Thesis (M.A.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Not embargoed. Vita. Bibliography: 69-71.

Thesis (Ph. D.)--University of Glasgow, 2003. / Ph. D. thesis submitted to the departments of Public Health and Health Policy and Management Studies, University of Glasgow, 2003. Includes bibliographical references. Print version also available.

Com o crescente aumento do número de dispositivos móveis no mercado, surge a possibilidade dos usuários carregarem consigo diversos livros em formato digital. Estes livros, originalmente desenvolvidos para outros formatos, apresentam vícios, e em alguns casos falhas, que prejudicam e confundem o usuário. Por este motivo surgem os livros digitais interativos, que nada mais são do que livros projetados especificamente para estes dispositivos móveis. Mas junto com estes produtos surgem dúvidas a respeito de quais embasamentos devem ser utilizados. Neste contexto, a presente pesquisa analisa se os conhecimentos relacionados a experiência do usuário, ao design de interação, ao design de informação, e ao design de interface, vinculados as bases teóricas utilizadas para o desenvolvimento de livros impressos, jornais/revistas digitais e aplicativos, podem orientar o processo de projeto e desenvolvimento de livros digitais interativos. O resultado desta analise permite realizar um levantamento, e consequentemente criar um guia de diretrizes que servirá como embasamento para o futuros desenvolvimento de livros digitais interativos. / The increasing number of mobile devices on the market, arises the possibility for users to carry several books in a digital format. These books, originally developed for other formats, have addictions, and in some cases failures, that hinder and confuse the user. In this scenario arise the interactive digital books, which are nothing more than books designed specifically for these mobile devices. But along with these products new doubts show up. In this context, the present study examines whether the knowledge related to the user experience, the interaction design, the information design, and interface design, tied the theoretical bases used for the development of printed books, newspapers / magazines and digital applications can guide the process of design and development of interactive digital books. The result of this analysis allows to conduct this work, and thus create guidelines that will serve as basis for the future development of interactive digital books.

BACKGROUND: Cervical cancer has historically been a major cause of mortality for women worldwide. Over the last 50 years, thanks to advances in screening technologies and the implementation of standardized management algorithms, the incidence of cervical cancer in the United States has been declining. LITERATURE REVIEW: In the most recent set of algorithms, the 2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors, the authors conclude that there is high-level evidence to support extended screening intervals for women who are at average-risk for cervical cancer and who have a history of negative screening tests. However, there is large population of women with a history of abnormal screening tests, and their risk of recurrent disease is not well understood. Additionally, the predictive value of the available screening tests for this cohort of women is unknown. The authors of the 2012 Guidelines warn that there is insufficient evidence for optimal management of these women, the current guidelines are based on expert opinion only, and studies providing high-level evidence are lacking. PROPOSED PROJECT: This thesis proposes a systematic literature review of the existing evidence regarding to what extent women who are treated for cervical abnormalities at baseline are at an increased risk for persistent or recurrent disease in the future. Journal articles will be gathered from three different databases and abstracts will be screened for duplicity and relevancy. After article selection, the quality of evidence presented in each paper will be evaluated using the GRADE system to facilitate a methodical and accurate comparison of the existing evidence. Finally, a scheme for data abstraction from the articles will be outlined. CONCLUSIONS: The results of this systematic literature review will serve multiple purposes, including identifying what research has been done since the latest revision of management guidelines, and aiding in the revision of the algorithms for the population of women who have had abnormal screening test results. It will also identify persistent gaps in the body of knowledge regarding this cohort of patients, and guide the development of additional research studies to fill those gaps. SIGNIFICANCE: Determining the risk of recurrent disease in women with abnormal cervical cancer screening tests will serve to more optimally manage this cohort of women. This will allow providers to effectively monitor patients for the recurrence of cervical disease, while also minimizing the risks associated with overscreening.

Masters of Science - Msc (Physiotherapy) / Concussion is one of the most common injuries in contact sports such as rugby and hockey. Concussion awareness has dramatically increased over the last 20 years. Concussion is a mild traumatic brain injury that often gets overlooked but can be fatal if not taken seriously. Early diagnosis and appropriate management of concussion is vital for safely integrating a player back into sport. Return to play guidelines serves to ensure the safety of the players. Even though a few studies have investigated the knowledge of concussion and the return to play guidelines amongst therapists, there are no South African studies focusing on high school rugby and hockey players.

