Le Trouble obsessionnel-compulsif (TOC) de l’enfant et de l’adolescent est un trouble fréquent mais encore peu reconnu. Le traitement de première intention est la thérapie cognitive et comportementale (TCC). Les objectifs de cette étude sont de démontrer la faisabilité d’un protocole de TCC en population clinique et de montrer l’évolution symptomatique pendant 18 mois. Neuf patients présentant un TOC âgés de 6 à 16 ans ont reçu 12 séances hebdomadaires de TCC. Une évaluation est réalisée avant et après le traitement puis tous les 6 mois pendant 18 mois, elle comprend la mesure des TOC (CY BOCS), également des symptômes anxieux (ECAP), de dépression (CDI), une échelle de fonctionnement global (C GAS) et d’amélioration (CGI). Trois subtests du WISC IV permettent d’analyser les capacités attentionnelles. Résultats : les patients s’améliorent de 46% à la CY BOCS après la TCC, de 69% à 18 mois. Les variations intra-individuelles montrent des profils évolutifs différents : réponse très rapide puis rémission, amélioration retardée suivie de rémission ou amélioration puis rechute. Un seul patient n’est pas répondeur. Un changement psychologique dans une optique différentielle et intra individuelle, par des techniques de ré échantillonage (Bootstrap) et de comparaison des profils (test de Kolmogorov-Smirnof) est observé pour les patients les plus sévèrement atteints initialement. Conclusions : Un protocole de TCC dans le TOC de l’enfant et de l’adolescent est réalisable en population clinique. L’efficacité est montrée et se poursuit pendant les 18 mois. La TCC permet une amélioration globale (CGI, C GAS), symptomatique (CY BOCS, ECAP, CDI) et cognitive (WISC IV). / Pediatric obsessive-compulsive disorder (OCD) is a frequent but a not usually recognized trouble. The first –line treatment is cognitive-behavioral therapy (CBT). Objective : To demonstrate the feasibility of CBT protocol delivered in an outpatient community-based clinic and to evaluate clinic symptoms at 18 months follow-up. Nine participants (age 6-16 years) received 12 CBT weekly sessions. Assessment is realized at pre and post treatment, and every 6 months during 18 months, including symptoms of TOC (CY BOC), of anxiety(ECAP), of depression ((CDI), global functioning (C GAS) and improvement (CGI). Three WISC IV subtests allow attentional capacity analysis. Results: patients improvements are : 46% at post treatment, and 69% at 18 months follow up. The intra-individual variations show differents evolutionary profiles : quick response and remission, delayed improvement followed by remission or improvement followed by relapse. Only one is non responder. A psychological change in a differential and intra-individual optical, with sample rate (Bootstrap) and profiles comparaison (test de Kolmogorov-Smirnof) is observed for the pre treatment more severe patients. Conclusions : CBT protocol of OCD in children and adolescent is feasible in community-base clinic. Efficiency is showed and continues during 18 months. CBT allows global (CGI, C GAS), symptom (CY BOCS, ECAP, CDI) and cognitive (WISC IV) improvements.

