Thesis (doctoral)--Malmö University, Sweden, 2009. / Includes bibliographical references. Also available on World Wide Web.

Thesis (doctoral)--Malmö University, Sweden, 2009. / Includes bibliographical references. Also available on World Wide Web.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-06-09T14:48:55Z No. of bitstreams: 1 ISADORA SAMARIDI.pdf: 3361742 bytes, checksum: 284d16da32f7ec2a752cde1f689fd59e (MD5) / Made available in DSpace on 2017-06-09T14:48:55Z (GMT). No. of bitstreams: 1 ISADORA SAMARIDI.pdf: 3361742 bytes, checksum: 284d16da32f7ec2a752cde1f689fd59e (MD5) Previous issue date: 2017-03-31 / This dissertation discusses the understanding of General Health and Quality of Life (QL) of the fashion models in Goiânia. It focuses on identifying, describing and analyzing the perception of fashion models about the QL related to their work and their General Health, describing their sociodemographic profile, assessing the participants' QL in their physical, social, family and psychological aspects, as well as evaluating general health indicators such as: stress or psychic stress, death wish, lack of confidence in performance or self-efficacy, sleep disturbances, psychosomatic disorders, and absence of mental health or mental illness severity. Thus, being able to correlate QL and General Health of fashion models, evaluating the meaning of QL for each one in order to understand the senses produced relative to the aspects of General Health and QL of professional fashion models. This study is justified by the fact that Brazilian research on QL and General Health of fashion models is scarce, as well as the fact that information produced on workers' QL is usually made when they present health problems, with few studies of QL with population without clinical diagnosis. The dissertation is organized in two articles, the first of which is quantitative, descriptive, exploratory and transversal. The study was carried out with 45 models affiliated with a fashion agency in the city of Goiânia through the Whoqol Bref and the General Health Questionnaire (QSG). The correlations between QSG and WHOQOL Bref were significant and negative between General Health satisfaction in relation to stress and psychic stress, self efficacy and psychosomatic symptoms. The psychological domain showed a significant correlation with most of the relationships, except for the sleep disorder. The physical domain also showed a significant correlation with self-efficacy. It is concluded that when there is QL satisfaction the model is in good psychological and physical state. In article two, the qualitative methodology of content analysis of Bardin was used to understand and evaluate the meaning of QL and the senses produced related to the aspects of General Health and QL of professional fashion models, using as instrument the semi interview Structured. Eight fashion models from the city of Goiânia participated in a larger study that answered an interview conducted through a semi-structured script. There were four thematic categories produced: Quality of Life, Health, Professional Fashion Model and Coping Strategies. Through these categories, the production of several dualities was observed: to succeed in the professional area means a good QL, even if General Health, affectivity and social are not. With regard to General Health, the constructed meanings are reduced to affirmation or denial of physical illness. It is concluded that the biased view of General Health negatively impacts the Quality of Life conditions associated to the work of fashion models. / Essa dissertação discute a Saúde Geral e a Qualidade de Vida (QV) das modelos de moda em Goiânia. Tem como foco principal identificar, descrever e analisar a percepção de modelos de moda sobre a própria Saúde Geral e a QV relacionadas ao seu trabalho. Este estudo se justifica no fato de que são escassas as investigações brasileiras sobre a Saúde Geral e a QV de modelos de moda, bem como pelo fato de que informações produzidas sobre a QV do trabalhador, usualmente, são feitos quando os mesmos apresentam problemas de saúde, sendo poucos os estudos de QV com população sem diagnóstico clínico. A dissertação está organizada em formato híbrido: Introdução, capítulo de Percurso Metodológico e dois produtos em formato de artigos. No primeiro artigo a metodologia é quantitativa, descritiva, exploratória e transversal. Realizou-se o estudo com 45 modelos filiadas em uma agência de moda na cidade de Goiânia por meio do Whoqol Bref e do Questionário de Saúde Geral (QSG). As correlações entre QSG e WHOQOL Bref foram significativas e negativas entre a satisfação da Saúde Geral e a tensão e ao estresse psíquico, a autoeficácia e os sintomas psicossomáticos. O Domínio Psicológico da QV apresentou correlação significativa com a maioria dos itens do QSG, com exceção do distúrbio do sono. O Domínio Físico da QV também apresentou correlação significativa com a Autoeficácia. Conclui-se que quando existe satisfação da QV, a modelo encontra-se em bom estado Psicológico e Físico. No artigo dois, utilizou-se a metodologia qualitativa de análise de conteúdo de Bardin afim de compreender e avaliar o significado de QV e os sentidos produzidos relativos aos aspectos da Saúde Geral e da QV de modelos profissionais de moda, utilizando como instrumento a entrevista semiestruturada. Participaram oito modelos de moda, da cidade de Goiânia, componentes de um estudo mais amplo, que responderam a uma entrevista realizada por meio de um roteiro semiestruturado. Foram quatro as categorias temáticas produzidas: Qualidade de Vida, Saúde, Profissão Modelo de Moda e Estratégias de Enfrentamento. Por meio dessas categorias, observaram-se a produção de várias dualidades: terem êxito na área profissional significa uma boa QV, mesmo que a Saúde Geral, a afetividade e o social não estejam. No que refere-se à Saúde Geral, os significados construídos estão reduzidos a afirmação ou negação de doença física. Conclui-se que a visão parcializada da Saúde Geral impacta negativamente as condições de Qualidade de Vida associado ao trabalho das modelos de moda.

