Made available in DSpace on 2017-07-21T19:59:59Z (GMT). No. of bitstreams: 1 Denis Leandro Freitas.pdf: 2460536 bytes, checksum: 9c33d2a38cc2aba90b9f27c476e8d2c5 (MD5) Previous issue date: 2013-03-27 / Fundação Araucária de Apoio ao Desenvolvimento Científico e Tecnológico do Paraná / The urinary tract infections (UTI) have high incidence in the population, mainly affecting women, the elderly and pregnant women. In most cases an UTI is caused by Enterobacteriaceae, especially Escherichia coli. The main antimicrobials used in the treatment of UTIs, are the quinolones and fluoroquinolones. Since its discovery in the 60s, such antimicrobials were improved and increasing its spectrum of activity, but also the micro-organisms has evolved to develop resistance to these drugs. The resistance comes down to two mechanisms: changes in targets of quinolones or decreased concentration of the drug within the cell. Quinolones are antimicrobial agents that target two enzymes involved in transcription and replication of bacterial DNA, DNA Gyrase, consisting of two subunits GyrA and two GyrB products of the genes gyrA and gyrB respectively and Topoisomerase IV, also composed of two ParC and two ParE subunits, encoded from genes parC and parE. Mutations in these genes can confer high-level resistance to these antimicrobials. Other mechanisms involve genes carried in plasmids such as qnr's, responsible for the production of proteins that protect the target enzymes of quinolones. The gene aac (6 ')-Ib-cr also present in plasmids can alter the chemical structure of certain fluoroquinolones interfering efficiency. The association of resistance to quinolones and β-lactams due to the presence of Extended Spectrum β-lactamases (ESBL) has been widely reported in the literature. The main objective of this study was to evaluate the patterns of resistance to quinolones and fluoroquinolones in 55 samples of uropathogenic E. coli collected in Curitiba, PR, Brazil. The resistance to nalidixic acid, norfloxacin, ciprofloxacin and ofloxacin was observed in 69.1% of the samples. Molecular analysis of the resistant strains showed mutations in gyrA (codons 83 and 87) and parC (codon 80). Also investigated was the presence of genes qnr's and aac (6 ')-Ib-cr and their association with ESBLs. Two of the 55 samples were positive for aac (6 ')-Ib-cr. The presence of this gene in Brazil was first reported in 2012 in Belo Horizonte, MG. No samples were positive for the qnr's genes. These results show a high incidence of resistance to quinolones and the ability to horizontally spread of acquired resistance between the bacterial strains. / As infecções do trato urinário (ITU) apresentam grande ocorrência na população, afetando principalmente mulheres, idosos e gestantes. Na maioria dos casos uma ITU é causada por enterobactérias, especialmente Escherichia coli. A principal escolha no tratamento das ITUs são as quinolonas e fluorquinolonas. Desde sua descoberta na década de 60, tais antimicrobianos foram aperfeiçoados aumentando seu espectro de ação, porém os micro-organismos também evoluíram desenvolvendo resistência a tais fármacos. A resistência se resume a alterações nos alvos das quinolonas e ou a diminuição da concentração da droga no interior da célula. Quinolonas são antimicrobianos que têm como alvo duas enzimas envolvidas na replicação e transcrição do DNA bacteriano, a DNA Girase, formada por duas subunidades GyrA e duas GyrB, produtos dos genes gyrA e gyrB respectivamente e a Topoisomerase IV, também composta de duas subunidades ParC e duas ParE, codificadas a partir dos genes parC e parE. Mutações nesses genes podem conferir alto nível de resistência a estes antimicrobianos. Outros mecanismos envolvem genes transportados em plasmídeos, como os qnr’s, responsáveis pela produção de proteínas capazes de proteger as enzimas alvo das quinolonas. O gene aac(6’)-ib-cr, também presente em plasmídeos, é capaz de alterar a estrutura química de certas fluorquinolonas interferindo na sua eficiência. A associação de resistência a quinolonas e β-lactâmicos devido à presença de β-lactamases de espectro ampliado (ESBLs), tem sido amplamente relatada na literatura. O principal objetivo desse trabalho foi avaliar os padrões de resistência a quinolonas e fluorquinolonas em 55 amostras de E. coli uropatogênica coletadas em Curitiba, PR. A resistência ao ácido nalidíxico, a norfloxacina, ciprofloxacina e ofloxacina, foi observada em 69,1% das amostras. A análise molecular das cepas resistentes revelou mutações em gyrA (códons 83 e 87) e em parC (códon 80). Também foi pesquisada a presença dos genes qnr’s e aac(6’)-ib-cr e a associação destes com ESBLs. Duas das 55 amostras foram positivas para aac(6’)-ib-cr. A presença desse gene no Brasil foi relatada pela primeira vez em 2012, em Belo Horizonte, MG. Nenhuma amostra foi positiva para os genes qnr’s. Estes resultados mostram uma elevada incidência de resistência às quinolonas e a capacidade de transferência horizontal de resistência adquirida entre as cepas bacterianas.

