INTRODUÇÃO: A discinesia ciliar primária é uma doença genética que se caracteriza pela alteração da ultraestrutura e função do cílio móvel, com consequentes alterações do transporte mucociliar, causando infecções das vias aéreas superiores, inferiores e infertilidade. O diagnóstico, realizado por avaliação da ultraestrutura ou pesquisa de mutação genética, é feito mediante critérios de seleção de pacientes e testes de screening. Esta pesquisa avalia a ultraestrutura e frequência de batimento ciliar, propõe um modelo de investigação de discinesia ciliar primária, e caracteriza os pacientes diagnosticados. MÉTODO: Foi realizado um estudo transversal controlado entre janeiro de 2007 e julho de 2009, no Ambulatório de Pneumologia Pediátrica do Instituto da Criança. Foram selecionadas 28 crianças e adolescentes (6 meses a 19 anos, de ambos os sexos), de uma população de 75 crianças com pneumopatias crônicas e de repetição sem diagnóstico definido, que apresentavam ao menos um dos seguintes achados: bronquiectasia de causa desconhecida, doença de vias aéreas superiores com sintomatologia crônica, infecções pulmonares de repetição, dextrocardia e/ou situs inversus acompanhados de sintomas em vias aéreas superiores e/ou inferiores, e asma de difícil controle com sintomas em vias aéreas superiores e/ou inferiores. A presença de pneumopatias crônicas com diagnóstico definido foi utilizada como critério de exclusão por meio dos seguintes exames: dois testes do suor (exclusão de fibrose cística), tomografia computadorizada do tórax (suspeita de bronquiolite obliterante), dosagem de alfa-1 antitripsina (investigação de déficit de alfa-1 antitripsina), e exames de investigação das imunodeficiências mais frequentes (hemograma, dosagens de imunoglobulinas, contagem de linfócitos T e B, sorologias para avaliação da produção ativa de anticorpos, PPD e HIV). Foi desenvolvido um sistema medição da frequência de batimento ciliar, baseado em análise espectral. Dez adultos voluntários saudáveis (maiores ou iguais a 17 anos, de ambos os sexos), sem doença infecciosa respiratória aguda no último mês e não fumantes, formaram o grupo controle para a frequência do batimento ciliar. Foi realizada a coleta ciliar por escovado nasal. A amostra foi dividida para a avaliação da ultraestrutura e verificação da frequência do batimento ciliar. Os pacientes diagnosticados foram avaliados com tomografia de tórax e seios da face (esta última nos maiores de cinco anos), provas de função pulmonar e avaliação otorrinolaringológica. RESULTADOS: Os 28 pacientes selecionados foram submetidos ao escovado nasal. Para 24 dos 28 pacientes foi possível produzir filmes passíveis de avaliação. O grupo com ultraestrutura alterada (diagnóstico de discinesia ciliar primária) mostrou diferença das médias da frequência de batimento ciliar em relação ao grupo com ultraestrutura normal (p<0,001) e em relação ao grupo controle (p<0,001). O grupo com ultraestrutura normal e o grupo controle, quando comparados entre si, também apresentaram diferenças (p<0,005). Foram diagnosticados 12 pacientes com discinesia ciliar primária: dois com ausência de braços externos de dineína, um com encurtamento dos braços externos de dineína, cinco com defeitos nas espículas radiadas e braços internos de dineína, três com defeitos de ausência do par central com transposição, e um com ultraestrutura normal (Kartagener). Os pacientes, sete homens e cinco mulheres, com predomíno da etnia branca (11 pacientes - 91,6%), eram na maior parte fruto de pais consanguíneos (8 pacientes - 66,6%). Sete dos 12 pacientes (58,3%) apresentaram situs inversus. Sete dos dez pacientes que realizaram as provas de função pulmonar (70%) apresentaram distúrbio ventilatório obstrutivo. Achados radiológicos: Dez pacientes (83,3%) apresentaram algum grau de colapso ou consolidação, 11 (91,6%) apresentaram bronquiectasias, e todos (100%) algum grau de espessamento brônquico. A avaliação otorrinolaringológica apontou alterações em seis pacientes (50%): pólipos em três pacientes (25%), otite secretora em dois (16,6%), desvio de septo em dois (16,6%), e esclerose do tímpano em um (8,3%). CONCLUSÃO: Foi padronizada a técnica do escovado nasal para a coleta de material ciliar. Foram estabelecidos critérios de uniformidade quanto à análise dos defeitos ultraestruturais ciliares, baseados em experiência internacional. Foi desenvolvido um novo método de medição da frequência de batimento ciliar baseado em metodologia de análise espectral e vídeos de alta velocidade. Os pacientes diagnosticados com discinesia ciliar primária foram caracterizados, sendo a maioria: da etnia branca, de pais consanguíneos, com predomínio dos