Acute Complications of Crohn's Disease: Comparison of Multidetector-Row Computed Tomographic Enterography with Magnetic Resonance Enterography.

Objective: To compare multidetector-row computed tomographic (MDCT) enterography with magnetic resonance (MR) enterography performed upon acute exacerbation of Crohn's disease. Subjects and Methods: Fifty-seven patients (mean age 33.5) with proven Crohn's disease and symptoms suggesting acute exacerbation were prospectively included. After oral administration of 1-2 liters of 5% methylcellulose, MDCT and MR enterography were performed on each patient (mean delay <24 h). Three radiologists blindly and independently evaluated each examination for technical quality and in terms of 8 pathological features of Crohn's disease. Observers' agreement, sensitivity and specificity resulted from comparison with the reference standard [surgery (n = 24), endoscopy (n = 17) and long-term follow-up (n = 16)]. Results: MDCT enterography demonstrated fewer artifacts than MR enterography (p < 0.0001). In 48 MDCT/MR enterography examinations, active disease was demonstrated: abscesses (n = 11), fistulas (n = 13), stenoses (n = 23) and/or intestinal inflammation (n = 38). Observers' agreement (range 0.56-0.87) was not significantly different between MDCT and MR enterography, neither in terms of sensitivity (range 58-95%) nor specificity (range 67-100%) for each of the 8 pathological features. Conclusion: Statistically, MR enterography is of similar diagnostic value as MDCT enterography for acute complications of Crohn's disease. Since the typical Crohn's disease patient is young and will very likely undergo life-long imaging, and given concerns about radiation exposure with MDCT, MR enterography should be the preferred modality.

Sewage sludge as nitrogen and phosphorus source for cane-plant and first ratoon crops

The use of sewage sludge in Brazilian agriculture was regulated by the resolution no. 375 Conama, in 2006. However, there is a lack of research to adequate the mineral N and P fertilizer doses to be applied in agricultural fields treated with this residue. In a field experiment, the effects of application rates of sewage sludge and mineral N and P fertilizers on the productivity and technical characteristics of the cane-plant and first ratoon (residual effect) crops were evaluated. Four doses of sewage sludge (0, 3.6, 7.2 and 10.8 t ha-1, dry base), of N (0, 30, 60 and 90 kg ha-1) and of P2O5 (0, 60, 120 and 180 kg ha-1) were combined in a factorial and laid out on randomized block design, a with two replications. To evaluate the residual effect of the sludge, 120 kg ha-1 N and 140 kg ha-1 of K2O were applied in all plots. Sludge application at cane planting, with or without N and/or P fertilizer increased the stalk yield from 84 up to 118 t ha-1, with no alteration in the sugarcane quality, compared with the application of NPK fertilizer alone, resulting in a stalk yield of 91 t ha-1. The study of the response surface for stalk yield on lowfertility soil was the basis for a recommendation of mineral N and P fertilizer doses for sugarcane implantation as related to sewage sludge application rates. It was also concluded that a sludge application of 10.8 t ha-1, which is the sludge dose established based on the N criterion according to the resolution Conama nº 375, could a) reduce the use of mineral N by 100 % and of P2O5 by 30 %, with increments of 22 % in stalk yield, as a direct effect of sludge application to cane plant crop, and b) increase the stalk yield in the second harvest (first ratoon) by up to 12 % and sugar yield by up to 11 %, by the residual effect of sludge application to sugar cane.

Nontraumatic subarachnoid hemorrhage management: evaluation with reduced iodine volume at CT angiography.

PURPOSE: To evaluate the technical quality and the diagnostic performance of a protocol with use of low volumes of contrast medium (25 mL) at 64-detector spiral computed tomography (CT) in the diagnosis and management of adult, nontraumatic subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This study was performed outside the United States and was approved by the institutional review board. Intracranial CT angiography was performed in 73 consecutive patients with nontraumatic SAH diagnosed at nonenhanced CT. Image quality was evaluated by two observers using two criteria: degree of arterial enhancement and venous contamination. The two independent readers evaluated diagnostic performance (lesion detection and correct therapeutic decision-making process) by using rotational angiographic findings as the standard of reference. Sensitivity, specificity, and positive and negative predictive values were calculated for patients who underwent CT angiography and three-dimensional rotational angiography. The intraclass correlation coefficient was calculated to assess interobserver concordance concerning aneurysm measurements and therapeutic management. RESULTS: All aneurysms were detected, either ruptured or unruptured. Arterial opacification was excellent in 62 cases (85%), and venous contamination was absent or minor in 61 cases (84%). In 95% of cases, CT angiographic findings allowed optimal therapeutic management. The intraclass correlation coefficient ranged between 0.93 and 0.95, indicating excellent interobserver agreement. CONCLUSION: With only 25 mL of iodinated contrast medium focused on the arterial phase, 64-detector CT angiography allowed satisfactory diagnostic and therapeutic management of nontraumatic SAH.