The purpose of this study is to investigate how different preschools work with signs such as AAC also known as TAKK. The study examined preschool teacher's previous experience and their view of TAKK for language development. The method for this study is interviews at four different preschools who works with signs such as AAC. An interview with a teacher who works with special needs was also included in this study. The purpose was to see how preschools interact with special education in language development. The study shows that the interviewed teachers felt that TAKK could be used to improve children's ability to communicate. The teacher's previous experience of TAKK was for use with children in special education. The interviews showed that preschool teachers are willing to use TAKK as a tool for all children to support their speech and communication. / Studiens syfte är att undersöka hur förskolor med olika pedagogiska inriktningar arbetar med Tecken som Alternativ och Kompletterande Kommunikation förkortat TAKK. Studien bygger på pedagogernas skilda erfarenheter och syn på TAKK. Metoden som tillämpats för studien är semistrukturerade intervjuer på fyra olika förskolor som arbetar med TAKK. Intervju med specialpedagog genomfördes för att ta del av sambandet mellan förskolorna och elevhälsoteamet i det språkutvecklande arbetet. Resultatet visar att pedagogerna har olika erfarenheter av att arbeta med TAKK i relation till andra metoder och material. Utifrån intervjuerna framkommer det att pedagogerna är positiva till TAKK som en språkutvecklande metod. De arbetar med att tillämpa TAKK till hela barngrupperna för att inte utesluta någon.

With a large population of people who suffer from aphasia, it is imperative that an effective form of therapy is utilized. The purpose of this study was to investigate the effectiveness of augmentative and alternative communication (AAC) programs in improving the communication needs and lives of people affected by aphasia. Individuals (n = 20) suffering from aphasia for 3 months or more completed therapy sessions with speech and language pathologists and the AAC program. Pre- and post-intervention evaluations were administered, consisting of communication satisfaction and success questionnaires, the Western Aphasia Battery (WAB), and probing tests (prompt and response) with an EEG component. Only preliminary data analyses were completed, on three individuals, due to setbacks. All individuals improved on their post-WAB score and average scores on the questionnaires generally increased, but none were statistically significant. However, clinicians noted a clinical significance in improvements, which suggests that AACs are beneficial in aiding and improving people’s communicative functions and daily life. Resting state EEG data of one subject exhibited high mean power spectral densities (PSD) for delta and theta bands in the lobes before and after therapy, supporting previous literature. Mean PSDs of the left frontal lobe demonstrated a statistically significant decrease from pre- to post-, which in the case of the delta and theta bands may indicate possible recovery. More research is necessary to substantiate these conclusions and to explore the use of EEG in mapping brain lesions and tracking the brain’s rehabilitation, as well as the benefits of AACs.

