Objetivo: verificar a validade e a confiabilidade do Questionário de Qualidade de Vida para Pessoas com Espinha Bífida na língua Portuguesa, após tradução e adaptação cultural do Spina Bífida Health Related Quality of Life Questionnaire (HRQOL). Métodos: Dois professores de inglês realizaram a tradução literária e conceitual das versões para crianças (5-12 anos) e para adolescentes (13-20 anos) do HRQOL, chegando a uma versão inicial em português, denominada Questionário de Qualidade de Vida de Pessoas com Espinha Bífida (QQVEB). Após a tradução reversa por outros dois nativos de língua inglesa, um comitê revisou as versões. Após um pré-teste numa amostra de cinco sujeitos, a versão final do QQVEB foi aplicada em 51 crianças (7,7±2,1 anos) e 29 adolescentes (15,6±2,1 anos) com diagnóstico de mielomeningocele. Os sujeitos foram caracterizados quanto ao nível neurológico, controle motor grosseiro e classificação sócio-econômica. Para verificar a confiabilidade, foi analisada a consistência interna com o alpha de Cronbach e a reprodutibilidade com Coeficiente de Correlação Intraclasse (CCI) para as duas aplicações do questionário num intervalo de sete dias. Para verificar a validade de constructo convergente usamos a correlação de Pearson e o teste t entre o QQVEB e um questionário genérico de qualidade de vida, e para a validade de constructo discriminante foi utilizado o teste de Kruskall-Wallis para o QQVEB e o nível de acometimento neurológico. Resultados: Apenas cinco questões no questionário dos adolescentes sofreram modificações culturais. A análise da confiabilidade revelou boa consistência interna nos questionários das crianças (=0,88) e dos adolescentes (=0,93), e boa reprodutibilidade no questionário das crianças (CCI=0,83) e dos adolescentes (CCI=0,88). Na análise da validade convergente observou-se correlação do questionário genérico com o QQVEB dos adolescentes (r=0,63; p=0,0002), mas não com o de crianças (r=0,17; p=0,2318). A análise da validade discriminante revelou que pacientes com acometimento neurológico em nível torácico apresentam pior pontuação de forma significativa no questionário das crianças (p=0,02) e marginalmente significativa no caso dos adolescentes (p=0,07). Conclusões: A tradução e adaptação cultural do QQVEB foram realizadas com êxito, sendo que as duas versões do QQVEB apresentam boa confiabilidade. Porém, a baixa validade convergente do QQVEB das crianças e discriminante do QQVEB dos adolescentes pode estar relacionada a algumas falhas do questionário original, como a falta de um manual e ausência da divisão em domínios. Estes problemas podem ser solucionados desenvolvendo-se uma nova versão no questionário, tanto na língua inglesa, quanto portuguesa / Objective: to verify the validity and reliability of the Questionário de Qualidade de Vida para Pessoas com Espinha Bífida, in portuguese, after the translation and cultural adaptation of the Spina Bifida Health Related Quality of Life Questionnaire (HRQOL).Method: Two English teachers performed the literal and conceptual translation of the HRQOL, which has the children (5-12 years) and the adolescents (13-20 years) version. The Portuguese version was called Questionário de Qualidade de Vida de Pessoas com Espinha Bífida (QQVEB). Two other native English teachers made the reversal translation, and a committee revised all versions. After a pre-test in a sample of 5 subjects, the final version of the QQVEB was applied in 51 children (7,7±2,1 years) and 29 adolescents (15,6±2,1 years) with medical diagnoses of meningomyelocele. The subjects were characterized in neurological level of the malformation, gross motor control and social and economical classification. To verify the reliability, the internal consistence was analyzed with the Cronbachs alpha, and the reproducibility with the Intraclass Correlation Coefficient (ICC) for the two applications of the questionnaire within one week. To verify the converging construction validity, we used the Pearsons correlation and t test between the QQVEB and a generic quality of life questionnaire. To the discriminating construction validity we used the Kruskall-Wallis test between the QQVEB and the neurological level of the malformation. Results: Only five questions from the adolescents questionnaire had cultural adaptation. The reliability analysis showed good internal consistence in the childrens (=0,88) and adolescents (=0,93) questionnaires, and good reproducibility in the childrens (ICC=0,83) and adolescents (ICC=0,88) questionnaires. The converging validity analysis showed good correlation between the generic questionnaire and the adolescents QQVEB (r=0,63; p=0,0002), but not with the childrens (r=0,17; p=0,2318). The discriminating validity analysis showed that patients with thoracic malformation had significant worse scores in the childrens questionnaire (p=0,02) and marginally significant in the adolescents questionnaire (p=0,07). Conclusions: The translation and cultural adaptation were successfull, once the two versions of the QQVEB had good reliability. Therefore, the reduced converging validity of the childrens QQVEB and reduced discriminating validity of the adolescents QQVEB may be related to some problems in the original questionnaire, such as the inexistence of a user manual and the division of the instrument in domains. These aspects can be solved by developing a new version of the questionnaire, both in English and Portuguese