Measuring school demand in the presence of spatial dependence. A conditional approach

Improving educational quality is an important public policy goal. However, its success requires identifying factors associated with student achievement. At the core of these proposals lies the principle that increased public school quality can make school system more efficient, resulting in correspondingly stronger performance by students. Nevertheless, the public educational system is not devoid of competition which arises, among other factors, through the efficiency of management and the geographical location of schools. Moreover, families in Spain appear to choose a school on the grounds of location. In this environment, the objective of this paper is to analyze whether geographical space has an impact on the relationship between the level of technical quality of public schools (measured by the efficiency score) and the school demand index. To do this, an empirical application is performed on a sample of 1,695 public schools in the region of Catalonia (Spain). This application shows the effects of spatial autocorrelation on the estimation of the parameters and how these problems are addressed through spatial econometrics models. The results confirm that space has a moderating effect on the relationship between efficiency and school demand, although only in urban municipalities.

On Transmission System Design for Wireless Broadcasting

This thesis considers aspects related to the design and standardisation of transmission systems for wireless broadcasting, comprising terrestrial and mobile reception. The purpose is to identify which factors influence the technical decisions and what issues could be better considered in the design process in order to assess different use cases, service scenarios and end-user quality. Further, the necessity of cross-layer optimisation for efficient data transmission is emphasised and means to take this into consideration are suggested. The work is mainly related terrestrial and mobile digital video broadcasting systems but many of the findings can be generalised also to other transmission systems and design processes. The work has led to three main conclusions. First, it is discovered that there are no sufficiently accurate error criteria for measuring the subjective perceived audiovisual quality that could be utilised in transmission system design. Means for designing new error criteria for mobile TV (television) services are suggested and similar work related to other services is recommended. Second, it is suggested that in addition to commercial requirements there should be technical requirements setting the frame work for the design process of a new transmission system. The technical requirements should include the assessed reception conditions, technical quality of service and service functionalities. Reception conditions comprise radio channel models, receiver types and antenna types. Technical quality of service consists of bandwidth, timeliness and reliability. Of these, the thesis focuses on radio channel models and errorcriteria (reliability) as two of the most important design challenges and provides means to optimise transmission parameters based on these. Third, the thesis argues that the most favourable development for wireless broadcasting would be a single system suitable for all scenarios of wireless broadcasting. It is claimed that there are no major technical obstacles to achieve this and that the recently published second generation digital terrestrial television broadcasting system provides a good basis. The challenges and opportunities of a universal wireless broadcasting system are discussed mainly from technical but briefly also from commercial and regulatory aspect

Leimuhitsauksen kokonaisvaltainen laadunhallinta päättymättömässä valssauksessa

Leimuhitsauksen laadunhallinnassa tärkeää on prosessimainen toiminta ja toimintojen kokonaisvaltaisuuden hahmottaminen. Leimuhitsauksen ollessa osana päättymätöntä valssausta hitsauksen laadunhallinta voidaan jakaa kolmeen päävaiheeseen: ennen hitsausta, hitsauksen aikana ja hitsauksen jälkeen vaikuttaviin laaduntuottotekijöihin. Leimuhitsauksen laaduntuottotekijöiden määritys ja jaottelu kaavioiksi on toteutettu tässä työssä. Leimuhitsin tekniseen laatuun vaikuttavat monet ilmiöt ja parametrit hitsauksen aikana. Tärkeimpiä hitsausparametreista ovat hitsausjännite, alustan liikenopeus, tyssäysmatka sekä leimutusaika. Väärät hitsausolosuhteet tai hitsausparametrit aiheuttavat erilaisia mekaanisia ja metallurgisia vikoja leimuhitsiin. Eräs metallurginen vikatyyppi ovat oksidisulkeumat hitsialueella. Nämä hapettuneet alueet voivat johtaa juurensa erilaisista syistä ja esimerkiksi leimutusajan ja epätasaisen liitospinnan yhteyttä sulkeumien syntyyn on epäilty. Pidennetyillä leimutusajoilla tehtyjen hitsauskokeiden ja hitsien rikkovien aineenkoetuskokeiden tuloksena todettiin tässä tutkittujen koehitsien oksidisulkeumien syntyvän hapettumalla leimutuksen aikana tai juuri hetkellä ennen tyssäystä, minkä lisäksi kosteat olosuhteet hitsausatmosfäärin ympärillä heikentävät lopputuloksen laatua. Leimutusajalla on tärkein osa leimutettavia pintoja tasaavana tekijänä ja mitä epätasaisempi liitettävä pinta on, sitä pidemmän leimutusajan se tarvitsee.