Made available in DSpace on 2014-12-17T15:43:53Z (GMT). No. of bitstreams: 1 AnaCGF_DISSERT.pdf: 1143283 bytes, checksum: 0491ed52a7c8b359c5006cb09fc7ef05 (MD5) Previous issue date: 2013-04-30 / Instruments are used in odontology to measure the Quality of Life Related to Oral Health (OHRQoL) to scale how the oral condition interferes with functional areas, of the people s psychological and social life. This cross-sectional study, held in Natal/RN, with 215 students from the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) has investigated the association between the performance of daily activities and oral health status of school adolescents from 15 to 19 years of age, through the normative index DMFT (permanent teeth decayed, missing and filled), CPI (Community Periodontal Index) and DAI (dental Aesthetic Index) and subjective questionnaire assessment of quality of life related oral health OIDP index (oral impacts on daily performance). It was also carried out the socioeconomic characteristics of students through IFRN own data. Concerning the analysis of data was performed a descriptive analysis of the variables by their absolute and relative frequencies and measures of central tendency. The chi-square test was used to assess the association between the dependent variable and the independent categorical variables and the Student t test for quantitative. It was also conducted a further multiple analysis out using Poisson regression with robust variance between the outcome "presence of impact" and the independent variables that showed p <0.20. It was used for all the statistical tests a significance level of 5%. Among the adolescents surveyed, 51.16% reported that at least one activity assessed by OIDP had hampered its implementation due to some dental problem. The difficulties were more pronounced in the activities of eating (31.6%), oral hygiene (25.6%) and smile (25.1%).The tooth position, followed by toothache, were the causes of the impacts reported by most teenagers. There was a significant association between the presence and impact of the presence of one or more decayed teeth (p = 0.012), the presence of gum bleeding (p = 0.012) and for orthodontic treatment (p = 0.003), independently of other variables. There was no significant association between oral health status and socioeconomic and demographic characteristics of the adolescents. The survey results showed that there is an association between oral health status of the population studied and reports of difficulties in carrying out daily activities evaluated. The worse the oral health status, the greater the impact of this condition on the adolescents quality of life / Em odontologia utilizam-se instrumentos de mensura??o da Qualidade de Vida Relacionada ? Sa?de Bucal (QVRSB) para dimensionar o quanto a condi??o bucal interfere nos ?mbitos funcional, psicol?gico e social da vida das pessoas. Este estudo seccional, realizado em Natal/RN, com 215 alunos do Instituto Federal de Educa??o, Ci?ncia e Tecnologia do Rio Grande do Norte (IFRN), investigou a exist?ncia de associa??o entre o desempenho de atividades di?rias e a condi??o de sa?de bucal de adolescentes escolares de 15 a 19 anos de idade, atrav?s dos ?ndices normativos CPO-D (dentes permanentes cariados, perdidos e obturados), CPI (?ndice periodontal comunit?rio) e DAI (?ndice de est?tica dental) e do question?rio subjetivo de avalia??o da qualidade de vida relacionada ? sa?de bucal OIDP (?ndice de impactos orais no desempenho di?rio). Tamb?m foi realizada a caracteriza??o socioecon?mica dos alunos por meio de dados do pr?prio IFRN. Quanto ? an?lise dos dados, realizou-se a an?lise descritiva das vari?veis atrav?s de suas frequ?ncias absolutas e relativas e medidas de tend?ncia central. O teste do qui-quadrado foi utilizado para verificar a associa??o existente entre a vari?vel dependente e as vari?veis independentes categ?ricas e o teste t de Student para as quantitativas. Realizou-se ainda uma an?lise m?ltipla, pela regress?o de Poisson com vari?ncia robusta, entre o desfecho presen?a de impacto e as vari?veis