Aceitação e eficácia de um programa de intervenção psicoeducativa para pais de crianças com asma: Estudo exploratório

Considerando a importância que a educação sobre a asma deve assumir no plano de gestão familiar da doença, e a falta de programas deste tipo em Portugal, construímos uma intervenção psicoeducativa breve para pais de crianças com asma entre os 7 e os 13 anos, visando a aquisição de atitudes mais positivas na gestão da doença. O estudo teve como objetivo avaliar a aceitação, eficácia e a satisfação relativa ao programa intervenção. Completaram a intervenção 10 mães, tendo participado nas 3 sessões de grupo e nos 3 momentos de avaliação (linha de base, final da intervenção e follow-up a 9 meses). Para além da recolha de informação sociodemográfica e clínica, aplicaram-se dois questionários, um de conhecimentos sobre a asma e outro de qualidade de vida da criança (DISABKIDS-37, versões pais e criança). Utilizou-se também uma entrevista sobre a gestão da asma pela família (FAMSS) na avaliação inicial e no follow-up. Os resultados evidenciaram uma melhoria moderada no conhecimento dos pais e nas práticas de gestão da asma, confirmando a utilidade de incluir a intervenção psicoeducativa nos cuidados às crianças com asma.

Gymnasielärares skrivpraktiker : Skrivande som professionell handling i en digitaliserad skola

The aim of this thesis is to contribute to deeper knowledge about the writing practices of teachers in upper secondary school. Schools are under constant pressure to respond to the needs and expectations of an ever-changing society and political intentions. A major factor in this change which is taking place in schools is digitalization. Another factor is the adoption of new governing principles for schools involving management by goals and results, which brings increased demands for written documentation of teachers' work. In order to describe and problematize this development the thesis is based on a combination of Critical Discourse Analysis and New Literacy (Clark and Ivanič, 1997). The theoretical framework rests upon an understanding of writing as social action and the idea that texts both affect and are affected by the social environment. The empirical study focuses on twelve teachers and their writing practices, analyzed during week-long field visits over three years. The teachers' talk about their writing is used together with analyses of texts and images to investigate parts of teachers' writing which, according to the teachers, are considered complex and problematic. The findings indicate significant differences between the writing practices of the individual teachers, where each teacher has his or her own system of texts fulfilling different purposes. Despite these differences it is still possible to identify recurrent themes in the discursive conditions for teachers' writing: efficiency, reuse, authority, audit, relationships to addressees, and room to maneuver. The study illustrates possible dilemmas for teachers' writing at the intersection of teachers' professional responsibility and demands for accountability.

Building an Improved Community Support System

This research will serve to evaluate the current processes and procedures in place for the Community Case Management training, data entry, and quality assurance at the Department of Juvenile Justice. The goal of the research is to identify and establish a framework for a universal unit within the agency that will enhance the effectiveness of Case Management by consolidating and streamlining information to reduce conflicting standards to create a stronger support unit, and to facilitate learning and understanding for the staff.

Capacitação do doente oncológico com doença avançada/cuidador para a gestão da dor em domicílio