defeitos de espículas radiadas e braços internos de dineína, situs inversus, e distúrbio ventilatório obstrutivo. Problemas otorrinolaringológicos foram encontrados em metade dos pacientes. / INTRODUCTION: Primary ciliary dyskinesia (PCD) is a genetic disorder of the ultrastructure and function of mobile cilia, with consequent impairment of mucociliary clearance, leading to upper and lower airways respiratory infection and infertility. The diagnosis, based on ultrastructure evaluation or genetic scan, is performed according to patient selection and screening tests. This research evaluates cilia ultrastructure and beat frequency, proposes a model for investigating primary ciliary dyskinesia, and characterizes the patients diagnosed.METHOD: A controlled and observational study was carried out at the Pediatric Pulmonology Ambulatory of the Instituto da Criança between January 2007 and July 2009. Twenty eight children and teenagers (ages between 6 months and 19 years) were selected, from a population of 75 patients with chronic and repetition pneumopathies without a defined diagnosis, which met at least one of the following inclusion criteria: bronchiectasis of unknown cause, upper respiratory disease with chronic symptoms, repetition pulmonary infections, dextrocardia and/or situs inversus with symptoms in upper and/or lower respiratory airways, and asthma of difficult control with symptoms in upper and/or lower respiratory airways. The presence of cronic pneumopathies with a defined diagnosis was used as exclusion criterion, based on the following exams: two sweat tests (cystic fibrosis exclusion), lung CT scan (bronchiolitis obliterans exclusion), seric levels of alpha-1 anti-trypsin (alpha-1 anti-trypsin deficit evaluation), and evaluation of more frequent immunodeficiency disorders (white blood cells, T and B lymphocytes levels, and sorology tests for humoral immunity, PPD and HIV). A cilia beat frequency measurement system was developed, based on spectral analysis. Ten healthy adult volunteers (ages greater than or equal to 17 years old, of both sexes), without an acute respiratory disease in the last month, and non-smoking, formed the control group for the cilia beat frequency measurements. Cilia samples were collected employing nasal brushing. The sample was divided for cilia ultrastructure evaluation and for cilia beat frequency measurement. Diagnosed patients were sent to lung and sinuses CT scan (> 5 years), pulmonary function tests and ear, nose and throat evaluation. RESULTS: For the 28 patients selected a nasal brushing was performed. For 24 of the 28 patients it was possible to make films suitable for evaluation. The average cilia beat frequency of the defective ultrastructure group (primary ciliary dyskinesia group) was different from the average frequency of the normal ultrastructure group (p<0.001) and from the control group (p<0.001). The average cilia beat frequency of the normal ultrastructure group was different from the average frequency of the control group (p<0.005). Twelve patients were diagnosed with primary ciliary dyskinesia: two with absence of outer dynein arm, one with a shortened outer dynein arm, five with radial spoke and inner dynein arm, three with absence of central par and transposition, and one with a normal ultrastructure (Kartagener). The patients, seven men and five women, were mostly white (11 patients 91.6%) and had parents who were relatives (eight patients 66.6%). Seven of the twelve patients (58.3%) had Situs inversus. Seven of the ten patients (70%) for whom pulmonary function tests were performed presented a ventilatory obstructive pattern. Radiological findings: Ten patients (83.3%) presented signs of consolidation or collapse, eleven patients (91.6%) had bronchiectasis, and 12 (100%) presented some degree of bronchial wall thickening. Otorhinolaryngologycal evaluation indicated impairments in 6 patients (50%): polips in three patients (25%), effusion otitis in two (16.6%), sept problems in two (16.6%) and timpanus sclerosis in one (8,3%). CONCLUSION: The nasal brushing technique was standardized for the collection of cilia. Uniform criteria for the analysis of ultrastructural cilia defects were established, based on international experience. A new method of cilia beat frequency measurement was developed, based on spectral analysis and high speed video images. Patients diagnosed with primary ciliary dyskinesia were characterized. The majority was white, had parents who were also relatives, had a prevalence of radial spoke and inner dynein arm defects, situs inversus, and ventilatory obstructive pattern. Otorhinolaryngologycal problems were found in 50% of the patients.