Orientador: Marilza Vieira Cunha Rudge / Resumo: Adaptação transcultural e validação do Pregnancy Sexual Response Inventory (PSRI) para o espanhol em gestantes chilenas. Introdução: A gestação é marco especial na vida da mulher, ocorrem mudanças físicas e psicológicas que comumente impactam no bem-estar geral. Podem ser observadas modificações sexuais no período gestacional, fator que pode afetar negativamente a qualidade de vida. O Inventário de Resposta Sexual à Gravidez (PSRI) é ferramenta clínica com entrevista breve e semiestruturada para avaliar o impacto da gravidez na sexualidade, no entanto, atualmente não há tradução em espanhol do questionário PSRI. Objetivo: Traduzir, adaptar culturalmente e validar para língua espanhola (Chile) o PSRI em gestantes chilenas. Método: Estudo de corte transversal, internacional desenvolvido no Chile. Incialmente, o questionário PSRI foi validado na língua espanhola para gestantes chilenas. Posteriormente o PSRI validado foi aplicado com a finalidade de avaliar a qualidade sexual das gestantes em diferentes trimestres. Foi analisado “por domínio" e a pontuação "geral" que variam de 0 (pior) até 100 (o melhor) e a pontuação final em categorização dividida em quartis da seguinte forma: 0 <25 como "muito ruim", 25 <50 como "ruim", 50 <75 como "bom" e 75-100 como "excelente". Análise de dados: A distribuição dos escores do questionário PSRI foi avaliada pela média (desvio padrão [DP]); a confiabilidade foi avaliada pelo coeficiente alfa de Cronbach, que avaliou a consistência interna. A... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cross-cultural adaptation and validation of the questionnaire Pregnancy Sexual Response Inventory (PSRI) to Spanish version for Chilean pregnant women. Introduction: Gestation is a particular moment in women's lives, there are physical and psychological changes that commonly affect the general well-being. Sexual changes can be observed in the gestational period, a factor that can negatively affect the quality of life. The Pregnancy Sexual Response Inventory (PSRI) is a clinical tool with brief and semi-structured interview to assess the impact of pregnancy on sexuality, however, there is currently no Spanish translation of the PSRI questionnaire. Objective: To translate, culturally adapt and validate the Spanish language (Chile) the PSRI in Chilean pregnant women. Method: Cross-sectional, international study developed in Chile. Initially, the PSRI questionnaire in the Spanish language for pregnant women in Chile was validated. Subsequently the validated PSRI was applied with the purpose of evaluating the sexual quality of the pregnant women in different quarters. It was analyzed by "domain" and the "general" score ranging from 0 (worst) to 100 (the best) and the final score in categorization divided into quartiles as follows: 0<25 as "very bad," 25 <50 as “bad,” 50 <75 as "good" and 75-100 as "excellent". Data analysis: The distribution of PSRI scores was assessed by the mean (standard deviation [SD]); the reliability was evaluated by Cronbach's alpha coefficient, to analyze ... (Complete abstract click electronic access below) / Mestre

Individuals with developmental disabilities are at high risk for sexual abuse, exploitation, sexually transmitted diseases and unwanted pregnancies. Thorough screening by clinicians in outpatient settings recommending preventative measures to promote reproductive and sexual health, and developing caregiver trust are essential. The aim of this systematic review was to provide screening tools to assist clinicians in assessing the sexual histories of individuals with developmental or intellectual disabilities. The Iowa model and the cognitive behavioral theory were used as the theoretical frameworks that guided and informed this project. A total of 148 articles were sought and, of the 34 articles reviewed, 19 were pertinent to synthesize the literature. Articles were appraised using the John Hopkins evidence-based practice model. Results from the existing literature showed that no screening tools are available to assess the sexual histories of individuals with developmental and intellectual disabilities. Thorough screening the sexual histories of individuals with developmental and intellectual disabilities could empower safe sexual practices and the attainment of a life with personal fulfillment for members of this population. The results of this project can result in positive social change by protecting the population of individuals with developmental and intellectual disabilities from exploitation, unplanned pregnancy, and sexually-transmitted diseases. Future research is needed to fill the gap in the field and develop sexual history screening tools for this population.