Esta dissertação aborda a implantação de um guia orientativo de incerteza de medição aplicável aos avaliadores de laboratório da Rede Metrológica RS. A incerteza de medição é um importante tema para organismos de avaliação de laboratórios, como é o caso da Rede Metrológica RS, pois consiste em um dos requisitos básicos para o reconhecimento de competência de laboratórios. Dessa forma, é fundamental garantir que todos os avaliadores possuam um nível de conhecimento adequado sobre incerteza de medição. Assim, o objetivo principal deste trabalho consiste em implantar o referido guia orientativo de incerteza, propiciando melhorias no processo de avaliação da Rede Metrológica RS. Adicionalmente, foi elaborado um fluxograma explicativo dos passos para a expressão da incerteza de medição, assim como listadas componentes de incerteza típicas para áreas de ensaio e calibração e elaborada uma check-list para auxílio aos avaliadores quando da avaliação da incerteza. A implantação do guia orientativo de incerteza dos avaliadores foi realizada segundo as etapas do ciclo de melhoria PDCA. Na etapa plan foram coletados dados que corroboraram para uma necessidade de maior qualificação do grupo de avaliadores com relação à incerteza, sendo a área de ensaios a mais carente. Na etapa do, a minuta do documento foi elaborada de acordo com tópicos previamente definidos com um grupo de especialistas, que envolveu avaliadores experientes e membros da Rede Metrológica RS, assim como especialistas em incerteza do Inmetro. Na etapa check, a minuta do documento passou pela análise crítica do grupo de especialistas consultados e na etapa act foram realizados os ajustes finais e aprovado o documento. Como resultado, foi evidenciada a melhoria do nível de conhecimento dos avaliadores com relação ao tema. Tal fato pôde ser comprovado através da aplicação de provas antes e após o treinamento no novo documento elaborado, mostrando melhoria dos conhecimentos dos avaliadores com relação à incerteza. / This work is concerned with the implantation of a measurement uncertainty guideline applicable to Rede Metrológica RS' assessors. Measurement uncertainty is a quite relevant subject for all laboratory assessment bodies, such as Rede Metrológica RS, because it consists in an elementary requirement for laboratory competence recognition. Thus, it is essential to assure that all assessors have an adequate level of knowledge about measurement uncertainty. Therefore, the main objective of this work consists in the implantation of the referred guideline, yielding improvements on Rede Metrológica RS' assessment process. Additionally, a flow-chart was elaborated to help assessors better understand the procedure to the expression of uncertainty in measurement. A list of common uncertainty sources in calibration and testing fields was prepared, as well as a check-list to help assessors carry out measurement uncertainty assessment. The guideline implementation was carried out following the steps of PDCA improvement cycle. During the step 'plan', some data were collected that corroborated the identified need for better qualification of assessors with respect to measurement uncertainty theory and application. The most deficient field identified was testing assessors. On 'do' step, a guideline draft was prepared in accordance with the topics previously agreed with a group of experts, formed by experienced assessors and Rede Metrológica RS' collaborators, as well as, invited uncertainty experts from Inmetro. On the step 'check', the guideline draft was analyzed by the same group of experts and during the step act, the final adjustments were made and the guideline was formally approved. As a result, an improvement on the assessors' level of knowledge concerning measurement uncertainty was achieved. This was possible to verify by applying assessors' written exams about measurement uncertainty, before and after the training on the new guideline. The exams showed the improvement of the assessors.

Com o crescente aumento do número de dispositivos móveis no mercado, surge a possibilidade dos usuários carregarem consigo diversos livros em formato digital. Estes livros, originalmente desenvolvidos para outros formatos, apresentam vícios, e em alguns casos falhas, que prejudicam e confundem o usuário. Por este motivo surgem os livros digitais interativos, que nada mais são do que livros projetados especificamente para estes dispositivos móveis. Mas junto com estes produtos surgem dúvidas a respeito de quais embasamentos devem ser utilizados. Neste contexto, a presente pesquisa analisa se os conhecimentos relacionados a experiência do usuário, ao design de interação, ao design de informação, e ao design de interface, vinculados as bases teóricas utilizadas para o desenvolvimento de livros impressos, jornais/revistas digitais e aplicativos, podem orientar o processo de projeto e desenvolvimento de livros digitais interativos. O resultado desta analise permite realizar um levantamento, e consequentemente criar um guia de diretrizes que servirá como embasamento para o futuros desenvolvimento de livros digitais interativos. / The increasing number of mobile devices on the market, arises the possibility for users to carry several books in a digital format. These books, originally developed for other formats, have addictions, and in some cases failures, that hinder and confuse the user. In this scenario arise the interactive digital books, which are nothing more than books designed specifically for these mobile devices. But along with these products new doubts show up. In this context, the present study examines whether the knowledge related to the user experience, the interaction design, the information design, and interface design, tied the theoretical bases used for the development of printed books, newspapers / magazines and digital applications can guide the process of design and development of interactive digital books. The result of this analysis allows to conduct this work, and thus create guidelines that will serve as basis for the future development of interactive digital books.