Le trouble d’anxiété de séparation (TAS) est le trouble anxieux le plus prévalent chez les enfants. Il apparaît tôt et entraîne plusieurs conséquences négatives. La thérapie cognitivo-comportementale (TCC) a été reconnue efficace pour traiter les troubles anxieux. Toutefois, peu d’études ont vérifié son efficacité pour le traitement spécifique du TAS et très peu en ont examiné l’effet auprès d’enfants de moins de 7 ans. Les quelques interventions étudiées visant les moins de 7 ans ont en commun d’inclure le parent dans le traitement ou de l’offrir directement à celui-ci. L’objectif principal de cette thèse est de vérifier l’efficacité d’un programme d’entraînement parental de type TCC, adapté pour les parents d’enfants de 4 à 7 ans souffrant de TAS. Cette étude vise également deux objectifs spécifiques : observer la fluctuation des symptômes de TAS de l’enfant pendant le traitement et examiner l’impact du programme sur les variables parentales. Un devis à cas unique à niveaux de base multiples a été utilisé. Six familles ont pris part à l’étude. Des entrevues semi-structurées, des questionnaires auto-administrés et des calepins d’auto-observations quotidiennes ont été utilisés auprès des parents pour mesurer les symptômes anxieux des enfants, leurs pratiques parentales, le stress parental et leurs symptômes anxieux et dépressifs. Des questionnaires sur les difficultés de l’enfant incluant l’anxiété ont aussi été envoyés à l’éducatrice ou à l’enseignante. Tous les questionnaires ont été administrés aux trois temps de mesure (prétraitement, post-traitement et relance 3 mois). Les calepins d’auto-observations ont été remplis quotidiennement durant le niveau de base, pour toute la durée de l’intervention et pendant une à deux semaines à la relance. Les résultats de l’étude indiquent que cinq enfants sur six ne répondent plus au diagnostic de TAS suite au traitement ainsi que trois mois plus tard. Les résultats des calepins d’auto-observations montrent une amélioration claire des manifestations principales de TAS pour la moitié des enfants et plus mitigée pour l’autre moitié, de même qu’une amélioration systématique de la fréquence hebdomadaire totale de manifestations de TAS suite à l’intervention pour quatre enfants. Les résultats aux questionnaires remplis par les parents montrent une amélioration des symptômes d’anxiété et de TAS chez quatre enfants au post-test et/ou à la relance, tandis que les questionnaires de l’éducatrice (ou enseignante) suggèrent que les symptômes anxieux des enfants se manifestaient peu dans leur milieu scolaire ou de garde. L’impact du programme sur le stress parental et les pratiques parentales est également mitigé. Ces résultats suggèrent que le Programme d’entraînement parental pour les enfants souffrant d’anxiété de séparation (PEP-AS) est efficace pour réduire les symptômes de TAS chez les enfants d’âge préscolaire ou en début de parcours scolaire et appuient la pertinence d’offrir le traitement aux parents et d’inclure un volet relationnel. D’autres études seront cependant nécessaires pour répliquer ces résultats auprès d’un plus vaste échantillon. Il serait également intéressant de vérifier les effets indépendants des différentes composantes du traitement et d’évaluer les effets du programme sur davantage de pratiques parentales associées spécifiquement à l’anxiété. / Separation anxiety disorder (SAD) is the most prevalent anxiety disorder among children. It appears early in development and has multiple negative consequences. Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment for anxiety disorders. However, few studies have examined the efficacy of CBT to treat SAD in particular, and even fewer have examined the impact of this form of therapy on children younger than 7 years old. The main objective of the present doctoral thesis was to evaluate the efficacy of a CBT parent-training program, that was adapted specifically for parents of children aged 4 to 7 years old suffering from SAD. This study had two specific objectives: to observe any fluctuations in the child’s SAD symptoms during the treatment and to examine the impact of the program on parental variables. A single-case multiple baseline across-subjects design was used. Six families with a child aged 4-7 years old and with a diagnosis of SAD participated. Semi-structured interviews, self-reported questionnaires and daily diaries were used with the parents to assess the child’s anxiety symptoms, parental practices, parenting stress, and the parents anxious and/or depressive symptoms. Questionnaires on child problems were also sent to the children’ teacher or educator. All questionnaires were administered at three times of measurement (pre-treatment, post-treatment and 3 months follow-up). Daily diaries were also completed by the parents at baseline, throughout the treatment, and during one to two weeks at follow-up. Results revealed that five of the six children no longer met the criteria of a SAD diagnosis after treatment and three months later. Findings from the daily diaries showed a clear reduction of the principal SAD symptoms for half of the children but mixed results for the other half of the children and that four of six children presented a systematic favourable change of the total weekly frequency of SAD symptoms after the intervention. The results of parent questionnaires showed an improvement of SAD symptoms for four children at post-treatment and/or follow-up. The teacher/educator questionnaires indicated low impact of anxiety symptoms. The impact of the program on parenting stress and parental practices is mixed with some parents showing improvement and others less so. The results support the efficacy of the Programme d’entraînement parental pour les enfants souffrant d’anxiété de séparation (PEP-AS) to reduce SAD symptoms in preschool age children and support the relevance of directing the treatment towards parents and including a relational component in the intervention. However, more research is needed to replicate these findings with larger samples and randomized control trials. It would also be interesting to dismantle the program and to examine the various components of the treatment in different combinations, and to explore more specifically the program effects on parental variables.

