Made available in DSpace on 2016-03-15T19:39:40Z (GMT). No. of bitstreams: 1 Gisele da Silva Baraldi.pdf: 891815 bytes, checksum: 73401fda92bcb9ee3c69ff8f11ce6ea2 (MD5) Previous issue date: 2011-02-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / People with development disorders and intellectual disability usually present behavioral problems in different levels of severity. This impairs their development, social adaptation and possibilities of inclusion. The most frequent procedures to identify behavioral problems are behavioral observation and standardized behavioral inventories. In Brazil standardized instruments to evaluate behavioral problems in patients with atypical development are scarce. The objective of this study was to translate into Brazilian Portuguese and make a cultural adaptation of The Behavior Problems Inventory (BPI-01). The sample was composed of 60 children and adolescents (30 of them with typical development and 30 with atypical development), age range 6-16 years old, their respective caretakers and 3 professionals of the development disorders field. The instruments for data collection were the following: a) Brazilian version of The Behavior Problems Inventory (BPI-01), b) Brazilian version of Child Behavior Checklist for ages 6-18 (CBCL/6-18), c) Wechsler Intelligence Scale for Children, d) Autism Screening Questionnaire (ASQ). The coefficients of content validity obtained through the assessment of the items by referees based in objectivity, plainness and accuracy criteria ranged from 0,7 and 0,8 (70 to 80% of agreement). Internal consistency indicators among items of BPI-01, obtained through Cronbach‟s alpha, reached a coefficient of 0,65 in the scale of self-injury behaviors, 0,91 in the scale of stereotyped behaviors and 0,82 in the scale of aggressive/destructive behaviors. To assess the relation between sensibility and specificity among frequency values of the BPI-01 scales it was used the Receiver Operating Characteristic (ROC Curve). Preliminary results of this analysis identified sensibility values at 0,76 and specificity at 0,06 for a 0,5 point score in the scale of self-injury behaviors; sensibility at 0,40 and specificity at 0,03 for a 1,5 point score in the scale of stereotyped behaviors; sensibility at 0,23 and specificity at 0,03 for a 3,5 points score in the scale of aggressive/destructive behavior. A Spearman analysis made with BPI-01 scores and the scores of ASQ and CBCL/6-18 reached statistically significant coefficients of moderate to high level. Results show indicators of proper convergent validity among the scales of BPI-01 and CBCL/6-18 and ASQ inventories. The Cronbach‟s alpha coefficients displayed adequate statistical reliability properties of the Brazilian version of the instrument. Although it is necessary to broaden the sample, these preliminary values obtained through the ROC method indicate adequate indexes of sensibility and specificity in the scales of self- njury and stereotypy with cut-points at 0,5 and 1,5 among the typical and atypical groups respectively. / Pessoas com distúrbios do desenvolvimento e deficiência intelectual freqüentemente apresentam problemas de comportamento em níveis variados de gravidade que prejudicam seu desenvolvimento, adaptação social e possibilidades de inclusão. Os procedimentos mais utilizados para identificar problemas de comportamento são a observação comportamental e os inventários comportamentais padronizados. No Brasil há uma escassez de instrumentos padronizados para avaliar problemas de comportamento em populações com desenvolvimento atípico. O objetivo do estudo é traduzir e realizar adaptação cultural do instrumento The Behavior Problems Inventory-BPI-01 para a língua portuguesa do Brasil. A amostra foi composta por 60 crianças e adolescentes na faixa etária de 6 a 16 anos de idade (30 com desenvolvimento típico e 30 com desenvolvimento atípico), seus respectivos cuidadores e três profissionais da área de distúrbios do desenvolvimento. Os instrumentos de coleta de dados foram os seguintes: a) Versão Brasileira do Inventário de Problemas Comportamentais/The Behavior Problems Inventory-BPI-01, b) Versão brasileira do Inventário dos comportamentos de crianças e adolescentes de 6 a 18 anos (CBCL/ 6-18), c) Escala de Inteligência Wechsler para crianças, d) Questionário de Avaliação de Autismo/ASQ. Os coeficientes de validade de conteúdo resultantes da avaliação dos itens, efetuada pelos juízes com base nos critérios de objetividade, clareza e precisão oscilaram entre 0,7 e 0,8 (70 a 80% de