Introdução: O diagnóstico baseado unicamente na avaliação quantitativa dos sintomas e seu curso muitas vezes não é suficiente para o trabalho em psicoterapia psicodinâmica. Apesar disso, a literatura sobre diagnóstico psicodinâmico ainda é escassa, assim como os estudos empíricos na área. O Operationalized Psychodynamic Diagnosis-2 (OPD-2) tem o objetivo de ampliar o diagnóstico tradicional através da operacionalização de informações psicodinâmicas fundamentais para a compreensão dos fenômenos subjacentes à sintomatologia clínica. A construção multi-axial do OPD-2 possibilita que se abarque a complexidade e a inter-relação das condições e fatores que determinam os fenômenos e as patologias mentais do ponto de vista psicodinâmico. O OPD-2 é composto por 4 eixos psicodinâmicos e 1 eixo descritivo: I: vivência da doença e pré-requisitos para o tratamento; II: Relações interpessoais; III: Conflito psíquico; IV: Estrutura psíquica; V: Diagnóstico nosológico tradicional. Apesar de ser amplamente utilizado em vários países ainda não foram realizados estudos com o OPD-2 no Brasil. Objetivos: Esta dissertação apresenta a versão brasileira do OPD-2 e os estudos de validade de conteúdo, concordância inter-avaliadores e validade concorrente do instrumento. Método: A versão brasileira do instrumento foi criada através da adaptação da versão portuguesa. A avaliação do conteúdo do instrumento foi realizada por experts em psicoterapia psicodinâmica. A concordância inter-avaliadores foi avaliada utilizando-se 51 entrevistas de psicoterapia psicodinâmica. A validade concorrente comparou os itens do OPD-2 com os resultados do The World Health Organization Quality of Life - abbreviated version (WHOQOL-bref) e o Symptom Check-List-90-Revised (SCL-90R). Resultados: A avaliação de conteúdo considerou os itens claros quanto a linguagem e pertinentes teoricamente. Os eixos III e IV apresentaram maior índice de concordância inter-avaliadores. Os eixos I, III e IV obtiveram correlação significativa entre alguns itens com os resultados do SCL-90R e WHOQOL-bref. Conclusão: Este estudo demonstrou que o OPD-2 apresenta boas condições de avaliação de propriedades psicodinâmicas. Outros estudos com diferentes amostras e instrumentos devem ser realizados para verificação das propriedades psicométricas do OPD-2 no Brasil. / Background: Diagnoses based upon quantification of symptoms and their course is less suitable to psychodynamic psychotherapy, yet psychodynamic diagnoses are rarely scrutinized scientifically. The Operationalized Psychodynamic Diagnosis-2 seeks to enhance traditional diagnostic schemes through the operationalization of psychodynamic data relevant to the comprehension of psychological phenomena underlying clinical symptomatology. The multi-axial framing of OPD-2 allows the incorporation of the complexity and the inter-relations of conditions and factors determining mental phenomena and pathology from a psychodynamic perspective. OPD-2 has 4 psychodynamic and 1 descriptive axis: I: experience of illness and prerequisites for treatment; II: Interpersonal relations; III: Conflict ; IV: Structure ; V: Mental and psychosomatic disorders. Although largely used in a number of countries, there have been no studies with OPD-2 in Brazil. Objectives: We aimed to present the Brazilian version of OPD-2 and determine the content validity, inter-rater reliability and concurrent validity of the psychodynamic itens of the instrument. Methods: Experts in psychodynamic psychotherapy evaluated content and the inter-rater reliability was based on 51 dialogued interviews obtained during routine clinical practice in a specialized institution. Concurrent validity compared OPD-2 items with results from the World Health Organization Quality of Life - abbreviated version (WHOQOL-bref) and the Symptom Check-List-90-Revised (SCL-90-R). Results: Evaluation of content considered OPD-2 items as clear and theoretically pertinent. Axes III and IV had higher inter-rater concordance. Several items from axes I, III and IV correlated significantly with the SCL-90R and the WHOQOL-bref. Conclusion: OPD-2 is adequate to evaluate psychodynamic properties. Further studies with the OPD-2 in Brazil evaluating different samples and using distinct comparator instruments are needed to confirm and extend our findings.

