Introdução: Déficits cognitivos são parte integrante do quadro clinico da esquizofrenia. Vários estudos procuram métodos de treinamento cognitivo (remediação cognitiva) para melhora destes déficits, pouco responsivos ao tratamento medicamentoso. Ensaios clínicos de treinamento de remediação cognitiva utilizam diversas técnicas, com estimulação de vários domínios cognitivos simultaneamente. Muitos deles utilizam a técnica de errorless learning (aprendizagem sem erros). Pesquisas recentes indicam que alguns domínios cognitivos subjacentes à aprendizagem matemática (atenção, função executiva e memória de trabalho) estão também comprometidos na esquizofrenia. Entretanto não foram encontrados estudos de remediação cognitiva focados no treinamento aritmético em portadores de esquizofrenia. O método de cálculos aritméticos proposto pelo método Kumon utiliza técnica de aprendizagem sem erros e é amplamente utilizado como reforço pedagógico. Dois ensaios randomizados de remediação cognitiva através do método de cálculo aritmético Kumon em idosos sadios e em idosos com Alzheimer mostraram melhora de funções cognitivas com esta intervenção. Este estudo avaliou a eficácia do método de cálculos aritméticos Kumon como remediação cognitiva da memória de trabalho, função executiva e atenção na população com esquizofrenia. Método: 51 sujeitos com o diagnóstico de esquizofrenia (DSM-IV), de ambos os gêneros, idade entre 18 e 55 anos, alfabetizados foram incluídos e randomizados para treinamento de cálculos aritméticos pelo método Kumon (grupo experimental) ou atividades de recreação (grupo controle). Os sujeitos fizeram 48 sessões de intervenção ao longo de 6 meses. Os sujeitos foram avaliados através de uma bateria neuropsicológica, o desfecho clínico através da escala Escala de Síndromes Positiva e Negativa (PANSS) e funcionamento pessoal e social através da PSP no inicio da intervenção, após 6 meses (término da intervenção) e após 6 meses sem a intervenção. Resultados: O grupo experimental apresentou tendência de melhora em atenção sustentada (p=0.075), mas sem manutenção dos ganhos após 6 meses sem intervenção. Ambos os grupos apresentaram melhora em atenção seletiva e função executiva após 6 meses sem manutenção dos ganhos após 1 ano, sem diferenças entre os grupos. Não foram encontradas diferenças no funcionamento social entre os dois grupos e ao longo dos 12 meses de acompanhamento. Através da análise fatorial da PANSS utilizando 5 fatores (proposto por Van der Gaag 2006) não houve mudança significativa nos fatores ,,positivo\", ,,negativo\", ,,desorganização\" e ,,estresse emocional\" ao longo do tempo e entre os grupos. Apenas o grupo placebo demonstrou melhora significativa no fator \"excitação\" após 6 meses em comparação com o grupo experimental, que não persistiu após 6 meses sem intervenção. Conclusão: O treino cognitivo aritmético pelo método Kumon tende a melhorar a atenção sustentada após 6 meses, sem impacto na função executiva e na memória de trabalho. Esta tendência não se manteve após 6 meses sem intervenção / Introduction: Cognitive deficits are an integral part of the clinical picture of schizophrenia. Various studies seek cognitive training (cognitive remediation) methods in order to improve those deficits, which are poorly responsive to pharmacological treatment. Clinical trials of cognitive remediation training use a variety of techniques, with the stimulation of several cognitive domains simultaneously. Many of them employ the \"errorless learning\" technique. Recent research indicates that some cognitive domains underlying mathematical learning (attention, executive function and working memory) are also impaired in schizophrenia. However, no cognitive remediation studies were found focusing on arithmetic training in individuals with schizophrenia. The arithmetic calculation method proposed by Kumon employs the errorless learning technique and is widely used for supplemental education. Two randomized trials of cognitive remediation using the arithmetic calculation method Kumon with healthy elderly subjects as well as elderly subjects who had Alzheimer\'s disease showed cognitive function improvement with this intervention. The present study evaluated the effectiveness of the arithmetic calculation of the Kumon method as cognitive remediation for working memory, executive function and attention in a sample with schizophrenia. Method: 51 subjects with a diagnosis of schizophrenia (DSM-IV), male and female, literate, aged between 18-55 years, were included in the trial and randomized to arithmetic calculation training by the Kumon method (experimental group) or recreational activities (control group). The subjects received 48 intervention sessions over the course of 6 months. The subjects were evaluated through a neuropsychological battery; the clinical outcome was assessed by the Positive and Negative Syndrome Scale (PANSS), and personal and social functioning was evaluated using the Personal and Social Performance (PSP) scale at baseline, at 6 months (discontinuation of interventions) and after 6 months without interventions. Results: The experimental group tended to an improvement in sustained attention (p=0.075), yet this was not maintained after 6 months without interventions. Both groups showed improvements in selective attention