Examining the Role of Rebranding in Perceived Image of a Product Line

The main objective for this study was to explore certain organization’s product line rebranding process and its impact on product line’s perceived image. The case company is a global paper, packaging and forest products company, business segment paper board. The audience explored is one of the company’s major customers, merchant in Germany. The research was performed as a descriptive case study with a purpose to provide longitudinal insight into the product line image and its eventual alteration as a result of the case company’s rebranding process. Mainly qualitative methods were used for conducting the research. The data for the empirical part was collected with a web-based survey at two different points of time; before the rebranded products entered the market and after they had been available approximately six months. The results of this study reveal that the case company has performed well in its attempt to improve product line’s brand image through rebranding. It was found that between the two brand image measurements the product brand image seems to have improved in all of the areas which according to theoretical framework of this study contribute to formation of brand image; brand associations, marketing communications and interpersonal relationships, not forgetting the original platform that initiated the change; technical quality modifications. In other words it may be concluded that as technical quality was brought to a new level, also assessments about the brand image improved respectively.

Katsastuksen teknisen laadun mittaaminen ja johtaminen

Suorituskyvyn mittaamisella on monia myönteisiä vaikutuksia koko organisaation toimintaan. Mittaamisen avulla toimintaa voidaan johtaa haluttuun suuntaan. Tutkimuksen tavoitteena oli tutkia, minkälainen suorituskykymittaristo tarvitaan katsastusyrityksen ylimmän johdon käyttöön, jotta katsastuksen teknisen laadun johtaminen mahdollistuisi. Tutkimuksen tarkoituksena oli rakentaa katsastuksen teknisen laadun suorituskykymittaristo ylimmälle johdolle. Katsastuksen tekninen laatu on keskeinen kysymys katsastusyritysten olemassaololle. Tekninen laatu on koko katsastustoiminnan perusta, jonka päälle liiketoiminta voidaan rakentaa. Ilman tätä perustaa ei ole jatkuvuutta liiketoiminnalle. Teknisen laadun mittaaminen ei kuitenkaan ole tällä hetkellä järjestelmällistä, eikä käytettävissä ole ollut tehtävään soveltuvaa mittaristoa. Tutkimuksessa käytettiin A-Katsastus Oy:n vuosien 2008–2011 aikana syntyneitä katsastustilastoja. Tilastollista prosessin valvonta-menetelmää (SPC) soveltamalla määritettiin toimipaikka- ja katsastajakohtaiset valvontarajat hylkäysprosenteille ja vikojen määrille. Valvontarajojen avulla rakennettiin katsastuksen teknisen laadun suorituskykymittaristo toimiala-, yritys-, toimipaikka- ja katsastajatasoille. Mittariston avulla voidaan asettaa tekniselle laadulle tavoitteet, seurata tavoitteiden toteumaa ja käynnistää tarvittaessa korjaavat toimenpiteet.

Facteurs contextuels dans l'évaluation d'une politique de santé maternelle au Burkina Faso