Objetivo: Avaliar a eficácia da Terapia Focada na Compaixão em grupo no transtorno de estresse pós-traumático. Desenho: Estudo randomizado controlado, cego, dois braços paralelos, no grupo controle a Terapia de Apoio em grupo (TA-G) e no grupo experimental a Terapia Focada na Compaixão em grupo (TFC-G). Duração e frequência: Os dois grupos receberam oito sessões semanais de 90 minutos e, caso necessário, tratamento psiquiátrico. Todos preencheram escalas de avaliação, antes (T-1), depois da terapia (T-2) e no seguimento de três meses (T-3). Oitenta e sete pacientes foram randomizados (TA-G=44 e TFC-G=43) e sessenta e um pacientes completadores foram analisados (TA-G=30 e TFC-G=31). Resultados: Os pacientes melhoraram significativamente e não houve efeito de interação entre os grupos e os tempos, exceto na escala de trauma CAPS-5, F (1, 171) = 4,35, p = 0,041. Houve uma diminuição expressiva, comparando a média do T-3 em relação ao T-1, nos dois grupos (TA-G e TFC-G, respectivamente) nas escalas: CAPS-5 de trauma (24,40 e 29,77), DTS de trauma (31,83 e 33,94), BDI de depressão (9,77 e 12,06), BAI de ansiedade (7,33 e 8,23), BHS de desesperança (3,53 e 3,55), ATQ-N de pensamentos automáticos negativos (15,67 e 14,90), OAS de vergonha (8,20 e 7,68), FSCS de autocrítica (9,07 e 6,71) e aumento na escala ATQ-P de pensamentos automáticos positivos (10,96 e 16,36) e SCS de autocompaixão (0,50 e 0,52). Conclusões: A significativa melhora dos pacientes comprova a importância da terapia em grupo no tratamento do TEPT. A redução de 30 pontos na escala de trauma CAPS-5, em apenas oito semanas, somente no grupo da Terapia Focada na Compaixão, é uma evidência robusta de que este modelo de tratamento focado na compaixão, vergonha, culpa e autocrítica, é seguro, eficaz e uma esperançosa opção no tratamento de pessoas que vivenciaram eventos traumáticos / Objective: To evaluate the efficacy of Group Compassion-Focused Therapy in posttraumatic stress disorder. Design: A randomized controlled trial, blind study, with two parallel arms, control group with Supportive Therapy Group (SUP-G) and experimental group with Compassion-Focused Therapy Group (CFT-G). Duration: The two groups received eight weekly sessions of 90 minutes and, if necessary, psychiatric treatment. All patients completed evaluation scales, before (T-1), after therapy (T-2) and in three months follow-up (T-3). Eighty-seven patients were randomized (SUP-G=44 and CFT-G=43) and sixty-one completers were analyzed (SUP-G=30 and CFT-G=31). Results: Patients improved significantly and there was no interaction effect between groups and times, except for the trauma scale CAPS-5, F (1, 171) = 4.35, p = 0.041. There was an expressive decrease, comparing the mean of T-3 in the relation to T-1, in both groups (SUP-G and CFT-G, respectively) in the scales: trauma CAPS-5 (24,40 and 29,77), trauma DTS (31,83 and 33,94), depression BDI (9,77 and 12,06), anxiety BAI (7,33 and 8,23), hopelessness BHS (3,53 and 3,55), automatic negative thoughts ATQ-N (15,67 and 14,90), shame OAS (8,20 and 7,68), self-critical FSCS (9,07 and 6,71) and an increase in the scales of automatic positive thoughts ATQ-P (10,96 and 16,36) and self-compassion SCS (0,50 and 0,52). Conclusions: Significant improvements in the patients confirm the importance of group therapy in PTSD treatment. The 30-point CAPS-5 trauma scale reduction, in eight weeks only, in the Compassion-Focused Therapy group alone, is robust evidence that this treatment model focused on compassion, shame, guilt and self-criticism, is safe, effective and a hopeful option in treating people who have experienced traumatic events

