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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
211

Potrebbe l'applicazione di pesticidi influenzare l'abbondanza, la struttura, la biodiversità e la funzionalità della comunità microbica del suolo? / COULD PESTICIDE APPLICATION AFFECT ABUNDANCE, STRUCTURE, BIODIVERSITY AND FUNCTIONALITY OF SOIL MICROBIAL COMMUNITY?

PERTILE, GIORGIA 17 March 2016 (has links)
In agricoltura, i pesticidi sono stati usati molto frequentemente per salvaguardare le colture dagli attacchi di parassiti e dalle malattie. Questi pesticidi, oltre a uccidere gli organismi target, molte volte colpiscono anche gli organismi non-target. Tra gli organismi non-target, possiamo individuare molti microrganismi utili a determinare la fertilità e la qualità del terreno. La presenza di questi xenobiotici nel terreno può influenzare i principali cicli biogeochimici (N, C, S, P) e altre vie metaboliche (es. β-ketoadipate). In questo studio abbiamo analizzato gli effetti di isoproturon, tebuconazole e chlorpyrifos sull’abbondanza, sulla struttura e sulla diversità della comunità microbica. Inoltre, abbiamo anche studiato gli effetti di questi pesticidi sui geni coinvolti nel ciclo dell’azoto. Si è potuto notare che l’abbondanza della comunità batterica è molto influenzata dall’applicazione del fungicida tebuconazole . Per quanto riguarda gli studi sulla funzionalità e diversità della popolazione microbica, l’applicazione di questi pesticidi sembra non indurre una chiara dose-dipendente e un effetto tempo. Diversamente, in relazione all’analisi sulla diversità microbica, possiamo affermare che l’applicazione di questi tre pesticidi ha influenzato il numero di OTU rilevate; tuttavia, l’indice di diversità (H’) ci dice che l’uso di questi pesticidi porta ad un incremento della diversità all’interno dei campioni trattati. In conclusione, è possibile affermare che l’applicazione di questi pesticidi influenza l’abbondanza e la funzionalità della popolazione microbica, ma non induce una diminuzione della diversità all’interno della medesima comunità. / In agriculture, pesticides have been frequently used to protect crops from pest and disease attacks. Many times such pesticides, besides killing the target organisms, hit non-target organisms. Among the non-target organisms, we can find many useful microorganisms that determine fertility and soil quality. The presence of these xenobiotics in soil can influence the main biogeochemical cycles (N, C, S, P) and other metabolic pathways (eg. Β-ketoadipate). In this study, we investigated the effects of isoproturon, tebuconazole and chlorpyrifos on the abundance, the structure and the diversity of the microbial community. We have also studied the effects of these pesticides on the genes involved in the nitrogen cycle. It was observed that the abundance of the bacterial community is significantly affected by the application of the fungicide tebuconazole. As for the studies on the functionality and the diversity of the bacterial population, the application of these pesticides does not seem to induce a clear dose-dependent nor a time effect. On the contrary, with respect to the analysis on microbial diversity, we observed that the application of these three pesticides did influence the number of detected OTU, whereas the diversity index (H') tells us that the use of such pesticides leads to an increase of diversity within the treated samples. Finally, we can conclude that the application of these pesticides affects the abundance and function of the microbial population, but does not lead to lower diversity within the same community.
212

Towards the functionality South African internet banking websites should provide to address the needs of generation-Y users

Mtimkulu, Sebabatso 07 1900 (has links)
Despite the widespread adoption of Internet banking, no guidelines exist on what functionality the techno-savvy Generation-Y customer segment (20–37 years) expects from Internet banking websites. This research investigated the functionality that South African Generation-Y customers require from this transacting platform. A user-centred design philosophy with a mixed method research design was used. The technological characteristics of Generation-Y, abstracted from the literature, were aligned with functionality trends of future Internet banking websites to formulate an initial list of Internet banking functionality guidelines. These were evaluated using a survey and interviews, and were also used in a heuristic evaluation of the Internet banking platforms of five South African banks. The findings were integrated to synthesise functionality guidelines. A visual representation of these guidelines was constructed as wireframes for evaluation by Generation-Y users. This study makes a contribution by providing a validated list of Internet banking functionality guidelines for Generation-Y banking customers. / College of Engineering, Science & Technology / M. Tech. (Information Technology)
213

Kompiuterizuoto natų rašymo technologijų analizė / Analysis of Computerized Music Notation Technologies