The field of augmentative and alternative communication (AAC) has evolved since the 1970s, consequently there now exists a group of adults with cerebral palsy (CP), in the UK, who are life-time users of AAC prescribed as an intervention for their complex communication impairments. Ten adults, aged between 20-55 years, participated in conversations about their unique life experiences and aspirations, using AAC, including voice output communication aids (VOCAs). The ability and opportunity to interact and communicate personal accounts has significance for conceptualizing outcomes of intervention. Clinical practice informed this research project. A qualitative research design was employed to explore questions about the extent to which adult aided communicators talk about their lives, aspirations and opinions; the past life experiences participants talk about and finally how they talk about their quality of life. Conversational-styled, semi-structured interviewing using literature-guided questions yielded rich interactional data. A discourse analytical approach to the 34 interviews was taken. Findings identified a number of ordinary interactional features and discourses. Aided communicators used multimodal communication to interact and converse, positioning through their contributions as assertive speakers and engaged recipients. Interactional turns were managed with participants using unaided communication signals as conversational continuers. Participants demonstrated how to manage others who speak on their behalf. Examples of interactional repair were noted when participants pre-empted breakdown. Managing novel utterances was a feature with unexpected responses challenging the listener’s position. Participants constructed VOCA-mediated utterances to share long-term memories, worries, satisfaction with life, and aspirations. Aspirations included community ambitions and creating fulfilling daily lives. Some participants expressed frustration but balanced this against a position of contentment. Some participants also demonstrated personal responsibility and positioned themselves through their talk as contributors to communities. Recommendations for clinical practice are suggested that include the provision of adult clinical services and interaction focused intervention for adult aided communicators with cerebral palsy.

By combining context awareness and analytical based relevance computing software, the proposed Augmentative and Alternative Communication (AAC) framework aims provide a foundation to create communication systems to dramatically increase the words available to AAC users. The framework will allow the lexicon available to the user to be dynamically updated by varying sources and to promote words based on contextual relevance. This level of customization enables the development of highly customizable AAC devices that evolve with use to become more personal while also broadening the expressiveness of the user. In order to maximize the efficient creation of conversation for AAC users, the framework provides a lexicon with the ability to obtain words from multiple sources which are then organized according to relevance in a situational context.

Syftet med mitt arbete är att belysa på vilket sätt pedagoger i förskolan initierar tecken som alternativ och kompletterande kommunikation även kallad TAKK, i den dagliga verksamheten. Arbetet fokuserar på pedagogers upplevelse av TAKK som kommunikationsmetod och vilka verktyg, exempelvis vilka appar och böcker de använder. Materialinsamlingen skedde med observationer och intervjuer vilket sedan sammanställdes och analyserades utifrån det sociokulturella perspektivet. Sammanfattningsvis anses TAKK vara ett bra fungerande kommunikativt verktyg för alla barn på förskolan. Artefakterna som används är relativt lika på förskolornas avdelningar och används av pedagoger med eller utan barn, av barn med eller utan pedagog och av barn med eller utan andra barn. Det finns ingen manual eller mall att följa vid initieringen men överlag anses att kunskap om TAKK och teckenkunnande är nödvändigt för att TAKK ska kunna användas i förskolan. / The purpose of this work is to illustrate educators approach to initiate augamentative and alternative communication, also known as ACC. This work focuses on educators experiences when inititating ACC as a communicative method  in preschool and which tools, such as the apps and the books they use. The material gathering was conducted with observations and interviews, which were compiled and analyzed based on the socio-cultural perspective. In summary, ACC is considered a good working communicative tool for all children in preschool activities. The artifacts used are relative similar between departments and are used by educators with or without children, by children with or without other children. There is no manual or template to follow regarding the initiative but overall, it is considered that knowledge is necessary in order for ACC to be used in preschool activities.

