Objectives: The following thesis is presented within two separate pieces of work. A systematic literature review (SLR) aimed to evaluate the individual characteristics and psychometric properties of four dementia screening tools. These were the Dementia Questionnaire for People with Learning Disabilities (DLD) (Evenhuis, 2007), the Dementia Scale for Down Syndrome (DSDS) (Gedye, 1995), the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID) (Deb et al, 2007a) and the Adaptive Behaviour Dementia Questionnaire (ABDQ) (Prasher et al, 2004). The empirical research (ER) aimed to evaluate the clinical utility and longitudinal accuracy of two of these tools; the DLD and the ABDQ in a clinical population with intellectual disability (ID) and Down syndrome (DS). Methods: For the SLR a comprehensive list of electronic academic databases were searched to identify studies which included information relating to the psychometric properties of the DLD, DSDS, DSQIID and the ABDQ. Information within the studies was then extracted and rated using two quality assessment measures. These were the Characteristics of Assessment Instruments for Psychiatric Disorders in Persons with Intellectual Developmental Disabilities (CAPS-IDD) (Zeilinger et al, 2013b) and the Qualsyst (Kmet, 2004). For the ER, a repeated measures MANOVA was used to assess change over time between two groups of people with intellectual disabilities and Down syndrome; one with dementia and one without. Results: In the SLR, 16 studies were identified and rated using the CAPS-IDD and the Qualsyst. Detailed information related to the dementia screening tools and quality ratings of the papers are provided. In the ER both the ABDQ and the DLD demonstrated a clear difference between those who develop dementia and those who do not, with those in the ‘dementia’ group exhibiting increasing scores over time. Conclusions: The SLR concludes that the evidence base for these dementia screening tools remain limited. The largest evidence base was evidenced for the DLD. The ER concludes that the ABDQ and the DLD are useful tools to differentiate between those who develop dementia and those who do not. Further analysis incorporating the exploration of individual component items of tools is recommended.

The purpose of this study was to develop a questionnaire to identify students who are at risk of developing academic difficulties related to literacy in higher education in Saudi Arabia. The study adopted a mixed methodological pragmatic approach with two phases. Data for Phase One was obtained from 341 female Saudi students through the Student Academic Difficulties at Risk (SADR) questionnaire, administered at the beginning of the academic year. After six months, three sets of data were gathered: Students’ Self-Inventory (SSI) with 188 students, teacher reports on students’ academic performance with five teachers reporting on 96 students, and students’ academic Grade Point Average (GPA). In Phase Two, based on the findings of the SADR questionnaire, two students were purposively chosen from each of three different groups for case studies. The findings from Phase One suggested that some of the SADR subscales had high reliability and others showed poor reliability. The results also showed that the SADR questionnaire and GPA correlated and that the regression analysis showed a predictive value for the reading scale. However, case-level analysis showed that the SADR questionnaire could not be reliably used to predict GPA. Additional analysis showed that SSI had high reliability for all subscales and correlated with the SADR questionnaire as well as with GPA. The reading and writing subscales from the SADR questionnaire can predict continued academic difficulties that are related to reading and writing at university level. Phase Two involved case study investigations into true positive, false positive, and false negative predictions of the reliable scales in the SADR questionnaire. The findings of Phase Two showed that a variety of influences affected academic attainment, such as motivational, wellbeing-related, and socio-cultural reasons.