and executive function at 6 months, which were not maintained after one year, with no differences between groups. No differences were found in social functioning between the groups and throughout the 12 follow-up months. The factor analysis of the 5-factor PANSS (as proposed by Van der Gaag, 2006) showed no significant change in the factors \"positive\", \"negative\", \"disorganization\" and \"emotional distress\" over time and between groups. Only the placebo group exhibited a significant improvement in the factor \"excitement\" after 6 months compared with the experimental group, which was not maintained after 6 months without interventions. Conclusion: The cognitive arithmetic training by the Kumon method tends to improve sustained attention after 6 months, with no impact on either executive function or working memory. This trend was not sustained after 6 months without interventions

A migrânea está relacionada às disfunções das estruturas da coluna cervical, impulsos aferentes desse local podem ser facilitadores ou mesmo gatilhos da dor. Tratamentos com manipulação cervical isolada e combinada a medicação já foram testados, porém os resultados são conflitantes. O objetivo desse trabalho foi avaliar o efeito adicional da fisioterapia ao tratamento medicamentoso da migrânea na frequência, intensidade e duração da dor de cabeça. Foram inclusas mulheres com migrânea, na faixa etária de 18 e 55 anos, com mínimo de 06 dias de dor por mês, e que apresentasse dor na região craniocervical através do relato. Cinquenta mulheres foram igualmente randomizadas para um dos dois grupos de tratamento, Grupo Fisioterapia (terapia manual + medicação) e Grupo Controle (medicação). O diagnóstico de migrânea foi realizado por uma única neurologista, segundo a Classificação Internacional de Cefaleias. Foram realizadas 12 sessões de terapia manual, duas vezes por semana, durante 50 minutos, por uma única fisioterapeuta. A avaliação, a reavaliação e follow-up foram cegos. Os desfechos primários de frequência, intensidade e duração da dor de cabeça, foram avaliados por meio do diário de dor; e secundários, Limiar de dor por pressão (Algômetro), incapacidade relacionada à cefaleia (Migraine disability assessment program) e a coluna cervical (Neck disability índex), Patient Health Questionnaire eight-item depression scale (PHQ-8), alodinia com Allodynia Sympton Checklist (ASC- /12) e satisfação com Patients Global Impression of Change Scale (PGIC). A análise foi realizada por intenção de tratamento e foi utilizado o Modelo Linear de efeitos mistos e para atribuir relevância clínica o Effect size (ES) e Mínima mudança importante (MID). Não foram observadas diferenças entre os grupos na avaliação inicial. O GF apresentou redução de 37% na frequência de dias de dor de cabeça comparado ao GC que apresentou 22% (p<0.05 e ES 0,4) e (p<0.05 e ES 0,3) respectivamente. Não foram observadas diferenças clínicas significativas entre os grupos na duração e na intensidade da dor de cabeça. Também foi observado aumento significativo (p<0,05) do limiar de dor por pressão, bem como maior satisfação e percepção de mudança da doença ao paciente (p<0,05) no GF em comparação ao GC. Não foram observadas diferenças significativas nos demais parâmetros avaliados. A redução do limiar de dor dos músculos cervicais com o tratamento fisioterapêutico promoveu um efeito benéfico adicional ao medicamentoso, com maior redução da frequência de dias de dor de cabeça e maior satisfação e percepção de melhora dos pacientes. REBEC nº RBR-6kvx74 / Migraine is related to disorders of the cervical spine structures, afferent impulses that location can be facilitators or even triggers pain. Treatments with cervical manipulation alone and combined medication have been tested, but results are conflicting. The aim of this study was to evaluate the additional effect of physical therapy to drug treatment of migraine in frequency, intensity and duration of headache. Women with migraine were included, aged 18 to 55 years, with a minimum of 06 days of pain per month and report of pain in the craniocervical region. Fifty women were equally randomized to one of the two treatment groups, Physiotherapy Group (manual therapy and medication) and control group (medication). The diagnosis of migraine was performed according to the International Classification of headache by a single neurologist. All subjects received similar medications. 12 sessions of manual therapy, twice per week, during for 50 minutes, were done by same physical therapist. The assessment, revaluation and follow-up were blind. The primary endpoints of frequency, intensity and duration of headache were evaluated through diary pain, and secondary endpoints like pain threshold pressure (algometer), headache related disability (Migraine disability assessment program) and cervical spine (Neck disability index), patient Health Questionnaire eight- item depression scale (PHQ-8), with the severity of Allodynia Sympton Checklist (ASC-12) and patients Global Impression of Change Scale to assess satisfaction and perception of patient changes as its disease condition. The analysis was by intention to treat and we used the linear mixed effects model. To assign the clinical relevance Effect size (ES) and Minimum important change (MID) were used. No differences between