Thesis advisor: Susan Bruce / Augmentative and alternative communication (AAC) is central to the lives of many individuals who are not able to effectively use spoken language. AAC systems are an essential component of a student’s ability to access his/her world, including daily communication and school content. The provision of such systems is a high priority in the field and supports the emancipation of those with limited voice, power, and independence that must function within a social structure that has been designed for the more typically abled. The study employed a single-case multiple staggered baseline design with randomized intervention implementation and intervention schedule using the What Works Clearinghouse (WWC) standards from 2010. Five students with complex disabilities using advanced speech generating devices with the LAMP method, Language Acquisition Through Motor Planning, (Halloran & Halloran, 2006), of picture symbol organization participated in the study. The LAMP method was examined, and the potential impact on language and communication it may have. Specifically, the ability to use print versus picture symbols for communication and literacy was investigated within the context of a highly structured 1:1 literacy lesson facilitated by interventionists. Results indicated that all students made varying degrees of gains in the use of print words. These gains were sustained in the generalization phase. Operational skills were impacted demonstrated by increased skill development in navigation of the speech generating device and the type of vocabulary selected. In addition, communication functions were expanded, and in some cases, there was a significant increase in the complexity of word usage across people and settings. Discussions on interventionists perceptions are presented and integrated within individual student results providing context and direction on training needs. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Lynch School of Education. / Discipline: Teacher Education, Special Education, Curriculum and Instruction.

Having a meaningful system for expressing common needs and thoughts is important for overall quality of life for students with intellectual disability and limited expressive language. The current study was conducted to evaluate whether one communication system, Proloquo2Go ($249.99) or SwiftKey Symbols (FREE), is more effective in the acquisition of targeted expressive phrases in one student with intellectual disability who exhibited expressive communication difficulties. The student was provided with instruction in both systems using task analytic instruction and system of least prompting and encouraged to use each system at different times in a single case, alternating treatment design. Results indicated that Proloquo2Go led to faster acquisition of targeted phrases, although gains were shown with both devices. Although, given the cost difference, teachers and parents may want to consider free options, like SwiftKeys, given the student made gains with this device. Future research is needed to provide generalizability of these results.

The aim of this study was to assess the effectiveness of training preschool-aged children to support the communication of their peers with autism spectrum disorder. Four typically developing peers participated in a 12-week training study that consisted of video models, social narratives, and practice opportunities. The peers were taught to implement the strategies "show, wait, and tell" with a classmate with autism during play. Peers were also provided with instruction to make them more aware of communication via augmentative modalities and to understand the Pragmatically Organized Dynamic Display (PODD) that the classmate with autism used to communicate. A second child with autism served as a control subject to measure generalization of the training to other children with autism. The study also included a group of four control peers who received no training in order to distinguish the effect of the training from normal communicative and social developmental that one might see over the time of the study. All play sessions were video recorded and coded utilizing a coding system that identified verbal and non verbal behaviors of the peers and the children with autism. 3 of the 4 trained peers demonstrated the ability or willingness or implement the targeted strategies with the target child with autism. A single trained peer generalized the use of the trained strategies when interacting with to the control subject . Peers performed best when provided with clinician cues to implement strategies. Both children with autism increased their communication and interaction with trained peers during play when compared with their interactions with the control peers. Furthermore, the children with autism interacted maximally during sessions in which the trained peers utilized the communication strategies These results provide preliminary evidence of the effectiveness of preschool peer training to support the communication of children with autism.

Music therapists frequently work with clients with Autism Spectrum Disorder (ASD) who use Augmentative and Alternative Communication (AAC). The purpose of this study was to gather information on music therapists’ current experiences with AAC training as well as music therapists’ perceptions of their own communication abilities when communicating with clients who have ASD using their preferred AAC system. The researcher invited 7,279 board-certified music therapists to participate in this study via email, of which 366 completed the survey. Participants reported most often providing services to children and adolescents with ASD, and frequently using electronic AAC and electronic apps with their clients with ASD. The majority (71.2%) of participants stated that they would like additional training in the use of AAC. Of the music therapists who had participated in previous AAC training, many had received training at work or by an SLP or other certified professional. Results of this study provide information about the current practices and perceptions of board-certified music therapists working with clients with ASD.