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Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2008. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Thesis (Ph.D.) - James Cook University, 2004. / Typescript (photocopy). Appendices: leaves 95-103. Bibliography: leaves 89-94.

Orientador: Maria Helena Baena de Moraes Lopes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T09:33:15Z (GMT). No. of bitstreams: 1 Oliveira_LeaDoloresReganhande_M.pdf: 2693655 bytes, checksum: 3473444fadb6f799eaef463faa602d4c (MD5) Previous issue date: 2010 / Resumo: Este estudo teve por objetivos disponibilizar em língua portuguesa o Gaudenz-Fragebogen por meio do processo de adaptação cultural e verificação da confiabilidade e validade. Para garantir a equivalência entre a versão original e a brasileira foram seguidas as etapas metodológicas recomendadas pela literatura internacional para adaptação cultural: tradução inicial, síntese das traduções, retrotradução, avaliação pelo comitê de especialistas e aplicação do pré-teste. Para determinar o perfil das participantes foi utilizado um instrumento específico desenvolvido pela autora. O Gaudenz-Fragebogen e o questionário específico foram empregues em uma amostra composta por 116 mulheres com incontinência urinária. Para a verificação da confiabilidade foi aplicado o teste-reteste em 60 dessas mulheres e para a avaliação da validade de critério concorrente foram selecionadas 78 mulheres com incontinência urinária de esforço e 38 com de urgência, tendo sido considerado como padrão ouro do estudo - a avaliação urodinâmica. A adaptação do instrumento para a cultura brasileira foi realizada com sucesso, o emprego de uma metodologia criteriosamente definida respaldou e promoveu a obtenção de uma versão em português fiel à original em alemão. Em campo, o instrumento demonstrou ser de fácil compreensão e foi confirmado quanto à sua funcionalidade. Foram identificadas mulheres com idade entre 21 e 87 anos, com baixos níveis de escolaridade e de recursos financeiros, sendo que 103 delas encontravam-se no período de pós-menopausa; a maioria (88,7%) durante a fase reprodutiva vivenciou o parto vaginal, e 89% de co-morbidades estavam presentes entre as participantes. O instrumento adaptado demonstrou alta confiabilidade mediante estabilidade comprovada por meio do teste-reteste, expressa pelo Coeficiente de Correlação Intraclasse (CCI = 0,99). Referente à avaliação da validade de critério concorrente o Gaudenz-Fragebogen, de acordo com o ponto de corte de seus dois escores, não foi capaz de discriminar adequadamente o tipo de incontinência urinária e apresentou baixa sensibilidade para os escores de estresse (9,0%) e de urgência (44,7%). Conclui-se que o processo de adaptação cultural do instrumento sucedeu de maneira criteriosa e a contento. A amostra selecionada e estudada demonstrou um perfil condizente àqueles apresentados em outros estudos acerca da incontinência urinária feminina. O Gaudenz-Fragebogen demonstrou ser uma ferramenta aceitável, prática e confiável, porém, sua validade foi considerada insatisfatória em meio à cultura brasileira / Abstract: This study has the goals of making the Gaudenz-Fragebogen available in the Portuguese language through the process of cultural adaptation and verification of reliability and validity. In order to guarantee the equivalence between the original and the Brazilian versions, the methodological steps recommended by the international literature for cultural adaptation were followed: initial translation, synthesis of translations, back-translation, evaluation by the experts committee, and application of the pre-test. In order to determine the participants' profile, a specific instrument, developed by the author was used. The Gaudenz-Fragebogen and the specific questionnaire were applied to a sample composed of 116 women suffering from urinary incontinence. In order to verify the trustworthiness, the test-retest was applied in 60 of these women, and for the assessment of concurrent criterion 78 women suffering from effort urinary incontinence and 38 suffering from urgency urinary incontinence were selected, having been considered as golden standard of the study - the urodynamic evaluation. The adaptation of the instrument for the Brazilian culture was successfully achieved; the use of a carefully defined methodology supported and elicited the attainment of a version in Portuguese faithful to the original in German. In the field, the instrument proved to be easy to understand and was confirmed in respect to its functionality. The study identified women with ages varying from 21 to 87 years, with low levels of education and of financial resources, with 103 of them in the post-menopausal period; most of these (88.7%), during their reproductive stage, experienced vaginal childbirth, and 89% of co-morbidity were present in the participating subjects. The adapted instrument showed high levels of reliability, proven by means of the test-retest, and expressed by the Interclass Coefficient of Correlation (ICC = 0.99). In relation to the evaluation of concurrent criterion validity, the Gaudenz-Fragebogen, according to the cut point of its two scores, was not able to adequately discriminate the type of the urinary incontinence and presented low sensitivity to stress (9,0%) and urgency (44,7%) scores. It can be concluded that the process of cultural adaptation of the instrument occurred in a careful and adequate manner. The selected and studied sample demonstrated a profile equivalent to those presented in other studies about female urinary incontinence. The Gaudenz-Fragebogen proved to be an acceptable, practical and trustworthy tool, although its validity was considered unsatisfactory for the Brazilian culture / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

