Navegando por Palavras-chave "assesment"

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    Avaliação da concordância entre pais e professores para o reconhecimento de sintomas de tdah em crianças e adolescentes
    (Universidade Federal de São Paulo (UNIFESP), 2016-01-13) Machado, Felipe Salles Neves [UNIFESP]; Rosario, Maria Conceicao Do Rosario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Attention deficit hyperactivity disorder (ADHD) is the most common mental disease in childhood, affecting about 5.3% of children and 2.5% of adults. ADHD causes great impact on the functioning of patients and their families. Therefore, the correct identification and early treatment are extremely important to avoid compromising the lives of these families. Nevertheless, it is estimated that only about 16.2% to 19.9% of individuals with ADHD receive adequate treatment. Swanson, Nolan, and Pelham (SNAP-IV) rating scale has the potential to identify early those who require a more detailed review, besides assisting the professional in the clinical monitoring and planning of therapeutic intervention. Many studies have evaluated the agreement between parents and teachers, but there is no consensus among them. The majority indicates that agreement varies from regular to moderate. Missing data in the literature to explain these findings. This study had the following objectives: 1) to evaluate the agreement in the responses of the SNAP-IV parent-teacher; 2) to evaluate the correlation between SNAPs filled by parents and clinicians through KSADS; 3) evaluate which clinical variables and sociodemographic would be associated with the degree of agreement between the answers of the SNAP-IV. Cross-sectional study of comparison between groups, conducted with a sample of 235 children aged 6 to 17 years old coming from a public school and a specialized clinic in ADHD. The subjects were evaluated by experts in ADHD with the following instruments: KSADS (Diagnostic Interview "Schedule for Affective Disorders and Schizophrenia for School-Age Children") and SNAP-IV (ADHD Symptoms Assessment Scale "Swanson, Nolan, and Pelham"). RESULTS: The results showed a significant Spearman correlation (p <0.0001) for symptoms of inattention, hyperactivity / impulsivity symptoms and total, with the following values: 0.59, 0.63, 0.65, Pg 10 respectively. Regression analysis showed that the severity of ADHD symptoms was associated with rate agreement between parents and teachers (ß = 0.356 p = 0.001). DISCUSSION: Although there is no consensus among studies, most indicate that the correlation between the responses of parents and teachers in SNAP ranges from regular to moderate. The moderate concordance rates between parents and teachers in the current study corroborate the idea that SNAP is a reliable tool for the investigation of ADHD symptoms, especially in patients with more severe symptoms. CONCLUSIONS: Despite the moderate agreement, the SNAP-IV results also identified parents and teachers recognize the symptoms of ADHD in different ways and that SNAP should not be used in place of clinical evaluation in the diagnostic workup of patients. It is essential that health professionals know what variables are more or less associated with the agreement of the SNAP-IV for answers that do not make mistakes in the use of the scale.
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    Avaliação do índice de performance miocárdica em fetos com restrição do crescimento
    (Universidade Federal de São Paulo (UNIFESP), 2015-12-31) Silva, Carolina Pacheco [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: This study aims to evaluate the Myocardial Performance Index in fetuses with growth restriction (IUGR) compared with healthy fetuses. To assess the intra and interobserver repeatability of the method. Method: We conducted a prospective cross-sectional study in pregnant women between 24 and 34 weeks, with singleton pregnancies, divided in three groups (controls, restricted fetuses below the 3rd percentile and restricted between percentiles 3 and10). For the estimation of fetal weight (EPF), we used the formula of Hadlock 4. The fetal modified Myocardial Performance Index was assessed in all fetuses. Assessed restricted fetuses umbilical artery Doppler normal. Regarding the repeatability of the method used the intraclass correlation coefficient (ICC) and Bland-Altman. Results: There was no statistically significant difference between the values found in the IPM-mod among fetuses with growth restriction below the 3rd percentile (0.36 SD ± 0.06), fetuses between percentiles 3:10 (0.35 ± 0.05) and normal fetuses (0.32 ± 0.05). Regarding the repeatability, the intraclass correlation coefficient (ICC) was 0.726 intra and interobserver 0.76. Conclusion: The mod-IPM is an important tool for assessment of fetal cardiac function and the values found for fetuses with FGR with normal umbilical artery Doppler and healthy fetuses were not statistically significant, suggesting that at this stage of RCF these fetuses still present normal cardiac function. This valuation method proved reproducible, but requires a substantial number of measurements for non-experienced examiner to achieve competence