Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Bakgrund   Sedan mitten av 1990-talet har dödligheten av hjärtinfarkt halverats tack vare forskning kring hjärt- och kärlsjukdomar. Då flera studier visar att många patienter som överlever en hjärtinfarkt upplever lågt välbefinnande behöver dessa stöd i sin återhämtningsprocess. Syfte Syftet var att belysa betydelsefulla faktorer vid bemötandet av patienter under återhämtningsprocessen efter hjärtinfarkt, detta ur ett patientperspektiv. Metod   En litteraturstudie har gjorts utifrån tio kvalitativt vetenskapliga artiklar  hämtade från databaserna Cinahl och PubMed. Efter att kritiskt ha granskat artiklarnas resultat sammanfördes dessa i en översiktstabell. Utifrån detta identifierades återkommande nyckelord, vilka alla svarade på syftet, för att därefter sammanställas under fem kategorier.                              Resultat  De fem kategorier som framkom är: Kunskap och information, Acceptans och hanteringsstrategier, Den upplevda kroppen, Goda sociala relationer och Existentiell mening. Resultatet visar att patienter som överlevt en hjärtinfarkt är i stort behov av relevant kunskap och information, såväl verbal som skriftlig sådan. Även acceptans är väsentligt liksom möjligheten att skapa strategier för att kunna hantera den förändrade livssituationen. Genom familj och vänner men även genom medpatienter med liknande upplevelser visar sig goda sociala relationer ha stor betydelse för patienterna. Slutligen visar resultatet hur känslan av hopp och existentiell mening är ett viktigt stöd för en positiv återhämtningsprocess. Diskussion Diskussionen har berört de fem kategorierna utifrån såväl tidigare relevant forskning som Antonovskys teoribildning om Känsla av sammanhang, KASAM. Sjuksköterskor kan bidra till en god återhämtningsprocess genom att öka patienters kunskap och stärka förmågan att acceptera för att de ska kunna få en ökad förståelse och begriplighet för sitt aktuella hälsotillstånd. Verktyg och strategier för livsstilsförändringar bör erbjudas vilket kan underlätta för patienterna att kunna hantera sin situation. Dessutom ska sjuksköterskan inge stöd och hopp för att öka känslan av meningsfullhet. / Background  Thanks to cardiovascular science, myocardial infarction has been halved by fifty percent since the 1990’s. However, many studies show that the majority of the ones who survive from a myocardial infarction experience low levels of wellbeing why support is needed in the process of recovery. Aim The aim of this study was to illuminate significant factors in the encounter of patients recovering from a myocardial infarction, from a patient’s perspective Methods  A literature review was made based on ten qualitative, scientific articles retrieved from the databases Cinahl and PubMed. The contents of the                     articles were critically reviewed and put together in an overview table. Accordingly to the results of the studies significant keywords were identified and compiled into five categories. Results The five categories is: Knowledge and information, Acceptance and strategies, Experience of the body, Significant social relations and Existential meanings. The findings show that patients who survives a myocardial infarction is in great need of relevant knowledge and information, both verbally and in writing. Acceptance and strategies is important to handle the life changing factors. The result shows that social relations like family and friends, as well as other patients with similar experiences, also has a significant impact on the patients. Finally, hope and the experience of living a meaningful life is an important support in a positive process of recovery. Discussions The five categories have been discussed by previous, significant science and the theoretical base Sense of coherence, by Antonovsky. To achieve a positive process of recovery nurses can help patients by increasing their knowledge and strengthening their ability to accept and understand the new state of health. Life changing tools and coping strategies should be provided by nurses as well as giving hope and support to facilitate the situation and increase the experience of a meaningful life.