concordância). Indicadores de consistência interna entre os itens do BPI-01 mediante uso do coeficiente Alfa de Cronbach identificaram um coeficiente de 0,65 na escala de comportamentos auto-agressivos, 0,91 na escala de comportamentos estereotipados e 0,82 na escala de comportamentos agressivos/destrutivos. Para avaliar a relação entre sensibilidade e especificidade entre os valores de freqüência das escalas do BPI-01, foi utilizado o método das Curvas de Características de Operação do Receptor (Curva ROC - Receiver Operating Characteristic). Resultados preliminares desta análise identificaram valores de sensibilidade 0,76 e especificidade 0,06 para um escore de 0.5 ponto na escala de comportamentos auto-agressivos; 0,40 de sensibilidade e 0,03 de especificidade para um escore de 1,5 ponto na escala de comportamentos estereotipados e; 0,23 de sensibilidade e 0,03 de especificidade para escore igual a 3,5 pontos na escala de comportamentos agressivos/destrutivos. A análise de correlação mediante uso de coeficiente Spearman entre os escores do BPI-01 e os escores do inventário ASQ e CBCL/6-18 identificou coeficientes estatisticamente significativos de nível médio a moderado. Os resultados mostraram indicadores de validade convergente adequados entre as escalas do BPI-01 e os inventários CBCL/6-18 e o ASQ. Os valores dos coeficientes Alfa de Cronbach mostraram adequadas propriedades estatísticas de fidedignidade da versão brasileira do instrumento. Embora seja necessário ampliar o número amostral, os valores preliminares obtidos mediante uso de método ROC apontam para indicadores adequados de sensibilidade e especificidade nas escalas de auto-agressividade e estereotipia com pontos de corte entre o grupo típico e atípico de 0,5 e 1,5 respectivamente.

As principais desordens dos membros superiores e cervical (CANS - Complaints of arms, neck and shoulders) podem ser definidas como queixas musculoesqueléticas nas regiões de membro superior, ombro e pescoço não atribuídas a trauma agudo ou a desordens sistêmicas. Essas desordens são comuns entre trabalhadores usuários de computador. O Maastricht Upper Extremity Questionnaire (MUEQ) é uma das poucas ferramentas existentes na literatura para avaliação de risco ergonômico e psicossocial em trabalhadores, além da vantagem de ser específico para usuários de computador, porém não está validado no português-brasileiro. O objetivo deste trabalho foi realizar a adaptação transcultural para o português-brasileiro e validação do MUEQ em trabalhadores de escritório usuários de computador e verificar a prevalência das CANS na amostra recrutada. A tradução e adaptação transcultural seguiram as diretrizes do Consensus-based Standards for the selection of health status Measurement Instruments nos estágios: tradução, síntese, retrotradução, revisão pelo comitê de especialistas e pré-teste. Na etapa do teste da versão pré-final, foram aplicados 55 questionários em trabalhadores usuários de computador, que relataram dificuldades de compreensão abaixo do valor estipulado de 20%, não sendo necessária a reformulação da ferramenta. Para testar a confiabilidade, outros 50 sujeitos preencheram o questionário, em dois momentos, com nível de reprodutibilidade considerado excelente (ICC>0,75). A amostra para a análise da consistência interna e análise fatorial do questionário contou com 386 trabalhadores usuários de computador de mesa entre 18 e 60 anos. Para a consistência interna foram observados valores de de Cronbach maiores que 0,7 para todos os domínios. Na análise fatorial os domínios/subdomínios apresentaram valores de eigenvalue superiores a 1 e os valores de variância explicada acumulada dos fatores de cada domínio variou entre 40% e 60%. A prevalência das CANS nos últimos três meses por pelo menos uma semana foi de 73,32% (IC=0,69-0,77) na amostra total (n=283) e 82% (IC=0,76-0,87) das mulheres e 62% (IC=0,55-0,69) dos homens relataram alguma das CANS. Os domínios foram mantidos iguais à versão original do MUEQ. A queixa musculoesquelética mais observada foi a dor no pescoço (51%). A partir deste trabalho disponibilizou-se um instrumento abrangente e confiável para a avaliação ergonômica e psicossocial relacionado às queixas em cervical e membro superior em trabalhadores usuários de computador brasileiros e foi observada alta prevalência de CANS na população observada. / Complaints of the Arm, Neck and Shoulder (CANS) have a multifactorial etiology, and, therefore, its assessment should take into consideration work-related ergonomic and psychosocial aspects. The