Introdução: A dor oncológica é assustadora, tanto para o doente como para o cuidador, quer pela intensidade como por vezes surge, quer pela associação a outros sintomas e alterações nas atividades de vida, causando sofrimento e isolamento social. Capacitar o doente e o cuidador para a gestão da dor, passa por ensinar a identificar, a monitorizar, a relacionar a dor com outros sintomas e com as atividades de vida. Assim como, ensinar a gerir de forma adequada a terapêutica prescrita. Objetivos: Avaliar a aplicação de um programa educativo na capacitação do doente oncológico/cuidador com doença avançada, na gestão da dor em domicílio; Identificar intervenções de Enfermagem no decurso da aplicação do programa; Identificar dificuldades na capacitação do doente/cuidador; Avaliar a capacidade do doente antes e após a aplicação do programa educativo. Metodologia: Este estudo foi realizado no âmbito do projeto de doutoramento. Trata-se de um estudo longitudinal quase experimental, em que foi avaliado o conhecimento relativo à dor antes e depois da aplicação do programa e foi feita uma análise transversal dos registos elaborados pelos participantes, após os vários momentos de contacto/ensino. Participaram no estudo 52 doentes oncológicos com doença avançada, que frequentavam um hospital de dia, em consulta e tratamento sintomático ou curativo de 2ª ou 3ª linha. Resultados: A aplicação do programa educativo exigiu contactos (momentos de ensino) com os participantes, verificandose que 75% dos participantes iniciaram o programa no 1º contacto e 25% iniciaram no 2º contacto. O número de contactos por participante variou entre os 2 e os 6, tendo-se efetuado 3 contactos a 52% dos participantes, 4 a 25% e 2 a 21%. Um participante teve 5 momentos de contacto e outro, 6 momentos. Quanto à capacidade para realização completa dos registos, verificou-se que no final, 50% dos participantes realizaram registos completos de forma independente, destes, 8% adotaram o comportamento correto na tomada da medicação, 6% não modificaram o comportamento e nos restantes esta mudança não se revelou significativa. Trinta e três por cento dos participantes não conseguem realizar os registos sem ajuda, devido ao agravamento dos sintomas, ou baixo nível de literacia, mas identificam e avaliam a dor e outros sintomas. Quinze por cento realizam os registos de forma incompleta e 1 participante apenas descreve a experiência de dor. Conclusões: O desenvolvimento de um programa educativo para capacitação exige uma avaliação do número de momentos de interação necessários para que o processo ocorra. Existem condicionalismos à efetivação dos momentos de contacto, tais como, o estado clínico do doente, a literacia e o desenvolvimento do processo de saúde doença. A aplicação do programa em 3 momentos de ensino foi o mais frequente nesta população. Após a aplicação do programa, a maioria dos doentes/ cuidadores apresentam capacidade para identificar, avaliar e monitorizar a dor e outros sintomas, assim como as alterações nas atividades de vida. Verificou-se uma melhoria na gestão da terapêutica antiálgica. Palavras-chave: dor oncológica; programa educativo; intervenção de enfermagem; capacitação Referências bibliográficas: Borneman, T., Koczywas, M., Sun, V., Piper, B. F., Smith-Idell, C., Laroya, B., & Ferrell, B. (2011). Eficácia de uma intervenção clínica para eliminar as barreiras ao tratamento da dor e fadiga em oncologia. Journal of Palliative Medicine, 14(2), 197-205. doi: 10,1089 / jpm.2010.0268 Tsigaroppoulos, T., Mazaris, E., Chatzidarellis, E., Skolarikos, A. Varkarakis, I., & Deliveliotis, C. (2009). Problems faced by relatives caring for cancer patients at home. International Journal Of Nursing Practice, 15(1), 1-6. doi:10.1111/j.1440-172X.2008.01725.x Vallerand, A., Riley-Doucet, C., Hasenau, S., & Templin, T. (2004). Improving cancer pain management by homecare nurses. Oncology Nursing Forum, 31(4), 809-816. doi:10.1188/04.ONF.809-816 West, C., Dodd, M., Paul, S., Schumacher, K., Tripathy, D., Koo, P., & Miaskowski, C. (2003). The PRO-SELF(c): Pain control programan effective approach for cancer pain management. Oncology Nursing Forum, 30(1), 65-73. doi:10.1188/03

Auditoria e controlo interno no exército: Relatório de estágio

O Sector Público em Portugal atravessa um momento de viragem. O antigo modelo de gestão, burocrático e autoritário vai, aos poucos, dando lugar a um novo modelo assente no princípio dos três "E(s)"1, economia, eficiência, eficácia, ao qual se pode juntar a sustentabilidade e o respeito pelo ambiente, procura tomar os serviços públicos amigos dos cidadãos e das boas práticas. Esta metamorfose exige, contudo, uma acção concertada não só ao nível das práticas, mas também das mentalidades num trabalho conjunto de governantes gestores e auditores. É hoje indiscutível a importância que a auditoria interna tem no seio das organizações. O sector público começa agora a dar os primeiros passos nesta área procurando através da auditoria, não só evitar fraudes e detectar erros mas também apoiar a gestão através de uma actuação directa e eficaz sobre o que está a acontecer, garantindo que os recursos que são de todos, estão a ser gastos de forma adequada. No Exército já existe uma cultura de auditoria na sua vertente tradicional, ou seja, verificação do passado, efeito persuasor, verificação da legalidade detecção de erros e fraudes. A instituição só pode ganhar se nesta área for pioneira alargando o âmbito, da sua intervenção ao nível da verificação da eficácia e da eficiência melhorando e criando uma cultura de rigor e boas práticas na sua gestão. /ABSTRACT: The public sector in Portugal is at a turning point. The old management, bureaucratic and authoritarian model is gradually giving way to a new model based on the principle of the three "E (s)2”, economy, efficiency, effectiveness and, to which we can join sustainability and environmental respect. It aims at making the public service friendly for citizens and promoting better practices. This metamorphosis, however, requires a harmonized action not only at the practice level but also in the attitudes within a joint effort of governing managers and auditors. It is nowadays· indisputable the importance that internal audit has within organizations. The public sector is beginning to take the first steps in this area, seeking in the audit not only to prevent fraud and detect errors but also to support the management by working directly and effectively on what is happening, ensuring that the resources belong to everyone, and are all being spent properly. ln the Army there is already an audit culture in its traditional area, i.e., verification of the past, persuasive effect, verification of the legality, detecting errors and fraud. The institution can only win if it is pioneer in this area by expanding the scope of its intervention at the level of verification, effectiveness and efficiency, improving and creating a culture of rigor and better practices in its management. (1-Vectores chaves para o aumento da produtividade e da riqueza suporte do chamado Value for Money (VFM) - 2-Key vectors that increase the support productivity and wealth of the so called Value for Money (VFM) )