groups were observed at baseline. The PG showed a 37% reduction in the frequency of headache days compared to GC showed that 22 % (p<0.05 to ES0.4) and (p<0.05 to ES0.3) respectively. No clinically significant differences were observed between groups regarding the duration and intensity of the headache. Significant increase (p<0.05) pain threshold pressure was also observed, as well as greater satisfaction and changing perception of the disease to the patient (p<0.05) in the PG compared with the CG. No significant differences were observed in the other parameters. The reduction of the pain threshold of cervical muscles with physical therapy promoted a beneficial additional effect to medication, with greater reduction in frequency of headache days and greater satisfaction and perceived improvement of patients. REBEC no RBR - 6kvx74

Orientador: Enilson Antonio Sallum / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T18:53:40Z (GMT). No. of bitstreams: 1 Moreira_AnaReginaOliveira_M.pdf: 1385721 bytes, checksum: d11464d4ccf02ff2d2d33193a7be737f (MD5) Previous issue date: 2013 / Resumo: O objetivo do presente estudo foi comparar o resultado clínico do retalho posicionado coronariamente associado (RPC) ou não a enxerto de matriz de colágeno de origem suína (MG) no tratamento de retrações gengivais localizadas. Para este estudo clínico controlado, randomizado, cego, foram selecionados 30 pacientes com retrações gengivais Classe I ou II de Miller ? 2 mm, em dentes caninos ou pré-molares superiores. Os 30 defeitos foram aleatoriamente designados para o grupo RPC ou para o grupo RPC+MG. Os parâmetros clínicos avaliados foram: profundidade de sondagem, nível de inserção clínico, altura e largura da retração gengival, altura e espessura de tecido queratinizado, altura e largura da papila interdental, hipersensibilidade dentinária e satisfação estética. As medidas clínicas foram tomadas imediatamente antes da cirurgia e 45 dias, 2, 3 e 6 meses após as cirurgias. Nenhuma diferença estatisticamente significante foi observada entre os grupos em relação à redução da retração gengival, embora tenha sido encontrada maior porcentagem de cobertura radicular no grupo RPC+MG (77,8%), quando comparado ao RPC (72,5%) (p<0,05). Cobertura radicular completa foi obtida em 40% dos sítios tanto no RPC quanto no grupo RPC+MG. Ao final do estudo, o ganho na espessura de tecido queratinizado foi 0,21 mm maior para o grupo RPC+MG (p<0,05). Nenhum dos tratamentos reduziu hipersensibilidade dentinária de forma significativa (p>0,05), mas resultaram em aumento estatisticamente significante na satisfação estética dos pacientes (p<0,05), sendo esta maior quando o MG não foi utilizado (p<0,05). Dentro dos limites do presente estudo pôde-se concluir que o RPC, associado ou não a MG, levou a redução significativa da retração gengival, sem diferença estatística entre os grupos. Entretanto, quando MG foi utilizado, houve ganhado adicional na espessura de tecido queratinizado / Abstract: The aim of this study was to compare the clinical outcome of the coronally advanced flap technique (CAF) associated or not to a porcine collagen matrix graft (MG) in the treatment of localized gingival recessions. For this blinded randomized controlled clinical trial, 30 patients with Miller Class I or II gingival recession ? 2 mm in canines or premolars were selected. The 30 defects were randomly assigned to the CAF group or to the CAF+MG group. The clinical parameters evaluated were probing depth, clinical attachment level, gingival recession height, gingival recession width, height and thickness of keratinized tissue, height and width of interdental papilla, dentin hypersensitivity and aesthetic satisfaction. Clinical measurements were taken at baseline and 45 days, 2, 3 and 6 months after surgery. No statistically significant difference was observed between the two groups regarding gingival recession reduction, although it was found the highest percentage of root coverage in CAF + MG group (77.8%) compared to the CAF alone (72.5%) (p<0.05). Complete root coverage was achieved in 40% of the sites in both CAF and CAF + MG group. At the end of the study, the gain in keratinized tissue thickness was 0.21 mm higher in CAF + MG group (p <0.05). None of the treatments significantly reduced dentin hypersensitivity (0>0.05), but resulted in increased patient-reported aesthetic satisfaction (p<0.05), which was higher when the MG was not used (p<0.05). Within the limits of this study, it can be concluded that CAF, with or without MG, resulted in significant gingival recession reduction, with no statistical difference between groups. However, when MG was used, there was additional gain in keratinized tissue thickness / Mestrado / Periodontia / Mestra em Clínica Odontológica