Maastricht Upper Extremity Questionnaire (MUEQ) is among the few specific tools available to evaluate the nature and occurrence of CANS in computer office workers. The purpose of the present study was to perform the cross-cultural adaptation of the MUEQ to Brazilian Portuguese and verify the psychometric properties of the MUEQ-Br in Brazilian computer office workers and to assess the prevalence of CANS in a sample of Brazilian computer office workers. The translation and cultural adaptation followed the guidelines of the Consensus-based Standards for the selection of health status Measurement Instruments in six stages: translation, synthesis, back translation, review by the expert committee, pre-test and submission of documents to the committee. In the test of pre-final version, 55 questionnaires were administered to computer workers who reported difficulties in understanding below the stipulated 20%, without the need for redesign of the tool. The pre-final version test counted on the participation of 55 computer office workers. For reproducibility, it was considered a sample of 50 workers who answered the questionnaire twice with a one-week interval. A sample comprised by 386 (37.44 years, Confidence Interval (CI) 95%:36.50-38.38, 216 women and 170 men) workers from the University of São Paulo at Ribeirão Preto campus to validate the structure of the questionnaire, verify internal consistency and CANS prevalence. Intraclass Correlation Coefficient (ICC) was used for the statistical analysis of reproducibility, Cronbachs Alpha for Internal Consistency, and the Principal Component Analysis method for Exploratory Factor Analysis. The psychometric properties of the MUEQ were assessed using exploratory factor analysis, which revealed 14 factors. The calculation of internal consistency, reproducibility and cross validation provided evidence of reliability and lack of redundancy. It was verified ICC values greater than 0.75 and cronbachs alpha greater than 0.7. Factor analysis was conducted for every section of the questionnaire and 14 factors were found, two for each section accounting for approximately 40 to 60% of the variance. The prevalence rate of CANS indicated that 73% (IC=0,69-0,77) of the respondents reported at least one complaint in the arm, neck and/or shoulder in the total sample (n=283), 82% (IC=0,76-0,87) of the women and 62% IC=0,55-0,69) of the men. The highest prevalence rates were found for neck symptoms (51%). The MUEQ-Br demonstrated to be a valid tool for the assessment of risk factors related to pain in the upper extremity among Brazilian computer office workers.

INTRODUÇÃO: A Addenbrookes Cognitive Examination Revised (ACE-R) avalia cinco domínios cognitivos em conjunto e também oferece notas parciais para cada um deles, a saber: Atenção e Orientação, Memória, Fluência, Linguagem e Habilidades VisuaisEspaciais. Essa bateria tem se mostrado útil na diferenciação entre a doença de Alzheimer (DA) e a demência frontotemporal (DFT) em outros países. O instrumento foi submetido à adaptação para o português e sua versão brasileira foi previamente publicada pelos autores. OBJETIVO: Investigar o desempenho de indivíduos idosos cognitivamente saudáveis e de outros com DA provável leve na versão brasileira da ACE-R. MÉTODOS: O teste foi administrado a um grupo de 31 pacientes com DA provável leve e a 114 idosos cognitivamente saudáveis. Destes, 62 foram equiparados aos pacientes por idade e escolaridade. Todos os participantes incluídos tinham idade 60 anos e 4 anos de escolaridade. Não apresentavam sintomatologia depressiva associada, definida como pontuação > 7 na Escala Cornell para Depressão em Demência. O comprometimento cognitivo dos pacientes foi evidenciado por pontuação < 123 na Escala Mattis de Avaliação de Demência (DRS). Os controles apresentaram escore total na DRS 123. Dados normativos foram extraídos da amostra total de indivíduos sadios. Foi analisada a correlação entre a ACE-R e o Teste de Memória de Figuras (BCB-Edu), os de Fluência Verbal (Frutas e F.A.S.) e a Bateria de Avaliação Frontal. Os grupos/variáveis foram analisados pelos testes Qui-quadrado, Teste t de Student e Teste de Mann-Whitney. Analisou-se a influência da idade/escolaridade pelo ANOVA e Bonferroni (dados com distribuição normal) e pelo Teste de Kruskal- Wallis e Método Diferença Mínima Significativa (dados sem distribuição normal). Os índices de correlação de Pearson e Spearman foram utilizados para aferir a relação entre o desempenho na ACE-R e nos demais testes cognitivos. A acurácia da bateria