Objetivo: Atualmente, a medição de Testosterona Livre calculada é considerado como sendo o padrão-ouro no diagnóstico do hipogonadismo em homens, porém, não está disponível para todos os indivíduos com suspeita de diminuição da função testicular. Portanto, avaliamos se o questionário Adrogen Deficiency in the Aging Male (ADAM) e o questionário Massachusetts Male Ageing Study (MMAS) poderiam ser utilizados como substitutos das determinações bioquímicas na identificação de hipogonadismo em homens com 40 anos ou mais. Métodos: Foram analisados 460 homens, com 40 anos ou mais de idade, participantes voluntários do programa de rastreamento de câncer de próstata do Hospital de Clínicas de Porto Alegre. Foi avaliada a capacidade dos questionários ADAM e MMAS de identificar homens com níveis baixos de Testosterona Total, Livre Calculara e Biodisponível. Resultados: A sensibilidade e especificidade do questionário ADAM, com relação à Testosterona Livre Calculada, foram de 73,6% e 31,9%, respectivamente. O uso de ADAM resultou em uma classificação adequada da nossa população em indivíduos normais ou hipogonádicos em 52,75% dos casos. Para o questionário MMAS, a sensibilidade foi calculada em 59,9% e a especificidade em 42,9%. Com o seu uso, a classificação dos pacientes foi realizada corretamente em 51,4% dos casos. Conclusão: Os questionários ADAM e MMAS têm uma sensibilidade adequada para identificar homens com baixos níveis de testosterona livre. No entanto, devido à sua falta de especificidade, estes testes não podem ser utilizados como um substitutos da dosagem de Testosterona Livre Calculada em homens com 40 anos ou mais em nosso meio. / Objective: At present, calculated free testosterone assessment is considered as the gold standard in diagnosing male hypogonadism. However, this assessment is not available for all individuals diagnosed with decreased testicular function. The investigators of this study were, thus, prompted to evaluate whether the androgen deficiency in the aging male (ADAM) and the Massachusetts Male Ageing Study (MMAS) questionnaires could be used to replace biochemical parameters in the diagnosis for hypogonadism in men aged 40 years and above. Methods: We evaluated 460 men, aged 40 years and above, all volunteers of a screening program for prostate cancer based at the Hospital de Clínicas of Porto Alegre. In this study, we assessed the efficiency of the ADAM and MMAS questionnaires in diagnosing Brazilian men with low levels of total, calculated free, and bioavailable testosterone. Results: The sensitivity of the ADAM questionnaire in diagnosing the calculated free testosterone was 73.6%, whereas specificity was 31.9%. ADAM could be used to properly classify our cohort into normal or hypogonadal individuals in 52.75% of the cases. The sensitivity of the MMAS questionnaire was 59.9%, whereas the specificity was 42.9%, resulting in a successful classification of 51.4% of the patients. Conclusion: The ADAM and MMAS questionnaires showed adequate sensitivity in diagnosing male patients with low levels of free testosterone. However, because of the lack of specificity, these tools cannot replace calculated free testosterone assessments in men aged 40 years and above.

Objetivo: Atualmente, a medição de Testosterona Livre calculada é considerado como sendo o padrão-ouro no diagnóstico do hipogonadismo em homens, porém, não está disponível para todos os indivíduos com suspeita de diminuição da função testicular. Portanto, avaliamos se o questionário Adrogen Deficiency in the Aging Male (ADAM) e o questionário Massachusetts Male Ageing Study (MMAS) poderiam ser utilizados como substitutos das determinações bioquímicas na identificação de hipogonadismo em homens com 40 anos ou mais. Métodos: Foram analisados 460 homens, com 40 anos ou mais de idade, participantes voluntários do programa de rastreamento de câncer de próstata do Hospital de Clínicas de Porto Alegre. Foi avaliada a capacidade dos questionários ADAM e MMAS de identificar homens com níveis baixos de Testosterona Total, Livre Calculara e Biodisponível. Resultados: A sensibilidade e especificidade do questionário ADAM, com relação à Testosterona Livre Calculada, foram de 73,6% e 31,9%, respectivamente. O uso de ADAM resultou em uma classificação adequada da nossa população em indivíduos normais ou hipogonádicos em 52,75% dos casos. Para o questionário MMAS, a sensibilidade foi calculada em 59,9% e a especificidade em 42,9%. Com o seu uso, a classificação dos pacientes foi realizada corretamente em 51,4% dos casos. Conclusão: Os questionários ADAM e MMAS têm uma sensibilidade adequada para identificar homens com baixos níveis de testosterona livre. No entanto, devido à sua falta de especificidade, estes testes não podem ser utilizados como um substitutos da dosagem de Testosterona Livre Calculada em homens com 40 anos ou mais em nosso meio. / Objective: At present, calculated free testosterone assessment is considered as the gold standard in diagnosing male hypogonadism. However, this assessment is not available for all individuals diagnosed with decreased testicular function. The investigators of this study were, thus, prompted to evaluate whether the androgen deficiency in the aging male (ADAM) and the Massachusetts Male Ageing Study (MMAS) questionnaires could be used to replace biochemical parameters in the diagnosis for hypogonadism in men aged 40 years and above. Methods: We evaluated 460 men, aged 40 years and above, all volunteers of a screening program for prostate cancer based at the Hospital de Clínicas of Porto Alegre. In this study, we assessed the efficiency of the ADAM and MMAS questionnaires in diagnosing Brazilian men with low levels of total, calculated free, and bioavailable testosterone. Results: The sensitivity of the ADAM questionnaire in diagnosing the calculated free testosterone was 73.6%, whereas specificity was 31.9%. ADAM could be used to properly classify our cohort into normal or hypogonadal individuals in 52.75% of the cases. The sensitivity of the MMAS questionnaire was 59.9%, whereas the specificity was 42.9%, resulting in a successful classification of 51.4% of the patients. Conclusion: The ADAM and MMAS questionnaires showed adequate sensitivity in diagnosing male patients with low levels of free testosterone. However, because of the lack of specificity, these tools cannot replace calculated free testosterone assessments in men aged 40 years and above.