Milvydaitė, Aistė 02 September 2010 (has links)
Tikslas:Ištirti kompiuterizuotam natų rašymui skirtas technologijas. Tyrimo objektas:Natų saugojimo formatai ir jų kūrimo programinė įranga. Problemos analizė:Kompiuterizuotam natų rašymui yra sukurta nemažai specialios programinės įrangos ir jų rezultato saugojimo formatų. Tačiau susistemintos informacijos apie tokių technologijų privalumus ir trūkumus rasti gan sunku, todėl vartotojai patys turi jas bandyti ir atrasti jiems labiausiai tinkančias. Tyrimo metodologija:Teoriniai tyrimo metodai: literatūros apžvalga ir analizė. Praktiniai tyrimo metodai: natografijos failų formatų apimties skirtumo tyrimas, natų rašymui skirtos programinės įrangos funkcionalumo įvertinimo bei patrauklumo vartotojui stebėjimas ir tyrimas. Naudotos priemonės:Sibelius 6, Harmony Assitant, Quick Score Elite Level II, Denemo – tyrimo duomenų gavimui ir kūrimui; Microsoft Excel 2003 – tyrimo duomenų aprašymui ir susisteminimui; SPSS Statistics 17.0 – tyrimo duomenų apdorojimui, analizei ir pateikimui; Microsoft Word 2003 – darbo rengimui ir pateikimui. Tyrimo apimtis: Failų formatų apimtis lyginta atsižvelgiant į: failo dydį, natų formato tipą, formato skaitomumą vartotojui, failo apimtį ir jos sumažinimo galimybę. Programinės įrangos funkcionalumas ištirtas įvertinant funkcijų kiekio santykį atitinkamose funkcionalumo grupėse: teksto įterpimas ir apiforminimas, lapo formatavimas, pasirinktų natų ir ženklų atvaizdavimas penklinėje, partitūros rašymas MIDI klaviatūra ir kompiuterio klaviatūra, muzikos... [toliau žr. visą tekstą] / Many various science areas are gradually relocating to information technology space and the recording of notes is not an exception. Hence, there are many different note recording and preserving formats and special software intended for the creation of such formats. However, because of comparatively rapid IT advancement it is usually hard to follow the all existing IT solutions and select the most proper, therefore, the objective of this work is to examine the technologies intended for the recording and preserving notes on the computer. During the time of this work the following examinations were completed: • The examination of note preserving formats; • The analysis of note recording software functionality; • The research of note recording software appeal; After completing the review of note preserving formats it was clear that they can be categorized into three groups: ascii, xml and binary. The note preserving formats which are based on ascii and xml codes are more coherent for the common user and take less hard disk space. After analyzing the note recording software the final results reveal that the Harmony Asisstant program is highly advanced and supports most functions. The Sibelius 6 is also very advanced and functional. After completing the note recording software appeal survey it was discovered that the respondents consider Sibelius 6 as the most appealing and coherent program.
214

The functionality of a district municipality as a transport authority : the case of the West Rand, Gauteng Province / Herina Hamer

Hamer, Herina January 2006 (has links)
The White Paper on National Transport Policy (SA, 1996:12) identified the fragmentation of functions between different spheres of government as one of the main obstacles besetting the effective development and management of the transport system. It endorsed one of the principles in the Constitution of the Republic of South Africa Ad 108 of 1996, to devolve functions to the lowest appropriate sphere of government if it could be more effectively handled and if there was capacity to perform the functions. In pursuing the above objective, the purpose of this study was to determine the functionality of the West Rand District Municipality in terms of administrative as well as economic and transport management principles to fulfil the role as a transport authority in terms of the NLTTA for its present area of jurisdiction. The study therefore addressed the legal framework as well as transport and economic indicators defining the functional area of a transport authority. In determining the nature and extent of functions as fulfilled by the respective municipalities, use was made of dichotomous questionnaires. These findings were also supported with technical data based on surveys conducted through the Gauteng Household Travel Survey (2000) and the Operating Licensing Strategy (200212003). To further operationalise the research objectives of this study, and touching on Great Britain's transport experience over the past 75 years, a comparison was made between the present status of Transport Authorities in the United Kingdom, compared to those in South Africa (Gauteng Province). Upon analysing the empirical findings it was evident that the establishment of a Transport Authority for the area of jurisdiction of the West Rand would enable the WRDM to deliver on the following number of fronts: • Coherent Alignment to a Common Vision • Integration of Transport System • Control over Transport Modes • Optimised Utilisation of Funds To create a conducive environment for a West Rand Transport Authority to improve its functionality, it was recommended that serious attention be given to aspects such as funding mechanisms, legality of municipal entities, clarity on the status of transport powers at municipal level of government, assignment of functions and human resource capacity. Upon conclusion it was agreed that the successful implementation of a functional transport authority for the West Rand will be dependant, not only upon technical expertise and management and by resolving the above issues, but also on political support. / Thesis (M. Development and Management)--North-West University, Potchefstroom Campus, 2006.
215

