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BACKGROUND:Available measures of patient-reported outcomes for complementary and alternative medicine (CAM) inadequately capture the range of patient-reported treatment effects. The Self-Assessment of Change questionnaire was developed to measure multi-dimensional shifts in well-being for CAM users. With content derived from patient narratives, items were subsequently focused through interviews on a new cohort of participants. Here we present the development of the final version in which the content and format is refined through cognitive interviews.METHODS:We conducted cognitive interviews across five iterations of questionnaire refinement with a culturally diverse sample of 28 CAM users. In each iteration, participant critiques were used to revise the questionnaire, which was then re-tested in subsequent rounds of cognitive interviews. Following all five iterations, transcripts of cognitive interviews were systematically coded and analyzed to examine participants' understanding of the format and content of the final questionnaire. Based on this data, we established summary descriptions and selected exemplar quotations for each word pair on the final questionnaire.RESULTS:The final version of the Self-Assessment of Change questionnaire (SAC) includes 16 word pairs, nine of which remained unchanged from the original draft. Participants consistently said that these stable word pairs represented opposite ends of the same domain of experience and the meanings of these terms were stable across the participant pool. Five pairs underwent revision and two word pairs were added. Four word pairs were eliminated for redundancy or because participants did not agree on the meaning of the terms. Cognitive interviews indicate that participants understood the format of the questionnaire and considered each word pair to represent opposite poles of a shared domain of experience.CONCLUSIONS:We have placed lay language and direct experience at the center of questionnaire revision and refinement. In so doing, we provide an innovative model for the development of truly patient-centered outcome measures. Although this instrument was designed and tested in a CAM-specific population, it may be useful in assessing multi-dimensional shifts in well-being across a broader patient population.

Landstinget Västmanland genomför regelbundet enkätundersökningen Liv & hälsa ung Västerås som kartlägger hälsan bland ungdomar i årskurs nio i grundskolan och årskurs två i gymnasiet. Enkätundersökningen ska nästa gång genomföras i januari-februari år 2017 och landstinget vill ha underlag för hur de eventuellt kan utveckla sin undersökning för att unga hbtq [homosexuella, bisexuella, transpersoner, queera]-personer ska känna sig synliggjorda i den. Därför har syftet varit att undersöka hur unga hbtq-personer upplever undersökningen Liv & hälsa ung Västerås samt hur de upplever att den kan utvecklas. Detta har gjorts genom en kvalitativ undersökning som baseras på semistrukturerade intervjuer. Personerna som intervjuades var unga hbtq-personer under 26 år. Datamaterialet analyserades med stöd av manifest innehållsanalys. Resultatet av intervjuerna uppdagade att personerna inte kände sig representerade i enkätundersökningen då den upplevdes som begränsande och normativ avseende frågor och svarsmöjligheter. Utvecklingsmöjligheterna var att undersökningen kan bli mer inkluderande och att normmedvetenheten bör öka vilket kan ske genom förtydligande kring vilken definition som används på begrepp som samlag. Slutligen, om dessa förändringar genomförs skulle hbtq-ungdomarnas hälsa stärkas då målet att identifiera och uttrycka sig som de vill, kan uppnås. Som ökar möjligheterna till en god hälsa på lika villkor då rätt hälsoinsatser kan prioriteras när unga hbtq-personers förutsättningar framkommer. / The County Council of Västmanland regularly conducts the survey Liv & hälsa ung Västerås, which investigates the health of young people in the ninth grade in elementary school and the second grade in high school. The next survey will be conducted in January and February 2017. The County Council want to develop the questionnaire to raise the awareness of conditions affecting young lgbtq [lesbian, gay, bisexual, transgender, queer] –persons, and that is why these questions are now in focus. Therefore, the aim has been to investigate how young lgbtq-people experience the questionnaire Liv & hälsa ung Västerås and how they perceive that it can be developed. To answer the purpose, a qualitative study has been conducted and based on semi-structured interviews. The people interviewed are young lgbtq-people under the age of 26. Data were analyzed with a manifest content analysis. The result of the interviews revealed that people did not feel represented in the survey, as the questions and answers was perceived as restrictive and prescriptive. The development potential was that the questionnaire could be more inclusive, and that there is need for further clarification of certain terms (e.g. sexual intercourse). Finally, if these changes can be proceeded, the health of young lgbtq-people can be strengthened. If they can identify and express themselves as they wish, an improved access to high quality care, on equal terms, can be achieved. The right health interventions can be implemented and become a priority when the health conditions are visible to the county.