Canopy-scale biophysical controls of transpiration and evaporation in the Amazon Basin.

Canopy and aerodynamic conductances (gC and gA) are two of the key land surface biophysical variables that control the land surface response of land surface schemes in climate models. Their representation is crucial for predicting transpiration (λET) and evaporation (λEE) flux components of the terrestrial latent heat flux (λE), which has important implications for global climate change and water resource management. By physical integration of radiometric surface temperature (TR) into an integrated framework of the Penman?Monteith and Shuttleworth?Wallace models, we present a novel approach to directly quantify the canopy-scale biophysical controls on λET and λEE over multiple plant functional types (PFTs) in the Amazon Basin. Combining data from six LBA (Large-scale Biosphere-Atmosphere Experiment in Amazonia) eddy covariance tower sites and a TR-driven physically based modeling approach, we identified the canopy-scale feedback-response mechanism between gC, λET, and atmospheric vapor pressure deficit (DA), without using any leaf-scale empirical parameterizations for the modeling. The TR-based model shows minor biophysical control on λET during the wet (rainy) seasons where λET becomes predominantly radiation driven and net radiation (RN) determines 75 to 80 % of the variances of λET. However, biophysical control on λET is dramatically increased during the dry seasons, and particularly the 2005 drought year, explaining 50 to 65 % of the variances of λET, and indicates λET to be substantially soil moisture driven during the rainfall deficit phase. Despite substantial differences in gA between forests and pastures, very similar canopy?atmosphere "coupling" was found in these two biomes due to soil moisture-induced decrease in gC in the pasture. This revealed the pragmatic aspect of the TR-driven model behavior that exhibits a high sensitivity of gC to per unit change in wetness as opposed to gA that is marginally sensitive to surface wetness variability. Our results reveal the occurrence of a significant hysteresis between λET and gC during the dry season for the pasture sites, which is attributed to relatively low soil water availability as compared to the rainforests, likely due to differences in rooting depth between the two systems. Evaporation was significantly influenced by gA for all the PFTs and across all wetness conditions. Our analytical framework logically captures the responses of gC and gA to changes in atmospheric radiation, DA, and surface radiometric temperature, and thus appears to be promising for the improvement of existing land?surface?atmosphere exchange parameterizations across a range of spatial scales.

Canopy-scale biophysical controls of transpiration and evaporation in the Amazon Basin.