Cette thèse s’intéresse à l’influence des facteurs contextuels sur la mise en œuvre et les effets d’une politique de santé maternelle au Burkina Faso. Cette politique nommée la subvention SONU vise à faire augmenter la couverture des accouchements dans les établissements de santé publics en agissant sur l’accessibilité économique des ménages. La thèse propose une évaluation des processus de cette politique. Le cadre d’analyse repose sur des propositions théoriques issues du champ de l’étude des politiques sanitaires (les acteurs et leurs relations de pouvoir) et de l’anthropologie médicale critique (les représentations). L’étude s’est déroulée dans le district sanitaire de Djibo, situé dans la région du Sahel. Il s’agit d’une étude de cas multiples où chaque centre de santé représentait un cas. L’approche méthodologique employée était qualitative. Une enquête de terrain, des entretiens, des groupes de discussion, des observations non participantes et une analyse documentaire ont été les méthodes de collecte de données utilisées. Les résultats préliminaires de l’étude ont été présentés aux parties prenantes. Le premier article évalue l’implantation de cette subvention SONU au niveau d’un district et rend compte de l’influence des rapports de pouvoir sur la mise en œuvre de cette dernière. Les résultats indiquent que toutes les composantes de cette subvention sont mises en œuvre, à l’exception du fond d’indigence et de certaines composantes relatives à la qualité technique des soins telles que les sondages pour les bénéficiaires et l’équipe d’assurance qualité dans l’hôpital du district. Les professionnels et les gestionnaires de la santé expliquent les difficultés dans l’application de politique de subvention par un manque de clarté et de compréhension des directives officielles. Les relations de pouvoir entre les différents groupes d’acteurs ont une influence sur la mise en œuvre de cette politique. Les rapports entre gestionnaires du district et agents de santé sont basés sur des rapports hiérarchiques. Ainsi, les gestionnaires contrôlent le travail des agents de santé et imposent des changements à la mise en œuvre de la politique. Les rapports entre soignants et patients sont variables. Dans certains centres de santé, les communautés perçoivent positivement cette relation alors que dans d’autres, elle est perçue négativement. Les perceptions sur les relations entre les accoucheuses villageoises et les agents de santé sont également partagées. Pour les agents de santé, ces actrices peuvent être de potentielles alliées pour renforcer l’efficacité de la politique SONU en incitant les femmes à utiliser les services de santé, mais elles sont aussi perçues comme des obstacles, lorsqu’elles continuent à effectuer des accouchements à domicile. Les difficultés de compréhension des modalités de remboursement entrainent une rigidité dans les rapports entre agents de santé et comités de gestion. Le deuxième article vise à comprendre la variation observée sur la couverture des accouchements entre plusieurs centres de santé après la mise en œuvre de cette politique SONU. Les facteurs contextuels et plus spécifiquement humains ont une influence sur la couverture des accouchements assistés. Le leadership des agents de santé, caractérisé par l’initiative personnelle, l’éthique professionnelle et l’établissement d’un lien de confiance entre les populations et l’équipe sanitaire expliquent la différence d’effets observée sur la couverture des accouchements assistés après la mise en œuvre de cette dernière. Le troisième article analyse l’usage stratégique des référentiels ethnoculturels par certaines équipes sanitaires pour expliquer l’échec partiel de la politique SONU dans certains centres de santé. La référence à ces facteurs vise essentiellement à normaliser et légitimer l’absence d’effet de la politique sur la couverture des accouchements assistés. Elle contribue également à blâmer les populations. Enfin, le recours à ces référentiels tend à écarter les interprétations socioéconomiques et politiques qui sous-tendent la problématique des accouchements dans les établissements de santé publics. Sur le plan pratique, cette thèse permet de mieux comprendre le processus de mise en œuvre d’une politique de santé maternelle. Elle montre que les dimensions relatives à l’équité et à la qualité des soins sont négligées dans ce processus. Cette recherche met en lumière les difficultés auxquelles sont confrontés les agents de santé dans la mise en oeuvre de cette politique. Elle met également en exergue les facteurs qui expliquent l’hétérogénéité observée sur la couverture des accouchements assistés entre les centres de santé après la mise en œuvre de cette politique. Sur le plan théorique, cette thèse montre l’importance d’identifier les rapports de pouvoir qui s’exercent entre les différents acteurs impliqués dans les politiques sanitaires. Elle rappelle l’influence considérable des facteurs contextuels sur la mise en œuvre et les effets des politiques. Enfin, cette recherche révèle le poids des représentations sociales des acteurs dans la compréhension des effets des politiques. Cette thèse contribue au développement des connaissances dans le champ des politiques publiques sur le plan des thématiques abordées (mise en œuvre, rapports de pouvoir) et de l’approche méthodologique (enquête de terrain) utilisée. Elle participe aussi aux réflexions théoriques sur le concept de leadership des professionnels de la santé en Afrique.