Introdução: O diagnóstico baseado unicamente na avaliação quantitativa dos sintomas e seu curso muitas vezes não é suficiente para o trabalho em psicoterapia psicodinâmica. Apesar disso, a literatura sobre diagnóstico psicodinâmico ainda é escassa, assim como os estudos empíricos na área. O Operationalized Psychodynamic Diagnosis-2 (OPD-2) tem o objetivo de ampliar o diagnóstico tradicional através da operacionalização de informações psicodinâmicas fundamentais para a compreensão dos fenômenos subjacentes à sintomatologia clínica. A construção multi-axial do OPD-2 possibilita que se abarque a complexidade e a inter-relação das condições e fatores que determinam os fenômenos e as patologias mentais do ponto de vista psicodinâmico. O OPD-2 é composto por 4 eixos psicodinâmicos e 1 eixo descritivo: I: vivência da doença e pré-requisitos para o tratamento; II: Relações interpessoais; III: Conflito psíquico; IV: Estrutura psíquica; V: Diagnóstico nosológico tradicional. Apesar de ser amplamente utilizado em vários países ainda não foram realizados estudos com o OPD-2 no Brasil. Objetivos: Esta dissertação apresenta a versão brasileira do OPD-2 e os estudos de validade de conteúdo, concordância inter-avaliadores e validade concorrente do instrumento. Método: A versão brasileira do instrumento foi criada através da adaptação da versão portuguesa. A avaliação do conteúdo do instrumento foi realizada por experts em psicoterapia psicodinâmica. A concordância inter-avaliadores foi avaliada utilizando-se 51 entrevistas de psicoterapia psicodinâmica. A validade concorrente comparou os itens do OPD-2 com os resultados do The World Health Organization Quality of Life - abbreviated version (WHOQOL-bref) e o Symptom Check-List-90-Revised (SCL-90R). Resultados: A avaliação de conteúdo considerou os itens claros quanto a linguagem e pertinentes teoricamente. Os eixos III e IV apresentaram maior índice de concordância inter-avaliadores. Os eixos I, III e IV obtiveram correlação significativa entre alguns itens com os resultados do SCL-90R e WHOQOL-bref. Conclusão: Este estudo demonstrou que o OPD-2 apresenta boas condições de avaliação de propriedades psicodinâmicas. Outros estudos com diferentes amostras e instrumentos devem ser realizados para verificação das propriedades psicométricas do OPD-2 no Brasil. / Background: Diagnoses based upon quantification of symptoms and their course is less suitable to psychodynamic psychotherapy, yet psychodynamic diagnoses are rarely scrutinized scientifically. The Operationalized Psychodynamic Diagnosis-2 seeks to enhance traditional diagnostic schemes through the operationalization of psychodynamic data relevant to the comprehension of psychological phenomena underlying clinical symptomatology. The multi-axial framing of OPD-2 allows the incorporation of the complexity and the inter-relations of conditions and factors determining mental phenomena and pathology from a psychodynamic perspective. OPD-2 has 4 psychodynamic and 1 descriptive axis: I: experience of illness and prerequisites for treatment; II: Interpersonal relations; III: Conflict ; IV: Structure ; V: Mental and psychosomatic disorders. Although largely used in a number of countries, there have been no studies with OPD-2 in Brazil. Objectives: We aimed to present the Brazilian version of OPD-2 and determine the content validity, inter-rater reliability and concurrent validity of the psychodynamic itens of the instrument. Methods: Experts in psychodynamic psychotherapy evaluated content and the inter-rater reliability was based on 51 dialogued interviews obtained during routine clinical practice in a specialized institution. Concurrent validity compared OPD-2 items with results from the World Health Organization Quality of Life - abbreviated version (WHOQOL-bref) and the Symptom Check-List-90-Revised (SCL-90-R). Results: Evaluation of content considered OPD-2 items as clear and theoretically pertinent. Axes III and IV had higher inter-rater concordance. Several items from axes I, III and IV correlated significantly with the SCL-90R and the WHOQOL-bref. Conclusion: OPD-2 is adequate to evaluate psychodynamic properties. Further studies with the OPD-2 in Brazil evaluating different samples and using distinct comparator instruments are needed to confirm and extend our findings.