Canopy and aerodynamic conductances (gC and gA) are two of the key land surface biophysical variables that control the land surface response of land surface schemes in climate models. Their representation is crucial for predicting transpiration (?ET) and evaporation (?EE) flux components of the terrestrial latent heat flux (?E), which has important implications for global climate change and water resource management. By physical integration of radiometric surface temperature (TR) into an integrated framework of the Penman?Monteith and Shuttleworth?Wallace models, we present a novel approach to directly quantify the canopy-scale biophysical controls on ?ET and ?EE over multiple plant functional types (PFTs) in the Amazon Basin. Combining data from six LBA (Large-scale Biosphere-Atmosphere Experiment in Amazonia) eddy covariance tower sites and a TR-driven physically based modeling approach, we identified the canopy-scale feedback-response mechanism between gC, ?ET, and atmospheric vapor pressure deficit (DA), without using any leaf-scale empirical parameterizations for the modeling. The TR-based model shows minor biophysical control on ?ET during the wet (rainy) seasons where ?ET becomes predominantly radiation driven and net radiation (RN) determines 75 to 80?% of the variances of ?ET. However, biophysical control on ?ET is dramatically increased during the dry seasons, and particularly the 2005 drought year, explaining 50 to 65?% of the variances of ?ET, and indicates ?ET to be substantially soil moisture driven during the rainfall deficit phase. Despite substantial differences in gA between forests and pastures, very similar canopy?atmosphere "coupling" was found in these two biomes due to soil moisture-induced decrease in gC in the pasture. This revealed the pragmatic aspect of the TR-driven model behavior that exhibits a high sensitivity of gC to per unit change in wetness as opposed to gA that is marginally sensitive to surface wetness variability. Our results reveal the occurrence of a significant hysteresis between ?ET and gC during the dry season for the pasture sites, which is attributed to relatively low soil water availability as compared to the rainforests, likely due to differences in rooting depth between the two systems. Evaporation was significantly influenced by gA for all the PFTs and across all wetness conditions. Our analytical framework logically captures the responses of gC and gA to changes in atmospheric radiation, DA, and surface radiometric temperature, and thus appears to be promising for the improvement of existing land?surface?atmosphere exchange parameterizations across a range of spatial scales.

Utilizzo di una rete protesica in polipropilene in supporto all'erniorrafia perineale tradizionale nel cane

Scopo del progetto di dottorato è stato quello di mettere a punto l’utilizzo di una tecnica alternativa, rispetto a quelle riportate in letteratura, per la risoluzione dell’ernia perineale nel cane. Tale tecnica si propone di risolvere il difetto mediante l’ausilio di una rete protesica in polipropilene in supporto all’erniorrafia perineale tradizionale, mediante sutura a punti staccati dei muscoli che costituiscono il diaframma pelvico. Questa procedura risulta meno invasiva per l’animale rispetto alla tecnica che in letteratura viene definita il gold standard, ovvero la trasposizione del muscolo otturatore interno (Shaughnessy and Monnet, 2015), ed altre tecniche traspositive, quali la trasposizione del muscolo semitendinoso (Morello et al., 2015) e del gluteo superficiale (Bellenger & Canfield, 2002), con tempi di recupero postoperatori più rapidi e una gestione più semplice da parte del proprietario, pur mantenendo eccellenti outcomes. La messa a punto di questa procedura nasce dalla necessità di trovare una tecnica semplice da eseguire, che determini una chiusura del diaframma pelvico tale da evitare la comparsa di recidive e minimizzare le complicazioni post-operatorie. L’intento del progetto è stato di combinare l’erniorrafia perineale tradizionale con l’utilizzo di reti protesiche così da ricostruire il diaframma pelvico con i muscoli deputati a svolgere tale compito e fornire, tramite la rete, un maggiore supporto alla rafia, evitando le trasposizioni muscolari che comporterebbero un intervento più demolitivo e un recupero più lento da parte del paziente. Sono stati inclusi nello studio 30 cani portatori di ernia perineale, per un totale di 50 ernie, trattati con l’intervento proposto dal progetto. Di ogni caso sono stati raccolti il segnalamento, l’anamnesi, le indagini diagnostiche e i successivi follow up post-operatori considerando le eventuali complicazioni o la comparsa di recidiva dell’ernia.

Rapid detection of enterovirus in cerebrospinal fluid by a fully-automated PCR assay is associated with improved management of aseptic meningitis in adult patients.

BACKGROUND: Enterovirus (EV) is the most frequent cause of aseptic meningitis (AM). Lack of microbiological documentation results in unnecessary antimicrobial therapy and hospitalization. OBJECTIVES: To assess the impact of rapid EV detection in cerebrospinal fluid (CSF) by a fully-automated PCR (GeneXpert EV assay, GXEA) on the management of AM. STUDY DESIGN: Observational study in adult patients with AM. Three groups were analyzed according to EV documentation in CSF: group A=no PCR or negative PCR (n=17), group B=positive real-time PCR (n=20), and group C=positive GXEA (n=22). Clinical, laboratory and health-care costs data were compared. RESULTS: Clinical characteristics were similar in the 3 groups. Median turn-around time of EV PCR decreased from 60h (IQR (interquartile range) 44-87) in group B to 5h (IQR 4-11) in group C (p<0.0001). Median duration of antibiotics was 1 (IQR 0-6), 1 (0-1.9), and 0.5 days (single dose) in groups A, B, and C, respectively (p<0.001). Median length of hospitalization was 4 days (2.5-7.5), 2 (1-3.7), and 0.5 (0.3-0.7), respectively (p<0.001). Median hospitalization costs were $5458 (2676-6274) in group A, $2796 (2062-5726) in group B, and $921 (765-1230) in group C (p<0.0001). CONCLUSIONS: Rapid EV detection in CSF by a fully-automated PCR improves management of AM by significantly reducing antibiotic use, hospitalization length and costs.