回顧地震災難心理學的相關研究指出，災難創傷所引起的心理壓力反應具有長期、慢性化的影響，然而許多有心理壓力反應症狀的民眾可能會因為精神疾病的污名化、社會文化的漠視或忽視、應付接踵而至的生活事件、或症狀引起的退縮行為等種種因素，而不願或未求助心理專業的協助，因此相關的研究同時也指出發展外展心理介入計劃的必要性；然而不論在實務或在研究方面，對有心理症狀但未求助的災民實施外展心理介入卻是鮮而少見的。 / 本篇研究採用已獲多數研究證實有效治療創傷壓力疾患（Posttraumatic Stress Disorder, PTSD）的認知行為治療（Cognitive-Behavioral Therapy, CBT），做為對有症狀但未求助的九二一災民外展心理介入的工作架構，再透過發現取向（discovery-oriented）的研究方法，整理分析介入訪談的資料，以獲得外展心理介入歷程的發現與探討。 / 整理、分析研究資料發現：災民容易因為災後接踵而至的生活變動或退縮而無法求助心理專業，災民因為地震後引發早期適應不良基模和外在聚焦的因應型態，以致無法覺察沒有求助或造成心理症狀慢性化，此與吳英璋（2000）所論及性格特質與災後處遇因素影響災後心理反應是一致的。外展心理介入以持續、密集的方式與災民建立適當的工作關係，改變災民對人負向的基本信念，讓災民有更深入的敘述與自我覺察，其次在貼近災民的日常生活脈絡中，從日常生活事件反覆地分析與練習，才足以動搖既有的信念與行為反應，使災民對事件產生內在聚焦的因應來增加自我效能和控制感，並且從災民置身所在的環境脈絡裡處理創傷個案的經驗迴避問題。以CBT做為外展心理介入的架構進行介入，比較無法使用家庭作業讓個案學習與練習，需透過個案所及能說的日常生活事件中，對其內在經驗聚焦、反覆辯證以致增加個案正向經驗、辨識刺激控制、以及思考的辨證，使個案增加自我效能、控制感、自我肯定等，以達到增加個人資源與賦權之目的。 / There are lots of studies about disaster psychology related earthquakes presenting long-term chronically influence to psychological reactions, and implicating the importance of outreach intervention programs for non-seeking people with traumatic psychological reactions or posttraumatic stress disorder(PTSD). The people might not get help from professionals because stigmatization, apathy or ignore of society, business on going daily events, or withdrawal symptoms. So far as, neither even practicing nor research, there is few article about outreach intervention program for the people with psychological symptoms but non-seeking help. This study applies the framework of cognitive-behavioral therapy(CBT) verified by a lot of studies and practice for PTSD, and uses the discovery-oriented research, to discover and gain the understandings of outreach psychological intervention to non-seeking help people with psychological stress reactions in 921 earthquake. The result finds that people with psychological stress reactions mostly accompany with continuously daily event and withdrawal symptoms to seek help. The early maladaptive schemas invoked by earthquake and the external focus make people difficult to aware the need for help and chronically, and this finding is consistent with the discussion of the psychological reactions influenced by personality trait and disaster management in Wu (2000). Outreach psychological intervention established the working relationship through continuously, condensed schedule changing their negative belief to people, and having them deeper narrative and self-awareness. Secondary, by closed their contextual daily life and repeated exercises by daily event, such impacts are enough to shake their steadily believes and habituated behavioral reactions, then to have people internal focus and increase self-efficacy and controllability; further management is contextual analysis and treatment of experiential avoidance in the ecological context of daily life. The outreach psychological intervention by the framework of cognitive-behavioral therapy, it is difficult to apply homework assignment as review or exercise between sessions; and for regaining personal resource and empowerment, outreach psychological intervention mostly applies internal focus and repeated dialectical discussion to increase positive experience, discriminate of stimulus control, and dialectical thinking, and finally people have more self-efficacy, controllability, and self-assertiveness.