People living with heart failure (PLHF) should be screened for symptoms at every healthcare visit since they are 3 times more likely to experience ventricular arrhythmias. This quality improvement project (QIP) compared 3 self-administered HF symptoms questionnaires to determine the best screening tool for a tertiary hospital arrhythmia devices clinic. The instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the Self-Reported Heart Failure Symptoms (SHEFS) questionnaire. For a 30-day period, 76 people were eligible to participate in the QIP, with 55 participants included in the final analysis (72.5% participation). The questionnaires were compared and assessed with the gold standard laboratory test for HF (NT-proBNP) for sensitivity and specificity. For HF, the SHEFS was the most sensitive (83%) compared to the NT-proBNP, but the MLHFQ was most specific (89%). When compared to the MLHFQ as the standard, SHEFS was 71% sensitive, and 73% specific for HF. Similarly, when compared to the KCCQ, the SHEFS was both, 75% specific and sensitive in identifying HF. However, the rate of correlation to a positive or negative NT-proBNP test results was the highest for the SHEFS (87%). All 3 questionnaires were statistically significant in predicting admission to hospital for HF in the past 6 months (p = 0.02 to 0.03). Finally, given the shortest length and simplicity of use, the SHEFS was selected by the stakeholders to be the standard screening tool for the clinic. This project contributes to positive social change by providing the first reported comparison in the literature to implement questionnaires in a clinic to assess symptoms for PLHF attending an arrhythmia devices clinic.

Objetivo: Determinar los factores asociados al conocimiento sobre el manejo de trauma dentoalveolar en profesores. Materiales y métodos: Se analizaron 347 cuestionarios resueltos por profesores de 6 instituciones educativas de Lima. Se utilizó el instrumento elaborado por Young que estuvo estructurado en 2 partes: características demográficas y conocimiento sobre el manejo de trauma dentoalveolar. Los datos fueron analizados mediante estadística descriptiva; y se utilizó la prueba de Chi cuadrado, prueba exacta de Fisher y Regresión de Poisson con varianza robusta para determinar la asociación entre el conocimiento sobre manejo de trauma dentoalveolar y las variables de estudio. También se calculó las PR crudos y ajustados con IC95%. Resultados: Se determinó que el género, edad, entrenamiento de primeros auxilios generales, información adicional de lesiones dentales, entrenamiento de primeros auxilios sobre lesiones dentales y tipo de colegio fueron catalogados como factores asociados al conocimiento sobre el “manejo de los dientes desplazados”. También, se comprobó que el entrenamiento de primeros auxilios tanto generales como de lesiones dentales fueron factores asociados al conocimiento sobre la “decisión de reimplantar los dientes de leche avulsionados”. Conclusiones: El entrenamiento de primeros auxilios generales y el entrenamiento de primeros auxilios sobre lesiones dentales han demostrado ser factores asociados en el conocimiento sobre el manejo de las diferentes situaciones y/o emergencias de traumatismo dentoalveolar. / Objective: The objective of this study is to determine the factors associated with knowledge about the management of dentoalveolar trauma in teachers Materials and methods: 347 questionnaires were analyzed, resolved by teachers from 6 educational institutions in Lima. The instrument developed for young people was used, which was structured in 2 parts: demographic characteristics and knowledge about the management of dentoalveolar trauma. The data was analyzed by descriptive statistics; and the Chi squared test, the Fisher exact test and the Poisson regression with robust variance to determine the association between knowledge about dentoalveolar trauma management and the study variables. Crude and adjusted prevalence ratios were also calculated with 95% CI. Results: It was determined that gender, age, general first aid training, additional information on dental injuries, first aid training on dental injuries and type of school were cataloged as factors associated with knowledge about the "management of displaced teeth". Also, it was found that both general and dental injury first aid training were factors associated with knowledge about the "decision to reimplant the avulsed milk teeth". Conclusions: General first aid training and first aid training on dental injuries have been shown to be associated factors in the knowledge of the management of different situations and / or emergencies of dentoalveolar trauma. / Tesis