Visión de la calidad y el riesgo en instituciones de salud con programas de formación médica en Colombia

Este tuvo como objetivo describir la tendencia que tuvieron los resultados de los indicadores de calidad técnica y gerencia del riesgo: infecciones intrahospitalarias, mortalidad hospitalaria y reingreso hospitalario desde el año 2006 al 2010 y establecer si existieron diferencias entre las Instituciones de salud, con y sin convenios docente asistenciales tanto públicas y privadas de 11 ciudades de Colombia. Este estudio encontró que posterior a la promulgación de la ley 30 de 1992, el número de programas de medicina se incrementó considerablemente en la última década. Esta situación llevó a considerar dos cosas: primero que el número de Instituciones de práctica en el país puede ser insuficiente ante la gran cantidad de nuevos estudiantes de medicina, con algún grado de hacinamiento en los sitios de práctica y segundo que esa situación puede tener algún efecto sobre la calidad de la atención y el resultado de los indicadores medidos. Se evidenciaron importantes deficiencias técnicas en el reporte obligatorio de la información por parte de los hospitales, donde solo un 10% de ellas cumplieron con el reporte completo de los indicadores desde el año 2006; encontrando que se registra solamente un 65% del total de la información que debería estar publicada. En cuanto al análisis estadístico de los datos, se utilizó el chi cuadrado de tendencias, que no arrojó diferencias estadísticamente significativas de los indicadores en los periodos analizados entre las instituciones con y sin convenios docentes; pero sí evidenció diferencias entre la suma de mínimos cuadrados de dos de los indicadores.

Variabilidad en la lectura de radiografía de tórax en el diagnóstico de neumoconiosis del minero de carbón

Diversas clasificaciones radiológicas han sido desarrolladas para apoyar el diagnóstico de la neumoconiosis. El propósito de este estudio fue comparar la concordancia de los hallazgos radiográficos relacionados con el diagnóstico de neumoconiosis detectados en la lectura de la radiografía de tórax realizada por medico entrenado en sistema de clasificación de la Organización Internacional del Trabajo (OIT 2.000) y radiólogo especialista. Metodología: Estudio descriptivo. Se comparó la lectura realizada a 142 radiografías de tórax convencionales respecto a hallazgos sugestivos de neumoconiosis detectados por el medico entrenado en la clasificación internacional de la OIT y radiólogo especialista, utilizando el índice de Kappa para concordancia entre dos observadores, también se tuvieron en cuenta observaciones reportadas sobre calidad cinematográfica en la toma de la radiografía y otros hallazgos diferentes o afines a neumoconiosis. Resultados: En 47 lecturas OIT, 33,1% y 9,9% (14) lecturas de radiólogo, hubo hallazgos sugestivos de neumoconiosis. En 123 (86,6%) lecturas OIT y 1 (0,7%) lectura de radiólogo, hubo hallazgos de falta de calidad técnica. En 26 (18,3%) lecturas OIT, y 9 (6,3%) lecturas de radiólogo, hubo detección de otros hallazgos. El acuerdo inter-lector de hallazgos sugestivos de neumoconiosis fue débil con un valor Kappa de 0.245, el de Calidad técnica fue pobre, con valor Kappa de 0.02 y el acuerdo en la detección de otros hallazgos diferentes a neumoconiosis fue débil con valor Kappa de 0.274. Conclusiones: El sistema de clasificación de la OIT puede ser más sensible para detectar hallazgos sugestivos de neumoconiosis, de falta de calidad técnica y otros hallazgos en la radiografía de tórax.

En förstudie till kvalitetsutveckling på GD-tryck

The print- and mailroom at Gefle Dagblad (GD-tyck) is handling an increasing amount of commercial jobsalong with the newspaper production. Investments have above all been done in the mailroom to be able tooffer commercial costumers a higher degree of finishing and there are plans to expand further in the commercialmarket. GD-tryck is of the opinion that they need to secure the quality of their production to be ableto do such expansion, which is the reason why a quality system of some kind may be appropriate. Howeverthere are no plans to certify such a quality system according to ISO 9001:2000.In this exam report the present methods of working have been analysed from a quality perspective.Suggestions on how GD-tryck should be working with quality development is presented in the fields whereshortage of quality has been discovered. The suggestions taken together do not form a quality system butcan be looked at as ideas of approach to quality fields that have to be developed if a working quality systemshall be accomplished.Many of the quality fields that have been discussed do not have anything to do with technical qualitydirectly but are in some degree requirements for a working quality system. It also feels urgent to illustratethese fields in this exam report when most people at GD seems to place quality as identical with technicalquality. Technical quality is also a quality field where GD-tryck has few concrete problems today and theyalready produce printed matters of a high quality. Afact that might make it difficult to adopt a quality systemas the benefits of such a system is not obvious.

