A marcha é um importante biomarcador na evolução funcional das crianças com distrofia muscular de Duchenne (DMD). A escala de Avaliação Funcional - domínio marcha (FES-DMD-DOMÍNIO MARCHA) foi desenvolvida e teve sua confiabilidade demonstrada em estudo prévio. Atualmente, as escalas funcionais são necessárias para fundamentação da tomada de decisão clínica e como medidas de desfecho em pesquisas científicas e, para tanto, devem ser confiáveis, validas e responsivas. O objetivo do presente estudo foi determinar a responsividade da FES-DMD-domínio marcha no período de um ano, considerando suas três fases e o escore total. Trata-se de estudo observacional, longitudinal e retrospectivo. Foi estudada amostra de 160 avaliações funcionais a partir de filmagens de 32 crianças com DMD (5 a 15 anos). A atividade da marcha foi pesquisada com intervalos de avaliações de 3 meses, totalizando 5 coletas (0, 3, 6, 9 e 12 meses). A responsividade foi analisada por meio dos testes estatísticos tamanho do efeito (TE) e resposta média padronizada (RMP). A responsividade nos intervalos de avaliação de três meses foi considerada de baixa a moderada para as três fases da escala (TE variando de 0.12 a 0.34 e MRP variando de 0.27 a 0.80); de baixa a alta para os intervalos de avaliação de seis meses (TE variando de 0.36 a 0.72 e MRP variando de 0.37 a 1.10); de moderada a alta para os intervalos de avaliação de nove meses (TE variando de 0.70 a 1.0 e MRP variando de 0.50 a 1.43) e alta no período de avaliação de um ano (TE variando de 0.74 a 1.34 e MRP variando de 0.88 a 1.53). O domínio marcha da FES-DMD se mostrou responsivo a partir do intervalo de três meses, aumentado sua capacidade de resposta ao longo das avaliações em até 12 meses. Recomenda-se o uso da FES-DMD-domínio marcha a partir do intervalo de seis meses, que apresenta responsividade, no mínimo moderada para fins de pesquisa, embora seu uso a partir de intervalos de avaliação de três meses possa oferecer informações relevantes nas tomadas de decisão clínico-fisioterapêuticas / March is an important biomarker in the functional evaluation of children with Duchenne muscular dystrophy (DMD). The Functional Scale Evaluation -march domain (FES-DMD-march domain) was developed and its reliability was demonstrated in a previous study. Currently, functional scales are necessary for the reasoning of clinical decision making and as an outcome measure in scientific research and to do so, must be reliable, valid and responsive. The aim of this study was to determine the responsiveness of the FES-DMD-march domain in a one year follow up, considering its three phases and the total score. It is an observational, longitudinal and retrospective study. A sample of 160 functional assessments from filming of 32 children with DMD (5-15 years) was studied. The course of the activity was studied at three monthly intervals evaluations totaling 5 samples (0, 3, 6, 9 and 12 months). Responsiveness was analyzed by statistical tests named effect size (ES) and standardized response mean (SRM). The responsiveness in the three-month evaluation intervals analyzed was considered low to moderate for the three phases of the scale (ES ranging from 0:12 to 0:34 and SRM ranging from 0.27 to 0.80); varied from low to high for the six-months evaluation intervals (ES ranging from 0.36 to 0.72 and SRM ranging from 0:37 to 1:10); varied from moderate to high for the nine-month evaluation intervals (ES ranging from 0.70 to 1.0 and SRM ranging from 0:50 to 1:43) and was high in one year evaluation period (ES ranging from 0.74 to 1.34 and SRM ranging from 0.88 to 1.53). The domain march of the FES-DMD scale showed responsive from the three-month interval, increased their responsiveness during the evaluations within 12 months. It is recommended the use of FES-DMD-march domain from the six-month interval, which presents responsiveness, at least moderate, although its use from three-month evaluation intervals may provide relevant information in clinical-physiotherapeutic decision-making

The purpose of the study was to describe factors contributing to mortality among HIVinfected people on Isoniazid Preventive Therapy (IPT) in Botswana. A quantitative, explorative, descriptive study was used and 80 records of deceased IPT respondents were reviewed through the use of a checklist. The demographic factors, baseline physical examination, hospitalisation and drug history were taken into consideration. Out of the deceased patients, 75% were female. The major findings showed that 100% (N=80), the most highly indicated causes of death were gastroenteritis (18.75%), cryptococcal meningitis (17.5%) andpneumonia (16.25%). Of the patients (28.75%) who died before completing the six months of IPT. The causes of death were gastroenteritis (21.7%), symptoms and signs of bacterial pneumonia (17.4%), cryptococcal meningitis (13%), Pulmonary Tuberculosis (PTB) (13%), septicaemia (13%), and murder (13%). It has been recommended that there should be reorganisation of services of care for HIV-infected persons, such as provision of Cotrimoxazole Prophylaxis Therapy (CPT) and Antiretroviral Therapy (ART) to ensure holistic approach care. The future study should include HIV-infected children on IPT using the same or modified objectives. The conclusion drawn was that disintegrated interventions of IPT, CPT and ART and lack of holistic care for PLHIV lead to opportunistic infections that caused mortality on patients on IPT. / Department of Health Studies / M.A. (Public Health)