Les traductions du Daode jing (道德經) de Julien (1842), Duyvendak (1953) et Mathieu (2008) : intentions, interventions, fonctionnalité

Laporte, Luc 08 1900 (has links)
Étude de maîtrise sponsorisée par le Fonds québécois de recherche Société et Culture (gouvernement du Québec), le programme Renforcement du secteur langagier au Canada (gouvernement du Canada), ainsi que par diverses bourses octroyées par l'Université de Montréal. / Cette étude traductologique a pour cadre l’approche « skopos plus loyalty » (Nord [1997] 2007 : 123). Elle illustre l’important potentiel heuristique et didactique de cette méthode lorsque appliquée de manière contrastive à des traductions philologiques, en démontrant clairement que des intentions différentes commandent des techniques et procédés différents pour la résolution de problématiques similaires (ibid. : 115 116). Trois traductions ont été choisies pour leur fonctionnalité. Leur consigne de traduction (Nord [1997] 2007 : 30) a été inférée, puis les interventions (Chesterman 1997; Gagnon 2006) délibérées (Bastin 2007) qui ont favorisé leur réception ont été relevées et qualifiées. Leurs effets sur l’articulation de certains passages probants et sur la « triple loyauté du traducteur » ont été jaugés, et celles qui se sont avérées malencontreuses ont été commentées selon les présupposés et mésinterprétations culturels de Ke (1999). / The theoretical framework of this study is Nord’s "skopos plus loyalty" approach ([1997] 2007 : 123). It exemplifies its heuristic and didactic potential when applied to philological translations, following Nord’s saying that "Comparing translations of various texts in various situations at various moments in history we find that different purposes can very often explain why translators have chosen different techniques or procedures to solve similar or analogous problems." (ibid. : 115 116) Three translations were selected for their functionality; their translation brief (Nord ibid. : 30) has been inferred, and the deliberate (Bastin 2007) translation shifts (Chesterman 1997; Gagnon 2006) which contributed to their functionality were identified. The "distribution" of the "translator’s threefold loyalty" has been evaluated, and those shifts which proved to be "unfortunate" were explained in terms of Ke's cultural presuppositions and misreadings (1999).
216

Étude de la fonctionnalité alimentaire de plats industriels / Study of functionnality of different food preparations

Hyardin, Aude 25 September 2008 (has links)
Consommateurs, chercheurs et industriels cherchent de plus en plus à associer à la valeur nutritionnelle des aliments, un effet bénéfique pour la santé. Les aliments caractérisés par des pouvoirs antioxydants élevés semblent correspondre à cette demande. En effet, plusieurs travaux mentionnent les bénéfices santé de ces aliments. Pour répondre à cette demande les industriels mettent en avant ce critère. La fonctionnalité alimentaire, aux bénéfices prometteurs pour la santé publique, reste un concept néanmoins complexe dans la pratique. Ce travail met l’accent sur le fait que les propriétés fonctionnelles d’un aliment ne sont pas directement liées à la composition en ingrédients. L’évaluation du pouvoir antioxydant d'un aliment est dans la plupart des cas réalisée à partir des valeurs des différents ingrédients avant formulation et mise en œuvre des procédés. Pourtant, plusieurs phénomènes sont susceptibles de modifier le pouvoir antioxydant lors de la durée de vie d'un produit alimentaire. D’un point de vue industriel, il est nécessaire de développer une méthode de prédiction de cette activité. Les objectifs de ce travail étaient d’adapter une méthode reproductible et facile à réaliser de quantification du pouvoir antioxydant sur des aliments complexes et de comparer cet index d'un ensemble de produits contenant une large gamme de matières premières. Enfin, a été discuté l’intérêt que représente, dans le domaine des propriétés anti oxydantes, la quantification de l’index créé. Au moment où les industriels vont être amenés à proposer des allégations liées à l’effet bénéfique de l’aliment choisi parmi un échantillon de plus en plus ample / Consumers, researchers and industrialists try more and more to associate with the nutritional value of food, a beneficial effect for the health. Food characterized by high antioxidant powers seems to correspond to this demand. From an industrial point of view, it is necessary to develop methods of predicting this antioxidant capacity. The objectives of this work were to adapt a method reproducible and easy to realize of quantification of the antioxidant power on complex food and to compare this index of a set of products containing a wide range of raw materials. Until now, it has been considered that the use of raw materials characterized by a high antioxidant capacity also leads to a preparation with a high antioxidant activity. We evaluated many of the factors affecting the antioxidant activity of convenience foods (phenol content, effects of formulation, culinary reheating, and preservation) and to provide data on convenience foods consumed by the French population. The total antioxidant capacity of the ethanolic extracts was evaluated by the method of the equivalent Trolox (TEAC) using the radical cation ABTS•+. The concentration of the total phenolic compounds of the same extracts was determined by the Folin-Ciocalteu method. The results show that the food matrix is an important factor for the modulation of activities of antioxidants. A standardised testing protocol for evaluating antioxidative effects is necessary. Then, we discussed the interest of an index, as the industrialists are going to be brought to claim to the beneficial effect of the food chosen among a more and more ample sample
217