Utveckling av metod för att bedöma behovet av ogräsbekämpning i spår

A system for weed management on railway embankments that is both adapted to the environment and efficient in terms of resources requires knowledge and understanding about the growing conditions of vegetation so that methods to control its growth can be adapted accordingly. Automated records could complement present-day manual inspections and over time come to replace these. One challenge is to devise a method that will result in a reasonable breakdown of gathered information that can be managed rationally by affected parties and, at the same time, serve as a basis for decisions with sufficient precision. The project examined two automated methods that may be useful for the Swedish Transport Administration in the future: 1) A machine vision method, which makes use of camera sensors as a way of sensing the environment in the visible and near infrared spectrum; and 2) An N-Sensor method, which transmits light within an area that is reflected by the chlorophyll in the plants. The amount of chlorophyll provides a value that can be correlated with the biomass. The choice of technique depends on how the information is to be used. If the purpose is to form a general picture of the growth of vegetation on railway embankments as a way to plan for maintenance measures, then the N-Sensor technique may be the right choice. If the plan is to form a general picture as well as monitor and survey current and exact vegetation status on the surface over time as a way to fight specific vegetation with the correct means, then the machine vision method is the better of the two. Both techniques involve registering data using GPS positioning. In the future, it will be possible to store this information in databases that are directly accessible to stakeholders online during or in conjunction with measures to deal with the vegetation. The two techniques were compared with manual (visual) estimations as to the levels of vegetation growth. The observers (raters) visual estimation of weed coverage (%) differed statistically from person to person. In terms of estimating the frequency (number) of woody plants (trees and bushes) in the test areas, the observers were generally in agreement. The same person is often consistent in his or her estimation: it is the comparison with the estimations of others that can lead to misleading results. The system for using the information about vegetation growth requires development. The threshold for the amount of weeds that can be tolerated in different track types is an important component in such a system. The classification system must be capable of dealing with the demands placed on it so as to ensure the quality of the track and other pre-conditions such as traffic levels, conditions pertaining to track location, and the characteristics of the vegetation. The project recommends that the Swedish Transport Administration: Discusses how threshold values for the growth of vegetation on railway embankments can be determined Carries out registration of the growth of vegetation over longer and a larger number of railway sections using one or more of the methods studied in the project Introduces a system that effectively matches the information about vegetation to its position Includes information about the growth of vegetation in the records that are currently maintained of the track’s technical quality, and link the data material to other maintenance-related databases Establishes a number of representative surfaces in which weed inventories (by measuring) are regularly conducted, as a means of developing an overview of the long-term development that can serve as a basis for more precise prognoses in terms of vegetation growth Ensures that necessary opportunities for education are put in place

Concordância no diagnóstico radiológico da doença respiratória aguda baixa em crianças

Objetivo: Estudar a concordância no diagnóstico radiológico da doença respiratória aguda baixa (DRAB) em crianças. Métodos: Sessenta radiogramas do tórax de crianças menores de cinco anos foram avaliados, individualmente, por três médicos: um radiologista pediátrico (RP), um pneumologista pediatra (PP) e 1 pediatra experiente no atendimento de sala de emergências (PE). Todas as crianças tinham procurado atendimento por apresentar um quadro agudo de infecção respiratória com aparente participação pulmonar. Os avaliadores desconheciam os diagnósticos originais, mas receberam uma ficha padrão com dados clínicos e laboratoriais dos pacientes no momento da consulta inicial. Variáveis: Agrupadas em cinco categorias: a) qualidade técnica do filme; b) localização da alteração; c) padrões radiográficos; d) outras alterações radiográficas; e) diagnóstico. Análise Estatística: Para estudar a concordância entre as três duplas posíveis de observadores, utilizou-se a estatística de Kappa, aceitándo-se os valores ajustados para viés de prevalência (PABAK). Resultados: Os valores Kappa totais de cada dupla de observadores (RP x PP, RP x PE e PP x PE) foram 0.41, 0.43, e 0.39 respectivamente, o que representa em média, uma concordância interobservadores moderada (0.41). Outras variáveis: “qualidade técnica” teve uma concordância regular (0.30); com “localização”, foi moderada (0.48); com “padrões radiográficos” foi regular (0.29); com “outras alterações radiográficas” foi moderada (0,43); e com “diagnóstico”, regular (0.33). Quanto à concordância global intraobservadores, a mesma foi moderada (0.54), com valores menores dos descritos na literatura. Conclusões: A variabilidade interobservadores é inerente à interpretação dos achados radiológicos, e determinar o diagnóstico exato da DRAB nas crianças tem seus desafíos. Nossos resultados foram similares aos descritos na literatura.