Forest regeneration capacity and its enhancement by forest management and silviculture in Cabo Delgado

SDC has been involved in rural development in Cabo Delgado for more than 30 years. Shortly after the independence of Mozambique, projects in water supply and integrated rural development were initiated. The silvoagropastoral project FO9 based in Mueda was a very early experience in forestry in Cabo Delgado. Andreas Kläy was responsible for the forestry sector in FO9 for 3 years in the early 1980s and had an opportunity to initiate an exchange of ideas and experience in rural development theory and approaches with Yussuf Adam, who was doing research in human anthropology and history in the province. 25 years later, the current situation of forest management in Cabo Delgado was reassessed, with a specific focus on concessions in the North. The opportunity for a partnership between the MITI SA, the University of Eduardo Mondlane, and CDE was created on the basis of this preliminary study1. The aim of this partnership is to generate knowledge and develop capacity for sustainable forest management. The preliminary study showed that “…we have to face weaknesses and would like to start a learning process with the main institutions, organisations, and stakeholder groups active in forest management and research in the North of Cabo Delgado. This learning process will involve studies supported by competent research institutions and workshops …” The specific objectives of ESAPP project Q804 are the following: 1. Contribute to understanding of the forestry sector; 2. Capacity development for professionals and academics; 3. Support for the private sector and the local forest service; 4. Support data generation at Cabo Delgado's Provincial Service; 5. Capacity development for Swiss academic institutions (CDE and ETHZ). A conceptual planning platform was elaborated as a basis for cooperation and research in the partnership (cf. Annex 1). The partners agreed to work on two lines of research: biophysical and socio-economic. In order to ensure a transdisciplinary approach, disciplinary research is anchored in common understanding in workshops based on the LforS methods. These workshops integrate the main stakeholders in the local context of the COMADEL concession in Nangade District managed by MITI SA, and take place in the village of Namiune. The research team observed that current management schemes consist mainly of strategies of nature mining by most stakeholders involved. Institutional settings - formal and informal - have little impact due to weak capacity at the local level and corruption. Local difficulties in a remote rural area facilitate external access to resources and are perpetuated by the loss of benefits. The benefits of logging remain at the top level (economic and political elites). The interests of the owners of the concession in stopping the loss of resources caused by this regime offers a unique opportunity to intervene in the logic of resource degradation and agony in rural development and forest management.

Diversity faultlines, shared objectives, and top management team performance

Faultline theory suggests that negative effects of team diversity are better understood by considering the influence of different dimensions of diversity in conjunction, rather than for each dimension separately. We develop and extend the social categorization analysis that lies at the heart of faultline theory to identify a factor that attenuates the negative influence of faultlines: the extent to which the team has shared objectives. The hypothesized moderating role of shared objectives received support in a study of faultlines formed by differences in gender, tenure, and functional background in 42 top management teams. The focus on top management teams has the additional benefit of providing the first test of the relationship between diversity faultlines and objective indicators of organizational performance. We discuss how these findings, and the innovative way in which we operationalized faultlines, extend faultline theory and research as well as offer guidelines to manage diversity faultlines.

A Conceptual Framework to Develop Long-Term Ecological Research and Management Objectives in the Wider Caribbean Region

The Caribbean Sea and its watersheds show signs of environmental degradation. These fragile coastal ecosystems are susceptible to environmental impacts, in part because of their oligotrophic conditions and their critical support of economic development. Tourism is one of the major sources of income in the Caribbean, making the region one of the most ecotourism dependent in the world. Yet there are few explicit, long-term, comprehensive studies describing the structure and function of Caribbean ecosystems. We propose a conceptual framework using the environmental signature hypothesis of tropical coastal settings to develop a series of research questions for the reef–sea-grass–wetland seascape. We applied this approach across 13 sites throughout the region, including ecosystems in a variety of coastal settings with different vulnerabilities to environmental impacts. This approach follows the strategy developed by the Long Term Ecological Research program of the National Science Foundation to establish ecological research questions best studied over decades and large spatial areas.