ADHD affects executive functions and pharmacological treatment is the most common intervention. Medication is ineffective for some and psychosocial interventions are scarcely available. CBT that teaches organizational skills for managing ADHD-symptoms has shown promising results. Smartphones can help individuals perform executive tasks such as planning and organization and they could be efficacious as a support tool for ADHD patients. The current study is a RCT that compares an online course (n=29) based on previously effective CBT treatments for ADHD to a wait-list control (n=29). The intervention focused on teaching the use of an online calendar and smartphone apps. The intervention brought significant improvement (p < 0.001) to participants regarding ADHD symptoms and 38% of participants were considered clinically significantly improved. This indicates that online treatments using IT-tools for ADHD is effective and that smartphones can be used as a tool for aiding individuals with impairments in executive functions.

Sömnsvårigheter inklusive insomni är ett utbrett problem för stora delar av befolkningen. Personer med insomni tenderar att oroa sig över sin sömn och har dysfunktionella antaganden kring sömnbristens konsekvenser. Studiens huvudsakliga syfte var att undersöka om skillnader i utfall mellan två behandlingsmetoder för insomni kunde tillräknas en exponeringseffekt. Studiens hypoteser var: 1a) Patienter som deltar i sömnrestriktion kommer få en större reducering av oro över sin sömn. 1b) Det finns ett samband mellan hög följsamhet till behandlingsmetoden och minskad oro över sömnen. 2) En kraftigare exponering medför lägre följsamhet till behandlingsmetoden. 3) Det finns ett samband mellan minskad oro över sömnen och minskade insomnisymptom. Data användes där 185 deltagare randomiserats till någon av KBT-behandlingarna för insomni sömnkomprimering (n=93) och sömnrestriktion (n=92). Oron hade minskat för studiedeltagarna fem veckor efter behandlingsstart men inga signifikanta skillnader påträffades mellan grupperna. Ett signifikant samband observerades mellan minskning av insomnisymptom och oro över sömnbrist. Slutsatser från uppsatsen är det redan etablerade sambandet mellan oro och insomni bekräftas. Studien kunde inte bekräfta hypotesen att exponering leder till minskad oro. Vidare forskning rekommenderas för att avgöra hur exponering kan användas för patienter med insomni för att möjliggöra effektivare behandlingsmetoder. / Sleep impairments including insomnia is a widespread problem affecting a large quantity of the population. Insomnia patients tend to worry about their sleep and having dysfunctional beliefs about sleep deficit consequences. The main purpose of this study was to examine if differences in results between two treatment methods could be attributed to effects of exposure. The hypotheses in the study were: 1a) Patients who participate in sleep restriction will have a greater reduction of sleep-related worry. 1b) There is a correlation between high compliance to the treatment methods and reduced sleep-related worry. 2) A greater exposure induces lower compliance to the treatment methods. 3a) There is a correlation between reduction of sleep-related worry and reduction of insomnia symptoms. Data consisted of 185 participants who was randomised into the CBT-treatments for insomnia sleep compression (n=93) or sleep restriction (n=92). A hypothesis was that sleep restriction implicate more exposure than sleep compression. Worry had decreased among participants after five weeks of treatment but no significant differences occurred between the groups. A significant correlation occurred between reduction of insomnia symptoms and reduction of worries regarding sleep deficit. Conclusions is that the already established correlation between worry and insomnia is confirmed. This study failed to confirm that exposure leads to reduced worry. Further research is advised to determine how exposure can be used for insomnia patients to enable more efficient treatment methods. / ClinicalTrials.gov Identifier: NCT02743338, CompRest - a Comparison Between Sleep Compression and Sleep Restriction for Treating Insomnia

