Introdução: A importância de manter os pacientes DPOC ativos é inquestionável e para que se interfira neste comportamento é essencial compreender os fatores que estão associados ao nível de atividade física na vida diária (AFVD) nesta população. A percepção da própria doença é um fator psicossocial que tem sido estudado em inúmeras doenças crônicas e que apresenta associação com diversos desfechos clínicos relevantes tais como a qualidade de vida e adesão à terapêutica. Porém, sua relação com o nível de AFVD em pacientes com DPOC clinicamente estáveis é pouco conhecido. Objetivo: Identificar possíveis grupos (clusters) de acordo com a percepção da doença e identificar se há diferença no nível de AFVD e nos demais fatores clínicos, demográficos e psicossociais entre estes grupos. Métodos: Estudo transversal no qual foram recrutados 150 pacientes com DPOC e avaliados em relação à percepção da própria doença, auto-eficácia, suporte social, qualidade de vida, controle clínico da doença e nível de AFVD (Actigraph GT3x). Foi realizada uma análise de cluster de acordo com a percepção da doença para identificar grupos de pacientes com perfis semelhantes e investigada as características e diferenças entre os clusters. Resultados: A análise de cluster identificou dois grupos: O cluster 1 apresentou uma percepção mais negativa da doença (PND; n=95) e cluster 2 uma percepção mais positiva da doença (PPD; n=55). O cluster PND apresentou pior escolaridade, dispneia, auto-eficácia, qualidade de vida e controle clínico (p < 0,001 para todas as variáveis) em comparação ao cluster PPD. Não foi observada diferença em relação ao nível de AFVD entre os clusters. Conclusão: Pacientes com uma percepção negativa de sua doença também apresentaram pior dispnéia, autoeficácia, qualidade de vida, controle clinico e nível educacional apesar de não haver diferença na função pulmonar entre os clusters. Estes achados sugerem a relevância de investigar e identificar a percepção da doença para estabelecer melhores estratégias terapêuticas nesta população / Rationale: Illness perception (IP) concerns how patients evaluate living with a disease and this perceptions may influence quality of life health and patients\' adherence behaviors. However, how IP is related with daily life physical activity (DLPA) in COPD patients remains poorly known. Objective: To identify possible clusters according to COPD patients IPs and explore associations between IPs with DLPA and psycho-demographic factors. Methods: This cross-sectional study included 150 COPD outpatients in medical treatment from an University hospital. Illness perception, social support, clinical control, health-related quality of life, self-efficacy and DPLA (GT3X, accelerometer) were evaluated. Cluster analysis of IPs was used to establish groups of patients holding distinct beliefs. Differences between clusters were tested using a T-test or a Mann-Whitney-U-test. Results: Cluster analysis revealed two distinct groups. In the cluster NIP (negative illness perception; n=95) patients presented a worst IP than cluster PIP (positive illness perceptions; n=55). The NIP presented the worst education, dyspnea, self-efficacy, quality of life and clinical control (p < 0.0001 for all variables) compared to the cluster PIP. There was no difference in the level of DLPA. Conclusions: Patients with a negative perception of their disease also presented worse dyspnea, self-efficacy, quality of life, clinical control and educational level, although there was no difference in lung function among the clusters. These findings suggest the relevance of investigating and identifying the perception of the disease to establish better therapeutic strategies in this population

Submitted by Eunice Novais (enovais@uepg.br) on 2018-08-14T19:45:54Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Elize Bonafé.pdf: 1934448 bytes, checksum: 54db0cfbde18a5f1603e8ffae5321cd9 (MD5) / Made available in DSpace on 2018-08-14T19:45:54Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Elize Bonafé.pdf: 1934448 bytes, checksum: 54db0cfbde18a5f1603e8ffae5321cd9 (MD5) Previous issue date: 2016-07-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Os objetivos desse trabalho foram verificar se existe influência da personalidade na escolha por tratamentos estéticos, mensurar a auto percepção de estética orofacial, verificar se o clareamento dental pode promover alteração em nível de qualidade de vida e alterações nos domínios da personalidade, além de validar a versão em português da Oral Esthetic Escale (OES) e avaliar suas propriedades psicométricas. No estudo 1, 128 pacientes foram selecionados para realizar clareamento dental, no entanto, desses 58 aceitaram enquanto 70 recusaram o tratamento. Os pacientes de ambos os grupos foram avaliados quanto aos seus domínios de personalidade por meio da aplicação do NEO-FFI. Para cada comparação de domínio, Mann-Whitney foi utilizado e para comparação entre os domínios antes e após o clareamento dental foi utilizado Wilcoxon Signed Rank. Houve prevalência do domínio Extroversão nos pacientes que aceitaram realizar o tratamento (p = 0,01), apesar de não haver diferença estatisticamente significante quando o questionário foi aplicado antes e depois do clareamento (p > 0,01). No estudo 2, 63 pacientes receberam clareamento dental e desses, 55 foram avaliados quanto aos seus domínios de personalidade (NEO-FFI-R), auto percepção de estética (PIDAQ) e qualidade de vida (WHOQOL-bref). Todos os questionários foram aplicados antes e após o tratamento. Uma análise descritiva foi realizada sobre os dados demográficos da pesquisa e uma correlação Pearson foi realizada para avaliar diferenças estatisticamente significantes entre os dados dos grupos. Os dados dos domínios dos testes foram avaliados quanto a alterações com Wilcoxon Signed Rank (α = 0,05). Não houve diferença estatisticamente significante entre os domínios de personalidade e na qualidade de vida antes e após o tratamento. No entanto, houve diferença em todos os domínios do teste e foi verificada predominância de pacientes com maior pontuação no domínio Extroversão. No estudo 3 um instrumento de avaliação de auto percepção estética (OES) foi traduzido para a língua portuguesa. O OES foi traduzido, adaptado e sua nova versão foi denominada EEO. Nessa etapa, 151 pacientes participaram. A confiabilidade do teste foi avaliada pelo alfa de Cronbach. Além disso, a correlação intra-classe foi verificada (α=0,05) e também o tamanho do efeito (d de Cohen). Validade convergente, discriminante e fatorial também foram verificados. O EEO demonstrou características semelhantes ao questionário original e possui propriedades psicométricas satisfatórias para a avaliação da estética orofacial. / The objectives of this study were to determine whether is there influence of personality in the choice of aesthetic treatments, measure the perception of orofacial aesthetics, verify if tooth whitening can promote changes in quality of life and changes in personality traits, perform a Portuguese version of the Oral Esthetic Scale (OES) and evaluate its psychometric properties. In first study, 128 patients were selected for performing dental bleaching, however, 70 accepted while 58 of these refused treatment. Patients of both groups were evaluated through NEO-FFI, to evaluate their personality traits. For each domain comparison, Mann-Whitney test was used and for comparison between domains before and after bleaching was it used Wilcoxon. There was prevalence of Extraversion domain in patients who accepted treatment (p = 0.01), among the evaluations there was no statistically significant difference (P> 0.01). In study 2, 63 patients received dental bleaching and were evaluated for their personality traits (NEO-FFI-R), aesthetic perception (PIDAQ) and quality of life (WHOQOL-bref). All questionnaires were applied previously and after treatment. A descriptive analysis was performed about demographics characteristics and Pearson correlation was performed to evaluate any statistically significant difference between the group data. The internal consistency of the test was assessed by Cronbach's Alpha. The domain data changes of the tests were evaluated by Wilcoxon Signed Rank (α = 0.05). There was no statistically significant difference between personality traits before and after treatment and quality of life, however, it was found predominance of patients with higher scores in Extraversion domain. In study 3, an instrument for evaluating aesthetic perception (OES) was translated into Portuguese. The OES was translated, adapted and a new version was called EEO. At this stage, 151 patients participated. The reliability was assessed by Cronbach's alpha, the intraclass correlation was assessed (α = 0.05) and the size of the effect was evaluated (Cohen´s d). Convergent, discriminant, and factorial validity were also checked. The EEO showed similar characteristics to the original questionnaire and has satisfactory psychometric properties for evaluation of orofacial aesthetics.

A ocorrência de diversos tipos de desastres nas últimas décadas tem aumentado a concentração de estudos e pesquisas sobre a atuação profissional no gerenciamento de riscos e na gestão de emergências e desastres. O efeito de um desastre é proporcional à vulnerabilidade tanto do ambiente atingido (que compreende a parte física e humana), quanto da capacidade e recursos do local, dos afetados e das equipes de apoio. De acordo com a Política de Proteção e Defesa Civil, as ações são divididas em cinco etapas: prevenção, mitigação, preparação, resposta e reconstrução. A atuação da Psicologia, nestas situações, pode ser implementada em todas as fases e, embora constitua uma área relativamente recente dentro da Psicologia, a criação de órgãos e eventos no Brasil, bem como a busca por intervenções eficazes fizeram crescer o apelo para seu crescimento. Uma das demandas está ligada às possibilidades de violações de direitos de crianças e adolescentes, tais como violência sexual, negligência, trabalho infantil, práticas de ato infracional e uso de drogas. Existem documentos institucionais e referências científicas que abordam essa temática, ressaltando a importância da Atenção Psicossocial, a qual deve ser oferecida aos afetados, principalmente a populações vulneráveis, como crianças, adolescentes, pessoas com deficiência e idosos. O presente trabalho se constituiu em estudo exploratório, descritivo e explicativo, com uma metodologia etnográfica e qualitativa. O objetivo foi investigar as percepções e perspectivas de profissionais, crianças e responsáveis, sobre os cuidados oferecidos às crianças que vivem em áreas de risco para desastres, especialmente inundações, em um bairro na zona leste da cidade de São Paulo. Foram analisados documentos de referência e a literatura científica sobre crianças em situações de riscos e desastres. Por meio de entrevistas e grupos focais, foi