Development of motion abilities of women's volleyball players in the age from 14 to 15 years. Goal: The purpose was to found out, how trainers of pupil's categories are realizing the fitness preparation with category of "older women pupils " Methods: For collecting the datas was used Unstandardised Questionnaure (form) and also was used so called Half-Structurized Interview. For following processing and evaluation of collected datas from half-structurized form , we used Sector Diagram and Chart of Frequency, and also we used verbal summary for half-structurized interview. Results: We found out from processed datas that trainers are not realising evenly fitness preparation in training units . Trainers are not keeping rules of growth of motion abilities (universality, individuality, following compensation training). By some trainers we completely miss even their professional knowledge in the area of fitness development of youth . Key words: Volleyball - development of fitness abilities - training unit - Unstandardised Questionnaire - Half-Structurized Interview

Introdução: As grandes perdas de maxila condicionam grande defeito oral que afetam a qualidade de vida do paciente em diversos domínios. Porém, não há na literatura um questionário específico para esta condição. Proposição: Desenvolver e validar um instrumento de qualidade de vida para as grandes perdas de maxila sem envolvimento facial. Material e Método: Elaboração de um questionário piloto baseado nos achados de outros estudos e seleção de perguntas de instrumentos já existentes que trabalham com domínios semelhantes. Em seguida, clínicos avaliaram estas questões, que poderiam sugerir a inclusão e exclusão de questões. A seguir, pacientes pontuaram os itens gerados numa escala de 0 a 10 segundo a relevância e importância para redução de itens segundo o método de impacto. Por fim, dois pesquisadores agruparam os itens em domínios e se determinou a consistência interna pelo coeficiente alfa de Cronbach. Resultados e Discussão: O questionário preliminar contou inicialmente com 60 questões que, após a entrevista com pacientes, foi reduzido a 33. O alfa de Cronbach foi de 0,92 e os itens foram separados em oito domínios: relações sociais; fala e voz; alimentação; emocional; bem estar material; dor; estética; e halitose. Apenas uma questão, que não obteve índice de impacto suficiente, foi incluída devido aos achados de outros estudos e falta de outra pergunta similar. O instrumento gerado necessita de um processo de validação final. Conclusões: Obtenção de um questionário preliminar sobre qualidade de vida nas grandes perdas de maxila sem envolvimento facial com validade de conteúdo. / Introduction: Maxilla defects affect patients quality of life on several domains. There is not a specific instrument to this condition. Proposition: Develop and validate a disease-specific health related quality of life questionnaire for acquired maxilla defect. Materials and Methods: To elaborate a pilot questionnaire based on other studies results and select questions using instruments that deal with similar domains. Then, experts assessed these items and could suggest including or excluding questions. After that, patients scored the items according to relevance and importance in order to reduce the number of questions using the impact method. At last, two researchers grouped the questions into domains and the internal consistency was calculated using the Cronbachs alpha coefficient. Results and Discussion: The pilot questionnaire contained 60 questions and after we performed the impact method it was reduced to 33 items. The Cronbachs alpha coefficient was 0,92. The researchers compiled the items into eight domains: social relationships; speech and voice; feeding; emotional; material wellbeing; pain; aesthetics ;and halitosis. Only one question did not reach the minimum impact score was included in the questionnaire due to findings in others studies and lack of a similar items. The preliminary instrument presented here needs to undergo a complete validation process in to assess the psychometric properties and to decide on the final version. Conclusions: A preliminary version of the instrument with content validity was obtained.