Systém pro podporu auditu / Audit Supporting System

Wrana, Tomáš Unknown Date (has links)
The aim of this thesis is to illustrate the problems of auditing of information technology and to propose a design of an information system which would support the audit process. The scope of such system is beyond the framework of this thesis and therefore the specification of requirements and system design is only on a general level. We will approach in a more detailed way only one selected component, which is to be implemented. This tool is concerned with the management of assignments. It will record and evaluate the assignments, including the hours charged and hours budgeted to an assignment. In this paper, the system is described, analyzed in detail with respect to the requirements, then implemented, and its functionality tested.
218

POST HARVEST STORAGE OF BIOFORTIFIED MAIZE IN PURDUE IMPROVED CROP STORAGE (PICS) BAGS AND EFFECT ON SUBSEQUENT FLOUR RHEOLOGY AND CAROTENOID BIOACCESSIBILITY

Smith G Nkhata (6668768) 15 August 2019 (has links)
<p>Successful adoption of biofortified orange maize in developing countries requires careful consideration of factors across the chain from farm to fork. This includes consideration of post-harvest storage conditions optimal for the retention of both proviatamin A carotenoids and cooking quality critical to consumers. In these considerations, identification of economical storage methods is critical considering the limitations within specific countries that biofortified maize is being disseminated. To address these points, this dissertation research focused on evaluation of the utility of the Purdue Improved Crop Storage (PICS) bags as a post-harvest storage solution for biofortified maize. The specific focus of this research was to monitor retention of provitamin A and other carotenoids in two biofortified maize genotypes (OPVI and OPVII) as well as storage effect on flour functionality. Finally, a preliminary assessment of the impacts of storage on carotenoid bioaccessibility was completed to begin to translate findings to practice.</p><p>Maize grain from 2016 harvest was stored at ambient conditions for eight months in either PICS bags with or without an O<sub>2</sub> scavenger, (PICS-oxy) and (PICS-noxy), respectively and compared to storage in common polypropylene woven bags (control). After 4 months of storage carotenoid content was significantly higher (p<0.05) in PICS-oxy compared to PICS-noxy and woven bags demonstrating the importance of entrapped oxygen on maize carotenoid degradation. Furthermore, differences in carotenoid stability between maize genotypes were observed with OPVI having higher retention than OPVII. After 8 months, carotenoid retention remained dependent on storage bag and genotype with retention being greater in PICS-oxy and PICS-noxy compared to woven bags. However, final levels after 8 months were more similar between storage methods. Overall, oxygen content and genotype were found to be determining factors in the effectiveness of PICS to mitigate carotenoid degradation during post-harvest storage of maize.</p><p>While reducing the rate of carotenoid degradation during postharvest storage of biofortified maize is important, success of biofortified maize is also dependent on consumer adoption of these grains and their performance in traditional food preparation. Assessment of the rheological and functional properties of these two biofortified maize genotypes as a function of post-harvest storage was completed to assess the impact of post-harvest storage in PICS bags on flour functionality and rheological properties for the two biofortified orange maize genotypes and a control white maize genotype. Flour pasting profiles were assessed initially and at 4 and 8 months. After 8 month storage in woven and PICS bag, OPVI and OPVII produced porridges with similar viscosities to their initial viscosities regardless of postharvest storage type. White maize viscosities progressively decreased with storage and were significantly lower (p<0.05) in woven compared to PICS storage. Sequestration of oxygen (PICS-oxy) had modest but significant effects (p<0.05) on key pasting parameters including peak and final viscosities. These results suggest that oxygen sequestration has a critical effect on final flour functionality. DTT treatment partially restored flour pasting profiles suggesting disulfide linkages may modify pasting profiles of flour. There was also an increase in free ferrulic and <i>p</i>-coumaric acids during storage which may have contributed to observed decreases in porridge viscosities. Evidence of this was found through Raman spectroscopy with spectral intensity at both 478cm<sup>-1</sup> and 2911cm<sup>-1</sup> decreasing with storage suggesting the potential for structural changes induced by storage on starch polymer. While storage in PICS bags does not seem to adversely affect flour functionality it may provide some additional economic benefit resulting from requiring proportionally less flour to achieve similar final viscosities as flour from woven bag stored grains. </p><p>Finally, the effect of postharvest storage on bioaccessibility of carotenoids was explored using experimental wet cooked porridges made from ‘fresh’ and stored grains using an established three stage in-<i>vitro</i> digestion model. Relative carotenoid bioaccessibility (% micellarization) was generally higher in less viscous porridge made from grains stored in woven bags compared to porridge from initial or PICS bags stored grains suggesting that higher viscosity might partly explain lower relative bioaccessibility in porridge from grains stored in PICS bags. Absolute carotenoid bioaccessibility from experimental porridge was dependent on carotenoid species and storage system. Extrapolation of relative bioaccessibility (%) to absolute bioaccessibility (µg/g flour) suggests that fresh grains and their corresponding porridges would provide more absolute bioaccessible carotenoids compared to stored grains despite some improvement in relative accessibility. As such, storage losses remain the main factor impacting total available carotenoids and should continue to be an area of focus for future mitigation. With the potential to minimize post-harvest losses, improve carotenoid retention and provide a product with improved cooking performance, PICS bags do appear to offer a viable storage alternative to improve both food and nutrition security in developing countries.</p><p></p>
219

Funcionalidade e desempenho cognitivo na demência frontotemporal variante comportamental / Functionality and cognitive performance of patients with behavioral variant Frontotemporal Dementia

