Article / PURPOSE: To determine the prevalence of disability in Peru, explore dependency on caregiver's assistance and assess access to rehabilitation care. METHOD: Data from Disability National Survey (ENEDIS), including urban and rural areas, were analyzed. Disability was defined as a permanent limitation on movement, vision, communication, hearing, learning/remembering or social relationships. Dependency was defined as the self-reported need for a caregiver to help with daily activities; and access to rehabilitation care was defined as the self-report of any therapy for disabilities. Estimates and projections were calculated using sample strata, primary sampling units and population weights, and prevalence ratios (PRs) and 95%CI were reported. RESULTS: From 798 308 people screened, 37 524 (5.1%; 95%CI 4.9--5.2%) had at least one disability. A total of 37 117 were included in further analysis, mean age 57.8 (SD ± 24.1) years, 52.1% women. Dependency was self-reported by 14 980 (40.5%; 95%CI: 39.2-41.9%) individuals with disabilities. A family member, usually female, was identified as a caregiver in 94.3% (95%CI: 93.3-95.3%) of dependent participants. Only 2881 (10.7%; 95%CI: 9.7-11.9%) of people with disabilities reported access to rehabilitation care. Major inequality patterns of disability burden versus access to rehabilitation care were observed by age and education level. Older age groups had higher disability burden yet lower chances of access to rehabilitation care. Conversely, the higher the education level, the lesser the overall disability burden but also the higher chances of reporting receiving care. Private healthcare insurance doubled the probability of having access to rehabilitation compared with those without insurance. CONCLUSIONS: Approximately 1.6 million Peruvians have at least one disability, and 40% of them require assistance with daily activities. Informal caregiving, likely female and relative-provided, is highly common. Rehabilitation care access is low and inequitable. Our results signal a major need to implement strategies to guarantee the highest standard of health care for people with disabilities. Implications for Rehabilitation Major inequality patterns in terms of burden of disability versus access to rehabilitation care were observed: those groups who concentrate more disability reported receiving less rehabilitation care. Caregiving is mostly informal and provided by a direct relative, mainly a woman, who resigned to their usual activities in order to help care for the person with disability. As a result, there is a need to develop appropriate support and training for caregivers. Access to care services in Peru is low and inequitable, but especially for people with disabilities: they experience greater barriers when accessing healthcare services even in the case of having health insurance. / Revisión por pares

Observational learning has been defined as the learning of new responses that occurs as a result of observing the responding of a model and the consequences that this responding produces (Catania, 2007; Taylor & DeQuinzio, 2012). The following study compared the effectiveness of a peer and staff model for teaching four adults with intellectual and developmental disabilities a new response chained task. An alternating treatment design, counterbalanced across subjects was used to evaluate the effects of each modeling condition. Results indicated that all four adults learned the skill with fewer sessions by observing the peer model. Following acquisition of each task, the degree of generalization and maintenance of responding was also evaluated. Implications and directions for future research are further discussed.

The present study used a delay discounting task and the Valued Living Questionnaire to examine the relationship between delay discounting and self-reported values. Thirty-eight participants completed the study. Participants were asked to make choices between immediate and delayed monetary rewards to determine rates of discounting. An exponential function (R2=0.97) provided a strong fit for discounting scores. On the Valued Living Questionnaire, participants rated on a Likert-type scale of 1-10 both the importance and their action in the previous week toward the following values: Family, marriage, parenting, friends, work, education, recreation, spirituality, community, and physical well-being. A composite valued living scored was calculated and compared to participant discounting rates; results suggest that there was a significant relationship between participant valued living scores and K-values (p<0.01) and participant valued living scores and AUC (p<0.02). The results of this study, while preliminary, are important for beginning to understand how values impact decision making.

A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies

The main focus of this thesis was to determine psychologically-informed methods of enhancing endurance performance, particularly in endurance sport events. There were three main research aims. First, this thesis aimed to synthesise research conducted to date on the psychological determinants of endurance performance. A systematic literature review was conducted to identify psychological interventions that affect endurance performance in experimental research. Learning psychological skills, verbal encouragement, and head-to-head competition enhanced endurance performance, whereas mental fatigue undermined endurance performance. Second, this thesis aimed to inform the design of performance-enhancement psychological interventions for endurance sports. In the first study addressing this aim, focus group interviews were conducted with recreational endurance athletes of various endurance sports, distances, and competitive levels to identify psychological demands that are commonly experienced by endurance athletes. Seven common psychological demands were identified using a thematic analysis. These demands were commonly encountered away from the competitive environment (time investment and lifestyle sacrifices, commitment to training sessions, concerns about optimising training, and exercise sensations during training), preceding an event (pre-event stressors), and during an event (exercise sensations, optimising pacing, and remaining focused despite adversity). Psychological interventions that help endurance athletes to cope with these psychological demands could potentially enhance performance in endurance events. In the second study that aimed to inform the design of an intervention, a psychophysiology experiment applied research on the facial feedback hypothesis to determine whether frowning modulates perception of effort during endurance performance. Contrary to hypotheses, intentionally frowning throughout a cycling time-to-exhaustion test did not influence perception of effort or time to exhaustion. This finding suggests that novel interventions that are informed by the facial feedback hypothesis and that target the expression of a frown would be unlikely to enhance endurance performance. Finally, this thesis aimed to examine the effect of a psychological skills training intervention on performance in a real-life endurance event. A randomised, controlled experiment was conducted to examine the effect of learning motivational self-talk on performance in a 60-mile, overnight ultramarathon. Although performance times indicated that motivational self-talk possibly produced a performance enhancement that might benefit ultramarathon runners, additional data will be collected at the same ultramarathon in 2016 to draw firmer conclusions. Overall, the findings of this thesis draw attention to psychological factors that influence performance in endurance events and demonstrate that psychologically-informed interventions can enhance endurance performance. People involved in endurance sports, such as athletes and coaches, are therefore encouraged to systematically work on the psychological aspects of training, preparing for a competition, and competing. Suggestions for how to approach this practically are scrutinised throughout the thesis.