We live in a society where the individual is prioritised over the collective. Newspaper articles abound lamenting adolescents' lack of personal responsibility and social commentators are increasingly highlighting the need to recapture and interweave an agenda of personal responsibility into the social fabric. Personal responsibility has been defined as being accountable to oneself and the needs and well-being of others (Ruyter, 2002). Doherty (1998) has argued that there is an increasing trend in society to refuse accountability and to blame others for one's situation. Despite these assertions, there is little empirical research that has attempted to define and examine personal responsibility. This dissertation is about the role of personal responsibility in the lives of adolescents. The research program was divided into three studies utilising quantitative and qualitative research methods to answer four research questions. Study 1: How do adolescents and teachers understand 'personal responsibility?' Study 2: Can a quantitative questionnaire define and measure an adolescent's level of personal responsibility? Study 3: Can a program aimed at enhancing the personal responsibility level of adolescents be taught in a high school and demonstrate measurable effect? Is there a relationship between personal responsibility, emotional intelligence and self-esteem? Study 1 used focus groups to address research question 1. Four focus groups with a total of 20 Year 11 students, and two focus groups with a total of 10 teachers were conducted. The results revealed that key components of the personal responsibility variable were choices and consequences, behavioural control, thoughts and feelings, and consideration for others. This finding complemented the definition derived from the literature review. Additionally, the focus group data served to inform Study 2, the development of the Personal Responsibility Questionnaire and Study 3, the creation, implementation and evaluation of the Personal Responsibility Program. Study 2 involved examining appropriate literature, focus group data from Study 1, and related measures to create a quantitative measure assessing personal responsibility in adolescents. A 100-item measure was created and tested on more than 500 adolescents. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to determine a final 30-item Personal Responsibility Questionnaire with two factors (factor 1 - 'self control of emotion and thoughts' and factor 2 - 'self control of behaviour'). This measure was to serve in the evaluation of the Personal Responsibility Program. A fundamental aim of the study was to determine whether a Personal Responsibility Program could be implemented in a high school and demonstrate measurable effect. Study 3 involved the creation of the Personal Responsibility Program through examining other values-based education programs and the focus group data obtained in Study 1. Once created, the five-lesson program was implemented twice in one high school, with approximately half of the Year 11 students undertaking the first implementation (the experimental group), and the remaining Year 11 students completing the program during its second implementation (the control group). To assess whether the program had generated any changes in the adolescents' levels of personal responsibility, the Personal Responsibility Questionnaire developed in Study 2 was administered pre- and post-intervention to both the experimental and control groups. Additionally, the well-established constructs of emotional intelligence and self-esteem were assessed using the Emotional Intelligence Scale (Schutte et al., 1998) and the Rosenberg Self-Esteem Scale (Rosenberg, 1965) to determine potential relationships between these variables and to provide additional construct validity for the measure. The results from Study 3 revealed no significant findings on any variable at any time (pre- or post-intervention). Despite this finding, certain data trends were apparent between males and females across the experimental and control groups. Overall, females demonstrated slightly higher mean scores on emotional intelligence and personal responsibility than males, while males had slightly higher mean scores than females on self-esteem. In order to gather additional feedback about the program and the students' learning, qualitative data were gathered from the students and the teachers by completion of a feedback sheet at the end of each lesson and a teacher focus group interview after the first implementation of the Personal Responsibility Program. In relation to student learning, the qualitative data offered by the students showed that learning in the key areas targeted had occurred, with students reflecting on their growth and changing understandings about personal responsibility. With reference to the program, the students commented that the program was fun, interesting, relevant, valuable, and enabled them to learn new things about themselves. Feedback from the teachers highlighted that the students appeared to engage with the program, and that teaching it was rewarding. This research program has contributed to the literature by providing a theoretically and empirically derived definition of personal responsibility. The focus group process highlighted that personal responsibility could be understood and considered by adolescents due to the cognitive and moral sophistication that develops early in this developmental timeframe. Study 2 generated a Personal Responsibility Questionnaire that can be used to assess personal responsibility in adolescents, and Study 3 contributed a Personal Responsibility Program which has been developed from conceptual and empirical literature. The program was designed to be "teacher friendly' and allowed the schools to gather qualitative and quantitative feedback on the success of the program's implementation. As school administrators and teachers often lament the lack of personal responsibility in their students (Lickona, 1992), this program could be used to address this concern and put the issue of personal responsibility firmly on the agenda in high schools.