The role of local Chinese media has become more important as the size of the Chinese community in New Zealand has increased rapidly in recent years. The function of local Chinese media could be like a bridge connecting the Chinese community and the mainstream society. This was an exploratory study which examined the current situation of local Chinese media to determine such issues as to whether they are the main source of information for the Chinese community, what if any difficulties they are facing and how they may develop in the future. A general research was conducted for the local Chinese media in Auckland, which covers brief introductions for some local Chinese newspapers, radio, websites, and the sole Chinese television company-World TV. Meanwhile, the researcher collected 102 questionnaires and conducted 10 in-depth interviews from the local Chinese residents and the staff working in local Chinese media companies. The findings of research suggest that most local Chinese residents utilize Chinese language media as a tool to collect daily information either from local society or their original countries. The local Chinese media not only provides information for the local community, but also has social value as a means for self-representation of the Chinese community in New Zealand and better adaptation to the mainstream society. On the other hand, the funding shortage as well as the tough competition became the obstacles for the future development for the local Chinese media. The results of this research may point to what the government’s role should be.

This thesis examines the implications of using different correlation input matrices and estimation techniques in confirmatory factor analyses (CFAs) when analyzing ordinal, nonnormal data derived from responses of recently arrived Australian immigrants to the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 is one of the most widely used instruments for determining wellbeing in populations. The response format of the GHQ-12 comprises four ordinal categories and underlying distributions of data obtained invariably do not approximate univariate or multivariate normality. Owing to these data properties, consideration should be given to the application of appropriate statistical approaches for analyzing this type of data sets. This study also investigates the extent to which the GHQ-12 is invariant across gender and cultural groups. A three-dimensional measurement model for the GHQ-12 was initially examined for four groups of Australian immigrants who originated from Hong Kong (n = 201), Mainland China (n =213), former Yugoslavia (n = 259), and the United Kingdom (n = 428). A series of CFAs using either a Pearson�s product-moment or a polychoric correlation input matrix and employing either maximum likelihood (ML), weighted least squares (WLS) or diagonally weighted least squares (DWLS) estimation methods was conducted on the data. A comparison of the parameter estimates and goodness-of-fit statistics obtained for the different analyses provided support for using polychoric correlation input matrices and DWLS estimation in CFAs when analyzing ordinal, nonnormal data with smaller sample sizes. Invariance tests across gender and cultural groups were conducted on a second-order measurement model for the GHQ-12, culminating in significant differences between the two Asian and two European cohorts. The GHQ-12 was invariant for immigrants from Hong Kong and Mainland China, as well as for males and females from the United Kingdom. Partial invariance of the GHQ-12 was found for immigrants from Asia, the United Kingdom, and former Yugoslavia and for Asian males and females. Findings from the present study suggest that estimating models based on nonnormal ordinal responses using polychoric correlations with DWLS is more likely to result in a solution with higher parameter estimates and better indices of fit than other approaches. Further research should be conducted on real and simulated data to investigate the efficacy of WLS and DWLS estimation in CFAs when using polychoric correlations as the input data for varying categorical response formats, with a range of model and sample sizes.