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Made available in DSpace on 2015-03-26T13:55:13Z (GMT). No. of bitstreams: 1 texto completo.pdf: 545117 bytes, checksum: 7ad3378bf0c824361e4be8d29161719b (MD5) Previous issue date: 2012-07-12 / The purpose this work was to evaluate milk quality in different production systems and its variation throughout the year. The database used in this work were from 943 milk farms from different regions: south, midwest and central of state of Minas Gerais and Vale Paraíba, state of São Paulo. Data totaled 18.026 samples, collected between January (2009) and September (2011), and it was granted by Danone Firm. The milk farms were classified in three different production systems: confined, semi-confined and extensive system (grass fed). Somatic cells count (SCC), total bacterial count (TBC) and milk protein and fat contents were evaluated. The data was analyzed in a completely randomized design in a repeated measured scheme, and theproc MIXED procedure of SAS (2008) was used. The production system did not affect milk protein and fat contents, neither the SCC. However, the production system affected the TBC, indicating that TBC is related to the available structure for feeding animals. It is possible that the results are consequence of a payment program for quality, whichwas started by the milk industry in 2002. Seasonal variations in results of SCC, CBT and milk protein and fat contents were observed. The milk protein content was greater between March and June, while the milk fat content was greater between May and August. TBC and SCC were greater between December and March. In conclusion, production system does not affect milk protein and fat contents, neither SCC. However, confined systems have better TBC results. Furthermore, month and year affect the milk quality (TBC, SCC, milk protein and fat content results), where better results are observed in cold seasons. / Objetivou-se avaliar a qualidade do leite cru em diferentes sistemas de produção e sua variação ao longo do ano. Os dados utilizados nesse trabalho foram obtidos de 943 propriedades leiteiras das regiões do Sul de Minas, Centro-Oeste e Central Mineira no estado de Minas Gerais e na região do Vale do Paraíba no estado de São Paulo. Os mesmos foram concedidos pela Empresa Danone, em um total de 18.026 amostras, no período de janeiro de 2009 a setembro de 2011. As propriedades foram divididas em sistema de produção confinado, semi-confinado e extensivo. Os itens avaliados foram contagem de células somáticas (CCS), contagem bacteriana total (CBT) e teores de proteína e gordura. Os dados foram analisados em esquema de medidas repetidas no tempo, utilizando o procedimento proc MIXED do SAS (2008). Não houve efeito de sistema de produção sobre os teores de proteína, gordura e CCS. Já a CBT foi afetada pelo sistema de produção estando relacionada com o tipo de estrutura para alimentar os animais. Possivelmente, os resultados são consequência do programa de pagamento por qualidade implantando pelo laticínio desde o ano de 2002. Foram encontradas variações sazonais de CCS, CBT, proteína e gordura; sendo os valores de proteína mais elevados de Março a Junho, os valores de gordura mais elevados de Maio a Agosto, os valores de CBT e CCS mais elevados de Dezembro a Março.Conclui-se que o sistema de produção não interfere na porcentagem de gordura e proteína e CCS do leite. No entanto, sistemas confinados apresentam melhor padrão de CBT. Conclui-se, também, que tanto mês quanto ano são fatores que interferem na CBT, CCS, proteína e gordura do leite, sendo os melhores padrões encontrados nas épocas mais frias do ano.