independentes que apresentaram valor de p<0,20. Para todos os testes estat?sticos foi adotado um n?vel de signific?ncia de 5%. Entre os adolescentes pesquisados, 51,16% relataram que ao menos uma atividade avaliada pelo OIDP tinha sua execu??o dificultada em decorr?ncia de algum problema odontol?gico. As dificuldades foram mais acentuadas nas atividades de comer (31,6%), higienizar a boca (25,6%) e sorrir (25,1%). A posi??o dent?ria, seguida pela dor de dentes, foram as causas dos impactos mais relatadas pelos adolescentes. Existiu uma associa??o significativa entre a presen?a do impacto e a presen?a de um ou mais dentes cariados (p=0,012), a presen?a de sangramento gengival (p=0,012) e a necessidade de tratamento ortod?ntico (p=0,003), independente das demais vari?veis. N?o houve associa??o significativa entre as condi??es de sa?de bucal e as caracter?sticas socioecon?micas e demogr?ficas dos adolescentes. Os resultados da pesquisa demonstraram que existe uma associa??o entre as condi??es de sa?de bucal da popula??o estudada e os relatos de dificuldades na realiza??o das atividades di?rias avaliadas. Quanto piores as condi??es de sa?de bucal, maiores s?o os impactos dessa condi??o na qualidade de vida dos adolescentes

Submitted by admin tede (tede@pucgoias.edu.br) on 2018-05-03T13:18:42Z No. of bitstreams: 1 GEYSE CHRYSTINE PEREIRA SOUZA FERNANDES.pdf: 1016215 bytes, checksum: c945ea694c1550a64eecbe5e576496c3 (MD5) / Made available in DSpace on 2018-05-03T13:18:42Z (GMT). No. of bitstreams: 1 GEYSE CHRYSTINE PEREIRA SOUZA FERNANDES.pdf: 1016215 bytes, checksum: c945ea694c1550a64eecbe5e576496c3 (MD5) Previous issue date: 2018-03-12 / Objective: To analyze the correlation between musculoskeletal symptoms and the quality of life of primary school teachers in Guanambi, Bahia. Methods: This is an analytical cross-sectional study with a quantitative approach. The research was carried out with 52 elementary school teachers from the municipality of Guanambi / BA. The following instruments were used: Occupational sociodemographic questionnaire, Nordic Osteomuscular Symptom Questionnaire (QNSO), Quality of Life Assessment Tool - WHOQOL-Bref. Results: The occupational sociodemographic profile showed a predominance of females (96.2%), the majority (88.5%) with a workday of 40 hours per week and with 92.3% having a postgraduate degree. A total of 96.2% understood that their work is at risk to health and 65.4% said that they tire frequently. There was a high prevalence of musculoskeletal symptoms (84.6%), mainly in four parts of the body: knee, lumbar spine, shoulder and neck. Also the departures were due to these same parts. In the statistical analysis of the musculoskeletal symptoms in correlation with the occupational sociodemographic profile, there was a significant relation between the distance and feeling tired at work (p = 0.04), showing that the more the feeling of fatigue was the distance of musculoskeletal problems. In Whoqol-bref the total quality of life (3.64 ± 0.29), the perception of quality of life (3.75 ± 0.44) and personal satisfaction (3.48 ± 0.80) presented good averages with a higher score in the psychological domain (4.74 ± 0.42) and lower in the environmental domain (3.71 ± 0.35). Total quality of life presented a better score, in which they reported receiving from four to six minimum wages (p = 0.03), for those who believe that their work environment poses health risks (p = 0.03), in those who reported not to get tired in the work environment (p <0.001) and in those who practiced physical activity (p = 0.020). Total quality of life and physical domain were affected in all results correlating with musculoskeletal symptoms. Conclusion: Musculoskeletal symptoms directly affect the quality of life of primary school teachers in the municipality of Guanambi. / Objetivo: Analisar a correlação entre os sintomas osteomusculares e a qualidade de vida de professores do ensino fundamental da rede pública da cidade de Guanambi, Bahia. Métodos: Trata-se de estudo transversal analítico com abordagem quantitativa. A pesquisa foi