verificada a percepção de crianças afetadas, responsáveis, e profissionais envolvidos no apoio a desastres. Destaca-se que o oferecimento da Atenção Psicossocial, somada aos cuidados em Saúde Mental e a proteção e garantia de Direitos Humanos, constitui cenário providencial para o bem-estar infantil e pleno desenvolvimento físico, cognitivo, social, espiritual e emocional de crianças no contexto de riscos e desastres / The occurrence of several types of disasters in the last decades has increased the concentration of studies and research about the professional performance in the management of risks as well as emergencies and disasters. The effect of a disaster is proportional to the vulnerability either of the affected environment (which includes the physical and human aspects) or the capacity and resources of the place, the affected individuals and the support teams. According to the Protection and Civil Defense Policy, the actions are divided into five stages: prevention, mitigation, preparation, response and reconstruction. The Psychology´s operation in these situations can be implemented in all phases, and although it constitutes a relatively recent area within this field, the creation of organs and events in Brazil and the search for effective interventions have increased the appeal for its growth. One of the demands is linked to the possibilities of children and adolescents´ rights violentions, such as sexual violence, neglect, child labor, practices of infraction and drugs use. There are institutional documents and scientific references that address this issue and raise the importance of the psychosocial support that should be offered to those affected, especially vulnerable populations such as children, adolescents, people with disabilities and the old-aged. The present work constitutes an exploratory, descriptive and explanatory study, with an ethnographic and qualitative methodology. The goal was to investigate the perceptions and perspectives of professionals, children and parents about the care offered to children living in areas at risk of disasters, especially floods, in a neighborhood in the east end of São Paulo city. Reference documents and the scientific literature on children in risks and disasters situation were analyzed. The perception about disasters support were investigated by means of interviews and focus groups. It is noteworthy that the provision of psychosocial support, with care of mental health, plus protection and guarantee of human rights, is a providential scenario for children\'s well-being and complete physical, cognitive, social, spiritual and emotional development of children in the context of risks and disasters

Made available in DSpace on 2015-05-14T12:56:00Z (GMT). No. of bitstreams: 1 Arquivototal.pdf: 12440507 bytes, checksum: 4c602610a4947af78ebd9048d453e0e8 (MD5) Previous issue date: 2004-09-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study had two objectives. The main objective was to evaluate the association of the impact of temporomandibular disorders (TMD) on oral health related quality of life to the psychosocial and psychological factors. The specific objective was to validate the Portuguese version of Axis II questionnaire to Research Diagnostic Criteria for TMD (RDC/TMD) as preconized by Dworkin and LeResche at 1992. The sample was compounded by 156 patients, with TMD, who attempted at Orofacial Pain Control Center School of Dentistry of Pernambuco University, from July 2003 to February 2004. Data collection was done by the author using the following instruments: Simplified Anamnesis Index DMF for screening patients with TMD; RDC/TMD Axis I to evaluated clinically and to classify TMD and Axis II to evaluate psychosocial and psychological factors; the specific questionnaires to evaluated oral health related to quality of life, OIDP and OHIP-14. Two different types of studies were conducted: validation study and cross sectional study. The validation study consisted on the evaluation of internal consistence by alpha Crombach reliability test; reliability and reproducibility estimated by Kappa statistics and by Spearman correlation and also concurrent validity (Spearman). For the transversal study, one has used Kruskall Wallis to test OIDP and ANOVA to test OHIP-14. The Portuguese version for Axis II of RDC/TMD was considered consistent (Crombach a=0,72), reliable (Kappa 0,73-0,91; p<0,01) and valid (p<0,01). According to transversal study, among the variables for sample characterization, the impact on oral health related qualify of life was statistical associated to sex and scholarship, this factor exclusively for OHIP-14. On Axis I, using OIDP, the impact was associated to groups I and II, muscle and joint disorders, respectively. While for OHIP-14, only for group I (muscle disorders) the association was detected. On Axis II, psychological factors, as depression and somatization (inespecific organic symptoms with or without pain) and psychosocial factor of disability and pain were statically associated to the impact of oral health related quality of life, according to evaluation with OIDP and OHIP-14. The validity of Axis II of RDC/TMD followed the methodology proposed at the literature and showed reproducbility and validity for brazilian population. Temporomandibular disorders and psychosocial and psychological factors produced an important impact on oral health related quality of life, associated to psychosocial and