Prevention and slowing the progression, of chronic diseases ( such as cancer, heart disease, arthritis, diabetes, asthma, osteoporosis, dementia and incontinence ), and influencing risk factors and health behaviours of a population, relies on the best available data - driven evidence. The quality of measurement techniques to collect representative population health survey and surveillance data is, as a consequence, brought under scrutiny. The presentation of this thesis is the culmination of 17 years work that has been focused on contributing to improving public health in South Australia. It is premised on the understanding that continual epidemiological assessment using representative population health surveys can deliver evidence - based information needed by health policy makers, health planners and health promoters to make appropriate, timely and efficient evidence - based decisions. The objective of the portfolio of published papers was to demonstrate the contribution to producing quality data - driven evidence using population surveys through rigour in collecting self - reported data, diversifying surveillance data collection methods and facilitating collaboration. This portfolio presents papers that have addressed a range of methodological and chronic disease and risk factor epidemiological issues. In terms of demonstrating rigour the publications have addressed the bias associated with non - response, the methodological rigour inherent in face - to - face surveys, the differences in estimates that can occur based on mode of administration, the science of telephone surveying and the importance of good questionnaire design to produce valid and meaningful data. The literature presented has also demonstrated the first South Australian population - wide prevalence survey dealing with the consequences of domestic violence and associated issues ( for males and females ) in the community, and in doing so, demonstrated the use of the telephone to collect large - scale data in Australia on domestic violence and associated factors in the population. In addition, the first time the importance of undertaking an array of methodological precautions during the data collection phase associated with collecting data on sensitive health issues on the telephone was demonstrated in Australia as was the assessment of the bias obtained in health estimates dependent upon which telephone - based sample was used. In demonstrating the need for diversity in data collection the research submitted within this thesis has demonstrated the range of telephone surveying development issues and challenges in Australia and the benefits and the value of both face - to - face and telephone as survey data collection tools in Australia. The publications also made a significant contribution to the literature in the survey methodology area, in particular, within the systematic error in questionnaire design, the measurement error in BMI self - reported measurements, validity of self - reported height and weight, and the overall CATI methodology area. Epidemiological collaborative research in particular in the areas of social capital, HRT, mental health, suicide ideation, osteoporosis, interpersonal violence, chronic disease epidemiology and risk factor epidemiology was demonstrated. As a consequence of my research, surveying populations about their health is now entrenched into public health and health service sectors in SA. Rigour in collecting self - reported data, diversifying survey and surveillance data collection methods and facilitating collaboration, has produced quality date - driven evidence for South Australia. / Thesis (Ph.D.)--University of Adelaide, School of Medicine, Discipline of Medicine, 2006.