Medical guidelines on the same medical condition differ between England and the Netherlands. These guidelines are referred to as evidence-based because they are supposedly based on a systematic searching for and appraisal of medical studies to drive recommendations for appropriate care for specific clinical circumstances. This comparative study interrogates what causes these differences and similarities between guidelines and tries to uncover the mechanisms behind the development of medical practice guidelines. Four case studies, on lower back pain and on type 2 diabetes in both countries, are used to provide a detailed empirical account of the development of medical guidelines. Interviews with guideline developers are combined with a detailed analysis of available guideline documents. The overarching finding of this thesis is that medical evidence plays a more limited and nuanced role in guideline construction than might be expected and that guidelines are manifestations of professional (self-) regulation. Importantly, the research also finds that institutions shape guidelines in a multitude of ways. This study has endeavoured to add to a more nuanced understanding of evidence within the literature: conceptualising evidence as part of a process of a social and institutional construction. This construction is used within a collaborative and communicative process aimed at creating 'objective facts'. Contrary to existing scholarship, this thesis argues that evidence merely informs the understanding of members of guideline groups while a range of economic, cultural, institutional, and political factors, that together form cognitive frames, provide the driving force behind the development of guidelines. Institutional factors have shown to be essential elements in guideline development, influencing all aspects of development through institutional cultures of practice. This study concludes that calling guidelines evidence-based is an important rhetorical instrument, which helps to conceal and legitimize some of the normative choices that are inherent in guideline making.

Esta dissertação aborda a implantação de um guia orientativo de incerteza de medição aplicável aos avaliadores de laboratório da Rede Metrológica RS. A incerteza de medição é um importante tema para organismos de avaliação de laboratórios, como é o caso da Rede Metrológica RS, pois consiste em um dos requisitos básicos para o reconhecimento de competência de laboratórios. Dessa forma, é fundamental garantir que todos os avaliadores possuam um nível de conhecimento adequado sobre incerteza de medição. Assim, o objetivo principal deste trabalho consiste em implantar o referido guia orientativo de incerteza, propiciando melhorias no processo de avaliação da Rede Metrológica RS. Adicionalmente, foi elaborado um fluxograma explicativo dos passos para a expressão da incerteza de medição, assim como listadas componentes de incerteza típicas para áreas de ensaio e calibração e elaborada uma check-list para auxílio aos avaliadores quando da avaliação da incerteza. A implantação do guia orientativo de incerteza dos avaliadores foi realizada segundo as etapas do ciclo de melhoria PDCA. Na etapa plan foram coletados dados que corroboraram para uma necessidade de maior qualificação do grupo de avaliadores com relação à incerteza, sendo a área de ensaios a mais carente. Na etapa do, a minuta do documento foi elaborada de acordo com tópicos previamente definidos com um grupo de especialistas, que envolveu avaliadores experientes e membros da Rede Metrológica RS, assim como especialistas em incerteza do Inmetro. Na etapa check, a minuta do documento passou pela análise crítica do grupo de especialistas consultados e na etapa act foram realizados os ajustes finais e aprovado o documento. Como resultado, foi evidenciada a melhoria do nível de conhecimento dos avaliadores com relação ao tema. Tal fato pôde ser comprovado através da aplicação de provas antes e após o treinamento no novo documento elaborado, mostrando melhoria dos conhecimentos dos avaliadores com relação à incerteza. / This work is concerned with the implantation of a measurement uncertainty guideline applicable to Rede Metrológica RS' assessors. Measurement uncertainty is a quite relevant subject for all laboratory assessment bodies, such as Rede Metrológica RS, because it consists in an elementary requirement for laboratory competence recognition. Thus, it is essential to assure that all assessors have an adequate level of knowledge about measurement uncertainty. Therefore, the main objective of this work consists in the implantation of the referred guideline, yielding improvements on Rede Metrológica RS' assessment process. Additionally, a flow-chart was elaborated to help assessors better understand the procedure to the expression of uncertainty in measurement. A list of common uncertainty sources in calibration and testing fields was prepared, as well as a check-list to help assessors carry out measurement uncertainty assessment. The guideline implementation was carried out following the steps of PDCA improvement cycle. During the step 'plan', some data were collected that corroborated the identified need for better qualification of assessors with respect to measurement uncertainty theory and application. The most deficient field identified was testing assessors. On 'do' step, a guideline draft was prepared in accordance with the topics previously agreed with a group of experts, formed by experienced assessors and Rede Metrológica RS' collaborators, as well as, invited uncertainty experts from Inmetro. On the step 'check', the guideline draft was analyzed by the same group of experts and during the step act, the final adjustments were made and the guideline was formally approved. As a result, an improvement on the assessors' level of knowledge concerning measurement uncertainty was achieved. This was possible to verify by applying assessors' written exams about measurement uncertainty, before and after the training on the new guideline. The exams showed the improvement of the assessors.