Background. Medical imaging has played an important role in the diagnosis, progress monitoring and follow-up of most disease entities, in particular chest infections. The emergence of a novel chest disease poses an immediate challenge to the pillars of imaging, namely chest radiography and computed tomography. The characteristic imaging appearances, differential diagnoses and diagnostic pitfalls need to be established for correct diagnosis and appropriate management. The sensitivity and utility of the different imaging modalities will also need to be addressed. / In the event of an outbreak or epidemic, these challenges are made more difficult by an overwhelming number of patients and limited resources. In March 2003, we were faced with such a situation in our institution and the disease was later termed Severe Acute Respiratory Syndrome (SARS). / Patients in Hong Kong were treated with a combination of an antiviral agent and corticosteroids in addition to respiratory support. The majority of patients improved with treatment, although between 20--36% required treatment in an intensive care unit. / Problems and importance. This novel disease of high infectivity, morbidity and mortality posed a major threat to public health and a challenge to health authorities both locally and internationally. With regard to medical imaging, the following research questions were identified: (1) What are the imaging signs of this new disease? (2) Does chest imaging provide a high degree of sensitivity for diagnosing the infection? (3) Are the imaging signs disease-specific or are they similar to other pathology? (4) Does the progressive evolution of the imaging appearance correlate with the clinical status of the patient? (5) Could the imaging appearance be useful for predicting the final outcome? (6) Are there complications that require detection by imaging? / The lung parenchyma is the main site of infection and the resultant microscopic pathology included: pulmonary exudate, sequestration of macrophages, diffuse alveolar damage, proliferation of epithelial cells and hyaline membrane formation. Macroscopic features include alveolar consolidation in the early stages and later, organizing pneumonia or bronchiolitis obliterans organizing pneumonia. / These answers to these questions are essential to our understanding of the disease and to increase our diagnostic ability. (Abstract shortened by UMI.) / This newly emerged disease is a respiratory infection with a high morbidity/mortality and was found to be caused by a coronavirus (SARS CoV). By the end of the outbreak a total of 8098 probable cases of infection were reported worldwide, with a mortality rate of 9.6% (774 deaths). Hong Kong was one of the hardest hit regions, totaling 1755 probable cases of infection and 299 deaths by the end of the outbreak. / Antonio Gregory Ernest. / "September 2005." / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3745. / Thesis (M.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 245-258). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

In part ONE of this thesis, including the most up to date information on SARS virology, disease transmission, pathogenesis and laboratory diagnosis will be summarized and presented, including the results of many studies in which I have participated (these references will be underlined as they appear in text). This of course summarizes knowledge that is now known in 2006 but was largely unknown during the initial outbreak. In part TWO, six original clinical studies performed at PWH will be presented: study (1) describes the clinical manifestations and severity of SARS, and its potential to cause major hospital outbreaks; (2) demonstrates the importance of epidemiological linkage in diagnosing SARS; (3) reports the clinical outcomes of a stepwise treatment protocol, which includes the use of corticosteroid therapy as an immunomodulant; (4) demonstrates that corticosteroid therapy can retard viral clearance, and should be used judiciously; (5) demonstrates that a more robust humoral response is associated with severe SARS, thus indicating that passive immunity treatment strategies seem only suitable either during early illness or as prophylaxis; and (6) shows that SARS has few early discriminating laboratory features compared to other causes of community-acquired pneumonia, thus a high index of suspicion is needed to recognize this infection in the absence of worldwide transmission. A thorough review of the relevant published material will be included in the discussion section of each study. / Severe Acute Respiratory Syndrome (SARS) is an