Lima-Silva, Thais Bento 31 January 2013 (has links)
Lima-Silva TB. Funcionalidade e desempenho cognitivo na demência frontotemporal variante comportamental. [Dissertação]. São Paulo: Faculdade de Medicina, Universidade de São Paulo, 2012. Resumo Introdução: Existem poucos estudos sobre alterações funcionais na Demência Frontotemporal variante comportamental (DFTvc). Subtipos de demência menos estudados, como a DFTvc, vêm ganhando destaque, por também apresentarem importância epidemiológica. Objetivou-se no presente estudo: 1. Caracterizar o desempenho funcional e cognitivo de pacientes com diagnóstico prévio de DFTvc, atendidos em ambulatórios de Neurologia e Psiquiatria e compará-los a pacientes com Doença de Alzheimer (DA) e controles saudáveis; 2. Examinar a correlação entre o desempenho em escalas funcionais (DAFS-BR, DAD e PFAQ) e o desempenho cognitivo; 3. Avaliar a acurácia diagnóstica da DAFS-BR para a detecção da DFTvc e da DA. Métodos: Participaram 96 indivíduos com idade igual ou superior a 45 anos, com escolaridade formal acima de dois anos. Destes, 31 haviam recebido o diagnóstico de DFTvc, 31 de DA e 34 eram adultos saudáveis pareados aos pacientes com DFTvc e DA para idade e escolaridade. Foram aplicados: questionário sociodemográfico e de variáveis clínicas; Escala de Depressão Geriátrica (Geriatric Depression Scale - GDS) de 15 itens, Escala de Ansiedade Geriátrica (Geriatric Anxiety Inventory - GAI), Addenbrooke Cognitive Examination-Revised (ACE-R) que engloba as questões do Mini Exame do Estado Mental (MEEM), Executive Interview (EXIT-25), Direct Assessment of Functional Status (DAFS-BR). O protocolo dos acompanhantes conteve a Escala Cornell de Depressão em Demência, Pfeffer Functional Activities Questionnaire (PFAQ), Disability Assessment for Dementia (DAD), Inventário Neuropsiquiátrico (NPI) e a Escala de Avaliação Clínica da Demência (CDR). Resultados: Pôde-se observar que o grupo com DFTvc apresentou pior desempenho em Alimentação na DAFS-BR e nos domínios de Iniciação e Planejamento/Organização na DAD, comparado aos idosos com DA, sugerindo que a dependência na DFTvc é mais acentuada. A pontuação mais elevada na PFAQ, sugeriu que a dependência na DFTvc é mais acentuada. Foram encontradas correlações significativas entre o desempenho cognitivo e funcional. Os dados de acurácia para a DAFS-BR sugeriram que a escala pode auxiliar na identificação das demências, apresentando limitações no diagnóstico diferencial entre os subtipos. Considerações finais: Os resultados apresentados sugerem que indivíduos com DFTvc apresentam maior prejuízo funcional, quando comparados com participantes com DA e adultos saudáveis. Os resultados apresentados destacaram a importância da avaliação funcional de pacientes com suspeita de DFTvc, devido à relevância destas alterações para o diagnóstico e manejo clínico deste subtipo de demência. / Summary