Este trabalho é um relato de um projeto visando inserir o estudante do Ensino Médio no contexto da mecânica ondulatória, portal de entrada da física moderna, através de uma abordagem diferenciada enfocando duas das propriedades mais importantes e definidoras de qualquer fenômeno ondulatório, a Difração e a Interferência, assuntos que normalmente não são tratados adequadamente no Ensino Médio. Preparamos, para professores de Física do Ensino Médio, um material instrucional sobre o tema, o qual inclui um hipertexto de apoio, uma seleção de 25 experimentos de baixo custo e uma relação de animações e simulações, acessíveis a partir da Internet, relacionados aos conceitos físicos envolvidos nos experimentos. Este material foi testado em um modelo didático de aulas prevendo uma intensa participação dos estudantes em todas as atividades e incluindo também o trabalho com mapas conceituais em todas as aulas, tanto com objetivos de reforço pedagógico no processo de aprendizagem como na avaliação da evolução cognitiva dos estudantes. O material instrucional desenvolvido como produto deste projeto está disponibilizado no servidor Wiki do Instituto de Física da UFRGS. Apesar deste produto ter sido desenvolvido como material de apoio ao professor, pode ser utilizado como material de consulta por parte dos estudantes. / This monograph is related to a project whose main objective is to insert the high school student in the context of wave mechanics, the entrance to modern Physics. This goal achieved using a peculiar approach of the two main properties which define any ondulatory phenomenon: diffraction and interference. These matters are not usually properly handled at high school. We prepared support material for teachers including several lessons, hypertext, a selection of 25 low cost experiments and web available animations and simulations. These animations are all related to all the physical phenomenon involved in the experiments. This material was extensively tested in a didactic class model, having extensive students participation in all activities, and also including concept maps exercises in all classes. Concept maps were applied as a pedagogic reinforcement on learning process and to evaluate cognitive improvements of the students. The institutional material developed as a product of this available at the Wiki server of UFRGS Physics Institute. Although this product have been developed as support material for teachers, it can also be used as research source for students.

A presente tese apresenta como foco de investigação um tipo de produção textual: a narrativa escrita de pré-adolescentes. O estudo teve como objetivo geral compreender como as operações mentais do sujeito se expressam nas atividades que envolvem a escrita da narrativa-conto na escola. A questão levantada é: Como os sujeitos préadolescentes constroem a coerência em seus textos narrativos? O problema é analisado do ponto de vista da Epistemologia Genética de Jean Piaget, incluindo contribuições relevantes de estudos relacionados com a área investigada. Este trabalho tem como unidade central de análise a operatividade do pensamento de pré-adolescentes durante a construção da coerência em textos de narrativa-conto e utiliza o estudo de casos múltiplos (YIN, 2001) como delineamento de pesquisa e as contribuições do método clínico em conversações durante a observação sistemática dos sujeitos envolvidos. A coleta das evidências foi realizada no ano de 2008, em 19 encontros extraclasse com alunas da turma em que a pesquisadora atuava como professora. As alunas frequentavam o 5º ano de escolaridade em uma escola pública da Rede Municipal de Ensino, em Porto Alegre. As tarefas propostas nas situações de produção exigiram regulações ativas das quatro alunas que constituíram os casos analisados. Essas tarefas possibilitaram o acompanhamento das modificações cognitivas que aconteceram durante o processo de construção da coerência na escrita de textos narrativos. Estudos que correspondem ao quarto período da obra de Jean Piaget (1974a, 1974b, 1986) mostraram-se fundamentais para a análise das evidências, por abordarem conceitos explicativos do progresso cognitivo através dos processos da tomada de consciência e da lógica das significações. Os resultados empíricos dos quatro casos foram analisados a partir de três categorias: 1) Implicação Significante (situação problema e desfecho); 2) Estruturação do Real (níveis de coerência e recursos coesivos); 3) Descentração / Tomada de Consciência: regulações e construção de novos possíveis. Os resultados alcançados mostram que as relações entre processos gerais de desenvolvimento cognitivo, como as tomadas de consciência e as implicações significantes, e a construção da coerência em textos escritos em narrativas-conto como conhecimento específico, se evidenciam no uso dos elementos de coesão que expressam relações lógicas na articulação do desfecho com a introdução e meio da história, no uso do tempo dos verbos e no uso de nexos com valor temporal, bem como