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TESTING A LOW-INTENSITY AND ACCESSIBLE COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I) INTERVENTION IN INDIVIDUALS NEWLY DIAGNOSED WITH CANCERAgyemang, Amma 01 January 2016 (has links)
Insomnia is defined as difficulty initiating or maintaining sleep, or nonrestorative sleep that lasts for at least one month and is accompanied by significant impairment in daytime functioning including fatigue, irritability, and/or difficulty concentrating. It is one of the most common complaints reported by individuals with cancer, especially around the time of cancer diagnosis and treatment. Yet it is often unrecognized and untreated, leading to adverse health consequences and increased healthcare costs. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been recommended as the gold standard for treating insomnia among individuals with cancer. Multiple studies have tested and proven the efficacy and effectiveness of CBT-I among individuals with cancer. However, only one study has investigated the efficacy of CBT-I in individuals newly diagnosed with cancer who are undergoing cancer treatment. Moreover, previous studies have been limited by their focus on largely homogenous samples of White, well-educated women with breast cancer. The dissemination of CBT-I among individuals with cancer is greatly limited by the lack of available providers and resources needed to implement the standard face-to-face treatment. One strategy to address this shortage has been to abbreviate standard CBT-I into low-intensity modalities that require fewer resources and can be self-administered on the Internet. The current study sought to examine the feasibility and acceptability, as well as the efficacy of one such program, an online low-intensity CBT-I intervention, Sleeping Healthy Using the Internet (SHUTi), supplemented with clinician support, in a sample of individuals newly diagnosed with heterogeneous malignancies who were undergoing chemotherapy and/or radiation. Results yielded support for the feasibility and acceptability of addressing individuals’ insomnia with a low-intensity CBT-I intervention while they are undergoing cancer treatment. With regard to sleep, there were significant treatment effects observed on a global measure of insomnia severity and on subjective sleep consolidation. There were also significant treatment effects for depressive symptoms. Findings are discussed in the context of study limitations and for the purpose of expanding the literature on disseminating CBT-I early in the cancer care trajectory.
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Capacitação técnica em boas práticas de ordenha e ocorrência de patógenos causadores de mastites contagiosas em propriedades leiteiras do estado de São Paulo / Training of good milking practices and occurrence of pathogens causing contagious mastitis in dairy farms from the State of Sao PauloCallay, Rocio Elizabeth Contero 10 October 2017 (has links)
A doença da inflamação da glândula mamária, também conhecida como mastite, tem como uma das características o aumento de células somáticas no leite de quartos afetados. Entre as bactérias predominantes causadoras de mastites, destacam-se Staphylococcus spp. e Streptococcus spp. Vários estudos sugerem que estes agentes são tipicamente transmitidos de uma vaca para outra durante o momento da ordenha. A aplicação de programas de boas práticas de ordenha (BPO) permitem o controle da mastite pela eliminação de infecções detectadas no rebanho, prevenção de riscos e adequadas condições produtivas e sanitárias. A interação contínua entre produtores e técnicos tem se confirmado como ferramenta importante nos programas de treinamento, favorecendo o compartilhamento de experiências. Sendo assim, o presente estudo teve como objetivo avaliar a influência da capacitação técnica em BPO na qualidade higiênica do leite, mediante o monitoramento das práticas de ordenha implementadas, análises de componentes químicos e microbiológicos, incluindo a identificação de Staphylococcus spp. e Streptococcus spp., em propriedades leiteiras do estado de São Paulo. Na fase final do estudo foi observado que 84% dos itens de BPO avaliados estavam sendo usados com capacitação técnica, incluindo modificações de infraestrutura e controle da qualidade da fonte de água. O sucesso da aplicação de programas de controle da qualidade requerem o comprometimento dos produtores de leite. Entre as BPO que não foram adotadas, destacam-se o uso de luvas durante a ordenha e sanitizante na limpeza dos equipamentos, práticas que poderiam diminuir a transmissão dos patógenos contagiosos entre os animais. Embora as análises microbiológicas e identificação dos patógenos dos diferentes pontos de coleta tenham apresentado resultados variáveis ao longo do estudo, elas constituíram uma ferramenta importante durante o processo de capacitação técnica. / The mammary gland disease, also known as mastitis, has as characteristic the increase of somatic cells in milk from affected udder. Among the predominant bacteria causing mastitis, Staphylococcus spp. and Streptococcus spp are highlighted. Several studies suggest that these agents are typically transmitted from one cow to another during the milking. The application of programs on good milking practices (GMP) allows the control of mastitis through the elimination of infections detected in the herd, prevention of risks and proper productive and sanitary conditions. The continuous interaction between farmers and trainers has been confirmed as an important tool on training programs, supporting sharing experiences. Therefore, the present study aimed to evaluate the influence of GMP training on hygienic quality of milk, by monitoring milking practices implemented, chemical and microbiological analyzes, including the identification of Staphylococcus spp. and Streptococcus spp. in dairy farms from Sao Paulo state. In the final phase of this study it was demonstrated that 84% of the BPO evaluated items were being used with training including infrastructure modifications and quality control of the water source. The success of the implementation of quality control programs requires the commitment of dairy farmers. The GMP not adopted included the use of gloves during milking and sanitizers on equipment cleaning, practices that could reduce the transmission of contagious pathogens among animals. Although the microbiological analyses of the pathogens in different points on the milking management were inconstant during the study, they constitute an important tool during the training process.