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Made available in DSpace on 2014-10-09T12:34:23Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:10:32Z (GMT). No. of bitstreams: 0 / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Made available in DSpace on 2014-10-09T12:34:23Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:10:32Z (GMT). No. of bitstreams: 0 / Este estudo teve como finalidade principal avaliar a qualidade de vida (QV) dos profissionais de saúde que compõem o serviço de radiodiagnóstico de um hospital da cidade de São Paulo. Além disso, objetivou conhecer o perfil desses profissionais, identificando as variáveis que podem influenciar a QV desses profissionais. Trata-se de um estudo descritivo e exploratório com abordagem quali-quantitativa. Os dados foram coletados usando os questionários: o instrumento abreviado de avaliação de QV - World Health Organization Quality of Life Instrument bref (WHOQOL-bref) da Organização Mundial da Saúde e um questionário sobre as variáveis de interesse: sociodemográficas, condições de trabalho e estilo de vida, ambos questionários auto-aplicáveis. A amostra foi constituída de 118 profissionais nas categorias de: médicos, tecnólogos/técnicos de radiologia, enfermeiros, técnicos e auxiliares de enfermagem, entre outros. A análise dos dados envolveu estatística descritiva, testes não paramétricos e o uso de um modelo de regressão linear. O grau de confiabilidade do instrumento foi avaliado por meio do Coeficiente Alfa de Cronbach (&alpha;). O WHOQOL-bref demonstrou ser um instrumento adequado, de aplicação fácil e rápida para a aferição da qualidade de vida; mostrou bom desempenho psicométrico e boa consistência interna (&alpha;=0,884). O estudo permitiu conhecer a percepção de qualidade de vida do grupo estudado. / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

The goal of this work was to apply an operable green façade wall system in order to analyze the benefits of vegetative surfaces in relation to hot arid urban climates. A second layer of information was also analyzed to provide an alternative to electricity. This method was used to actuate the operable green façade passively to enhance sustainable environmental strategies. Carbon emissions, temperature and relative humidity were evaluated in a hot arid climate on a kinetic green wall system physical scale model. Computer simulation provided insight to daylight, shading and solar irradiance within a mock up building. The results of these factors may be a useful tool to implement in building design for these climatic zones.

Abstract Sheltered housing for the elderly is an intermediate type of housing, between living in ones own home and living in an institution. The aim of this study was to describe the changes in physical, cognitive and psychological abilities among the elderly living in sheltered housing during a two-year follow-up period. In this study psychological abilities were represented by depressive symptoms. The changes in the abilities of the elderly people living in sheltered housing were compared with the corresponding changes among the elderly living in their own homes. Furthermore, the associated factors and the predictors of the decline in physical and cognitive abilities, as well as the depressive symptoms were examined. The control group consisted of elderly people who were matched with those living in sheltered housing in regard to age, sex, coping with activities of daily living and depressive symptoms. The data of this study were collected among elderly people living in 20 units of sheltered housing in Finland in 1994 and 1996. 725 residents were interviewed and 340 re-interviewed after two years. Cognitive capacity was assessed with the help of the Mini-Mental Examination test (MMSE). Depressive symptoms were assessed using the shortened version of the Zung Self-rating Depression Scale (ZSDS). The results showed that the elderly living in sheltered housing were widows or widowers and lived alone more often than the home-dwelling elderly. They perceived their health as poorer, had less contacts with other people and had fewer hobbies than the elderly living at home. Nevertheless, they felt less lonely and were more satisfied with their lives than those living at home. During the two-year follow-up period the decline in the functional capacity of the elderly living in sheltered housing did not essentially differ from the corresponding change among the home-dwelling elderly. The decline in physical and psychological abilities among the elderly living in sheltered housing was similar to the decline among those living at home. Even if the decline in cognitive abilities among the elderly living in sheltered housing was more rapid than the change among the home-dwelling elderly, the difference between the groups was slight. Living in sheltered housing appeared to have neither a negative nor a positive effect on the functional capacity of the elderly. The predictors of the physical decline among the elderly living in sheltered housing were a high age, poor physical abilities at baseline, a high number of depressive symptoms, the use of medication and a low number of hobbies. The predictors of the physical decline among the home-dwelling elderly were the female sex, a high age, poor physical abilities at baseline, a high number of depressive symptoms, health perceived as poor and low social participation. The predictors of the decline in cognitive abilities among the elderly living in sheltered housing included a high age, poor cognitive abilities at baseline, poor education, dissatisfaction with life and health perceived as good. Among the home-dwelling elderly the predictors of the decline in cognitive abilities were poor cognitive abilities at baseline and a low number of hobbies. Among the elderly living in sheltered housing the predictors of depressive symptoms included a high number of depressive symptoms at baseline, poor cognitive abilities, health perceived as poor, a high number of feelings of loneliness, a low number of visits paid to other people and high education. Among the home-dwelling elderly the predictors of depressive symptoms were a high number of depressive symptoms at baseline and a high age.