psychological factors associated and proportional to their intensity. / O presente estudo teve dois objetivos. O objetivo geral foi avaliar a associação entre o impacto da disfunção temporomandibular (DTM) na qualidade de vida relacionada à saúde bucal, e os fatores psicossocial e psicológicos. O objetivo específico foi realizar a validação da versão em português do questionário Eixo II dos Critérios Diagnósticos de Pesquisa em DTM (RDC/TMD), preconizado por Dworkin e LeResche, em 1992. A amostra foi composta por 155 pacientes portadores de DTM que procuraram atendimento no Centro de Controle da Dor Orofacial da Faculdade de Odontologia da Universidade de Pernambuco no período de Julho de 2003 a Fevereiro de 2004. Para a coleta de dados foram utilizados os seguintes instrumentos: Índice Anamnésico Simplificado DMF para a triagem dos pacientes com DTM; RDC/TMD: Eixo I para avaliação clínica e classificação da DTM, e Eixo II para avaliação psicossocial e psicológica e os questionários específicos para avaliação da qualidade de vida relacionada à saúde bucal OIDP e OHIP-14. Foram realizados dois tipos de estudo: estudo de validação e transversal. O estudo de validação constou da avaliação da consistência interna pelo teste de confiabilidade alfa Crombach; confiabilidade e reprodutibilidade, estimada pela estatística Kappa e correlação de Spearman e validação concorrente (Spearman). No estudo transversal, para o OIDP, utilizouse o teste Kruskal-Wallis e para o OHIP-14 o teste ANOVA. Os resultados revelaram que a versão em português Eixo II do RDC/TMD foi considerada consistente (Crombach=0,72); reprodutível (Kappa 0,73-0,91; p<0,01) e válida (p<0,01). No estudo transversal, dentre as variáveis de caracterização amostral, o impacto da qualidade de vida relacionado à saúde bucal foi estatisticamente associado com gênero e escolaridade, sendo este último fator apenas evidenciado quando da utilização do OHIP-14. No Eixo I, usando o OIDP, o impacto teve associação com os grupos I e III, de desordem muscular e articular, respectivamente; com o OHIP-14, teve associação apenas para o grupo I (desordem muscular). No Eixo II, os fatores psicológicos, como depressão e somatização (sintomas físicos não específicos, com e sem itens de dor), e o fator psicossocial de incapacidade e intensidade da dor, foram estatisticamente associados ao impacto da qualidade de vida relacionado à saúde bucal, quando avaliados pelo OIDP e OHIP-14. Conclui-se que a validação do Eixo II do RDC/TMD seguiu metodologia proposta na literatura e mostrou-se reprodutível e válida para a população brasileira. A disfunção temporomandibular e os fatores psicossocial e psicológicos produzem importante impacto nos portadores de DTM, interferindo negativamente na qualidade de vida relacionada à saúde bucal, e este impacto também foi associado ao grau de severidade dos fatores psicossocial e psicológicos.

A ocorrência de diversos tipos de desastres nas últimas décadas tem aumentado a concentração de estudos e pesquisas sobre a atuação profissional no gerenciamento de riscos e na gestão de emergências e desastres. O efeito de um desastre é proporcional à vulnerabilidade tanto do ambiente atingido (que compreende a parte física e humana), quanto da capacidade e recursos do local, dos afetados e das equipes de apoio. De acordo com a Política de Proteção e Defesa Civil, as ações são divididas em cinco etapas: prevenção, mitigação, preparação, resposta e reconstrução. A atuação da Psicologia, nestas situações, pode ser implementada em todas as fases e, embora constitua uma área relativamente recente dentro da Psicologia, a criação de órgãos e eventos no Brasil, bem como a busca por intervenções eficazes fizeram crescer o apelo para seu crescimento. Uma das demandas está ligada às possibilidades de violações de direitos de crianças e adolescentes, tais como violência sexual, negligência, trabalho infantil, práticas de ato infracional e uso de drogas. Existem documentos institucionais e referências científicas que abordam essa temática, ressaltando a importância da Atenção Psicossocial, a qual deve ser oferecida aos afetados, principalmente a populações vulneráveis, como crianças, adolescentes, pessoas com deficiência e idosos. O presente trabalho se constituiu em estudo exploratório, descritivo e explicativo, com uma metodologia etnográfica e qualitativa. O objetivo foi investigar as percepções e perspectivas de profissionais, crianças e responsáveis, sobre os cuidados oferecidos às crianças que vivem em áreas de risco para desastres, especialmente inundações, em um bairro na zona leste da cidade de São Paulo. Foram analisados documentos de referência e a literatura científica sobre crianças em situações de riscos e desastres. Por meio de entrevistas e grupos focais, foi verificada a percepção de crianças afetadas, responsáveis, e profissionais envolvidos no apoio a desastres. Destaca-se que o oferecimento da Atenção Psicossocial, somada aos cuidados em Saúde Mental e a proteção e garantia de Direitos Humanos, constitui cenário providencial para o bem-estar infantil e pleno desenvolvimento físico, cognitivo, social, espiritual e emocional de crianças no contexto de riscos e desastres / The occurrence of several types of disasters in the last decades has increased the concentration of studies and research about the professional performance in the management of risks as well as emergencies and disasters. The effect of a disaster is proportional to the