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Cognitive behavioural therapy intervention for children and adolescents with Autism Spectrum Disorders and anxiety : A systematic literature review from 2009 to 2019.Valencia Hernández, María Luisa January 2019 (has links)
Young people with Autism Spectrum Disorders (ASD) are more prone to experience anxiety disorders at a greater level compared to their neurotypical developing counterparts, causing lifelong impairments in family, social, academic and adaptive functioning. Early interventions in childhood have been designed to minimize these stressful events and to optimize children’s developmental outcomes. Cognitive behavioural therapy (CBT) is considered a first-line intervention of anxiety. The review aimed to synthesize empirical literature on modified CBT interventions from 2009 until 2019 focusing on reducing anxiety in children and adolescents with ASD. A systematic review of the literature was conducted in five databases. As a result, 10 articles were included to review. Modifications found were: a) audiovisual support and written materials, b) parental partic-ipation, c) sessions length, d) language, e) sensory and motor accommodations, f) emphasis into the behav-ioural component, g) enhancement of individual’s attention and participation, h) facilitating materials to access the content of CBT, and i) participants’ specific interests and worries. The interventions showed significant reductions in youth anxiety levels. Future research should focus on addressing which specific modifications contribute to anxiety reduction since to date, there is no evidence comparing standard CBT to modified CBT interventions. Moreover, there is a lack of anxiety-assessment instruments specially designed for individuals with ASD. In addition, considering the longstanding prevalence of male autistic rates, ASD diagnostic instru-ments should be revised to reduce bias that can mislead to an inattentive ascertainment of females with ASD.
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Enfants de parents bipolaires : évolution et TCC / Bipolar offspring : evolution and CBTScappaticci, Raphaelle 30 June 2017 (has links)
Le trouble bipolaire (TB) est un trouble psychiatrique qui toucherait au minimum 1% à 2% de la population adulte. Si l'étiologie de ce trouble reste complexe et multifactorielle, le poids des facteurs génétiques est conséquent avec une héritabilité estimée entre 70% et 80%. Le fait d'avoir un parent bipolaire apparaît comme le premier facteur de risque de développer soi-même un trouble bipolaire. Egalement, ces enfants présentent un très haut risque d’avoir des psychopathologies. Un marqueur intéressant chez ces enfants pour identifier ce risque est le profil de dysrégulation obtenu au CBCL-DP. Ainsi, l'accès à des programmes de prévention ciblés, avant même l’apparition des troubles de ces enfants « à risque » (enfants de parents bipolaires ayant des symptômes sub-cliniques et un profil au CBCL-DP élevé) est une démarche prometteuse. Les programmes centrés sur la famille (Family Focused Therapy, FFT) dont l'efficacité est établie dans le TB à début précoce pourraient servir de base à des actions de prévention. En France, à ce jour aucune étude ne s’est intéressée à ces enfants.Méthode : Ce protocole exploratoire a été écrit dans le cadre d’une collaboration entre le service de pédopsychiatrie et le Centre Expert Bipolaire au sein du CHU de Montpellier. Nous proposons de faire participer 17 enfants « à risque » (moyenne age = 9,6 ans) à un programme de TCC multifamilles centré sur la gestion émotionnelle et la résolution de problèmes afin de voir si la dimension de dysrégulation est améliorée en fin de groupe. Au terme de ce groupe et à 12 mois, une réévaluation est proposée afin d’en mesurer les éventuels bénéfices par rapport à l’évaluation initiale.Résultats : Une amélioration significative est montrée sur la dimension de dysrégulation à la fin du groupe (p = 0,007) et en phase de suivi (p = <.001). Toutefois, compte tenu des limites méthodologiques de notre étude et en l’absence de groupe contrôle, il faut être prudent quant aux conclusions et répliquer cette étude avec un groupe contrôle. / Bipolar disorder (BD) is a