Introduction: There are but a few research studies on functional impairment in behavioral variant Frontotemporal Dementia. Less studied dementia subtypes, such as bvFTD, have been gaining prominence due to their epidemiological significance. The objectives of the present research were to: 1. Characterize the functional and cognitive performance of patients previously diagnosed with bvFTD treated at outpatient clinics of Neurology and Psychiatry, and compare their performance with that of patients with AD and normal controls; 2. Examine the correlation between performance in the functional scales (DAFS-BR, DAD e PFAQ) and cognitive performance; and 3. Evaluate the diagnostic accuracy of the DAFS-BR for detecting bvFTD and AD. Methodology: The sample consisted of 96 individuals aged 45 or older, with at least two years of formal education. Of these, 31 had been diagnosed with bvFTD, 31 with AD, and 34 were healthy adults paired with the patients with bvFTD and AD for age and education. The following instruments were used: sociodemographic and clinical questionnaire; 15-item Geriatric Depression Scale (GDS); Geriatric Anxiety Inventory (GAI); Addenbrooke Cognitive Examination-Revised (ACE-R), which includes the questions of the Mini Mental State Examination (MMSE); Executive Interview (EXIT-25); and the Direct Assessment of Functional Status Revised (DAFS-BR). The protocol for caregivers included the Cornell Scale for Depression in Dementia, Pfeffer Functional Activities Questionnaire (PFAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI) and the Clinical Dementia Rating scale (CDR). Results: Individuals in the bvFTD group had lower performance in the ´Eating skills´ item of the DAFS-BR, and in ´Initiation´ and in ´Planning/Organization´ in the DAD, suggesting a higher level of dependence in bvFTD, and Higher scores in the PFAQ suggested that dependence in bvFTD is more pronounced. Significant correlations were found between cognitive and functional performances. The accuracy data for the DAFS-BR indicated that the scale can help identify dementia however, it has limitations in the differential diagnosis among subtypes. Final Considerations: The results suggest that individuals with bvFTD display greater functional impairment when compared to individuals with AD and to healthy adults. These results highlight the importance of assessing functionality status among patients suspected to have bvFTD. These deficits are relevant for the diagnosis and clinical management of this subtype of dementia.
220

Estudo randomizado e controlado para avaliar a eficácia da terapia ocupacional na reabilitação de funções executivas em pacientes com esquizofrenia resistente ao tratamento / Randomized and controlled trial to evaluate the efficacy of occupational therapy in the rehabilitation of executive functions in patients with treatment-resistant schizophrenia