na distinção da fala do narrador da fala do personagem através da mudança de linha nos parágrafos e no uso do sinal de dois pontos e travessão. / This thesis focuses on a type of textual production: written narratives produced by preadolescents. The study aims at understanding how the subject’s mental operations are expressed in activities involving the writing of tales in school. The question is: how do preadolescents construct coherence in their narrative texts? The problem is analyzed according to Piaget’s Genetic Epistemology viewpoint. including relevant contributions from studies related to the investigated area. The central unit of analysis of the study is the operativity of preadolescent thought while constructing coherence in tales. It uses the multiple case study design (YIN, 2001) and the contributions of the clinical method while systematically observing the participants during their conversations. Data collection occurred in the 19 extra-class meetings with girls who were drawn from the class the researcher was teaching in the 2008 year. The students were 5th graders of a public school of the city of Porto Alegre, farthest south of Brazil. Tasks presented during the situations of text production required active regulations from the four students who compounded the analyzed cases. These tasks made it possible to follow the cognitive changes that occurred during the process of construction of coherence in the writing of the narrative texts. Studies corresponding to the fourth period of Piaget’s work (1974a, 1974b, 1986) have showed to be critical for analyzing the evidences, as they addressed explanations of the cognitive progress by processes of grasping of consciousness and logic of meanings. The empirical results of the four cases were analyzed according to three categories: 1) significant implication (problem situation and end); 2) Structuring of the real (coherence levels and cohesive resources); Decentralization/ grasp of consciousness: regulations and construction of new possibles. Results show that relationships between general processes of cognitive development, such as the grasping of consciousness and significant implications, and the construction of coherence in tale type written texts as specific knowledge, become evident in the utilization of cohesive elements expressing logic relationships in the articulation of the end with the introduction and the middle of the story, in the use of verbs tenses and connections with temporal value. It becomes evident as well in the distinction between the narrator’s and the character’s speech by changing to another line in paragraphs, and in the use of colon and dash.

Statewide accountability programs are incorporating academic growth estimates for general assessments. This transition focuses attention on modeling growth for students with significant cognitive disabilities (SWSCD) who take alternate assessments based on alternate achievement standards (AA-AAS), as most states attempt to structure their AA-AAS systems as similarly as possible to their general assessments (GA). Test scaling, group heterogeneity, small sample sizes, missing data, and the use of status-based assessments that were not necessarily designed to measure a developmental continuum complicate modeling growth for SWSCD. This study addressed these challenges by: (a) analyzing test results from a common scale, (b) modeling achievement and growth for students in multiple demographic and exceptionality categories, and (c) using multiple cohorts to increase sample sizes. Latent growth curve modeling (LGCM) was used to define growth estimates based on exceptionality, sex, race, and economic disadvantage. Unconditional latent class growth analysis (LCGA) was used to determine the number of homogeneous subgroups that existed within the heterogeneous population of SWSCD for subsequent growth mixture modeling (GMM). Unconditional GMM was used to define the number of homogeneous subgroups of students with similar intercept and growth patterns within the overall population of SWSCD. Discriminant function analysis (DFA) including student exceptionality, sex, race, and economic disadvantage status was also used to analyze class membership post hoc. SWSCD with different exceptionalities generally had significantly different average initial achievement but growth rates that did not differ significantly from each other. SWSCD classified as economically disadvantaged performed significantly lower than their peers in initial achievement, yet exhibited growth rates that were not statistically different than the reference group. This study also found evidence for two separate latent classes of students with exceptionalities on the Oregon AA-AAS. The first class had lower achievement and larger growth rates, while the second class had higher achievement and slower growth rates. Students identified as SLD and CD were generally higher-performing, while students identified as ID, ASD, and OI were lower performing across all analytic models.