emerging infectious disease caused by a novel coronavirus. It caused a global outbreak in 2003, resulting in more than 8000 infections, 700 deaths, and major social and economic disruption. In the initial phase of the SARS outbreak, the medical profession had no knowledge regarding the responsible pathogen, nor the clinical manifestations of SARS and the course of illness. There was no reliable diagnostic tool and no known effective therapy. But for the first time in medical history, we witnessed the rapid accumulation of knowledge on a disease as it evolved, which in turn assisted its management and control. / Since conducting randomized-controlled trials during the 2003 crisis was almost impossible, most of the presented studies are either descriptive or case-controlled in design. However, these studies have laid foundations for recent and future research into the clinical diagnosis and management of SARS. Moreover, the construction of the SARS clinical database has contributed to the work of other investigators, which has resulted in over thirty-six publications. It is my hope that these research endeavors can contribute to the understanding of this emerging, deadly disease. / Lee Lai Shun, Nelson. / "April 2006." / Source: Dissertation Abstracts International, Volume: 69-01, Section: B, page: 0205. / Thesis (M.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 264-292). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

INTRODUÇÃO: A discinesia ciliar primária é uma doença genética que se caracteriza pela alteração da ultraestrutura e função do cílio móvel, com consequentes alterações do transporte mucociliar, causando infecções das vias aéreas superiores, inferiores e infertilidade. O diagnóstico, realizado por avaliação da ultraestrutura ou pesquisa de mutação genética, é feito mediante critérios de seleção de pacientes e testes de screening. Esta pesquisa avalia a ultraestrutura e frequência de batimento ciliar, propõe um modelo de investigação de discinesia ciliar primária, e caracteriza os pacientes diagnosticados. MÉTODO: Foi realizado um estudo transversal controlado entre janeiro de 2007 e julho de 2009, no Ambulatório de Pneumologia Pediátrica do Instituto da Criança. Foram selecionadas 28 crianças e adolescentes (6 meses a 19 anos, de ambos os sexos), de uma população de 75 crianças com pneumopatias crônicas e de repetição sem diagnóstico definido, que apresentavam ao menos um dos seguintes achados: bronquiectasia de causa desconhecida, doença de vias aéreas superiores com sintomatologia crônica, infecções pulmonares de repetição, dextrocardia e/ou situs inversus acompanhados de sintomas em vias aéreas superiores e/ou inferiores, e asma de difícil controle com sintomas em vias aéreas superiores e/ou inferiores. A presença de pneumopatias crônicas com diagnóstico definido foi utilizada como critério de exclusão por meio dos seguintes exames: dois testes do suor (exclusão de fibrose cística), tomografia computadorizada do tórax (suspeita de bronquiolite obliterante), dosagem de alfa-1 antitripsina (investigação de déficit de alfa-1 antitripsina), e exames de investigação das imunodeficiências mais frequentes (hemograma, dosagens de imunoglobulinas, contagem de linfócitos T e B, sorologias para avaliação da produção ativa de anticorpos, PPD e HIV). Foi desenvolvido um sistema medição da frequência de batimento ciliar, baseado em análise espectral. Dez adultos voluntários saudáveis (maiores ou iguais a 17 anos, de ambos os sexos), sem doença infecciosa respiratória aguda no último mês e não fumantes, formaram o grupo controle para a frequência do batimento ciliar. Foi realizada a coleta ciliar por escovado nasal. A amostra foi dividida para a avaliação da ultraestrutura e verificação da frequência do batimento ciliar. Os pacientes diagnosticados foram avaliados com tomografia de tórax e seios da face (esta última nos maiores de cinco anos), provas de função pulmonar e avaliação otorrinolaringológica. RESULTADOS: Os 28 pacientes selecionados foram submetidos ao escovado nasal. Para 24 dos 28 pacientes foi possível produzir filmes passíveis de avaliação. O grupo com ultraestrutura alterada (diagnóstico de discinesia ciliar primária) mostrou diferença das médias da frequência de batimento ciliar em relação ao grupo com ultraestrutura normal (p<0,001) e em relação ao grupo controle (p<0,001). O grupo com ultraestrutura normal e o grupo controle, quando comparados entre si, também apresentaram diferenças (p<0,005). Foram diagnosticados 12 pacientes com discinesia ciliar primária: dois com ausência de braços externos de dineína, um com encurtamento