Made available in DSpace on 2014-06-11T19:23:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-03Bitstream added on 2014-06-13T19:29:06Z : No. of bitstreams: 1 lourenco_ts_me_botfm.pdf: 671367 bytes, checksum: bd5532536c0dd51f6b69d6c1bf7e94fc (MD5) / Fundação Pio Xii - Barretos / A mamografia constitui o método populacional mais eficaz na redução da mortalidade por câncer de mama, visto a elevação do diagnóstico de lesões precoces. Países em desenvolvimento apresentam uma elevação na incidência e mortalidade por câncer de mama, decorrente da limitação do exame de mamografia e de programas efetivos de rastreamento. Há inúmeras barreiras relacionadas a não realização do exame de mamografia, podendo estar relacionadas ao sistema de saúde, à educação e à adesão da paciente. Iniciou-se em 2003 na DRS-V um rastreamento mamográfico, controlando as variáveis relacionadas ao sistema de saúde e educação. Na região da DRS/V do Estado de São Paulo, constituída por 19 cidades, iniciou-se um rastreamento mamográfico organizado, a mulheres na faixa etária dos 40-69 anos, através de uma Unidade Móvel de Prevenção (UMP) contendo um mamógrafo, ou em uma unidade fixa, em local onde havia limitação prévia a realização deste exame. Avaliou-se as características de 17.964 mulheres atendidas nos dois primeiros anos do projeto, sendo avaliado as características desta população; e após a cobertura populacional de 50,3% das mulheres, foram entrevistadas 550 mulheres que nunca haviam realizado o exame de mamografia anteriormente. Nas mulheres refratárias foi aplicado questionário avaliando o conhecimento sobre o auto-exame da mama, a importância da mamografia, bem como estratégias para identificação desta população refratária ao exame. No início do projeto o Programa de Saúde da Família foi o principal fator motivador a realização do exame de mamografia (46,8%) e a maioria dos exames foi realizada em UMP (63,7). Cerca de 42,1% das mulheres nunca havia realizado o exame de mamografia na vida, sendo que as mulheres que não haviam realizado o exame previamente constituído principalmente de mulheres da faixa etária 40-69 anos, baixa... / Mammography breast screening is related to early breast cancer diagnosis and the reduction of breast mortality is related to the increase in early breast cancer diagnosis. Developing countries have an increase in incidence and mortality for breast cancer is related to low income of mammography and the absence of organized screening. There are barriers related to the low adherence to mammography exam, and the main reasons are related to health system, education and adherence to guidelines. In 2003 started in DRS-V a mammography screening controlling the factors related to health system and knowledge. We began a mammographic screening in São Paulo state DRS/5 region, consisted with 19 cities, a mammographic breast cancer screening in women between 40-69 years old using a Mobile Unit with a mammography or in a fixed unit. We evaluated the characteristics of 17.964 women screened from the first two years of the project. When 50,3% of women had been screened we found 550 women non adherent to the project and applied questions related to the knowledge about breast clinical examination or reasons related to non adherence to mammography exam, and we analyze the strategies used to find these women. The “Programa de Saúde da Família” was the main factor related to adherence to mammography (46,8%) and the main local related to exams was the Mobile Unit (63,7%). There were 42,1% of the women who hadn’t done de mammography in their life’s and these women were principally between 40-49 years old, low socio-economic status and low income. There was an inverse relation in mammography previously and years of schooling and income. There was 39,2% early breast cancer diagnosis. The 550 women had low years of schooling (84,7%), low income (66,8%) and were between 42-49 years old (43,8%). The clinical frequently doesn’t realize breast examination (14,9%), and low women know how to do this exam... (Complete abstract click electronic access below)