realizada com 52 professores do ensino fundamental do município de Guanambi/BA. Foram utilizados os seguintes instrumentos: Questionário sociodemográfico ocupacional, Questionário Nórdico de Sintomas Osteomusculares (QNSO), Instrumento de avaliação da qualidade de vida – WHOQOL-Bref. Resultados: O perfil sociodemográfico ocupacional demonstrou predominância do sexo feminino (96.2%), a maioria (88,5%) com jornada de trabalho de 40 horas semanais e com 92,3% possuindo pós-graduação. Um total de 96,2% entendeu que seu trabalho tem risco à saúde e 65,4% afirmou que se cansa com frequência. Houve alta prevalência de sintomas osteomusculares (84,6%), principalmente em quatro partes do corpo: joelho, coluna lombar, ombro e pescoço. Também os afastamentos foram devido à essas mesmas partes. Na análise estatística dos sintomas osteomusculares em correlação ao perfil sociodemográfico ocupacional houve relação significativa entre o afastamento e se sentir cansado no trabalho (p = 0,04), evidenciando que quanto mais o sentimento de cansaço maior foi o escore de afastamento por problemas osteomusculares. No Whoqol-bref a qualidade de vida total (3,64 ±0,29), a percepção da qualidade de vida (3,75 ±0,44) e a satisfação pessoal (3,48 ±0,80) apresentaram boas médias com maior escore no domínio psicológico (4,74±0,42) e menor no domínio ambiental (3,71±0,35). A qualidade de vida total apresentou melhor escore, nos que afirmaram receber de quatro a seis salários mínimos (p = 0,03), para os que entendem que seu ambiente laboral possui riscos à saúde (p = 0,03), naqueles que referiram não se cansar no ambiente de trabalho (p < 0,001) e nos que praticavam atividade física (p = 0,020). A qualidade de vida total e o domínio físico foram afetados em todos os resultados de correlação com os sintomas osteomusculares. Conclusão: Os sintomas osteomusculares afetam diretamente a qualidade de vida dos professores do ensino fundamental do município de Guanambi.

Fatigue secondary to chronic illness (FSCI) is a common experience in individuals with chronic conditions, with fatigue impacting on performance of daily activities and health-related quality of life (HRQoL). Due to the higher prevalence of FSCI in women, they may experience even greater disruption to roles and activity engagement. The literature consistently points to three main aspects when defining fatigue regardless of diagnoses; a physical aspect, a psychological aspect, and the impact on activity and participation. Research into the first two aspects has demonstrated relationships between fatigue, pain, depression, and social support. However, examination of the third aspect has been largely overlooked with respect its relationship to, and impact on, fatigue. Leisure theorists have hypothesized that engagement in leisure activities makes a positive contribution to physical and mental health. Previous research has measured leisure activities based on frequency of, or satisfaction with, participation. While some research has shown that physical and social activities have positive health benefits, gaps still exist in understanding the relative contribution of different types of leisure participation to fatigue and HRQoL.For example, little research has examined the contributions of leisure participation and leisure satisfaction to HRQoL and fatigue in women with chronic conditions. One explanation for the lack of research may be the absence of measurement tools developed to classify and quantify participation in different types of leisure activities for women with FSCI. Without a measurement tool, the relative contribution of participation in different activities (by frequency and/or satisfaction) to fatigue and HRQoL cannot be examined. / This PhD research aimed to fill the current gaps in understanding different types of leisure participation in related to fatigue and HRQoL. It sought to address two component parts: development and testing of the Classification of Leisure Participation (CLP) Scale; and an examination of the contribution of leisure participation to fatigue and HRQoL in women with FSCI.