dos braços externos de dineína, cinco com defeitos nas espículas radiadas e braços internos de dineína, três com defeitos de ausência do par central com transposição, e um com ultraestrutura normal (Kartagener). Os pacientes, sete homens e cinco mulheres, com predomíno da etnia branca (11 pacientes - 91,6%), eram na maior parte fruto de pais consanguíneos (8 pacientes - 66,6%). Sete dos 12 pacientes (58,3%) apresentaram situs inversus. Sete dos dez pacientes que realizaram as provas de função pulmonar (70%) apresentaram distúrbio ventilatório obstrutivo. Achados radiológicos: Dez pacientes (83,3%) apresentaram algum grau de colapso ou consolidação, 11 (91,6%) apresentaram bronquiectasias, e todos (100%) algum grau de espessamento brônquico. A avaliação otorrinolaringológica apontou alterações em seis pacientes (50%): pólipos em três pacientes (25%), otite secretora em dois (16,6%), desvio de septo em dois (16,6%), e esclerose do tímpano em um (8,3%). CONCLUSÃO: Foi padronizada a técnica do escovado nasal para a coleta de material ciliar. Foram estabelecidos critérios de uniformidade quanto à análise dos defeitos ultraestruturais ciliares, baseados em experiência internacional. Foi desenvolvido um novo método de medição da frequência de batimento ciliar baseado em metodologia de análise espectral e vídeos de alta velocidade. Os pacientes diagnosticados com discinesia ciliar primária foram caracterizados, sendo a maioria: da etnia branca, de pais consanguíneos, com predomínio dos defeitos de espículas radiadas e braços internos de dineína, situs inversus, e distúrbio ventilatório obstrutivo. Problemas otorrinolaringológicos foram encontrados em metade dos pacientes. / INTRODUCTION: Primary ciliary dyskinesia (PCD) is a genetic disorder of the ultrastructure and function of mobile cilia, with consequent impairment of mucociliary clearance, leading to upper and lower airways respiratory infection and infertility. The diagnosis, based on ultrastructure evaluation or genetic scan, is performed according to patient selection and screening tests. This research evaluates cilia ultrastructure and beat frequency, proposes a model for investigating primary ciliary dyskinesia, and characterizes the patients diagnosed.METHOD: A controlled and observational study was carried out at the Pediatric Pulmonology Ambulatory of the Instituto da Criança between January 2007 and July 2009. Twenty eight children and teenagers (ages between 6 months and 19 years) were selected, from a population of 75 patients with chronic and repetition pneumopathies without a defined diagnosis, which met at least one of the following inclusion criteria: bronchiectasis of unknown cause, upper respiratory disease with chronic symptoms, repetition pulmonary infections, dextrocardia and/or situs inversus with symptoms in upper and/or lower respiratory airways, and asthma of difficult control with symptoms in upper and/or lower respiratory airways. The presence of cronic pneumopathies with a defined diagnosis was used as exclusion criterion, based on the following exams: two sweat tests (cystic fibrosis exclusion), lung CT scan (bronchiolitis obliterans exclusion), seric levels of alpha-1 anti-trypsin (alpha-1 anti-trypsin deficit evaluation), and evaluation of more frequent immunodeficiency disorders (white blood cells, T and B lymphocytes levels, and sorology tests for humoral immunity, PPD and HIV). A cilia beat frequency measurement system was developed, based on spectral analysis. Ten healthy adult volunteers (ages greater than or equal to 17 years old, of both sexes), without an acute respiratory disease in the last month, and non-smoking, formed the control group for the cilia beat frequency measurements. Cilia samples were collected employing nasal brushing. The sample was divided for cilia ultrastructure evaluation and for cilia beat frequency measurement. Diagnosed patients were sent to lung and sinuses CT scan (> 5 years), pulmonary function tests and ear, nose and throat evaluation. RESULTS: For the 28 patients selected a nasal brushing was performed. For 24 of the 28 patients it was possible to make films suitable for evaluation. The average cilia beat frequency of the defective ultrastructure group (primary ciliary dyskinesia group) was different from the average frequency of the normal ultrastructure group (p<0.001) and from the control group (p<0.001). The average cilia beat frequency of the normal ultrastructure group was different from the average frequency of the control group (p<0.005). Twelve patients were diagnosed with primary ciliary dyskinesia: two with absence of outer dynein