Introdução: As grandes perdas de maxila condicionam grande defeito oral que afetam a qualidade de vida do paciente em diversos domínios. Porém, não há na literatura um questionário específico para esta condição. Proposição: Desenvolver e validar um instrumento de qualidade de vida para as grandes perdas de maxila sem envolvimento facial. Material e Método: Elaboração de um questionário piloto baseado nos achados de outros estudos e seleção de perguntas de instrumentos já existentes que trabalham com domínios semelhantes. Em seguida, clínicos avaliaram estas questões, que poderiam sugerir a inclusão e exclusão de questões. A seguir, pacientes pontuaram os itens gerados numa escala de 0 a 10 segundo a relevância e importância para redução de itens segundo o método de impacto. Por fim, dois pesquisadores agruparam os itens em domínios e se determinou a consistência interna pelo coeficiente alfa de Cronbach. Resultados e Discussão: O questionário preliminar contou inicialmente com 60 questões que, após a entrevista com pacientes, foi reduzido a 33. O alfa de Cronbach foi de 0,92 e os itens foram separados em oito domínios: relações sociais; fala e voz; alimentação; emocional; bem estar material; dor; estética; e halitose. Apenas uma questão, que não obteve índice de impacto suficiente, foi incluída devido aos achados de outros estudos e falta de outra pergunta similar. O instrumento gerado necessita de um processo de validação final. Conclusões: Obtenção de um questionário preliminar sobre qualidade de vida nas grandes perdas de maxila sem envolvimento facial com validade de conteúdo. / Introduction: Maxilla defects affect patients quality of life on several domains. There is not a specific instrument to this condition. Proposition: Develop and validate a disease-specific health related quality of life questionnaire for acquired maxilla defect. Materials and Methods: To elaborate a pilot questionnaire based on other studies results and select questions using instruments that deal with similar domains. Then, experts assessed these items and could suggest including or excluding questions. After that, patients scored the items according to relevance and importance in order to reduce the number of questions using the impact method. At last, two researchers grouped the questions into domains and the internal consistency was calculated using the Cronbachs alpha coefficient. Results and Discussion: The pilot questionnaire contained 60 questions and after we performed the impact method it was reduced to 33 items. The Cronbachs alpha coefficient was 0,92. The researchers compiled the items into eight domains: social relationships; speech and voice; feeding; emotional; material wellbeing; pain; aesthetics ;and halitosis. Only one question did not reach the minimum impact score was included in the questionnaire due to findings in others studies and lack of a similar items. The preliminary instrument presented here needs to undergo a complete validation process in to assess the psychometric properties and to decide on the final version. Conclusions: A preliminary version of the instrument with content validity was obtained.

Résumé : Dans le secteur médical, la nanovectorisation ciblée (NVC) est susceptible de lever de nombreux verrous technologiques en matière de traitements médicaux. L’absence d’une démarche axée sur les impacts possibles, l’acceptation et l’acceptabilité de la NVC pourrait toutefois conduire à un manque d’adéquation entre les applications développées et les besoins et valeurs des utilisateurs, freinant ultimement leur déploiement. Sur la base d’un modèle interdisciplinaire d’analyse d’impact et d’acceptabilité, les variables de perception des impacts, d’acceptation d’acceptabilité ont été opérationnalisées et étudiées au regard de la nature du nanovecteur, du contexte d’usage clinique et de la culture disciplinaire et sociale des répondants. L’exploration des impacts perçus, mobilisés et pondérés sur un ensemble d’enjeux éthiques, économiques, environnementaux, légaux et sociaux (E[indice supérieur 3]LS) a permis d’établir un premier portrait de l’acceptabilité de cette application. Une approche descriptive-exploratoire fondée sur un devis mixte avec triangulation séquentielle des données a été employée. Les données ont été collectées en deux phases, d’abord par le biais d’un questionnaire en ligne (n=214), puis par des entrevues individuelles semi-dirigées (n=22). Une recension des scientifiques actifs du secteur des technologies émergentes œuvrant en sciences naturelles et ingénierie ainsi qu’en sciences humaines et sociales a permis de former l’échantillon final composé de chercheurs Français et Québécois. L’opérationnalisation du cadre de référence a permis de montrer l’importance de distinguer le dispositif et les usages lors de la formulation du jugement d’acceptabilité, relevant parallèlement une influence du contexte d’usage sur l’acceptabilité des applications de NVC. Des variations disciplinaires et sociales quant aux jugements d’acceptabilité ont aussi été soulevées, soulignant des sensibilités culturelles relativement aux éléments mobilisés dans le jugement d’acceptabilité. Ces distinctions relatives à la manière d’appréhender la NVC invitent à dépasser les approches traditionnelles d’acceptation technologiques et à converger vers une approche d’acceptabilité axée sur les impacts perçus et valorisés relativement à un ensemble d’enjeux E[indice supérieur 3]LS. Les résultats des deux phases de l’étude ont aussi montré que l’opérationnalisation du cadre théorique de référence était adéquate pour arriver à cette fin. Ultimement, afin de prendre en compte et de comprendre l’étendue possible des impacts perçus et valorisés dans le jugement d’acceptabilité de l’ensemble des acteurs concernés par les nouvelles applications nanomédicales, l’élaboration de ces applications bénéficierait à employer une telle approche et à l’intégrer aux processus de développement technologique. / Abstract : In many medical fields, nanocarrier-based targeted drug-delivery (TDD) is likely to remove many technical obstacles regarding treatment. The