Due to advances in detection and treatment, increasing numbers of women are diagnosed with, and surviving, breast cancer each year, making women with breast cancer one of the largest groups of cancer survivors. Hence, ensuring good healthrelated quality of life (HRQoL) following treatment has become a focal point of cancer research and clinical interest. While our understanding about the impact of breast cancer is improving, little is known about the HRQoL among survivors in non-urban areas. This is important locally, as 45% of breast cancer survivors in Queensland, Australia, live outside major metropolitan areas. Therefore, this study investigated the HRQoL and accompanying correlates among regional and rural breast cancer survivors, and made comparisons with urban breast cancer survivors as well as women from the general population without a history of breast cancer. Three population-based studies comprise this project. Original data were collected by way of self-administered questionnaire from 323 women, diagnosed with a first, primary, invasive, unilateral breast cancer during 2006/2007 and residing in regional or rural areas of Queensland, 12 months following diagnosis. HRQoL was assessed using the Functional Assessment of Cancer Therapy, Breast plus additional concerns (FACT-B+4) questionnaire. Data from two existing data sources were also utilised. Women diagnosed with a first, primary, invasive, unilateral breast cancer in 2002 and residing within 100kms of Brisbane provided information on HRQoL, measured by the FACT-B+4, via self-administered questionnaire at six (n=287), 12 (n=277) and 18 (n=272) months post-diagnosis. Data at 12 months post-diagnosis was utilised for comparison with region and rural women with breast cancer. General population data for HRQoL, collected by self-administered questionnaire in 2004 using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, were derived from a subgroup of female residents without a history of breast cancer from urban (n=675), regional (n=184) and rural (n=281) Queensland. The two studies involving women with breast cancer were recruited sequentially through the Queensland Cancer Registry, whereas the study involving the general population used telephone survey methods initially to identify participants. Women who participated in all studies were aged between 30 and 74 years. Raw scores for overall HRQoL (FACT-B+4, FACT-G) and subscales were computed. According to developers of the instrument, raw score differences of eight points between groups on the FACT-B+4 scale and five points on the FACT-G scale reflect a clinically meaningful differences in HRQoL. Age-adjusted, mean HRQoL was similar between regional and rural women with breast cancer 12 months following diagnosis (e.g., FACT-B+4: 122.9 versus 123.7, respectively, p=0.74). However, younger regional and rural survivors reported lower HRQoL scores compared with their older counterparts (e.g., FACT-B+4: 112.0 and 115.8 versus 129.3 and 126.2, respectively, p<0.05 for all). In addition to age, other important correlates of lower overall HRQoL (FACT-B+4) among regional/rural breast cancer survivors included: receiving chemotherapy, reporting complications post-surgery, poorer upper-body function than most, higher amounts of stress, reduced coping, being socially isolated, not having a confidante for social-emotional support, unmet healthcare needs, and low self-efficacy. Multiple linear regression analysis was used to address the hypothesis regarding similarity of HRQoL following breast cancer among women residing in regional and rural locations. After adjusting for the above factors, there was no statistically significant or clinically important difference in overall HRQoL (FACT-B+4) between regional and rural women with breast cancer 12 months following diagnosis (122.1 versus 125.1, respectively, p=0.07). Data from regional and rural women were pooled, based on the above analyses, and compared with urban women. Multiple linear regression analysis was used to test the hypothesis that HRQoL following breast cancer among women residing in regional/rural locations would be lower than that reported by women residing in urban locations. Potential confounders of the association between overall HRQoL (FACT-B+4) and place of residence included: marital status, upper-body function, amount of stress and perceived handling of stress. After adjusting for factors that differed between urban and regional/rural survivors, overall HRQoL (FACT-B+4) was lower among younger regional/rural survivors than their urban peers, and the findings were both statistically significant and clinically important (115.3 versus 123.7, respectively, p=0.001). Older women reported similar mean HRQoL, regardless of regional/rural or urban residence (128.2 versus 131.6, respectively, p=0.03). Further multiple linear regression analyses were undertaken to investigate whether women with breast cancer would report HRQoL equivalent to that reported by similarly-aged women in the general population. After adjusting for potential confounding factors that are known or suspected risk factors for breast cancer (age, marital status, education level, private health insurance, smoking status, physical activity, body mass index, co-morbidities), overall HRQoL (FACT-G) among breast cancer survivors