Submitted by Cláudia Bueno (claudiamoura18@gmail.com) on 2016-01-08T15:32:37Z No. of bitstreams: 2 Dissertação - Thamara Venâncio de Almeida - 2015.pdf: 1390852 bytes, checksum: 5f0b1c9700873dd65b4e3d743efec82f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-01-11T06:39:56Z (GMT) No. of bitstreams: 2 Dissertação - Thamara Venâncio de Almeida - 2015.pdf: 1390852 bytes, checksum: 5f0b1c9700873dd65b4e3d743efec82f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-01-11T06:39:56Z (GMT). No. of bitstreams: 2 Dissertação - Thamara Venâncio de Almeida - 2015.pdf: 1390852 bytes, checksum: 5f0b1c9700873dd65b4e3d743efec82f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-08-21 / For assessing compliance with the quality requirements established by the Normative Instruction No. 62, a milk sample each property or community tank should be analyzed on a monthly basis by one of the laboratories accredited by the Brazilian Laboratories Network for Milk Quality Control . There are still doubts about what would be the maximum temperature and the time of milk sample storage without jeopardizing the results of the electronic analysis. The objective of this study was to evaluate the effects of temperature and storage time of cooled samples of raw milk on the results of milk quality electronic analysis. Refrigerated raw milk samples were collected from expansion tanks for individual use of farms located in the middle region of the state of Goiás, and stored at four different temperatures (3 °C, 11 °C, 17 °C and 25 °C) for 16 days. Total bacterial count (TBC), somatic cell count (SCC) and chemical composition were performed daily. The results were submitted to analysis of variance in split plot design in randomized blocks, and the means were compared by Duncan test. We concluded that, when azidiol is added as preservative to samples for TBC, they can be analyzed up to 16 days after collection when stored at temperatures of 3 °C and 11 °C, and up to 10 days when stored at 17 °C. Moreover, when bronopol is added as preservative, samples for SCC and chemical composition analysis can be stored for up to 16 days after collection when stored at temperatures of 3 °C and 11 °C, and for up to seven days when stored at 17 °C. / Para a avaliação do cumprimento dos requisitos de qualidade estabelecidos pela Instrução Normativa nº 62, uma amostra de leite de cada propriedade ou tanque comunitário deve ser analisada mensalmente por um dos laboratórios credenciados pela Rede Brasileira de Laboratórios de Controle da Qualidade do Leite. Ainda existem dúvidas sobre quais seriam a temperatura e o tempo máximos de armazenamento das amostras de leite sem que houvesse comprometimento dos resultados das análises eletrônicas. Objetivou-se com este trabalho avaliar os efeitos da temperatura e do tempo de armazenamento de amostras de leite cru refrigerado nos resultados das análises eletrônicas da qualidade do leite. Amostras de leite cru refrigerado foram coletadas de tanques de expansão de uso individual de fazendas localizadas na mesorregião Centro Goiano no Estado de Goiás e armazenadas em quatro temperaturas diferentes (3°C, 11°C, 17°C e 25°C) durante 16 dias. Foram realizadas diariamente análises de contagem bacteriana total (CBT), contagem de células somáticas (CCS) e composição química. Os resultados obtidos foram submetidos à análise de variância em esquema de parcelas subdivididas no tempo em delineamento de blocos ao acaso e as médias comparadas pelo teste de Duncan. Concluiu-se que as amostras destinadas à análise de CBT, adicionadas do conservante azidiol, podem ser analisadas por até 16 dias após a coleta quando armazenadas em temperaturas de 3°C e 11°C e por até 10 dias quando armazenadas a 17°C. E as amostras destinadas às análises de CCS e composição química, adicionadas do conservante bronopol, podem ser analisadas por até 16 dias após a coleta quando armazenadas em temperaturas de 3°C e 11°C e por até sete dias quando armazenadas a 17°C.