lack of an approach based on variables such as potential impacts, acceptance, and acceptability could however lead to a mismatch between TDD applications being developed and users’ needs and values; this mismatch could ultimately hold back their deployment. Based on an interdisciplinary approach for the analysis of impact and acceptability of emerging technologies, three main concepts of a new theoretical framework—perceived impacts, acceptance, and acceptability—have been operationalized. This operationalisation has been studied in the light of several variables, namely the nature of the nanocarrier, the clinical context of use, and the disciplinary and social culture of the respondents. An exploration of the impacts perceived, mobilized and weighted, based on a set of ethical, economic, environmental, legal and social (E[superscript 3]LS) issues allowed to establish a first portrait of the acceptability of this application. A descriptive-exploratory approach based on a mixed-methods design with sequential data triangulation was used. The data were collected in two phases, first through an online questionnaire (n = 214), and then through semi-structured individual interviews (n = 22). The final sample was composed of French and French-Canadian researchers involved in themes related to emerging technologies, all from natural sciences and engineering or from humanities and social sciences. The operationalisation of the theoretical framework highlighted the importance of distinguishing the device and the uses when formulating the acceptability judgment, revealing also the influence of the context of use on the acceptability of TDD applications. Disciplinary and social variations related to acceptability judgments were also raised, highlighting possible cultural sensitivities regarding elements mobilized in those acceptability judgments. These distinctions on how are apprehended TDD applications invite to go beyond traditional approaches of technology acceptance and to converge toward approaches of acceptability; those approaches also need to integrate how impacts on E[superscript 3]LS issues are perceived and weighted. The results of both phases of the study also showed that the operationalization of the theoretical framework was adequate to achieve that end. Ultimately, in order to figure and to understand the broad spectrum of possible impacts that may be perceived and valued in the acceptability judgment of stakeholders affected by the development of new nanomedical applications as TDD, the development process of those applications could benefit from integrating this approach.

With the introduction of universal newborn hearing screening (UNHS) the need for quality early hearing intervention (EHI) services became critical. Screening is but the avenue to EHI services. Without appropriate intervention infants with hearing loss are at risk for language delay which might subsequently adversely influence academic success and vocational choices later on in life. The numerous socio-economic, cultural and healthcare barriers associated with developing countries such as South Africa, do not negate or diminish the need for optimal outcomes for infants with hearing loss through quality EHI services. The principle of quality EHI services, aligned with international standards, is endorsed by the HPCSA (2003: 2). In order to assure quality in EHI, service evaluation is critical. The necessary first step when evaluating service provision is to measure current service delivery. The main aim of this study was to determine whether South African audiologists provide EHI and support services aligned with international professional best practice to infants following the diagnosis of hearing loss. The first part of this study reviews the evidence available in EHI. The guidelines derived from the international evidence were stated as benchmarks against which South African EHI services were measured. These benchmarks were categorised using the so-called six M variation categories. These categories are: Man, machine (equipment), method (systemaric procedures), measurements, material (amplification devices) and Mother Nature. During the empirical research a descriptive design was followed comprising of questionnaire surveys to audiologists in different working sectors rendering EHI services to infants with hearing loss. The questionnaire survey explored the nature and scope of the EHI services offered to infants with hearing loss with regard to all the components (categorised in the six M categories) of the EHI programme of 40 South African audiologists. The results of this study indicate that respondents often do not use evidence-based measurements or methods during EHI services. Results suggest that undergraduate training in areas regarding the selection and fitting of amplification to infants with hearing loss is often inadequate (>20 respondents indicated that they are not trained). Evidence-based measurements are not typically performed when fitting amplification to infants (29 respondents do not perform probe-microphone or elctroacoustic measurements). Many respondents indicated that they do not have the necessary equipment to do these measurements. EHI services often (50% of respondents) do not provide A/R directly, but refer to other team members. From the results there seems to be significant delays in the rendering of EHI services to infants with hearing loss. Financial constraints of the family of the infants, accessibility problems, as well as a lack of infant support from their families often influence the EHI programmes of respondents. The implications of this study were discussed. Recommendations include the development of South African guidelines, aligned with international guidelines but taking into account the challenges posed by the unique South African context. Other recommendations include: Centres of excellence, relevant continuing education programmes and the evaluation of undergraduate training programmes. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / M (Communication Pathology) / unrestricted

No description available.