Several etiological models of recurrent abdominal pain (RAP) in children have been proposed but no one model has been able to adequately account for the symptoms of all children with RAP. The present study proposed that symptom presentation may provide a basis for treatment selection. Two etiological models were tested in the present study: the constipation model and the operant learning model. Subjects were assigned to either model based upon whether or not they presented with symptoms of constipation. The treatments derived from these two models were: daily dietary fiber supplements, and teaching children relaxation skills and teaching parents to respond to their child’s pain complaints by encouraging their child to cope with pain through relaxation. Thirteen subjects between the ages of six and 12 years of age were treated in a nonconcurrent multiple baseline A-B or A-B-C design. To control for nonspecific effects, some subjects in each model received the treatment suggested by the alternative model first. All four subjects in the constipation model showed substantial reductions in stomachache activity following the introduction of the dietary fiber treatment. Of the nine subjects in the operant learning model, one showed substantial reductions in stomachache activity following the introduction of the relaxation and parent instruction treatment, two showed reductions during both treatments, four responded to the dietary fiber treatment, and two showed no response to treatment. Results support the effectiveness of a dietary fiber treatment for children with RAP with symptoms of constipation. Minimal support was obtained for the effectiveness of a relaxation and parent instruction treatment for children with RAP without symptoms of constipation. Limitations, implications and directions for future research are discussed. / Ph. D.

A colonoscopia com magnificação de imagem (CMI), associada à cromoendoscopia, tem mostrado a possibilidade de se diferenciar lesões neoplásicas e não-neoplásicas. Duzentas e treze lesões colorretais foram magnificadas e analisadas, através da classificação de Kudo, por 3 observadores distintos e também comparadas com os resultados histopatológicos. Houve bom grau de concordância entre os observadores (Kappa = 0,561) para os diversos padrões de criptas. Não houve diferenças entre eles com relação à chance de acerto (p = 0,121; 0,500; 0,405). A acurácia do método foi de 84%, sensibilidade de 91,4%, especificidade de 67,2%, valores preditivos positivo e negativo de 86,6% e 79,3%, índice de Kappa de 0,61. Esses resultados mostram que a CMI não deve ser utilizada na definição de conduta frente a lesões polipóides / Magnifying colonoscopy (MC) associated with chromoendoscopy has showed the possibility of differentiating neoplastic from non-neoplastic lesions. Two hundred and thirteen lesions were magnifyied and analysed, according to Kudo's classification, by 3 observers and compared with histopathological results. There was a good agreement index among them (Kappa = 0.561) with respect to the aspects of the pits. No differences were found in relation to the possibility of being correct (p = 0.121; 0.500; 0.405). Accuracy of method was 84%, sensitivity of 91.4%, specificity of 67.2%, positive and negative predictive values of 86.6% and 79.3%; Kappa index of 0.61. These results show that MC must not be used to define what should be done with polypoid lesions

A colonoscopia com magnificação de imagem (CMI), associada à cromoendoscopia, tem mostrado a possibilidade de se diferenciar lesões neoplásicas e não-neoplásicas. Duzentas e treze lesões colorretais foram magnificadas e analisadas, através da classificação de Kudo, por 3 observadores distintos e também comparadas com os resultados histopatológicos. Houve bom grau de concordância entre os observadores (Kappa = 0,561) para os diversos padrões de criptas. Não houve diferenças entre eles com relação à chance de acerto (p = 0,121; 0,500; 0,405). A acurácia do método foi de 84%, sensibilidade de 91,4%, especificidade de 67,2%, valores preditivos positivo e negativo de 86,6% e 79,3%, índice de Kappa de 0,61. Esses resultados mostram que a CMI não deve ser utilizada na definição de conduta frente a lesões polipóides / Magnifying colonoscopy (MC) associated with chromoendoscopy has showed the possibility of differentiating neoplastic from non-neoplastic lesions. Two hundred and thirteen lesions were magnifyied and analysed, according to Kudo's classification, by 3 observers and compared with histopathological results. There was a good agreement index among them (Kappa = 0.561) with respect to the aspects of the pits. No differences were found in relation to the possibility of being correct (p = 0.121; 0.500; 0.405). Accuracy of method was 84%, sensitivity of 91.4%, specificity of 67.2%, positive and negative predictive values of 86.6% and 79.3%; Kappa index of 0.61. These results show that MC must not be used to define what should be done with polypoid lesions