foi investigada pela análise das áreas das curvas ROC. RESULTADOS: As médias (DP) de idade e escolaridade dos 62 controles foram de 77,82 (6,58) e 10,05 (4,98), e dos pacientes, 78,03 (6,74) e 9,97 (5,19), respectivamente. A amostra sadia foi subdividida em três faixas etárias (60-69, 70-79 e 80) e em três grupos de escolaridade (4-7, 8-11 e 12). As subescalas da ACE-R se correlacionaram significativamente com os demais testes. Os escores gerais da bateria e da DRS mostraram forte correlação A escolaridade influenciou em todos os escores da ACER. Já a idade interferiu nas subescalas Memória, Fluência e na pontuação total. A nota de corte < 78 na ACE-R demonstrou sensibilidade de 100% e especificidade de 82,26% para o diagnóstico de DA leve (ASC = 0,947). A nota de corte para DA determinada pela razão VLOM foi de > 3,22 (ASC = 0,836; sens. 67,74%; espec. 96,77% e VPP 91,73%). CONCLUSÕES: A versão brasileira da ACE-R provou ser um instrumento de boa acurácia e de propriedades diagnósticas satisfatórias para a avaliação cognitiva em nosso meio, tendo sido capaz de discriminar pacientes com DA leve de indivíduos controles, além de avaliar com eficiência vários domínios cognitivos comumente afetados em estágios iniciais da doença. Os dados normativos apresentados representam parâmetros úteis de normalidade em idosos brasileiros. / INTRODUCTION: The Addenbrooke\'s Cognitive Examination Revised (ACE-R) allows evaluation of five cognitive domains, namely: Attention and Orientation, Memory, Fluency, Language and Visuospatial. It is particularly useful in differentiating Alzheimer\'s disease (AD) from frontotemporal dementia (FTD). The instrument was adapted to the Brazilian population and this version has already been published by the authors. OBJECTIVES: To investigate the performance of healthy individuals and patients with mild probable AD in the ACE-R Brazilian version. METHODS: The test was administered to 31 AD patients and to 114 cognitively preserved elderly. Sixty two subjects of this healthy group were adequately matched to the patients for age and education. The participants included were aged 60 years, had 4 years of schooling and did not show depressive symptoms, defined by a score > 7 in the Cornell Scale for Depression in Dementia. Cognitive impairment was defined by a score < 123 in the Mattis Dementia Rating Scale (DRS), while control scores were 123 in the DRS. Normative data were extracted from the whole sample of healthy subjects. We correlated scores in the ACE-R with those in Memory tests from the BCB-Edu, with Verbal Fluency Tests (Fruits and F.A.S.) and with the Frontal Assessment Battery. Data were analyzed with Chi-square test, Students t test and Mann-Whitney test. The influence of age/educational level in ACE-R scores was investigated by ANOVA and Bonferroni Multiple test (normal distribution data) as well as by Kruskal-Wallis test and the Minimum Significant Difference test (non-normal distribution data). Pearsons and Spearmans correlation indexes were used to assess the relationship between performance in the ACE-R and other cognitive tests. The accuracy of the battery was investigated by ROC curve analysis. RESULTS: Mean (SD) age / schooling found in the groups were 77.82 (6.58) / 10.05 (4.98) for the 62 controls and 78.03 (6.74) / 9.97 (5.19) for the patients, respectively. The healthy sample of 114 subjects was divided into three age groups (60-69, 70-79 and 80 years) and into three groups according to education (4-7, 8-11 and 12 years). The performance in the ACE-R subscales significantly correlated with that in the other cognitive instruments. The total scores from both ACE-R and DRS were strongly correlated between themselves. The educational status influenced the ACE-R sub-scores. Age interfered in the Memory, Fluency and in the ACE-R composite score. The cut-off point < 78 of ACE-R demonstrated 100% of sensitivity and 82.26% of specificity for the diagnosis of mild AD (AUC = 0,947). The VLOM cut-off point to determinate AD was > 3.22 (AUC = 0.836; sens. 67.74%; spec. 96.77% and PPV 91.73%). CONCLUSIONS: The Brazilian version of the ACE-R displayed high accuracy and great diagnostic properties for cognitive assessment in our milieu; also it was able to discriminate patients with mild AD from cognitively healthy individuals. In addition, the ACE-R efficiently assesses multiple cognitive domains that are commonly affected in the early stages of dementia. Normative data presented here represent useful parameters for the clinical use of the ACE-R in Brazilian elderly.