vulnerability either of the affected environment (which includes the physical and human aspects) or the capacity and resources of the place, the affected individuals and the support teams. According to the Protection and Civil Defense Policy, the actions are divided into five stages: prevention, mitigation, preparation, response and reconstruction. The Psychology´s operation in these situations can be implemented in all phases, and although it constitutes a relatively recent area within this field, the creation of organs and events in Brazil and the search for effective interventions have increased the appeal for its growth. One of the demands is linked to the possibilities of children and adolescents´ rights violentions, such as sexual violence, neglect, child labor, practices of infraction and drugs use. There are institutional documents and scientific references that address this issue and raise the importance of the psychosocial support that should be offered to those affected, especially vulnerable populations such as children, adolescents, people with disabilities and the old-aged. The present work constitutes an exploratory, descriptive and explanatory study, with an ethnographic and qualitative methodology. The goal was to investigate the perceptions and perspectives of professionals, children and parents about the care offered to children living in areas at risk of disasters, especially floods, in a neighborhood in the east end of São Paulo city. Reference documents and the scientific literature on children in risks and disasters situation were analyzed. The perception about disasters support were investigated by means of interviews and focus groups. It is noteworthy that the provision of psychosocial support, with care of mental health, plus protection and guarantee of human rights, is a providential scenario for children\'s well-being and complete physical, cognitive, social, spiritual and emotional development of children in the context of risks and disasters

Introdução: A importância de manter os pacientes DPOC ativos é inquestionável e para que se interfira neste comportamento é essencial compreender os fatores que estão associados ao nível de atividade física na vida diária (AFVD) nesta população. A percepção da própria doença é um fator psicossocial que tem sido estudado em inúmeras doenças crônicas e que apresenta associação com diversos desfechos clínicos relevantes tais como a qualidade de vida e adesão à terapêutica. Porém, sua relação com o nível de AFVD em pacientes com DPOC clinicamente estáveis é pouco conhecido. Objetivo: Identificar possíveis grupos (clusters) de acordo com a percepção da doença e identificar se há diferença no nível de AFVD e nos demais fatores clínicos, demográficos e psicossociais entre estes grupos. Métodos: Estudo transversal no qual foram recrutados 150 pacientes com DPOC e avaliados em relação à percepção da própria doença, auto-eficácia, suporte social, qualidade de vida, controle clínico da doença e nível de AFVD (Actigraph GT3x). Foi realizada uma análise de cluster de acordo com a percepção da doença para identificar grupos de pacientes com perfis semelhantes e investigada as características e diferenças entre os clusters. Resultados: A análise de cluster identificou dois grupos: O cluster 1 apresentou uma percepção mais negativa da doença (PND; n=95) e cluster 2 uma percepção mais positiva da doença (PPD; n=55). O cluster PND apresentou pior escolaridade, dispneia, auto-eficácia, qualidade de vida e controle clínico (p < 0,001 para todas as variáveis) em comparação ao cluster PPD. Não foi observada diferença em relação ao nível de AFVD entre os clusters. Conclusão: Pacientes com uma percepção negativa de sua doença também apresentaram pior dispnéia, autoeficácia, qualidade de vida, controle clinico e nível educacional apesar de não haver diferença na função pulmonar entre os clusters. Estes achados sugerem a relevância de investigar e identificar a percepção da doença para estabelecer melhores estratégias terapêuticas nesta população / Rationale: Illness perception (IP) concerns how patients evaluate living with a disease and this perceptions may influence quality of life health and patients\' adherence behaviors. However, how IP is related with daily life physical activity (DLPA) in COPD patients remains poorly known. Objective: To identify possible clusters according to COPD patients IPs and explore associations between IPs with DLPA and psycho-demographic factors. Methods: This cross-sectional study included 150 COPD outpatients in medical treatment from an University hospital. Illness perception, social support, clinical control, health-related quality of life, self-efficacy and DPLA (GT3X, accelerometer) were evaluated. Cluster analysis of IPs was used to establish groups of patients holding distinct beliefs. Differences between clusters were tested using a T-test or a Mann-Whitney-U-test. Results: Cluster analysis revealed two distinct groups. In the cluster NIP (negative illness perception; n=95) patients presented a worst IP than cluster PIP (positive illness perceptions; n=55). The NIP presented the worst education, dyspnea, self-efficacy, quality of life and clinical control (p < 0.0001 for all variables) compared to the cluster PIP. There was no difference in the level of DLPA. Conclusions: Patients with a negative perception of their disease also presented worse dyspnea, self-efficacy, quality of life, clinical control and educational level, although there was no difference in lung function among the clusters. These findings suggest the relevance of investigating and identifying the perception of the disease to establish better therapeutic strategies in this population