psychiatric disorder that affects about 1% to 2% of adults. Its aetiology is complex and multifactorial but the genetic factors play an important role, with an estimated heritability between 70% and 80%. Having a bipolar parent appears to be the first risk factor for self-development of BD. Also, these children present a very high risk of having disorders.In this context, a high score in the Child Behavior Check-List-Dysregualtion Profile (CBCL-DP) is constantly reported as a reliable screener. Offering the identified children targeted prevention programs, in order to provide them strategies to face the developing symptoms, is a promising approach. The Family Focused Therapy (FFT) is a multifamily, parents-children CBT program. Its effectiveness was proved in early-onset BD and it is now considered as a possible preventive action for BD offsprings. In France, no study have been conducted on this population Method : The aim of our research is to test the efficacy of a FFT program on a French sample of 17 parents and BD offsprings (mean age = 9,6 years). The protocol was written in the context of a collaboration between the Child and Adolescent Mental Health Service (CAMHS) St Eloi and the Bipolar Expert Centre, within the University Hospital of Montpellier. Families were involved in a CBT program that focuses on emotion and problem solving strategies. Assessment was conducted at the end of this group and after 12 months, in order to measure the benefits compared to the first evaluation. Results: A significant decrease is shown on the dysregulation dimension at the end of the group (p = 0,007) and in the follow-up phase (p = <.001). However, given the methodological limitations of our study and in the absence of a control group, one should be cautious when considering caution should be exercised in making the findings. A replication of this first exploratory study, including a control group, is now necesary.
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Capacitação técnica em boas práticas de ordenha e ocorrência de patógenos causadores de mastites contagiosas em propriedades leiteiras do estado de São Paulo / Training of good milking practices and occurrence of pathogens causing contagious mastitis in dairy farms from the State of Sao PauloRocio Elizabeth Contero Callay 10 October 2017 (has links)
A doença da inflamação da glândula mamária, também conhecida como mastite, tem como uma das características o aumento de células somáticas no leite de quartos afetados. Entre as bactérias predominantes causadoras de mastites, destacam-se Staphylococcus spp. e Streptococcus spp. Vários estudos sugerem que estes agentes são tipicamente transmitidos de uma vaca para outra durante o momento da ordenha. A aplicação de programas de boas práticas de ordenha (BPO) permitem o controle da mastite pela eliminação de infecções detectadas no rebanho, prevenção de riscos e adequadas condições produtivas e sanitárias. A interação contínua entre produtores e técnicos tem se confirmado como ferramenta importante nos programas de treinamento, favorecendo o compartilhamento de experiências. Sendo assim, o presente estudo teve como objetivo avaliar a influência da capacitação técnica em BPO na qualidade higiênica do leite, mediante o monitoramento das práticas de ordenha implementadas, análises de componentes químicos e microbiológicos, incluindo a identificação de Staphylococcus spp. e Streptococcus spp., em propriedades leiteiras do estado de São Paulo. Na fase final do estudo foi observado que 84% dos itens de BPO avaliados estavam sendo usados com capacitação técnica, incluindo modificações de infraestrutura e controle da qualidade da fonte de água. O sucesso da aplicação de programas de controle da qualidade requerem o comprometimento dos produtores de leite. Entre as BPO que não foram adotadas, destacam-se o uso de luvas durante a ordenha e sanitizante na limpeza dos equipamentos, práticas que poderiam diminuir a transmissão dos patógenos contagiosos entre os animais. Embora as análises microbiológicas e identificação dos patógenos dos diferentes pontos de coleta tenham apresentado resultados variáveis ao longo do estudo, elas constituíram uma ferramenta importante durante o processo de capacitação