In recent years with the increasingly world-wide introduction of the Internet, the use of online questionnaires has increased dramatically. However in Thailand, there has been only very limited systematic research on web-based design in Thailand, including for Thai undergraduates who are the biggest group of Thai internet users. The particular characteristics of the Thai language (e.g. no capital letters, no break between words, Thai script etc.) present some interesting challenges for online Thai surveys. This experimental study investigated web-based survey design principles based on an English language background trial at a Thai university with individual interviews and focus groups with the use of think aloud and other research techniques. The findings of two types of web usability tests revealed that the scrolling web-based format was the most suitable for conducting surveys and that such surveys are most likely to attract higher response rates when endorsed by a trusted organization, when instructions are short, simple and specific, when closed and dichotomous questions provide sufficient answer options and when matrix and semantic differential questions are limited. Research also indicates that the font, Ms Sans Serif of size

Introduction: Ankle injuries are among the most prevalent acute musculoskeletal injuries, and are a significant burden on any health system. The interaction of the physiotherapist with the patient and their mutual understanding of impairments, function and recovery are important to achieving a satisfactory return to work and leisure activities. To date, little attention has focused on this interaction. There is a need for further exploration of differences and associations between outcome questionnaires that investigate similar domains of pain and function, and whether scores from such outcome measures are related to the patient’s perception of function and recovery. Of further interest is whether there are relationships between impairment measures and perceived function, and how actual performance of tasks might influence the patients understanding of their capabilities. To provide a more complete picture of these relationships, a ‘mixed methods’ approach using qualitative research methods within a quantitative study was thought to be most appropriate. The overall aim of this thesis was to utilise this research approach to investigate patients’ perceptions of their recovery and elucidate factors important to both therapists and patients that ultimately might enhance their understanding of recovery from an ankle injury. Literature reviews: Three literature reviews were undertaken. Firstly a review of systematic reviews investigating ankle sprains identified a wide variety of management strategies. There was a lack of strong evidence to support any particular management strategy. Hence clinicians are likely to have difficulty setting appropriate rehabilitation plans. Secondly a critical review identified a number of different outcome questionnaires that were utilised to gauge recovery level; however, justification for their selection was often lacking. This review also identified that little emphasis was placed on understanding the patients’ perception of their injury and the rehabilitation process. A final critical review investigated impairment and performance measures and identified four specific areas that were focused upon by clinicians during the treatment of ankle sprains: joint position sense, postural control, strength and performance during function. However, only weak evidence was found for there being a deficit in joint position sense, postural control and strength in the injured limb following an ankle sprain, and inconclusive evidence of deficits in physical performance of tasks related to function. Methods: Forty participants with an acute sprained ankle were recruited along with their treating physiotherapist. The participants completed a Global questionnaire, the Lower Limb Task Questionnaire (LLTQ) and the Short Form -36 (SF-36) Questionnaire at the initial visit, at discharge and at a six week follow up visit where they also undertook impairment testing involving, joint position sense, postural control and strength along with a functional performance test and selected functional activities. Ten participants were purposefully selected to undertake semi-structured interviews. The treating physiotherapists completed global questionnaires at the initial visit and at time of discharge. An interpretive hermeneutic approach was undertaken to examine the participants’ perceptions. Results: There were equal numbers of males and female participants and the average age of participants was 30.5 years. The relationship between questionnaires for the domains of pain and function varied between low and high degrees of association. The global limitations scores between the participants and physiotherapists were similar at the initial visit, whereas on discharge the participants had a significantly lower score (p<0.05) compared to the physiotherapists. With respect to impairment testing, there was a significant difference (p<0.05) between the uninjured limb compared to the injured limb for the joint position sense and performance agility hop test. All other comparisons of impairments were not significant (p>0.05). There was no association between questionnaire scores and impairment measures (p>0.05). Additionally there were no significant associations between previous injury and questionnaire scores and impairment measures. Finally in relation to the performance of specific functional tests there was a significant difference (p<0.05) between the six week follow up LLTQ score and the score following actual performance of the test. The findings of the participants’ interviews identified three key concerns. Firstly, that participants have a limited understanding of questionnaires, and secondly, that there is a difference in understanding of ‘recovery’ between the therapist and the patient at time of discharge. Thirdly, there was dissociation between outcome measures and the patient’s perception of their own recovery. Conclusions: This study revealed a lack of understanding and effective communication concerning physiotherapy practice in relation to ankle sprains. It was apparent that questionnaires purporting to measure similar constructs are at times dissimilar in scores and are not related strongly. Care needs to be taken in selecting and interpreting outcome measures particularly in relation to questionnaires. It was also apparent that caution should be exercised when considering the influence of impairment measures upon function. Physiotherapists should be aware that patients may perceive a lack of confidence in their level of function at the time of discharge. As a result physiotherapists need to incorporate strategies to improve patient confidence in their management plan.