Objetivo: Evaluar la asociación entre el impacto psicosocial de la estética dental con la discriminación auto percibida en pacientes ambulatorios de un hospital público en Lima. Materiales y Métodos: Un total de 207 pacientes ambulatorios fueron encuestados en este estudio, de edades comprendidas entre los 18 y 30 años. Para la evaluación del impacto psicosocial de la estética dental se utilizó el Cuestionario del Impacto Psicosocial de la Estética dental (PIDAQ). Asimismo, para la discriminación auto percibida se utilizó un pequeño cuestionario extraído de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza 2017. Además, se evaluaron otras variables como la edad, sexo, educación, ingreso económico, etnicidad y razón de discriminación. Se utilizó la regresión de Poisson con estimador robusto de varianza tanto como para la asociación de las variables, así como para el cálculo de las razones de prevalencia crudas y ajustadas. El nivel de confianza fue al 95% y el nivel de significancia se estableció como p < 0.05. Resultados: Los encuestados si se auto percibieron como discriminadas según el impacto psicosocial de su estética dental, observándose una asociación estadísticamente significativa positiva (RP 1.02 IC 95% 1.01 – 1.03). Conclusiones: Se observó que el impacto psicosocial de la estética dental se encuentra asociado con la discriminación auto percibida. Además, los pacientes que se auto perciben como discriminados en su mayoría son mujeres en promedio de veintitrés años, mestizos, con un ingreso económico medio bajo. / Aim: To evaluate the association between the psychosocial impact of dental aesthetics with self-perceived discrimination in outpatients of a public hospital in Lima. Materials and Methods: A total of 207 outpatients were evaluated, between 18 and 30 years old. The psychosocial impact of dental aesthetics was evaluated with the Psychosocial Impact of Dental Aesthetics questionnaire (PIDAQ). Likewise, for self-perceived discrimination, questions were selected from the Peruvian National Household Survey on Living Conditions and Poverty 2017. In addition, other variables such as age, sex, education, income, ethnicity and reason for discrimination were evaluated. The Poisson regression with robust estimator of variance was used for the association of the variables, as well as for the calculation of the crude and adjusted prevalence ratios. The confidence level was 95% and the level of significance was established as p <0.05. Results: Those surveyed perceived themselves as discriminated according to the psychosocial impact of their dental aesthetics, observing a positive significant association between both variables (PR 1.02, 95% CI 1.01 –1.03). Conclusions: The psychosocial impact of dental aesthetics was found to be associated with self-perceived discrimination. In addition, those who self-perceived themselves discriminated were mostly women, of twenty-three years old on average, mestizos, with a low average economic income. / Tesis

Objetivo: Determinar la asociación del impacto psicosocial de la estética dental entre hombres y mujeres universitarios de Lima – Perú. Materiales y Métodos: Estudio de tipo observacional, analítico y transversal con un total de 619 alumnos universitarios de Lima - Perú con edades entre los 18 y 25 años. Para la evaluación del impacto psicosocial de la estética dental se utilizó el Cuestionario del Impacto Psicosocial de la Estética dental (PIDAQ). Además, se evaluaron otras variables como sexo, edad, facultades universitarias, nivel educativo de los padres, institución de educación, ciclo académico e índice de masculinidad en el hogar. Para la comparación de las características de los estudiantes universitarios y su impacto psicosocial por dimensiones se utilizó la prueba de U de Mann-Whitney, ANOVA, Kruskal-Wallis y T-Student para pruebas no pareadas, y para correlacionar se utilizó el Coeficiente de correlación de Spearman. Finalmente, se utilizó la regresión de Poisson con estimador robusto de varianza para el cálculo de asociación mediante razones de tasa de incidencia crudas y ajustadas a todas las covariables, con intervalos de confianza al 95%. Resultados: El 41% de la muestra fueron hombres con un promedio de 36,48 puntos en el PIDAQ total y una correlación positiva con el índice de masculinidad en el hogar (Spearman 0.194). Asimismo, se encontró una asociación positiva, entre el sexo masculino, índice de masculinidad en el hogar y todas las dimensiones del impacto psicosocial. (IRR 1.10 IC 95% 1.01 – 1.20). Conclusiones: Se evidenció que el impacto psicosocial de la estética dental tiene una asociación positiva en los jóvenes universitarios con el sexo masculino y el índice de masculinidad en el hogar. / Objective: To determine the association of the psychosocial impact of dental aesthetics among university men and women from Lima – Peru. Materials and Methods: Observational, analytical and cross-sectional study with a total of 619 university students in Lima, Peru between the ages of 18 and 25 years. The Psychosocial Impact of Dental Esthetics Questionnaire (PIDAQ) was used to evaluate the psychosocial impact of dental esthetics. In addition, other variables such as