técnica. / The mammary gland disease, also known as mastitis, has as characteristic the increase of somatic cells in milk from affected udder. Among the predominant bacteria causing mastitis, Staphylococcus spp. and Streptococcus spp are highlighted. Several studies suggest that these agents are typically transmitted from one cow to another during the milking. The application of programs on good milking practices (GMP) allows the control of mastitis through the elimination of infections detected in the herd, prevention of risks and proper productive and sanitary conditions. The continuous interaction between farmers and trainers has been confirmed as an important tool on training programs, supporting sharing experiences. Therefore, the present study aimed to evaluate the influence of GMP training on hygienic quality of milk, by monitoring milking practices implemented, chemical and microbiological analyzes, including the identification of Staphylococcus spp. and Streptococcus spp. in dairy farms from Sao Paulo state. In the final phase of this study it was demonstrated that 84% of the BPO evaluated items were being used with training including infrastructure modifications and quality control of the water source. The success of the implementation of quality control programs requires the commitment of dairy farmers. The GMP not adopted included the use of gloves during milking and sanitizers on equipment cleaning, practices that could reduce the transmission of contagious pathogens among animals. Although the microbiological analyses of the pathogens in different points on the milking management were inconstant during the study, they constitute an important tool during the training process.
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Military culture and psychosocial factors associated with motivation for, and engagement in, rehabilitation after musculoskeletal injury : a feasibility study with male British military and civilian physiotherapy patientsPaskell, Rachel Grace January 2016 (has links)
Engagement in rehabilitation, such as physiotherapy, is critical to enhanced outcomes from musculoskeletal injuries (MIs) and has been found to be related to psychosocial factors, including increased personal control, higher levels of autonomous-motivation and more problem-focused type coping strategies in sports populations. However, this has not been empirically studied in British military groups, despite MIs being the most common reason for medical discharge from the British armed forces. Military personnel are thought to cope with injury within the context of a 'military culture' that is not found in civilians. This study tested a concept of military culture being related to greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation; lower levels of emotion-focused coping strategies; a greater use of problem-focused coping strategies and better engagement in rehabilitation. Data from self-report questionnaires and physiotherapist ratings of engagement in rehabilitation, provided by two groups, was compared. Group one consisted of 16 serving male military personnel and group two of 22 committed sports men; all had MIs sustained within the past 6 months, for which they were having physiotherapy. The sports group were found to show statistically significant greater adherence to masculine norms, and use of problem-focused and emotion-focused coping strategies. No significant differences were found between the groups on perceived personal control, autonomous motivation nor engagement in rehabilitation. A military culture defined by greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation and a greater use of problem-focused coping strategies has therefore not been supported by this study. However, only sufficient power was achieved for the analysis of emotional-focused coping strategies so caution must be taken when interpreting these results. Clinical and research implications are discussed with recommendations for further work with methodological lessons learnt.
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A replicated, single case, feasibility study of group cognitive behavioural therapy+ for provoked vulvodynia.Giles, Clover January 2019 (has links)
No description available.