Problem Statement: Because of the lack of evidence in support of a pathology-based approach to low back pain (LBP), many researchers advocate the use of classification systems that classify patients with LBP based on common clinical characteristics. Treatment based on direction tolerance can improve circulation, diminish pain and inflammation, restore normal motion, and reduce fear-avoidance beliefs. Treatment performed in the standing position can functionally integrate related regions of the body, can replicate normal tissue loading in standing position, replicate normal proprioceptive demands of motion performed in standing position, and address underlying movement impairments in related regions that may contribute to compensatory tissue pathology in the low back. The problem is that none of the existing functional classification systems for evaluation and treatment of LBP are designed for this purpose. The Direction Tolerance System (DTS) is a new functional classification system that is based on direction tolerance and performed entirely in the standing position. Objectives: The purpose of this research was to investigate the reliability, outcome, and prognostic ability of the DTS for evaluation and treatment of LBP. Methods: This exploratory research was a prospective cohort study with 60 patients seeking physical therapy (PT) for treatment of LBP by 5 different therapists. All patients were evaluated and treated for 8 visits using the DTS. Reliability was measured by comparing DTS scores (DTI) on visits 1 and 2. DTS treatment consisted of a scripted flexibility and strengthening exercise program based on motions that were determined to be non-aggravating during the DTS examination. Outcome was assessed using the DTI, modified Oswestry Disability Questionnaire (ODQ), Numeric Pain Rating Scale (NPRS) and Fear-Avoidance Beliefs Questionnaire Physical Activity Subscale (PABQ-PA). Baseline variables were assessed for correlation with successful outcome and ability to predict a successful outcome. Results: (1) Group intra-rater reliability between visits 1 and 2 using ICC (3,1) was good (.80, p<.001); (2) The group success rate was 62%, which exceeded the expected 50% success rate. (3) Baseline variables were not associated with a successful outcome and did not significantly predict a successful outcome. Discussion: The DTS is a simple, reliable and effective method of evaluating and treating LBP, and with proper training, can be used by clinicians.

No description available.

No description available.

This project investigates the extent to which EFL teachers’ assessment practices of two students’ written texts differ in a Swedish upper-secondary school. It also seeks to understand the factors influencing the teachers regarding inter-rater reliability in their assessment and marking process. The results show inconsistencies in the summative grades given by the raters; these inconsistencies include what the raters deem important in the rubric; however, the actual assessment process was very similar for different raters. Based on the themes found in the content analysis regarding what perceived factors affected the raters, the results showed that peer-assessment, assessment training, context, and time were of importance to the raters. Emerging themes indicate that the interpretation of rubrics, which should actually matter the most when it comes to assessment, causes inconsistencies in summative marking, regardless of the use of the same rubrics, criteria and instructions by the raters. The results suggest a need for peer-assessment as a tool in the assessment and marking of students’ texts to ensure inter-rater reliability, which would mean that more time needs to be allocated to grading.