Evaluating conservation and fisheries management strategies by linking spatial prioritization software and ecosystem and fisheries modelling tools

Well-designed marine protected area (MPA) networks can deliver a range of ecological, economic and social benefits, and so a great deal of research has focused on developing spatial conservation prioritization tools to help identify important areas. However, whilst these software tools are designed to identify MPA networks that both represent biodiversity and minimize impacts on stakeholders, they do not consider complex ecological processes. Thus, it is difficult to determine the impacts that proposed MPAs could have on marine ecosystem health, fisheries and fisheries sustainability. Using the eastern English Channel as a case study, this paper explores an approach to address these issues by identifying a series of MPA networks using the Marxan and Marxan with Zones conservation planning software and linking them with a spatially explicit ecosystem model developed in Ecopath with Ecosim. We then use these to investigate potential trade-offs associated with adopting different MPA management strategies. Limited-take MPAs, which restrict the use of some fishing gears, could have positive benefits for conservation and fisheries in the eastern English Channel, even though they generally receive far less attention in research on MPA network design. Our findings, however, also clearly indicate that no-take MPAs should form an integral component of proposed MPA networks in the eastern English Channel, as they not only result in substantial increases in ecosystem biomass, fisheries catches and the biomass of commercially valuable target species, but are fundamental to maintaining the sustainability of the fisheries. Synthesis and applications. Using the existing software tools Marxan with Zones and Ecopath with Ecosim in combination provides a powerful policy-screening approach. This could help inform marine spatial planning by identifying potential conflicts and by designing new regulations that better balance conservation objectives and stakeholder interests. In addition, it highlights that appropriate combinations of no-take and limited-take marine protected areas might be the most effective when making trade-offs between long-term ecological benefits and short-term political acceptability.

Objectives for management of socio-ecological systems in the Great Barrier Reef region, Australia

A wide range of goals and objectives have to be taken into account in natural resources management. Defining these objectives in operational terms, including dimensions such as sustainability, productivity, and equity, is by no means easy, especially if they must capture the diversity of community and stakeholder values. This is especially true in the coastal zone where land activities affect regional marine ecosystems. In this study, the aim was firstly to identify and hierarchically organise the goals and objectives for coastal systems, as defined by local stakeholders. Two case study areas are used within the Great Barrier Reef region being Mackay and Bowen–Burdekin. Secondly, the aim was to identify similarities between the case study results and thus develop a generic set of goals to be used as a starting point in other coastal communities. Results show that overarching high-level goals have nested sub-goals that contain a set of more detailed regional objectives. The similarities in high-level environmental, governance, and socio-economic goals suggest that regionally specific objectives can be developed based on a generic set of goals. The prominence of governance objectives reflects local stakeholder perceptions that current coastal zone management is not achieving the outcomes they feel important and that there is a need for increased community engagement and co-management. More importantly, it raises the question of how to make issues relevant for the local community and entice participation in the local management of public resources to achieve sustainable environmental, social, and economic management outcomes. © 2015 Springer-Verlag Berlin Heidelberg

Management of Chronic Unilateral Hematuria by Ureterorenoscopy

Background and Purpose: Chronic unilateral hematuria is characterized by intermittent or continuous gross hematuria that cannot be diagnosed using standard radiology and hematology methods. In the past, it was managed with partial or total nephrectomy. In the age of minimally invasive procedures, however, endoscopy has enabled more accurate diagnosis and management. We analyzed our experience with transurethral ureterorenoscopy using a flexible ureteroscope to determine the feasibility and success of endoscopic management of renal hematuria. Patients and Methods: We reviewed the records of 13 patients who presented with chronic unilateral hematuria, in whom radiologic and laboratory tests failed to reveal the source of bleeding. In the cases in which the lesion was identified, after complete inspection of the collecting systems, the bleeding site was treated ureteroscopically with a holmium: yttrium-aluminum-garnet ( YAG) laser. Results: Follow-up ranged from 4 to 60 months ( mean 26 mos). During the follow-up of the 13 patients, 11 remained symptom-free, with only one session of flexible ureterorenoscopy necessary. Relapse occurred in two patients after 4 months and 6 months, respectively; during a second session of flexible ureteroscopy, the bleeding site was successfully identified and cauterized with a holmium: YAG laser. No surgical complications occurred. Conclusions: Conservative treatment of patients with chronic unilateral hematuria should always be considered. Laser ureteroscopic treatment is an excellent method and should be considered as the first option for the management of chronic unilateral hematuria.