Introdução: A Neuropatia Periférica Induzida pela Quimioterapia (NPIQ) é um efeito adverso comum e debilitante ocasionado pela infusão de agentes quimioterápicos neurotóxicos como os taxanos, as platinas, alcalóides da vinca, bortezomibe e talidomida. A administração destas medicações aumentam a sobrevida do paciente, porém, aproximadamente, 30% a 40% desenvolvem NPIQ, o que afeta negativamente o tratamento planejado e a qualidade de vida ao interferir nas atividades diárias do paciente. A NPIQ manifesta-se com sintomas sensitivos (parestesia, disestesia, dor entre outros), motores (fraqueza, alterações na marcha e no equilíbrio, dificuldade nas habilidades motoras finas e outros) e neurovegetativos (constipação, retenção urinária, disfunção sexual e alterações na pressão sanguínea). Até o momento não foi concebido um instrumento que avalie a dor neuropática na NPIQ e, além disso, não há instrumento validado com essa finalidade no Brasil. Objetivos: Realizar a tradução e adaptação transcultural do instrumento Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT) para a língua portuguesa do Brasil e testar as propriedades psicométricas da versão adaptada em uma amostra de pacientes oncológicos, que apresentavam NPIQ. Métodos: Trata-se de um estudo metodológico com coleta de dados transversal. Para o processo de tradução e adaptação do instrumento, adotou-se o referencial teórico metodológico proposto por Beaton e colaboradores (2000). A coleta de dados ocorreu em dois hospitais referência no tratamento oncológico da cidade de São Paulo. Resultados: Obteve-se uma amostra de 245 participantes, sendo que, 135 (55,1%) apresentavam neoplasia maligna de intestino, 162 (66,1%) usavam um quimioterápico da classe análogos da platina, 125 (51%) manifestavam dormência nas mãos com gravidade média de 6,71 e angústia média de 7,0 (numa escala de 0-10), impactou negativamente nas Atividades de Vida Diária (AVD) como a prática de exercícios, o trabalho e atividades de lazer. Para testar a validade de construto convergente fez-se uma correlação de Spearmam da versão adaptada do CIPNAT com os instrumento NPSI e DN4 e, obteve-se uma moderada correlação. Não foi possível atingir a validade discriminante. A análise fatorial exploratória com rotação varimax identificou dois fatores, sendo estes, sintomas sensitivos e sintomas motores. Em relação a confiabilidade, alcançou-se um alfa de Cronbach de 0,87, considerado satisfatório. O teste-reteste demonstrou uma forte correlação entre a primeira e segunda avaliação pelo CIPNAT, sendo considerado estável. Conclusão: A análise psicométrica do CIPNAT foi adequada. Desta forma, estará disponível um instrumento válido e confiável que rastreia, caracteriza, avalia e mensura a NPIQ e seu impacto nas AVDs para que a enfermagem oncológica promova uma assistência segura e com qualidade / Background: Chemotherapy Induced Peripheral Neuropathy (CIPN) is a common and debilitating adverse effects caused by the infusion of neurotoxic chemotherapeutics such as taxanes, platines, vinca alkaloids, bortezomib and thalidomide. The administration of these medications increase patient survival, however, approximately 30% to 40% develop CIPN, which negatively affects the planned treatment and the quality of life by interfering with daily activities of the patient. The CIPN manifests itself with sensory symptoms (paresthesia, dysesthesia, pain and others), motors (weakness, changes in gait and balance, difficulty with fine motor skills and others) and neurovegetative (constipation, urinary retention, sexual dysfunction and changes in blood pressure). So far, it has not been a tool designed to evaluate the neuropathic pain in CIPN and furthermore, there is no validated instrument for this purpose in Brazil. Aims: To perform the translation and cultural adaptation of Chemotherapy- Induced Peripheral Neuropathy Assessment Tool instrument (CIPNAT) into Portuguese of Brazil and test the psychometric properties of the adapted version in a sample of cancer patients with CIPN. Methods: This is a methodological study with cross data collection. For the process of translation and adaptation of the instrument, it was adopted the methodological theoretical framework proposed by Beaton et al (2000). Data collection occurred in two referral hospitals in the oncological treatment of São Paulo. Results: There was obtained a sample of 245 participants, and that 135 (55.1%) had colorectal neoplasm, 162 (66.1%) used a platinum chemotherapeutic agent, 125 (51%) manifested numbness in the hands with medium gravity of 6.71 and average distress of 7.0 (on a scale of 0-10), impacted negatively on the activities of Daily Living (ADLs) such as exercise, work and leisure activities. To test the convergent validity has made a Spearman\' correlation of the adapted version of CIPNAT with NPSI and DN4 instrument and, was obtained a moderate correlation. Could not achieve the discriminant validity. Exploratory factor analysis with varimax rotation identified two factors, which are, sensory symptoms and motor symptoms. Regarding reliability, it was reached a Cronbach\'s alpha of 0.87, satisfactory. The test-retest showed a strong correlation between the first and second evaluation by CIPNAT and is considered stable. Conclusion: The psychometric analysis of CIPNAT was adequate. Thus, it will be available a valid and reliable instrument that tracks, features, evaluates and measures the CIPN and its impact on ADL for the oncology nursing promotes safe and quality care