O crack é a substância ilícita que mais leva à busca por tratamento para uso de substâncias no Sistema Único de Saúde (SUS). Os usuários frequentemente relatam dificuldades nos seus relacionamentos interpessoais, no entanto ter relacionamentos saudáveis é crucial para o processo de recuperação. As evidências até agora demonstram que além do uso de substâncias psicoativas, outros fatores da vida do sujeito, como características sociodemográficas, dificuldades emocionais, comportamentais e sociais podem se tornar barreiras para o resgate e cultivo de relacionamentos saudáveis. Sendo assim, a presente dissertação teve por objetivo investigar a associação entre severidade dos problemas no funcionamento interpessoal dos usuários de crack e fatores de risco associados, tais como características sociodemográficas, fatores relacionados ao uso de substâncias do paciente, de seus parceiros, familiares e amigos e comorbidades psiquiátricas. Este foi um estudo transversal multicêntrico, com a participação de homens e mulheres (N=407), em tratamento para problemas por uso de crack, na rede de saúde pública de seis capitais brasileiras. A magnitude de associação entre o desfecho (T-score: problemas na área Família/Social) e os fatores em estudo (características sociodemográficas, comorbidades psiquiátricas, exposição a eventos estressores na vida, uso recente de substâncias psicoativas, dados sobre o consumo de substâncias pelos usuários, seu parceiro, familiares adultos e amigos e envolvimento com atividades ilícitas) foi avaliada através da razão de prevalência (RP), estimada pela regressão de Poisson com variância robusta. Ter diagnóstico de abuso de álcool, transtorno de estresse pós-traumático, transtorno da personalidade antissocial, episódio depressivo atual e o número de dias consumindo crack no último mês estava significativamente associado com maior severidade nos problemas na área Família/Social. Os achados deste estudo demonstram uma relação entre maior frequência de uso de crack e co-morbidades psiquiátricas com ter mais problemas nos relacionamentos com parceiros, familiares e amigos. Sendo a reinserção social, uma conquista fundamental para a recuperação, nossos achados apontam que, além do uso de crack em si, outros elementos podem representar barreiras para o bom funcionamento social destas pessoas. Estes resultados advogam em favor do desenvolvimento de intervenções psicossociais que foquem na melhora do funcionamento interpessoal de usuários de crack e a inclusão de familiares e amigos nas abordagens terapêuticas. Além disso, sugere-se o oferecimento de tratamento concomitante para as comorbidades psiquiátricas. / Crack-cocaine is the illicit psychoactive substance that most leads to substance use treatment seeking in the Unified Health System (SUS). Users frequently report difficulties in interpersonal relationships, yet having healthy relationships is crucial to the process of recovery. Evidence so far demonstrate that in addition to psychoactive substance use, other factors in the user’s life, such as sociodemographic characteristics, emotional, behavioral, and social problems, may become barriers to the rescue and cultivation of healthy relationships. Thus, the present dissertation aimed to investigate the association between severity of problems in interpersonal functioning of crack-cocaine users and related risk factors such as sociodemographic characteristics, consumption of psychoactive substances by users, partners, adult relatives and friends, and psychiatric comorbidities. This was a multicenter cross-sectional study, involving men and women (N = 407), undergoing treatment for their crack-cocaine use in public health facilities of six Brazilian capitals. The magnitude of association between the outcome (T-score: problems in the Family/Social area) and factors under study (sociodemographic characteristics, psychiatric comorbidities, exposure to lifetime stressful events, data regarding the use of psychoactive substances by users, their partner, adult relatives and friends and engagement in illicit activities) was evaluated by the prevalence ratio (PR), estimated by Poisson regression with robust variance. Having a comorbid diagnosis of alcohol abuse, posttraumatic stress disorder, antisocial personality disorder, current depressive episode and the number of days of crack use in the last month was significantly associated with greater severity in the problems in the Family/Social area. These findings demonstrate a relationship between higher frequency of use of crack cocaine and psychiatric comorbidities with more problems in relationships with partners, family and friends. Since social reintegration is a fundamental achievement for recovery, our findings indicate that, besides the use of crack itself, other elements may represent barriers to the social functioning of these people. These results support development of psychosocial interventions that focus in the improvement of interpersonal relationships of crack cocaine users and the inclusion of family and friends in the treatment. In addition, it is suggested that interventions should target concomitant treatment for psychiatric comorbidities.