sex, age, university faculties, educational level of the parents, educational institution, academic cycle and masculinity index in the home were evaluated. For the comparison of the characteristics of university students and their psychosocial impact by dimensions, the Mann-Whitney U test, ANOVA, Kruskal-Wallis and T-Student for unpaired tests were used, and Spearman's correlation coefficient was used for correlations. Finally, Poisson regression with robust variance estimator was used to calculate association using crude and adjusted incidence rate ratios for all covariates, with 95% confidence intervals. Results: 41% of the sample were men with an average of 36.48 points on the total PIDAQ and a positive correlation with the masculinity index in the home (Spearman 0.194). Likewise, a positive association was found between male sex, masculinity index in the home and all dimensions of psychosocial impact. (IRR 1.10 IC 95% 1.01 - 1.20). Conclusions: It was evidenced that the psychosocial impact of dental aesthetics has a positive association in young university students with the male sex and the masculinity index at home. / Tesis

In Gaza, daily blackouts have lasted for over eleven years. Until recently, Palestinian families have received only four hours of power each day. Since Israel’s withdrawal from the region in 2005, the political discourse around the Right of Return has forced refugees to live in terrible conditions and darkness. The fear was that any transformation of the camps will bring about an integration of the refugee community with the local environment and thus any improvements to Gaza’s infrastructure and housing was seen as a direct erosion of the Right of Return. Can bringing light to Gaza transcend this boundary of temporality and restore hope to this impoverished community? With recent solar lighting ideas emerging to help solve Gaza’s energy shortage by solar energy companies such as SunBox and LittleSun, I plan to develop a solar urban lighting project for Gaza’s smallest refugee camp - Deir al-Balah (DEB) - to help improve security at night for residents and provide the community with opportunities to socialise in public common areas. In response to an ‘Improvement Plan’ conducted by the United Nations Relief and Works Agency (UNRWA) in 2017, which identifies DEB camp’s limited access to electricity and street lighting, I’d like to explore how a solar and ecologically-sensitive lighting programs can improve Gazan’s daily lives, by bringing clean, reliable and affordable energy access.

Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Access to wheelchairs is considered a basic human right. Wheelchairs enhance function, improve independence, and enables persons with disabilities to successfully live in the community. An inappropriate wheelchair may however limit function rather than promote it. Achieving an ideal match between user and technology, however is challenging. A recent audit in the Eastern Cape revealed that standard folding frame type wheelchairs were predominantly being issued and waiting list for wheelchairs is long. The need for investigation into prescription practice, from the perspective of both prescribing therapists as well as wheelchair users, was identified. Aims: To describe wheelchair prescription practice in the public sector of the Eastern Cape; and to determine whether the wheelchairs being issued address the psychosocial needs of users. Study design: A descriptive mixed-method cross-sectional study design was used. Quantitative and qualitative data from questionnaires and functional wheelchair skills tests of wheelchair users (Phase 1) and from semi-structured interviews with prescribing therapists (Phase 2) was used to describe prescription practice and investigate the psychosocial needs of wheelchair users. Methods: A small sample of convenienve according to home address was obtained that included 30 users (15 from a rural; 15 from a semi-rural setting). The Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaire, Functioning Everyday with a wheelchair (FEW/FMA) scale and a self-compiled wheelchair specifications checklist (WSC) were used to determine user functionality and level of satisfaction with the wheelchair. Purposive sampling was done to identify the therapists that had prescribed the wheelchairs for the participants in the first phase of the study. A semi- structured interview was used to determine prescription practice including perceived barriers of wheelchair prescription with ten prescribing therapists. Data analysis: Qualitative data was analysed deductively and frequency of responses tabulated. Quantitative data was summarised as means and standard deviations and subgroup analysis comparisons were done using the Chi-square test and relationships between variables investigated using Pearson/ Spearman correlation or ANOVA. A p < 0.05 was deemed significant. Results: Eighty three % of wheelchairs issued were urban wheelchairs. These are generally perceived by users as sufficient to address their psychosocial needs regarding mobility and transport, however, seem to fail users in terms of accessibility and independence within their rural/ semi- rural environment. According to the WSC scores, peri-urban wheelchairs were found to be more appropriate for the users than urban wheelchairs (p < 0.01). No significant relationships were found between wheelchair fit, use of a cushion, occurrence of pressure sores and self-perceived