Avec près d'un million de cas de démence en France en 2010, la maladie d'Alzheimer (MA) et les syndromes apparentés constituent un enjeu majeur de santé publique. A l'heure actuelle, il n'existe aucun traitement médicamenteux permettant de guérir de la MA. Ces médicaments visent à ralentir la progression de la maladie en améliorant certains symptômes. De ce fait, il semblait utile et nécessaire de disposer d'indicateurs permettant d'évaluer les prises en charge mises en place pour ces patients. La qualité de vie liée à la santé (QDV) est donc devenue un critère d'évaluation indispensable tant pour les chercheurs que pour les cliniciens.Les outils de QDV génériques sont en général moins sensibles pour une maladie donnée. C'est pourquoi d'autres outils spécifiques à la MA se sont développés. Aucun parmi eux n'était validé en langue française. L'objectif de cette thèse était donc, après une revue de la littérature, de réaliser la validation transculturelle puis psychométrique du « Quality of Life in Alzheimer's Disease » (QoL-AD) et du « Dementia Quality of Life » (DQoL). Ces deux questionnaires étaient d'après la littérature les plus utilisés en langue anglaise dans cette maladie.Ce travail de thèse a été réalisé sur les données du PHRC National 2004 « Evaluation de la qualité de vie chez le sujet âgé dément : validation d'un instrument spécifique ». Cette étude a permis de recueillir des données d'un total de 155 couples patient-aidant recrutés au sein de sept centres hospitaliers français et d'un centre suisse francophone participant à l'étude. Les patients présentaient une MA au stade léger ou stade modéré (Mini Mental State Examination > ou = 10). Le QoL-AD et le DQoL ont été administrés par un enquêteur. Le QoL-AD aidants a été auto-administré. L'adaptation transculturelle puis la validation psychométrique ont donc été réalisées pour ces deux questionnaires.Nous disposons donc désormais d'une version française du QoL-AD et d'une version française du DQoL, ayant bénéficié d'une adaptation transculturelle effectuée selon les recommandations internationales, et qui présentent toutes deux de bonnes propriétés psychométriques. / With nearly one million cases of dementia in France in 2010, Alzheimer's disease (AD) and related syndromes are a major public health issue. Up to now, there is no drug for treatment or preventing for AD. The only available drugs aim to slow down the progression of the disease by improving some symptoms. Therefore, it seemed necessary to have indicators enabling assessment of treatment strategies for these patients. So, health related quality of life (HRQoL) became an essential criterion for evaluation for both researchers and clinicians.Generic HRQoL tools are generally less sensitive for a given disease. That is why other specific tools for AD have been developed. None of them was validated in French. The aim of this thesis was therefore, after a review of the literature, to achieve a cross-cultural adaptation and psychometric validation of the "Quality of Life in Alzheimer's Disease" (QoL-AD) and "Dementia Quality of Life" (DQoL). These two questionnaires were selected because they were the most popular in English-language literature for this disease.This thesis was conducted on data collected during the PHRC National 2004 "Evaluation of the quality of life in elderly demented people: validation of a specific instrument". This study concerned a total of 155 patient-caregiver pairs recruited from seven French hospitals and a Francophone Swiss center. Patients had a confirmed diagnosis of AD (mild to moderate stage: Mini Mental State Examination > ou = 10). QoL-AD and DQoL were administered by an interviewer. The caregiver sheet of QoL-AD was self-administered. Cross-cultural adaptation and psychometric validation have been carried out for these two questionnaires.We now have at disposal two HRQoL questionnaires specifics for AD in French language. They are issued from a cross-cultural adaptation performed according to international quidelines and both have good psychometric properties. So they can be used to evaluate quality of life in Alzheimer's disease on French speaking population.