The purpose of the study was to describe factors contributing to mortality among HIVinfected people on Isoniazid Preventive Therapy (IPT) in Botswana. A quantitative, explorative, descriptive study was used and 80 records of deceased IPT respondents were reviewed through the use of a checklist. The demographic factors, baseline physical examination, hospitalisation and drug history were taken into consideration. Out of the deceased patients, 75% were female. The major findings showed that 100% (N=80), the most highly indicated causes of death were gastroenteritis (18.75%), cryptococcal meningitis (17.5%) andpneumonia (16.25%). Of the patients (28.75%) who died before completing the six months of IPT. The causes of death were gastroenteritis (21.7%), symptoms and signs of bacterial pneumonia (17.4%), cryptococcal meningitis (13%), Pulmonary Tuberculosis (PTB) (13%), septicaemia (13%), and murder (13%). It has been recommended that there should be reorganisation of services of care for HIV-infected persons, such as provision of Cotrimoxazole Prophylaxis Therapy (CPT) and Antiretroviral Therapy (ART) to ensure holistic approach care. The future study should include HIV-infected children on IPT using the same or modified objectives. The conclusion drawn was that disintegrated interventions of IPT, CPT and ART and lack of holistic care for PLHIV lead to opportunistic infections that caused mortality on patients on IPT. / Department of Health Studies / M.A. (Public Health)

由於不同的行業，其工作內涵差別極大，而不同的工作，其特性更是相去甚遠，自然，對於工作所需之人員，其應具備之資格條件也就大不相同，例如社會各種職場之報考者常常面臨著體格檢查限制的壓力，日常的生活、人際交往、求學、就業、失業、等等問題無時無刻不在困擾著他們，甚至在人生的每一個階段，他們都必須在縫隙中尋求生存的空間。 有些人事用人機關認為體格檢查限制並非是一種歧視行為，而是基於公共利益的需要而給予的合理的差別待遇，所謂「歧視」一詞具有多義性，在此應從侵害「國民就業機會平等」理解之。針對體格檢查限制之問題，本文擬先就體格檢查之意涵予以說明，並舉例說明公務人員考試之體格檢查限制，例如對B型肝炎帶原者限制其報考各類國家考試，這樣一個涉及健康標準的問題，其所設限之體檢標準是否合理？其唯一標準是「醫學標準」，如果科學證明B型肝炎帶原者對他人不構成傳染或雖有傳染性但並不嚴重且可以採取措施加以預防，則上開有關體檢之資格限制標準，構成對B型肝炎帶原者平等競爭公職權利的侵犯，是違憲的，因大量的醫學證明，B型肝炎帶原者並不會對公眾的健康構成威脅。 本文係以有關人民參加需經國家考試公務人員就業體格檢查限制所涉及之基本權利之保障與限制（干預）為研究之課題，人民就業體格檢查是否可以予以差別待遇？而該差別待遇是否合理？合乎比例原則？手段與目的之間如不符比例原則，恐有違憲之虞，故國家於設定體格檢查限制條件時，必須有合理的限制標準，並能依據合理的判斷基準予以救濟，避免侵害人民之權利，且立法、司法及行政各部門，更應負起積極的責任，研擬相關配套措施，以保障人民憲法上的基本權利，全文共分6章：第一章緒論，旨在說明本文之研究動機並界定研究範圍，同時提出本文之研究目的和方法。第二章體格檢查之基本概念，先敘明體格檢查之意涵，包括體格檢查之概念、目的（功能）、意義及特點（執行機構），再加以整理公務人員體格檢查標準之法規依據。第三至第五章構成本文之本論。旨在依序探討公務人員就業體格檢查限制所涉之基本權利保障與限制（干預），並檢討相關行政救濟案例，各章內容以我國憲法所保障之就業基本權利探討為主，並以憲法對於限制人權之相關原則的討論為輔。第六章結論，則在將前述各章之研究結果作綜合性的簡要陳述，並嘗試提出檢討及建議作為本論文之歸結。 / Each career has unique requirements for employees due to the different entity of the career. Therefore the job applicants have to face the pressure of physical examination during application to a new job frequently. Some human resource organizations consider “the abridgement of physical examination” as a rational differential treatment based on the public interests, rather than a discriminative behavior. As the term “discrimination” has versatile meanings, it will be interpreted as an interference of “the equal opportunity for civil employment” in this thesis. In this article, the meaning of the abridgement of physical examination on employment will be illustrated, followed by an example from the abridgement of the physical examination on professional examination. For example, it should be scrutinized whether it is appropriate to abridge a hepatitis B carrier of attending the civil examination, which is concerned from a view of health judged by the medical standard. Some researchers argued that the scientific evidences showed hepatitis B will not be transmitted via carriers, or even can be transmitted but not severely and can be prevented. Then standards of the physical examination on employment would invade the right of equal competition for civil service. Those would be unconstitutional because hepatitis B carriers would not make any threat to public health, which were proved through lots of medical evidences. The main purpose of this thesis concentrated on the protection and interference of basic rights involved in the abridgement of physical examination on civil service. The study will scrutinize the appropriateness, rationality, equality of discriminative treatment in the physical examination on civil service. If the goal and the means of public deeds are not proportional, it would be unconstitutional. To set up the conditions for the abridgement of physical examination, the government should have reasonable standards of restriction and also reasonable judgment criteria of relief for the abridgement of physical examination to avoid invading civil rights. The organization of legislation, justice and administration should take the responsibility of drafting relevant integrated measures to guard the civil privilege. The thesis consists of six chapters. Chapter one (prolegomenon) includes the motive, scope, goal and methods of this study. Chapter two (introduction) elucidates the concept, goal (function), construction and characteristics (an executive body) of the physical examination, and regulations related to standards for the physical examination on the civil service. Chapter three to five (main body) center on the protection and abridgement (interference) of basic rights and the review of administrative relief cases involved in the physical examination of employment. We will study the protection of right of work in our constitution mainly, accompanied by discussion of the relative principles of interference of human rights as well. Chapter six (conclusion) summarizes the research results in previous chapters and make conclusions and suggestions.