arm, one with a shortened outer dynein arm, five with radial spoke and inner dynein arm, three with absence of central par and transposition, and one with a normal ultrastructure (Kartagener). The patients, seven men and five women, were mostly white (11 patients 91.6%) and had parents who were relatives (eight patients 66.6%). Seven of the twelve patients (58.3%) had Situs inversus. Seven of the ten patients (70%) for whom pulmonary function tests were performed presented a ventilatory obstructive pattern. Radiological findings: Ten patients (83.3%) presented signs of consolidation or collapse, eleven patients (91.6%) had bronchiectasis, and 12 (100%) presented some degree of bronchial wall thickening. Otorhinolaryngologycal evaluation indicated impairments in 6 patients (50%): polips in three patients (25%), effusion otitis in two (16.6%), sept problems in two (16.6%) and timpanus sclerosis in one (8,3%). CONCLUSION: The nasal brushing technique was standardized for the collection of cilia. Uniform criteria for the analysis of ultrastructural cilia defects were established, based on international experience. A new method of cilia beat frequency measurement was developed, based on spectral analysis and high speed video images. Patients diagnosed with primary ciliary dyskinesia were characterized. The majority was white, had parents who were also relatives, had a prevalence of radial spoke and inner dynein arm defects, situs inversus, and ventilatory obstructive pattern. Otorhinolaryngologycal problems were found in 50% of the patients.

No description available.

Given the broad public health concern, lack of reliability of diagnosis across providers and substantial resources needed to support individuals with Autism Spectrum Disorder, the current study serves to contribute to the field in informing the contexts of both research and clinical service. The utility of a standardized sensory-motor battery was investigated in regards to its ability (1) to determine what, if any, differences exist between ASD diagnoses or subgroups in both sensory functioning and motor functioning; and (2) to determine whether such discrepancies, if they exist, are capable of differentiating groups. Results from the quadratic discriminant analysis demonstrated that the factor scores derived from the Dean-Woodcock Sensory-Motor Battery significantly differentiated the ASD and nonclinical comparison groups. Factor 1 (Simple Sensory Skills) exhibited the strongest relationship, followed by Factor 2 (Cortical Motor and Complex Sensory Skills), then Factor 3 (Subcortical Motor Tasks and Auditory/Visual Acuity Skills). Findings from the study lend initial evidence of the use of the DWSMB as a potential measure to include within the two-stage diagnostic process for ASD. Use of the DWSMB as a screening measure may facilitate access to early intervention services given the primitive nature of sensory-motor tasks. In addition, the availability of the DWSMB as a standardized measure of sensory and motor functioning may promote increased sensitivity and specificity among diagnostic providers thus improving outcomes of individuals with ASD who can access services more readily with earlier, more reliable diagnoses. / Access to thesis permanently restricted to Ball State community only. / Department of Educational Psychology

Bibliography: leaves 223-229. / xiii, 229 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / This thesis considers several aspects of multivariate analysis motivated by the South Australian prenatal Down's syndrome screen, which seeks to identify those pregnancies at high risk to Down's syndrome from several risk factors, amongst them maternal age and measurements from four analyte concentrations found in maternal blood. The primary aim is to discriminate between the unaffected and affected pregnancies in terms of these observed risk factors. Through the development of multivariate regression models it is examined how the Mahalanobis distance might be decomposed into distances that give more insight into where the discrimination is derived and how this might change with the gestational age at which the analyte concentrations are measured. A second multivariate aspect motivated by the screen surrounds the detection of directional outliers and the incorporation of knowledge of likely departures into the outlier identification technique. A method is also developed to account for misreporting in inferences of gestational age. Similarities with measurement error and misclassification models are explored. / Thesis (Ph.D.)--University of Adelaide, Dept. of Statistics, 1998?