Objetivo: Adaptar culturalmente y reportar evidencia de validez de contenido del cuestionario de usabilidad mHealth App Usability Questionnaire (MAUQ) de aplicaciones interactivas al idioma español en proveedores de atención médica. Materiales y Métodos: Estudio de diseño transversal e instrumental que busca analizar las propiedades psicométricas sobre las evidencias de validez y fiabilidad de instrumentos de medida, además de estar encaminados en procesos de adaptación, en el cual se evaluó el cuestionario en base a las categorías Coherencia, Relevancia, Claridad y Suficiencia. También se evaluó la redacción y la equivalencia semántica del nuevo instrumento con el original. Se calculó el V de Aiken por pregunta en las categorías Coherencia, Relevancia y Claridad con un intervalo de confianza (IC) al 95%. Se consideró aceptable un IC como límite inferior mayor o igual a 0.70. Se aplicó una prueba piloto en 30 médicos usuarios de aplicaciones interactivas para medir el coeficiente Alfa de Cronbach. La evaluación de la categoría Suficiencia, se dio por el grupo de ítems que conforman la dimensión a valorar, y no por ítem, dado que se evalúa si son suficientes o no para ello. Resultados: Todos los resultados obtenidos para los ítems tuvieron un V de Aiken con IC al 95% mayor a 0.70. El promedio de edad de los participantes fue 32.1 (DE = 4.61) y 17 (56.7%) eran de sexo masculino. En la traducción directa, las diferencias más resaltantes fueron los términos “involved”, “recover” y “manage”, los cuales fueron traducidos como “dedicado”, “corregí” y “manejar” respectivamente. Además, en el proceso de traducción inversa se pudo observar diferencias semánticas en la retraducción de los términos “deliver” y “acknowledged” originales del cuestionario. Para la fiabilidad, la primera dimensión (Facilidad de uso y satisfacción) tuvo un α= 0.90, la segunda dimensión (Estructura de la información del sistema) tuvo un α= 0.87 y la tercera dimensión (Utilidad) tuvo un α= 0.92. Todos los valores de Alfa fueron superiores a 0.70. Conclusión: A partir del desarrollo de este estudio se contará con una herramienta adaptada culturalmente y con evidencia de validez de contenido. Dicha herramienta contribuirá a medir la usabilidad de aplicaciones por parte de médicos. / Objective: To culturally adapt and report evidence of content validation of the mHealth App Usability Questionnaire (MAUQ) of interactive applications in the Spanish version among health care providers. Materials and Methods: Cross-sectional and instrumental design study that seeks to analyze the psychometric properties on the evidence of validity and reliability of measurement instruments in addition to being directed towards adaptation processes, in which the questionnaire was evaluated based on the characteristics of Coherence, Relevance, Clarity, and Sufficiency. Besides, we also evaluated the new instrument's wording and semantic equivalence compared to the original document. The Aiken’s V was calculated per question for the characteristics of Coherence, Relevance, and Clarity, and the confidence interval (CI) was 95%. The minimum acceptable standard for CI was 0.70. A pilot test was administered among 30 doctors who were users of interactive applications to measure the Cronbach’s alpha coefficient. Regarding the characteristic of Sufficiency, validation was not conducted per item, but per item sections that made up the dimension to be evaluated, since we assess whether they are sufficient to do so or not. Results: All the results obtained for the items showed Aiken's V with CI of 95% higher than 0.70. The participants’ average age was 32.1 (SD = 4.61) and 17 (56.7%) were male. When translating from English into Spanish, the most relevant differences were the terms “involved”, “recover”, and “manage”, since they were translated as dedicado (devoted), corregir (correct), and manejar (handle), respectively. Furthermore, when translating from Spanish into English, we observed semantic differences in the back-translation process of the terms “deliver” and “acknowledged” on the original questionnaire. Regarding reliability, the first dimension (ease of use and satisfaction) achieved α= 0.90, the second dimension (system information arrangement) achieved α= 0.87, and the third dimension (usefulness) achieved α= 0.92. All alpha values were higher than 0.70. Conclusion: Based on the development of this research study, we will have an instrument that is culturally adapted and shows evidence of content validation. This instrument will allow us to measure the usability of applications among doctors. / Tesis

With our increasingly competitive globalized economy, we are experiencing an emerging trend of firms competing on new international business markets (Bell et al. 2001; Huang 2010). In order to successfully negotiate in an international context, cultural sensitivity needs to be taken into consideration (Manrai &amp; Manrai 2010). This study aims to examine how and to what extent professionalnegotiators’ international negotiation process is influenced by different businesscultures. The study was made by in-depth interviews of five Swedish based professional negotiators and their experiences from negotiating in France, Brazil and Singapore. The mentioned negotiation process was based on Ghuari’s(2003) international business negotiation model which consists of a pre- negotiation stage, a face-to-face negotiation stage and a post-negotiation stage. These stages have been analyzed and interconnected with several cultural variables such as cultural intelligence, adaptation, communication, hierarchy and the Hofstede (2011) parameter of collectivistic versus individualistic cultures to substantiate our two research questions: 1) How does culture intervene in the different stages of the negotiation process? And 2) How are the negotiators adjusting their negotiation strategy to better accommodate the specific culture? The empirical findings showed that there are several differences in both theFrench, Brazilian and Singaporean business culture as well as the negotiators’experiences of their need of adapting to the culture they are negotiating with. The data highlighted the importance of cultural understanding and obtaining the knowledge in a pre-negotiation stage in order to prevent unnecessary misunderstandings which could obstruct the negotiation. The major differenceswhich required the negotiators’ understanding and adaptation was the crucialfactor of building a relationship with the Singaporean delegation, the French’stough negotiation approach and the hierarchical setting in Brazil. The conclusions demonstrated the benefits of cultural adaption as well as the potential pitfall of over-adapting and the imperative preparatory work needed in the pre-negotiation stage of the negotiation.