A significant landscape element is a tool of general protection of the nature and landscape, the announcement of which is formally one of the fastest and easiest ways to protect. Act No. 114/1992 Coll. represents basic legislative document where is significant landscape element defined as an environmentally, geomorphologically or aesthetically valuable part of the landscape, which shapes its typical appearance or contributes to the maintenance of its stability. The theme of my thesis was the mapping of important landscape elements and the proposal for registration of a new significant landscape element in Pelhřimov area. Four cadastral territories were selected, in which significant landscape features were characterized. In the area of interest it was selected 4 registered significant landscape elements and 13 significant landscape elements of the law, which were divided into subcategories of watercourses, ponds and forests.

Submitted by Simone Souza (simonecgsouza@hotmail.com) on 2017-06-23T16:07:51Z No. of bitstreams: 1 DISS_2014_Alexandre da Silva.pdf: 7060762 bytes, checksum: ea9d2edd290fb861a336952dbd88f77e (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2017-06-26T15:48:48Z (GMT) No. of bitstreams: 1 DISS_2014_Alexandre da Silva.pdf: 7060762 bytes, checksum: ea9d2edd290fb861a336952dbd88f77e (MD5) / Made available in DSpace on 2017-06-26T15:48:49Z (GMT). No. of bitstreams: 1 DISS_2014_Alexandre da Silva.pdf: 7060762 bytes, checksum: ea9d2edd290fb861a336952dbd88f77e (MD5) Previous issue date: 2014-02-18 / Neste trabalho, são apresentados os resultados de um estudo feito junto a estudantes do ensino médio de uma escola pública localizada na cidade de Cuiabá-MT. O trabalho foi realizado no ano de 2012 durante o período do terceiro bimestre letivo da escola, sendo utilizado um material instrucional, composto por um organizador e um objeto de aprendizagem, sendo que o organizador fez a parte introdutória do assunto e o objeto trabalhou as partes específicas. O assunto escolhido foi à eletrostática, o organizador elaborado trata-se de uma apresentação de slides com características de movimento em cada quadro da animação. Com o uso do organizador foram apresentados diversos conceitos físicos relacionados a eletrostática. Posteriormente, foi utilizado um objeto de aprendizagem desenvolvido em flash, usado nas aulas posteriores. As simulações foram organizadas em três arquivos e desenvolvidas de tal maneira a obedecer a uma organização conceitual previamente estabelecida, favorecendo os processos de diferenciação progressiva e reconciliação integradora fundamentada pela teoria de aprendizagem de Ausubel. Ao todo, foram sete aulas, sendo que a primeira e a última foram utilizadas para aplicação dos testes, para posterior comparação dos resultados. Os resultados foram usados para verificar em quais dos assuntos trabalhados dentro do conteúdo da eletrostática, o objeto de aprendizagem (Simulação) se mostrou eficiente e em quais seria necessário um outro material complementar. O material utilizado foi elaborado como material de apoio para ser utilizado em meio as aulas expositivas, ou em slides, mas também em conjunto com outros tipos de materiais instrucionais, como experimentos, maquetes e ainda outras simulações com o objetivo de promover a aprendizagem e despertar o interesse dos alunos. / In this paper are presented the results of a research done with the high school students of a public school located in the Cuiabá - MT City. The research was conducted in 2012 during the third quarter of the school that an instructional material, consisting of an organizer and a learning object, where the organizer did the introduction about the subject and the object showed about specific parts used. The subject chosen was to electrostatic, the organizer developed it is a slideshow with motion characteristics in each frame of the animation. With the use of the organizer, several physical concepts related to electrostatic were presented. Subsequently, a learning object developed in flash, used in subsequent classes was used. The simulations were organized into three files and developed in such a way as to comply with a previously established conceptual organization, favoring the process of progressive differentiation and integrator reconciliation that is based by the learning theory of Ausubel. Altogether, there were seven classes, with the first and last were used for the tests, for later comparison of results. The results were used to verify which of the subjects shown within the content of electrostatics, the learning object (Simulation) was efficient and in which subjects will be needed another complementary material. The material used was prepared as material support for to be used in lectures, or slides, but also in conjunction with other types of instructional materials such as experiments, mockups and others simulations with the goal of promoting learning and awakening student interest.