Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided the theoretical framework to guide this quality improvement project. A 45-minute in-service and accompanying reference manual was given to 4 participating PCPs, along with a demographic questionnaire asking about their age, race, gender, marital status, and years in practice. Following the in-service, a 10-question self-completed questionnaire consisting of a combination of open-ended and nominal scale yes/no questions, was administered. A thematic analysis revealed 2 primary barriers for diagnosis without the FDST: lengthy screening time and trouble differentiating FMS from a patient's other conditions. In response to one of the yes/no questions, the participants all replied that the in-service on FDST was helpful in diagnosing FMS. Implications for social change include improved diagnosis with a diagnostic screening instrument, improved quality of health care, and cost effectiveness at the system level for chronic disease prevention and management. This project demonstrates in a localized primary care setting that the FDST may offers PCPs a reliable method to diagnose FMS.

<p>Eligibility for antiretroviral therapy (ART) in HIV-infected patients is defined either by a cluster of differentiation antigen 4 (CD4) count of less than 200cells/mm3 or clinical diagnosis of WHO stage III and IV. Therefore, the decision to start ART becomes difficult when CD4 cell count is not available. With limited laboratory infrastructure, the decision to start ART is usually made based on clinical symptoms leading to late commencement of ART. This calls for alternative criteria to see if nail discoloration (ND) correlates with low CD4 count among untreated HIV infected patients. This will serve as a complementary screening tool for identifying asymptomatic ARV naive HIV patients with a CD4 cell count of less than 200cells/mm3 which signifies&nbsp / severe immunosuppression. Study Design and Setting: This was a quantitative cross-sectional descriptive and analytical study involving adult ART na&iuml / ve HIV infected patients in WHO stage I and II. Systematic sampling was used to select the participants from all adult ART na&iuml / ve HIV infected patients attending APIN clinic, located at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Data Collection: Face-to-face interviews, physical examination and relevant laboratory investigations with selected participants were conducted using a questionnaire guide. Questions on socio-demographic characteristics, clinical data, general physical examinations including finger nail examination and photographing with subsequent laboratory investigations including CD4 count and western blot were employed. Data Analysis: Variables were categorized and data analyzed using descriptive statistics including the frequency, percentage frequency / mean and standard deviation of continuous variables. Association between CD4 count of &le / 200cells/mm3 and ND was tested using the chisquare test with an alpha level of 0.05. Prevalence of ND, sensitivity, specificity, positive predictive and negative predictive values and accuracy of the screening test of ND was calculated. Results: 394 patients had their fingernails photographed and assessed. It was shown that distal banded and grey nails were the common types of ND seen with a prevalence of 38%. There was an association between CD4 count &le / 200cells/mm3 and ND (p&lt / 0.0001). CD4 count &le / 200cells/mm3 was a risk factor for developing ND (RR=2.3[1.8-3.6]). The association has a sensitivity of 78%, specificity of 55%, positive predictive value of 50%, and negative predictive value of 80% and accuracy of test 63%. Conclusion: With a significant association (p&lt / 0.0001) and a sensitivity of 78%, ND can be a useful clinical indicator of immune dysfunction mediated by HIV among patients in WHO stage I or II. ND can either be a clinical sign or a symptom in HIV patients with a CD4 of &le / 200cells/mm3 as seen in the study as the specificity and sensitivity of ND compared favourably with other WHO stage III diagnosis. Recommendations: Nail discoloration should complement CD4 count as an additional staging sign to help identify patients likely to benefit from ART especially in resource-limited settings. Finally, all patients with grey or distal banded should be on co-trimoxaxole prophylaxis in line with WHO /national guideline on the use of co-trimoxaxole for all HIV positive patients with a CD4 cell count of &le / 350cells/mm3.</p>

<p>Eligibility for antiretroviral therapy (ART) in HIV-infected patients is defined either by a cluster of differentiation antigen 4 (CD4) count of less than 200cells/mm3 or clinical diagnosis of WHO stage III and IV. Therefore, the decision to start ART becomes difficult when CD4 cell count is not available. With limited laboratory infrastructure, the decision to start ART is usually made based on clinical symptoms leading to late commencement of ART. This calls for alternative criteria to see if nail discoloration (ND) correlates with low CD4 count among untreated HIV infected patients. This will serve as a complementary screening tool for identifying asymptomatic ARV naive HIV patients with a CD4 cell count of less than 200cells/mm3 which signifies&nbsp / severe immunosuppression. Study Design and Setting: This was a quantitative cross-sectional descriptive and analytical study involving adult ART na&iuml / ve HIV infected patients in WHO stage I and II. Systematic sampling was used to select the participants from all adult ART na&iuml / ve HIV infected patients attending APIN clinic, located at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Data Collection: Face-to-face interviews, physical examination and relevant laboratory investigations with selected participants were conducted using a questionnaire guide. Questions on socio-demographic characteristics, clinical data, general physical examinations including finger nail examination and photographing with subsequent laboratory investigations including CD4 count and western blot were employed. Data Analysis: Variables were categorized and data analyzed using descriptive statistics including the frequency, percentage frequency / mean and standard deviation of continuous variables. Association between CD4 count of &le / 200cells/mm3 and ND was tested using the chisquare test with an alpha level of 0.05. Prevalence of ND, sensitivity, specificity, positive predictive and negative predictive values and accuracy of the screening test of ND was calculated. Results: 394 patients had their fingernails photographed and assessed. It was shown that distal banded and grey nails were the common types of ND seen with a prevalence of 38%. There was an association between CD4 count &le / 200cells/mm3 and ND (p&lt / 0.0001). CD4 count &le / 200cells/mm3 was a risk factor for developing ND (RR=2.3[1.8-3.6]). The association has a sensitivity of 78%, specificity of 55%, positive predictive value of 50%, and negative predictive value of 80% and accuracy of test 63%. Conclusion: With a significant association (p&lt / 0.0001) and a sensitivity of 78%, ND can be a useful clinical indicator of immune dysfunction mediated by HIV among patients in WHO stage I or II. ND can either be a clinical sign or a symptom in HIV patients with a CD4 of &le / 200cells/mm3 as seen in the study as the specificity and sensitivity of ND compared favourably with other WHO stage III diagnosis. Recommendations: Nail discoloration should complement CD4 count as an additional staging sign to help identify patients likely to benefit from ART especially in resource-limited settings. Finally, all patients with grey or distal banded should be on co-trimoxaxole prophylaxis in line with WHO /national guideline on the use of co-trimoxaxole for all HIV positive patients with a CD4 cell count of &le / 350cells/mm3.</p>

Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Increased development pressure led the United Counties of Prescott and Russell to seek development of a GIS-based Aquifer Capability Screening Tool (ACST). A Pilot ACST, developed by a project partner within this study, was made for the City of Clarence-Rockland, Ontario, and consists of several maps showing delineated areas where there may be groundwater limitations in terms of quality or quantity. This study gathered the chemistry data needed for the Pilot ACST from 127 domestic dug and drilled wells. The results showed exceedances of provincial health and aesthetic standards, which were then used to delineate maps for the Pilot ACST. An evaluation of the necessary data source and sampling scale for ACST development revealed that data gathered from existing reports was inadequate for various reasons and sampling scale should be on a grid 2x2 km2 or smaller. Further recommendations were provided for future ACST development studies.

An analysis of interrater agreement across multiple respondents on anecdotal assessments and correspondence between functional analysis outcomes was completed. Experiment I evaluated overall agreement among multiple respondents (direct-care staff) on the hypothesized function of each residents (28 adults with mental retardation) problematic behavior using the Motivational Assessment Scale (MAS) and the Functional Analysis Screening Tool (FAST). Results of the questionnaires indicated that respondents agreed on the function of the problematic behavior for 10 of the 28 residents. Experiment II examined whether, for selected cases in which 4 out of 5 respondents agreed on the function of the problematic behavior, correspondence occurred between functional analyses and anecdotal assessments outcomes. Two of the 6 functional analyses did not evoke the problematic behavior. However, 4 functional analyses did produce corresponding outcomes suggesting that, when the functional analyses produced interpretable data, the results of the functional analyses corresponded with those of the anecdotal assessments.

Bakgrund: Våld i nära relation ses som ett globalt folkhälsoproblem där kvinnor världen över faller offer för våldet. Det som kännetecknar våld i nära relation är att det finns en relation och känslomässigt band mellan offer och förövare. Våldet kan ge uttryck fysiskt, psykiskt, sexuellt, materiellt, ekonomiskt och socialt. Tidigare forskning visade att cirka var tredje kvinna som varit i en relation har utsatts för någon form av våld. Enligt Världshälso-organisationen (WHO) bör hälso- och sjukvården vara drivande i arbetet mot våld i nära relationer. Syfte: Syftet med studien var att undersöka hur yrkesverksamma inom hälso- och sjukvården kan identifiera tecken på att kvinnor blivit utsatta för våld i nära relation. Metod: Litteraturöversikt användes som metod till studien. Åtta kvalitativa och en kvantitativ artikel valdes ut. Resultat: Hälso- och sjukvårdspersonal var ofta de första som mötte kvinnor som utsatts för våld i nära relation. Sjukvården arbetar utifrån olika screeningmetoder där bland annat frågor ställs för att utforska kvinnans situation och hälsa. Det var viktigt att screening genomfördes för att identifiera om eventuell våldsproblematik fanns. Utifrån artiklarnas resultat framträdde tre subteman och ett huvudtema som svarade till studiens syfte. Konklusion: Studiens resultat visade att hälso- och sjukvården var medvetna om kvinnans utsatthet för våld i nära relation. Sjukvården hade ett flertal metoder som rekommenderades att arbeta efter, dock fanns det hinder som resulterade i att screening inte användes på rätt sätt och i vissa fall inte användes alls. Det finns förbättringsområden i sjukvårdens arbete med våldsutsatta kvinnor. / Background: Intimate partner violence is a global public health problem where women all around the world fall victims to violence. Intimate partner violence is the relationship and emotional bond between victim and perpetrator. Violence can manifest in several different ways, such as physical, mental, sexual, material, economic or social. Previous research showed that about every third woman who had been in a relationship were victims to some form of violence. According to the World Health Organization (WHO) health care services should be a driving force in the work against intimate partner violence.  Aim: The aim of the study was to investigate how health care professionals can identify expose of intimate partner violence among women.  Method: A literature review was conducted. Eight qualitative and one quantitative article were selected.  Results: Health care professionals are often the first to meet the woman who has been subjected to violence. The health care services used various screening methods where, questions are asked to explore the woman's situation. Based on the results of the articles, a main theme and three sub-themes were constructed.  Conclusion: The result of this study shows that the health care services are aware of the woman's exposure to violence. The health care system has several methods that they should work with, however there are many obstacles that result in both screening not being used correctly and in some not being used at all. There are areas for improvement in health care work with women exposed to violence.

No description available.