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IMPROVING EDUCATION THROUGH E LEARNINGShahzad, Muhammad, Javed, Shahid January 2013 (has links)
Information Communication Technologies (ICT) are taking pace with rapid development,with the strive to impart education among learners in a way that they become highly satisfied.With a help of different electronic tools in educational technology using media and makingright environments to enhance learning, develop creativity, stimulate communication, createchannels for collaboration, and hence, engaging in the continued development and applicationto knowledge and skills. Usage of technology spans across all academic areas with theincreasing popularity of information technology that is evolving rapidly towards bettermentwith increased capabilities every day. Educationalists are interested in knowing howtechnology would create a variation for the students in the classroom. The purpose of using ELearningis to create a learning platform with combination of the existing knowledge andInformation Communication Technologies (ICT). High growth in Information Technology thatis user friendly, accessible, and reliable at the same time providing improved ways incollaborating in a new approach possible. Students from different units would be able tocollaborate forming cross-unit teams and working on common or multiple assignmentshelping each other in different ways. Internet, video conferencing, and emails are wellestablished collaborative tools for exchange of information. Investigating that why there is aneed of technology in the education and which technologies would help in improving learningprocesses is the main purpose of this research. And also to find that what would be thenecessary infrastructure required to get facilitated by this technology. The research revolvesaround the theory of Computer Based Training (CBT) which refers to particular part of theinstructional development or educational media. / Program: Magisterutbildning i informatik
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'You know, you've got to be kind of human' : how CBT therapists experience personal therapy in clinical practiceNoble, Ariele M. January 2017 (has links)
This study explores the subjective experiences of CBT therapists who have undergone personal therapy and seeks to gain insight into the significance of personal therapy in CBT clinical practice. Seven CBT therapists who have undergone personal therapy were interviewed. Interpretative Phenomenological Analysis (IPA) was chosen to generate rich interview data. Participants were asked about their experience of personal therapy in clinical practice. Participants' narratives were analysed using IPA to identify common themes. The analysis resulted in twelve interrelated themes from which three master themes emerged. The first theme, 'Personal therapy creates conflict', explores a paradox that arises between personal therapy and CBT clinical practice; participants suggest that personal therapy equips them with therapeutic tools that paradoxically hinder their capacity to practice a standardised protocol-led CBT. The second master theme, 'Personal therapy ties me to humanity', suggests that the gap between personal therapy and CBT practice narrows by participants' 'use of self': calling upon their own vulnerabilities to forge fundamental connections with their clients based on the shared experience of being human. This study finds that all participants value 'being human' with their clients, however, struggle to find the space 'to just be' within an action-focused, goal-orientated CBT model. This is further explored in the final theme, 'Personal therapy: Being and doing'. Potential implications of the themes that emerged were considered. This study contributes to the literature on CBT and counselling psychology, and to the understanding of a divide in the psychotherapy profession between evidence-based priorities and expectations of reflective practice.
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Les croyances associées à l'alcool et leur lien avec les expériences traumatiques et certains troubles psychologiques en Arabie Saoudite : étude exploratoire / The beliefs associated with alcohol and their link with traumatic experiences and several psychological disorders in Saudi Arabia : an exploratory researchTammar, Raghdah 21 December 2017 (has links)
Introduction: Souvent, les recherches sur ce sujet se réalisent dans un environnement de consommation légal. Pourtant, le cas de l'Arabie saoudite devrait donner des résultats différents. pour la théorie cognitive, la dépendance chimique consiste en une forte interaction entre les cognitions (pensée, croyance, schéma), valeur, opinion, attente, supposition, attitude, émotions, connexion familiale et sociale, impact social et procédure naturelle et physiologique. En s’intéressant à explorer ces croyances dans une société interdisant l'alcool et à présenter un protocole d'évaluation complet adapté à cette culture. Méthode: L’étude inclue 144 sujets, séparés en 3 groupes selon la dépendance et le sexe. Résultats: Les positives croyances liées à l'alcool sont plus élevées chez les alcooliques alors qu'il n'y a pas de différence liée au sexe. Une corrélation positive entre le craving et la rechute. Le niveau de trauma est plus élevé chez les alcooliques et positivement lié à la rechute. Conclusion: Les croyances liées à l’alcool comme toutes les variables precitées ont une rôle essentiel dans la compréhension et le traitement de ce problème. / Introduction: Mostly, the researches about this subject are done in legal alcohol consumption environment. Therefore the case of Saudi Arabia should give different results. Regarding cognitive theory, chemical dependence consists of a strong interaction between cognitions (thoughts, convictions, schemas), values, opinions, expectations and suppositions attitudes; emotions; familial and social connections; social impacts; and natural and physiological procedures. We are interested in exploring these beliefs in a society that forbids alcohol and presenting a complete evaluation protocol adapting to Saudi culture. Method: We studied 144 subjects, separated into 3 groups depending on addiction and gender. Results: Higher positive believes related to alcohol in alcoholics while there is no difference between men and women. A positive correlation between craving and relapse. The traumatic experiences are higher in alcoholics and positively correlated with relapse. Conclusion: The beliefs related to alcohol consumption beside all other variables that are mentioned above have a vital role in the comprehension and the treatment of this issue.
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