psychosocial needs in this sample. The users experienced most difficulty with outdoor mobility (57% needed full assistance) and transport (63% needed full assistance) within their current wheelchairs. Ten prescribing therapists participated in the study. Most valued appropriate seating, are knowledgeable regarding prescription practice, but reported several barriers to this practice including budget restraints (90%), time to delivery (100%) and lack of training (40%). The need for more appropriate wheelchair designs to suit multi- level manoeuvrability of persons in rural/ semi-rural environments was also reported (60%). Conclusion: The results of this study show that wheelchair prescription in the Western Region of the Eastern Cape (WRoEC) has various challenges. Although the wheelchair users were mostly satisfied with their wheelchairs, this study identified areas for improvement in the users’ functioning, postural support and biomechanics within their wheelchairs, especially as it relates to their home environment. There is scope for improvement of wheelchair delivery to persons in the WRoEC – from on-going training of therapists and clients to more appropriate wheelchair designs for persons in rural settings. Further research in this field is recommended. / AFRIKAANSE OPSOMMING: Agtergrond: Toegang tot rolstoele word as ‘n basiese mensereg geag. Rolstoele dra by tot verbeterde funksionaliteit, groter onafhanklikheid, en bemagtig mense met gestremdhede om suksesvol in die gemeenskap te lewe. Nietemin, ‘n onvanpaste rolstoel mag funksie beperk eerder as om dit te bevorder. Om die ideale pas tussen rolstoel gebruiker en tegnologie te vind is uitdagend.’n Onlangse oudit in die Oos- Kaap het getoon dat standaard vou-raam tipe rolstoele oorwegend uitgereik word, en dat die waglys vir rolstoele lank is. Die gaping vir verdere ondersoek rakende voorskrif praktyk, vanaf beide die perspektief van die terapeute wat voorskryf asook rolstoel gebruikers, is geidentifiseer. Doel: Om rolstoel voorskrif praktryk in die publieke sektor van die Oos- Kaap te beskryf; en om vas te stel of die rolstoele wat uitgereik word die psigososiale behoeftes van gebruikers addresseer. Studie Ontwerp: ‘n Beskrywende gemengde metode deursnee studie ontwerp is gebruik. Kwantitatiewe en kwalitatiewe data van vraelyste en funksionele rolstoelvaardigheids toetse van rosltoel gebruikers (Fase 1) en van semi- gestruktureerde onderhoude met voorskrywende terapeute (Fase 2) is gebruik om voorskrif praktyk te beskryf en om die psigososiale behoeftes van gebruikers te ondersoek. Metodes: Dertig rolstoel gebruikers (15 van ‘n landelike; 15 van ‘n gedeeltelik- landelike opset) het deelgeneem in die studie. Die PIADS vraelys, “Functioning Everyday with a Wheelchair” (FMA/ FEW) skaal en ‘n self-opgestelde rolstoel spesifikasie kontrolelys (WSC) is gebruik om gebruiker funksionaliteit en tevredenheid met die rolstoel vas te stel. ‘n Semi- gestruktureerde onderhoud is gebruik om rolstoel voorskrifpraktyk insluitend persepsies van beperkinge tot die voorskrifte van rolstoele vas te stel onder tien terapeute. Dataverwerking: Kwalitatiewe data is deduktief geanaliseer en getal response is getabuleer. Kwantitatiewe data is opgesom as gemiddeldes en standaardafwykings en subgroep analise vergelyking is gedoen deur middel van die Chi- square toets. Verhoudings tussen veranderlikes is ondersoek deur middel van die Pearson/ Spearman korrelasie/ ANOVA. P < 0.05 is as statisties beduidend aanskou. Resultate: Drie-en-tagtig % van die uitgereikte rolstoele was landelike rolstoele. Hierdie stoele word oor die algemeen deur gebruikers ervaar as genoegsaam om hulle psigososiale behoeftes rakende vervoer en mobilitiet te bevredig, maar skiet nietemin tekort as dit kom by toeganklikheid en onafhanklikheid binne hulle landelike-/ semi- landelike omgewing. Volgens die WSC resultate, is die semi- landelike rolstoele meer toepaslik vir die gebruikers as die stedelike rolstoele. Geen merkwaardige verhoudings is gevind tussen rolstoel pas, gebruik van kussing, druksere en persepsie van psigososiale behoeftes nie. Die gebruikers het die meeste gesukkel met buitemuurse mobiliteit (57% het volle bystand benodig) en vervoer (63% het volle bystand benodig) in hulle huidige rolstoele. Tien terapeute het aan semi-gestruktureerde onderhoude deelgeneem. Daar is bevind dat hulle korrekte “seating” waardevol ag, kundig is rakende voorskrif praktyk, maar het talle beperkinge geidentifiseer in die praktyk insluitend: begrotings beperkings (90%), tyd tot aflewering (100%) en tekort aan opleiding in dié veld (40%). Die behoefte aan meer toepaslike rolstoel ontwerpe om multi- dimensionele beweeglikheid van persone in landelike/ semi- landelike omgewings te verseker, is ook vasgestel (60%). Gevolgtrekking: Die resultate van hierdie studie toon dat die voorskryf van rolstoele in die Westelike streek van die Oos- Kaap (WSvOK) vele uitdagings het. Alhoewel die rolstoel gebruikers grotendeels tevrede was met hulle rolstoele, het hierdie studie areas vir verbetering geidentifiseer in die gebruikers se funksionaliteit, posturale ondersteuning en biomeganika in hulle rolstoele, veral soos dit van toepassing is op hulle tuis omgewing. Daar is ruimte vir verbetering vir rolstoel lewering aan persone in die WSvOK; vanaf deurlopende opleiding vir terapeute en gebruikers, tot meer toepaslike rolstoel ontwerpe vir persone in landelike gebiede. Verdere navorsing in dié veld word aanbeveel.