Vizzotto, Adriana Dias Barbosa 13 December 2018 (has links)
A esquizofrenia é uma das 25 principais causas de incapacidade em todo o mundo. Indivíduos que desenvolvem a doença apresentam prejuízos cognitivos relevantes ao longo vida. A combinação de tratamentos farmacológico e psicossocial é eficaz na melhora das dimensões psicopatológicas da esquizofrenia, porém a maioria dos pacientes apresenta importantes déficits cognitivos, principalmente em funções executivas (FE) com impacto na funcionalidade, impossibilitando uma vida independente. O método Occupational Goal Intervention (OGI) é eficaz na melhora de FE, porém não foi testado em pacientes com esquizofrenia resistente (ER). Realizamos estudo piloto cujos resultados foram descritos na dissertação de mestrado e publicados no periódico Psychiatry Research. O presente trabalho inclui o estudo completo com follow-up de 6 meses. Objetivos: Trata-se de um ensaio clínico comparando a intervenção de Terapia Ocupacional (TO), baseada no método OGI para a reabilitação de FE, com um grupo-controle de indivíduos com ER. Método: O estudo desenvolveu-se em 3 tempos: baseline, pós-tratamento e follow-up. Cinquenta e quatro pacientes com diagnóstico de ER foram randomizados e distribuídos em dois grupos: experimental e controle (placebo). O grupo experimental recebeu 30 sessões de TO com o método OGI e o grupo controle (GC) recebeu 30 sessões de atividades artesanais de livre escolha, sem intervenção ativa do terapeuta (placebo). As medidas de desfecho primário foram avaliadas pela BADS, e as de desfecho secundário pela DAFS-BR e ILSS-BR O impacto sobre a cognição foi avaliado por uma bateria neuropsicológica padrão, que mediu as seguintes funções: atenção, fluência verbal, FE, memória e o QI estimado. As escalas PANSS e o CGI foram utilizadas para monitorar a gravidade dos sintomas psicopatológicos. A eficácia foi avaliada nos três tempos do estudo por meio da análise linear de efeitos mistos e obtido o tamanho de efeito por meio d de Cohen. Resultados: Observou-se melhora significativa com tamanhos de efeito de médios a altos na BADS total (d=0,73), com pequena redução no follow-up (d=0,69).Na DAFS-BR total os tamanhos de efeito foram médios (d=0,58) porém não se sustentou no follow-up (d=0,39). Os resultados de tamanhos de efeito na ILSS-BR total foi alto (d=1,09) e com aumento de melhora clínica no follow-up (d=1,19). Não foram observadas mudanças nas funções cognitivas avaliadas pela bateria neuropsicológica. Conclusão: o método OGI mostrou-se eficaz na melhora da maioria das FE relacionadas à capacidade de controle inibitório, planejamento, resolução de problemas e flexibilidade mental de pacientes com ER quando comparado ao placebo, melhora esta que foi mantida 6 meses de seguimento / Schizophrenia is one of the top 25 causes of disability worldwide. Individuals who develop the disease have relevant cognitive impairments over a long period of time. The combination of pharmacological and psychosocial treatments is effective in improving the psychopathological dimensions of schizophrenia, but the majority of patients present significant cognitive deficits, especially in executive functions (EF) with an impact on functionality, making life independent. The Occupational Goal Intervention (OGI) method is effective in improving EF but has not been tested in patients with resistant schizophrenia (RE). We conducted a pilot study whose results were described in the master\'s thesis and published in the journal Psychiatry Research. The present study includes the complete 6-month follow-up study. Objectives: This is a clinical trial comparing Occupational Therapy (OT), based on the OGI method for the rehabilitation of EF, with a control group of individuals with RE. Method: The study was developed in 3 stages: baseline, post-treatment, and follow-up. Fifty-four patients diagnosed with RE were randomized and divided into two groups: experimental and control (placebo). The experimental group received 30 OT sessions with the OGI method and the control group received 30 sessions of free-choice craft activities without active therapist intervention (placebo). Primary outcome measures were evaluated by the BADS and secondary endpoints by DAFS-BR and ILSS-BR. The impact on cognition was assessed by a standard neuropsychological battery, which measured the following functions: attention, verbal fluency, EF, memory, and estimated IQ. PANSS scales and CGI were used to monitor the severity of psychopathological symptoms. Efficacy was assessed in the three study times by means of the linear analysis of mixed effects and the effect size obtained by means d of Cohen. Results: A significant improvement was observed with mean to high effect sizes in the total BADS (d = 0.73), with a small reduction in follow-up (d = 0.69). In DAFS-BR total effect sizes were medium (d = 0.58) but did not sustained at the follow-up (d = 0.39). The results of effect sizes in the total ILSS-BR were high (d = 1.09) and with an increase in clinical followup at follow-up (d = 1.19). No changes were observed in the cognitive functions evaluated by the neuropsychological battery. Conclusion: the OGI method proved to be effective in improving the majority of EF related to inhibitory control capacity, planning, problem-solving, and mental flexibility of RE patients when compared to placebo, which was maintained 6 months after follow-up

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