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 4 uppsatser.

Psychology / (M.A.(Clinical Psycholoy)

A temporalidade é considerada, na perspectiva teórica deste estudo, como uma condição essencial do indivíduo no mundo, possibilitando a constituição de sentido do percebido e do vivido e evidenciando, ainda, a circunstância da qual partem todas as possíveis concepções de tempo. Além disso, o homem também é considerado em sua intencionalidade, na qual está dirigido para algo, ou seja, só pode haver mundo percebido e definido para o sujeito que pode percebê-lo, estando voltado para ele. A síndrome de Asperger (SA), um transtorno invasivo de desenvolvimento pertencente ao espectro autístico, caracteriza-se por seus portadores apresentarem um modo de interação extremamente peculiar, no qual é considerada a presença de prejuízos relacionados à simbolização, à comunicação e à socialização. Em uma vertente teórica psicossocial, esses aspectos têm sido compreendidos a partir da possibilidade de haver uma inabilidade inata na criança autista que compromete a atitude conativo-afetiva (relacionada à intencionalidade) fundamental no processo de desenvolvimento. Questões a respeito da rigidez na experiência da duração de períodos de tempo, das dificuldades para aceitação e compreensão da possibilidade de mudanças de fatos previstos e da aparente restrição de perspectiva temporal, independentemente do nível intelectual, têm sido evidenciadas na prática clínica com esta população. Dessa forma, o presente trabalho objetivou caracterizar a noção de tempo e a temporalidade em portadores da síndrome de Asperger. Sua constituição ocorreu em duas fases complementares e fundamentais. Na primeira, a partir de uma amostra de trinta indivíduos em cada grupo (grupo síndrome de Asperger e grupo de comparação) verificaram-se aspectos de noção de duração tempo através de instrumentos quantitativos e qualitativos. Na segunda fase a partir de uma amostra de quinze indivíduos em cada grupo (grupo síndrome de Asperger e grupo de comparação) investigaram-se, através de entrevista qualitativa, temas relacionados à temporalidade. Na descrição dos resultados pôde-se constatar uma temporalidade restrita evidenciada pela presença de prejuízos relacionados à continuidade no contato com o ambiente, à limitada perspectiva no sentido do devir e noção de tempo a partir de elementos espaciais, em detrimento dos aspectos subjetivos, restringindo o compartilhar do tempo comum e a formação de projetos de vida / Based on a theoretic-phenomenological perspective, temporality is defined as an essential condition of a person in view of the world. This condition is determinant to build what is perceived and experienced as well as makes evident the circumstances from which all possible conceptions of time emerge. In addition, the subject is also considered accordingly to his intentionality by which he is directed towards something. In other words, a defined and perceived world can only exist for a subject who, being directed towards it, can conceive that world through his senses and consciousness. The Asperger syndrome (AS), a pervasive developmental disorder belonging to the autistic spectrum, is characterized in individuals showing a very peculiar pattern of interaction, particularly displaying deficits of symbolization, communication and socialization. Under a psychosocial point of view, these aspects have been understood as an innate lack of affective-conative attitude impairing the development of autistic children. In clinical practice dealing with these children, professionals have been asking questions on their inflexibility in time span experience, on the difficulties in accepting and understanding changes and on the apparent restriction of the perspective in temporality independently of their intellectual levels. Temporality in Asperger syndrome was herein investigated aiming at its characterization. The study was constituted by two complementary and fundamental phases. In the first phase (N = 30 for the AS group; N = 30 for the comparison group) aspects of time notion were evaluated through quantitative and qualitative instruments. In the second phase (N = 15 for the AS group; N = 15 for the comparison group) matters related to temporality were investigated through a qualitative interview. The results have shown a restricted temporality evidenced by impairments related to the continuity of contact with the environment, by a limited perspective in the sense of becoming, and by a notion of time based on spatial elements, all in detriment of subjective aspects, thus restricting time sharing with people and elaboration of projects of life