Purpose: The purpose of this study was to determine the usefulness of SBAR-cued web-based communication skills training and address study participants' perceptions of the training. Specific Aims: Evaluate the usefulness and accuracy of participants to answer prompts of SBAR-cued communication responses. Describe individuals' perspectives of the acceptability of using SBAR patient-HCP communication simulation to better prepare for ED visits during a SCC. Framework: This study was guided by The Theory of Self-Care Management for Sickle Cell Disease (SCMSCD). Design: A secondary analysis was conducted using a qualitative descriptive approach. Inter-rater reliability (IRR) of qualitative data was used to evaluate the usefulness and accuracy of participants to answer prompts of SBAR-cued communication responses. Content analysis was also utilized to describe individuals' perspectives of the acceptability of using SBAR patient-HCP communication simulation to better prepare for ED visits during a SCC. Results: IRR between raters ranged from 64%-94% with predominant themes of (1) Patient-Provider Communication and Interaction, (2) Patients want to be Heard and Believed, (3) Accuracy of the ED Experience and Incorporating the Uniqueness of each Patient and (4) Overall Usefulness of the Video Trainer emerging. Conclusions: This secondary analysis supported how SBAR can be effectively used to assist patients in a SCC to communicate with their HCP. Participants' responses indicated the training module facilitated communication between patients and HCPs.

In spite of growing scholarship on environmentally induced non-migration research in Africa, comprehensive empirical evidence of non-migration drivers is extremely difficult to find. We review 77 rigorously selected empirical articles on the drivers of environmental non-migration. A variety of relevant keywords was applied to search, identify, and select key publications from ScienceDirect, Web of Knowledge, Google Scholar, and the Climig databases. Content analysis and inter-rater reliability (IRR) analysis were used to summarize the literature and identify key drivers of environmental non-migration decisions across all retained articles. The study structure was informed by the Foresight (2011a) conceptual framework. A growth in the non-migration literature across the time period was observed. Social factors, particularly place-based attachment and family/cultural obligations, was identified as the most important driver of non-migration (IRR score = 0.67). Environmental factors were ranked second, particularly the ability of the affected to develop coping capacity through experiential learning even in contexts marred by resource scarcity and widespread poverty. Given the limited literature on environmental nonmigration decisions, we recommend increased non-migration research across Africa to better inform policy decisions. This is particularly important as climate-related disasters surge. Frequent reviews on diverse aspects of non-migration studies are recommended to redefine future research and non-migration policy considerations in Africa.

No description available.

<p>Introduction</p> <p>The most common complication following invasive cardiac procedures is the development of vascular access site (VAS) bruising. The extent and impact of VAS bruising is poorly understood and minimally reported in the literature. Research into this common post-procedure complication is hindered by the lack of a reliable bruise measurement tool, and the concept that VAS bruising is a minor complication. This mixed methods study examined the inter-rater reliability of two methods to measure VAS bruise size. The embedded qualitative descriptive study explored patient perceptions of VAS bruising.</p> <p>Methods</p> <p>Participants having femoral or radial artery puncture for invasive cardiac procedures were included in this study. Participants reporting VAS bruising completed self measurement of bruise size using two methods, linear measurement and planimetry. The principal investigator and research assistant completed bruise measurements at the same time, and were blinded to participant and each others’ measurements. Following bruise measurement, the principal investigator conducted semi-structured interviews on a convenience sample of participants; including both sexes, a range of ages, and bruise sizes.</p> <p>Results</p> <p>Measurements were completed on 40 participants with VAS bruises. Analysis of inter-rater reliability was done using the intraclass correlation coefficient (ICC), two-way random effects model. The inter-rater reliability for both linear measurement and planimetry between all three measurers was high (.929; .914 respectively). Analysis of participant narratives uncovered three major themes concerns, impact and mediating factors, with several sub-themes.</p> <p>The findings of this study support the reliability of patient VAS bruise measurement using linear measurement and planimetry. The goals and available resources for VAS research may determine the choice of measurement approach. Qualitative descriptive results indicate that patients have concerns related to VAS bruising and that this bruising may impact activities of daily living. Future research examining VAS complications should include evaluation of VAS bruising as significant patient outcome.</p> / Doctor of Philosophy (PhD)