Objetivo: Atualmente, a medição de Testosterona Livre calculada é considerado como sendo o padrão-ouro no diagnóstico do hipogonadismo em homens, porém, não está disponível para todos os indivíduos com suspeita de diminuição da função testicular. Portanto, avaliamos se o questionário Adrogen Deficiency in the Aging Male (ADAM) e o questionário Massachusetts Male Ageing Study (MMAS) poderiam ser utilizados como substitutos das determinações bioquímicas na identificação de hipogonadismo em homens com 40 anos ou mais. Métodos: Foram analisados 460 homens, com 40 anos ou mais de idade, participantes voluntários do programa de rastreamento de câncer de próstata do Hospital de Clínicas de Porto Alegre. Foi avaliada a capacidade dos questionários ADAM e MMAS de identificar homens com níveis baixos de Testosterona Total, Livre Calculara e Biodisponível. Resultados: A sensibilidade e especificidade do questionário ADAM, com relação à Testosterona Livre Calculada, foram de 73,6% e 31,9%, respectivamente. O uso de ADAM resultou em uma classificação adequada da nossa população em indivíduos normais ou hipogonádicos em 52,75% dos casos. Para o questionário MMAS, a sensibilidade foi calculada em 59,9% e a especificidade em 42,9%. Com o seu uso, a classificação dos pacientes foi realizada corretamente em 51,4% dos casos. Conclusão: Os questionários ADAM e MMAS têm uma sensibilidade adequada para identificar homens com baixos níveis de testosterona livre. No entanto, devido à sua falta de especificidade, estes testes não podem ser utilizados como um substitutos da dosagem de Testosterona Livre Calculada em homens com 40 anos ou mais em nosso meio. / Objective: At present, calculated free testosterone assessment is considered as the gold standard in diagnosing male hypogonadism. However, this assessment is not available for all individuals diagnosed with decreased testicular function. The investigators of this study were, thus, prompted to evaluate whether the androgen deficiency in the aging male (ADAM) and the Massachusetts Male Ageing Study (MMAS) questionnaires could be used to replace biochemical parameters in the diagnosis for hypogonadism in men aged 40 years and above. Methods: We evaluated 460 men, aged 40 years and above, all volunteers of a screening program for prostate cancer based at the Hospital de Clínicas of Porto Alegre. In this study, we assessed the efficiency of the ADAM and MMAS questionnaires in diagnosing Brazilian men with low levels of total, calculated free, and bioavailable testosterone. Results: The sensitivity of the ADAM questionnaire in diagnosing the calculated free testosterone was 73.6%, whereas specificity was 31.9%. ADAM could be used to properly classify our cohort into normal or hypogonadal individuals in 52.75% of the cases. The sensitivity of the MMAS questionnaire was 59.9%, whereas the specificity was 42.9%, resulting in a successful classification of 51.4% of the patients. Conclusion: The ADAM and MMAS questionnaires showed adequate sensitivity in diagnosing male patients with low levels of free testosterone. However, because of the lack of specificity, these tools cannot replace calculated free testosterone assessments in men aged 40 years and above.

<p><strong>Purpose:</strong></p> <p>The purpose of this study was to determine what cut-off of the Orebro Musculoskeletal Pain Screening Questionnaire score will best differentiate workers with acute musculoskeletal injuries at-risk for delayed return to work (greater than 3 months), in a population of workers of less than 3 weeks injury duration.</p> <p><strong>Study Design:</strong></p> <p>Retrospective cohort design, using a sample of convenience.</p> <p><strong>Methods:</strong></p> <p>A sample of 259 consecutive WCB patients seeking assessment and treatment at a multidisciplinary rehabilitation facility were reviewed, with 152 meeting the inclusion criteria of having sustained a soft tissue injury within 3 weeks of initial assessment. Descriptive statistics, tests of difference between Time 1 and Time 2 OMPSQ scores and Receiver Operator Characteristic curves were generated. The method of determining predictive ability of the OMPSQ at two points in time was by means of ROC analysis.</p> <p><strong>Results:</strong></p> <p>This study determined that the OMPSQ is moderately predictive of failure to achieve timely return to work (RTW) in a population of injured workers with acute musculoskeletal soft tissue injuries, when assessed two-weeks after treatment is initiated, and less predictive at the initial intake into treatment. Delayed RTW was defined as those workers who had not returned to their pre-injury job full time by 90 days, due to reduced functional ability as it related to their pre-injury occupation.</p> <p><strong>Conclusions:</strong></p> <p>This study demonstrates that there is variability in cut-off scores across studies. Future research should attempt to define cut-off scores as they relate to the population , outcome, condition and time-frame of interest . <strong></strong></p> / Master of Science Rehabilitation Science (MSc)