Objetivo: Avaliar a eficácia da Terapia Focada na Compaixão em grupo no transtorno de estresse pós-traumático. Desenho: Estudo randomizado controlado, cego, dois braços paralelos, no grupo controle a Terapia de Apoio em grupo (TA-G) e no grupo experimental a Terapia Focada na Compaixão em grupo (TFC-G). Duração e frequência: Os dois grupos receberam oito sessões semanais de 90 minutos e, caso necessário, tratamento psiquiátrico. Todos preencheram escalas de avaliação, antes (T-1), depois da terapia (T-2) e no seguimento de três meses (T-3). Oitenta e sete pacientes foram randomizados (TA-G=44 e TFC-G=43) e sessenta e um pacientes completadores foram analisados (TA-G=30 e TFC-G=31). Resultados: Os pacientes melhoraram significativamente e não houve efeito de interação entre os grupos e os tempos, exceto na escala de trauma CAPS-5, F (1, 171) = 4,35, p = 0,041. Houve uma diminuição expressiva, comparando a média do T-3 em relação ao T-1, nos dois grupos (TA-G e TFC-G, respectivamente) nas escalas: CAPS-5 de trauma (24,40 e 29,77), DTS de trauma (31,83 e 33,94), BDI de depressão (9,77 e 12,06), BAI de ansiedade (7,33 e 8,23), BHS de desesperança (3,53 e 3,55), ATQ-N de pensamentos automáticos negativos (15,67 e 14,90), OAS de vergonha (8,20 e 7,68), FSCS de autocrítica (9,07 e 6,71) e aumento na escala ATQ-P de pensamentos automáticos positivos (10,96 e 16,36) e SCS de autocompaixão (0,50 e 0,52). Conclusões: A significativa melhora dos pacientes comprova a importância da terapia em grupo no tratamento do TEPT. A redução de 30 pontos na escala de trauma CAPS-5, em apenas oito semanas, somente no grupo da Terapia Focada na Compaixão, é uma evidência robusta de que este modelo de tratamento focado na compaixão, vergonha, culpa e autocrítica, é seguro, eficaz e uma esperançosa opção no tratamento de pessoas que vivenciaram eventos traumáticos / Objective: To evaluate the efficacy of Group Compassion-Focused Therapy in posttraumatic stress disorder. Design: A randomized controlled trial, blind study, with two parallel arms, control group with Supportive Therapy Group (SUP-G) and experimental group with Compassion-Focused Therapy Group (CFT-G). Duration: The two groups received eight weekly sessions of 90 minutes and, if necessary, psychiatric treatment. All patients completed evaluation scales, before (T-1), after therapy (T-2) and in three months follow-up (T-3). Eighty-seven patients were randomized (SUP-G=44 and CFT-G=43) and sixty-one completers were analyzed (SUP-G=30 and CFT-G=31). Results: Patients improved significantly and there was no interaction effect between groups and times, except for the trauma scale CAPS-5, F (1, 171) = 4.35, p = 0.041. There was an expressive decrease, comparing the mean of T-3 in the relation to T-1, in both groups (SUP-G and CFT-G, respectively) in the scales: trauma CAPS-5 (24,40 and 29,77), trauma DTS (31,83 and 33,94), depression BDI (9,77 and 12,06), anxiety BAI (7,33 and 8,23), hopelessness BHS (3,53 and 3,55), automatic negative thoughts ATQ-N (15,67 and 14,90), shame OAS (8,20 and 7,68), self-critical FSCS (9,07 and 6,71) and an increase in the scales of automatic positive thoughts ATQ-P (10,96 and 16,36) and self-compassion SCS (0,50 and 0,52). Conclusions: Significant improvements in the patients confirm the importance of group therapy in PTSD treatment. The 30-point CAPS-5 trauma scale reduction, in eight weeks only, in the Compassion-Focused Therapy group alone, is robust evidence that this treatment model focused on compassion, shame, guilt and self-criticism, is safe, effective and a hopeful option in treating people who have experienced traumatic events