was comparable to the general population 12 months following diagnosis (urban: 88.0 versus 86.9, respectively, p=0.28; regional/rural: 86.2 versus 85.8, respectively, p=0.79). However, 26% of survivors experienced worse overall HRQoL (FACT-G) compared with normative levels. HRQoL subscales contributing most to this deficit were physical well-being, with 29% of breast cancer survivors reporting scores below the norm, and emotional well-being among younger women, with 46% reporting scores below the norm. Logistic regression analysis was used to identify subgroups of breast cancer survivors who reported HRQoL below normative levels; reporting poorer upper-body function than most and not handling stress well increased the odds of reporting overall HRQoL (FACT-G: odds ratios (ORs) = 4.44 and 4.24, respectively, p<0.01 for both), physical well-being (ORs = 5.93 and 2.92, respectively, p<0.01 for both) and emotional well-being (among younger women: ORs = 2.81 and 5.90, respectively, p<0.01 for both) below normative levels. The cross-sectional nature of the study design for regional and rural breast cancer survivors, and the potential selection and response biases in all three studies, represent the main limitations of this work. The cross-sectional design precludes causal inference about observed associations, but even characterising relevant correlates allows for adjustment of potential confounding and provides insight into factors that may be important in contributing to HRQoL among breast cancer survivors. Moreover, the potential impact of the latter limitations is in the conservative direction, whereby differences in HRQoL between groups will be more difficult to identify. Since these biases are expected to be present to a similar degree across all study groups, the absolute difference in HRQoL by residence and cancer status observed are likely to exist. In contrast, the work is supported by a population based, state-wide sample of breast cancer survivors, comparisons with the general population, and use of standardised instruments. Therefore, the conclusions derived from this research are likely to be generalisable to the wider population of women in Queensland with unilateral breast cancer, aged 74 years or younger, and perhaps to similar women in other western countries, depending on variations in healthcare systems and the provision of oncology services. This research supports the initial supposition that while some findings may generalise to all breast cancer survivors, non-urban breast cancer survivors also have distinct experiences that influence their HRQoL. Results from this work highlight the HRQoL domains and characteristics of breast cancer survivors most in need of assistance to facilitate recovery following diagnosis and treatment. Characteristics include some already established and reconfirmed here, namely, emotional wellbeing among younger women, and other novel subgroups, including regional/rural survivors who receive chemotherapy or have a low self-efficacy and all survivors, regardless of residence, with upper-body problems or a low perception of handling stress. These results demonstrate the potential for identifying subgroups of women with breast cancer at risk for low HRQoL who may benefit from additional attention and possible tailored recovery interventions to increase their overall HRQoL. As such, researchers and clinicians need to consider the role of these factors when designing interventions to assist women as they deal with the challenges imposed upon them by their breast cancer. However, it was found here that the FACT-G instrument has ceiling effects. This means that positive changes reflecting improved status, such as those achieved through recovery interventions, will often fail to be measured appropriately if there is no room to indicate improvements. Overall HRQoL results indicated that there is room for improvement past 12 months following treatment, with a significant proportion of breast cancer survivors reporting HRQoL below normative levels. HRQoL concerns 12 months following diagnosis are likely to be distinct from the more acute issues reported earlier on in the literature. Therefore, the development of a cancer survivorship module to accompany the FACT-G would be useful to counteract the ceiling effects observed as well as to capture issues distinct to cancer survivorship. This is the first study to describe in detail the HRQoL of breast cancer survivors across all areas of Queensland and to compare it to the HRQoL reported by the general population of Queensland. Therefore, it represents a unique and substantial contribution to the existing knowledge on survivorship issues following diagnosis and treatment for breast cancer in Australia. Through this research, a number of questions remain that could be addressed by relevant investigations and which are likely to be important in the future to ultimately guide practice. Specifically, implementation of the concept of HRQoL in practice is the next important step forward. Furthermore, the development of a survivorship care plan that incorporates guidelines on HRQoL recovery could provide options for referral and support.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol inst., 2004. / Härtill 5 uppsatser.

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.