Intimate Partner Violence (IPV) is common among refugee women, and some adulthood and childhood factors are more influencing IPV against this group of women. Generally, there is a gap in research about the different influencing factors of IPV against refugee women. There is little empirical evidence and research about influencing factors for IPV in this vulnerable population and few studies on this specific topic in Sweden. To fill in this gap, this study aims to investigate the adulthood and childhood determinants of intimate partner violence against Persian refugee women in Sweden who had intimate partners during the past year. The main theoretical framework of this study was the Socio-ecological model (SEM). I conducted a cross-sectional study using an online survey with five questionnaires and I did descriptive analysis for reaching results and final analysis for this project. I did linear regression to analyze how much two independent variables which are socio-cultural adaptation and childhood abuse victimization affect the main dependent variable. Findings show that; childhood abuse experience/victimization history as one of the main independent variables was significantly a higher predictor of the main dependent variable. According to the findings of this study, different layers of the socio-ecological model (SEM), such as individual, family, community, and society, influenced the main outcome of the study, which was emotional and economic violence against Persian refugee women in Sweden by their intimate partners. IPV can be identified, analyzed, and prevented using the SEM model and taking into account its various interconnected layers. Research on IPV and the factors that contribute to IPV victimization in women can advance knowledge in this field and aid in the development of future preventive interventions and programs to assist this vulnerable group.

PhDr. Ondřej Hubáček: Socio-cultural adaptation of local communities. Dissertation 2012. Abstract This dissertation deal with the socio-cultural adaptation of local communities to the external (exogenous) changes by means of internal (endogenous) changes of the elements of the local socio-cultural system. The dissertation builds on the long-term research on local culture conducted by the Department of Cultural Studies, Faculty of Arts, Charles University in Prague. It focuses on issues of socio-cultural potential of towns, which observes from two aspects. In terms of specifics of the towns, especially the differences between the particular components and forms of socio- cultural potential, and in terms of its reproduction, ie the process of changes in their components and forms. Methodologically, the dissertation is based on secondary analysis of data collected in the research and reinterpretation of findings and conclusions made out in past analyzes. The dissertation has three objectives. First, to complete spectrum of views on the issue of changes taking place due to macro-social transformation processes at the level of local communities and local cultures with the view of cultural studies. Second, to contribute to the theoretical conceptualization and operationalization of socio-cultural phenomena...

Indiana University-Purdue University Indianapolis (IUPUI) / Since the King Abdullah Scholarship Program was initiated in 2006, more than 50,000 Saudi women are studying abroad. Each year hundreds of Saudi female students are returning every year from a study abroad experience from a western country. However, there is a lack of research examining their reentry experience and its effect on their re-adaptation and cultural integration. This study analyzes how the participants adapted the learned skills and communication style from the host culture to their home culture. Qualitative methods were used to explore the re-adaptation and cultural integration experience of the reentry experience. In-depth interviews were conducted with twelve returned Saudi female students. Grounded theory methodology was used to analyze the interviews, with Kim’s (2001) integrative theory of communication and cross-cultural adaptation (ITCCA) providing the theoretical framework for the analysis. This research provided an insight into the Saudi women experience, by examining their pre-entry characteristics, intercultural transformation, communication competence, and the formation of their intercultural personhood. Further, to help minimize the returners’ challenges and maximize their benefits. The reentry consolation program and reentry-training program that I proposed would help the returners understand the faced challenges to better adjust and grow in their home culture. Also, it will help the returners reflect in their professional lives and better understand their work environment to help enhance and integrate their skills to maximize their productivity.