles found, only 05 were inserted in the qualitative synthesis in proposing inclusion. QUEST can be considered the most translated and adapted instrument for other cultures. The findings of Phase B, expose a high index of content validity, certifying the quality of the items that represent the concept measured. All cases that received the cross-cultural adaptation process were classified as easy to understand and no item was included or removed from the Structuring Framework for a Conceptual Modeling of Assistive Technology Devices Results

本研究共訪問二十位來台唸書的陸生，試圖透過深度訪談了解陸生在台灣所面臨的文化衝擊以及文化適應方法，以及臉書在陸生文化適應扮演的角色。從訪談與線上觀察了解陸生使用臉書表現，探究臉書對於陸生認識台灣與交友的影響，並歸納陸生使用臉書所採用的疑慮消除策略。 研究發現，多數陸生在台灣面臨的壓力為學業壓力、人際關係、意識型態與政策限制。由於受訪者多為碩博士學生，剛來台灣就感受到龐大的學業壓力，直接進入文化衝擊期。多數的文化衝擊，陸生都能透過自我調適或尋求人際管道、大眾媒體調整自我，融入台灣社會。另外，在使用臉書的疑慮消除策略上，多數陸生皆採取被動策略與互動策略。隨著在台時間越久，對台灣社會越熟悉，人際網絡越牢固，陸生使用臉書改採被動策略。由此可知，臉書對於陸生初進入跨文化社會時，提供一個方便觀察與認識台灣的管道。 / By conducting 20 in-depth interviews with Mainland students studying in Taiwan, this research aims to investigate the culture shock that Mainland students are confronted with and their cultural adaptation in Taiwan. Moreover, the role of “Face-book” in cross-cultural adaptation for Mainland students is also a subject of the study. Based on the interviews and online observation, this research seeks to understand the behavior of Mainland students’ using Facebook, and explore how Facebook affects Mainland students’ understanding of Taiwan and interpersonal relations with Taiwanese. Finally, the research attempts to conclude what uncertainty reduction strategies Mainland students adopt with their using Facebook. The research finds that Mainland students are most pressured by academics, interpersonal relations, ideology and policy restrictions for their study in Taiwan. The 17 interviewees are all graduate students, owing to which they experience“culture shock stage”with enormous academic stress in the early days of their living in Taiwan. Most culture shocks could be overcome and they integrate themselves into local society by self-adaptation, interpersonal communication and mass communication. Moreover, most Mainland students use passive and interactive strategies to reduce their uncertainty in Facebook using. The longer they stay in Taiwan, the deeper they understand local society and the stronger they stay in Taiwan, the deeper they understand local society and the stronger their friendship network grows, and then they turn to passive strategies in uncertainty reduction. Therefore, Facebook provides Mainland students with a channel of observing and understanding Taiwan on the initial stage of entering a new culture.

Les troubles musculo-squelettiques du membre supérieur (TMS-MS) peuvent avoir un impact négatif sur l'autonomie d’une personne. À ce jour, il n’existe pas d’outils en français évaluant les limitations d'activités et les restrictions de participation, disposant de bonnes propriétés métrologiques et d'applicabilité dans un contexte clinique marqué par des contraintes de temps. L’Upper Limb Functional Index (ULFI), qui présente de bonnes qualités métrologiques et applicabilité clinique adéquate, s'avère un outil intéressant pour les ergothérapeutes de par son approche centrée sur la personne. Toutefois, il n'était disponible qu'en anglais et en espagnol. La présente recherche, constituée de deux études, visait à adapter l’ULFI à la population canadienne française et à évaluer ses propriétés métrologiques et son applicabilité clinique. La première étude a examiné sa cohérence interne, sa validité convergente et son applicabilité clinique auprès de 50 patients bilingues atteints de TMS-MS. La seconde étude visait à analyser sa fidélité test-retest et sa sensibilité au changement auprès de 60 patients francophones. Les résultats ont révélé que l'ULFI-CF possède des propriétés métrologiques solides : une cohérence interne élevée (α de Cronbach = 0,93), une excellente fidélité test-retest (CCI = 0,87-0,95), une excellente validité convergente (r = 0,70-0,85) et une sensibilité au changement de bonne à excellente (tailles d'effet = 0,49-0,88 et r = 0,64 pour la section 1). L'ULFI-CF démontre également une bonne applicabilité clinique. En conclusion, l’ULFI-CF s’avère un outil pertinent pour les cliniciens œuvrant auprès d’une clientèle canadienne française souffrant d'un TMS-MS dans un contexte clinique marqué par des contraintes de temps. / Upper limb musculoskeletal disorders (UL-MSD) can negatively impact on patients' autonomy. There are no existing outcome measures available in French to assess activity limitations and participation restrictions caused by UL-MSD that have sound metrological properties and are applicable in a clinical context where clinicians have limited assessment time for each patient. The Upper Limb Functional Index (ULFI), having good metrological qualities and clinical applicability, is a relevant tool for clinicians since it promotes a patient-centered approach. However, the tool was only available in English and Spanish until now. This research project included two studies and aimed at adapting the ULFI to the French Canadian population and to assess the metrological properties of the adapted version (ULFI-FC) and its clinical applicability. The first study examined its internal consistency, convergent validity and clinical applicability among 50 bilingual patients with UL-MSD. The second study aimed to analyse its test-retest reliability and responsiveness among 60 French-speaking patients. The findings revealed that the ULFI-FC possesses sound metrological properties: a high internal consistency (Cronbach α = 0.93 for Part 1), an excellent test-retest reliability (ICC = 0.87-0.95), an excellent convergent validity (r = 0.70-0.85), and good to excellent responsiveness (effect size = 0.49-0.88; and r = 0.64 for Part 1), as well as good clinical applicability in a context where assessment time devoted to each patient is limited. In conclusion, the ULFI-CF is a relevant and attractive tool assessing activity limitations and participation restrictions for clinicians working with French Canadian UL-MSD patients in a busy clinical setting.