Aim: To improve the dental behaviour and knowledge of mothers of infants with cleft lip and/or palate (CLP). Design: A randomised controlled, single blind, prospective clinical trial of one year duration, measuring the effectiveness of a preventive dental health programme. All mothers and their infants attending the regional cleft unit following primary surgery were invited to participate. All data collection took place within the same cleft unit. Primary objectives examined dental attendance, use of a fluoride toothpaste and introduction of a feeder cup. Mothers completed dental behaviour and dental health knowledge questionnaires followed by stratified random allocation concealed from the researcher, to test or control groups. Preventive dental advice was given according to group allocation. Data were collected at baseline, after 12 months and aged three years at a multidisciplinary clinic review. An independent researcher collected the 12 months data and a specialist in paediatric dentistry the data at aged three years, both were blinded to group allocation. Results: 88 infants were recruited with 87 available at 12 months and 82 at three years, median age at baseline 10.5 months. More infants in the test group had been examined by their dentist, 12 months (p = 0.063), 3 years (p = 0.054). More infants in the test group were using a high fluoride toothpaste at 12 months (p = 0.001), no difference was found at three years (p = 0.105). Fewer infants in the test group were consuming drinks considered detrimental between meals at 12 months (p = 0.022), no difference was detected at three years (p = 1.000). A comparison of dental health knowledge over time revealed some differences. The dental health status reported 60 (73%) children were caries free and 17 (21%) with dentinal caries requiring attention. Four children were in need of dental extractions under general anaesthesia. This study was not powered to detect important differences between groups. The mean caries experience, decayed, missing and filled teeth (dmft) for 82 children examined at three years was 0.51(SD 1.45) and for those 17 (21%) with caries into dentine, 2.47 (SD 2.35). Conclusion: A dental health programme initially changes behaviour, however over time this is not maintained. Due to moderate caries levels the regional cleft Unit should ensure that all children with CLP receive preventive dental advice and dental care from either a hospital or community based specialist in paediatric dentistry. Further research is needed to improve the future care of this important group.

Introduction : L’allaitement maternel est recommandé par les instances nationales et internationales pour ses bénéfices sur la santé des mères et des enfants. Près de neuf mères sur dix initient l’allaitement au Québec. Pour celles qui arrêtent dans le premier mois, une sur deux met en cause des problèmes mécaniques de succion chez le bébé en dépit du support de consultantes en lactation (CL). Les ostéopathes, dans le monde entier, reçoivent ces bébés. Cependant, peu d’études scientifiques sont publiées sur la contribution de cette profession à ce sujet. L’objectif primaire de cette étude était de déterminer l’efficacité d’un traitement ostéopathique, couplé à des consultations d’allaitement usuelles, chez les nouveau-nés ayant des difficultés mécaniques de succion. Méthode : Un essai contrôlé randomisé en simple aveugle portant sur 97 dyades maman-bébé référées par des CL a été réalisé. Les dyades étaient réparties en deux groupes : intervention ostéopathique ou soins usuels. Quatre temps de mesure sur une période de 10 jours, ont permis de déterminer l’efficacité de la succion pré et post intervention, l’intensité de la douleur chez la mère ainsi que tout effets secondaires perçus. Les lésions ostéopathiques ont été colligées afin de dresser un profil. Des tests-t, des Chi-carrés ainsi que des modèles de régression ont permis l’analyse des différences entre les deux groupes à l’étude. Résultats : Les bébés ayant reçu l’intervention ostéopathique ont montré une efficacité de succion cliniquement et statistiquement supérieure au groupe de soins usuels (p<0.001). Les analyses n’ont pas montré de différence statistiquement significative entre les groupes quant à la douleur ressentie par la mère aux différents temps de mesure. Cependant, à 3 jours post intervention, les mères du groupe intervention ont perçu une diminution significative de leur douleur (p=0.001). Un profil des bébés recrutés a pu être dressé avec des dysfonctions en postérieur du crâne chez 84,5% d’entre eux. Aucun effet secondaire grave ni sévère n’a été rapporté. Conclusion : L’ostéopathie couplée à un suivi par des CL, semble une approche prometteuse pour les dyades mère-bébé ayant des difficultés mécaniques de succion. D’autres recherches seraient à prévoir pour bonifier l’intervention ostéopathique en terme de moment, de bébés pouvant profiter de ce type de suivi, et aussi la documentation des zones en lésion. / Abstract: Background: National and international policies recommend breastfeeding for its benefits on mothers’ and infants’ health. In Quebec, almost nine out of ten mothers initiate breastfeeding with their baby but half of these stop during the first month, due to biomechanical sucking difficulties, and this, despite increasing support from lactation consultants (LC). Osteopaths worldwide work with these babies, but there is little empirical evidence for this type of treatment. The primary objective of this study was to determine the efficacy of an osteopathic treatment coupled with usual lactation consultations on infants’ identified as having biomechanical sucking difficulties. Methods: A single blind randomized controlled trial including 97 mother-infant dyads referred by LC. The dyads were randomized into two groups: osteopathic intervention or usual care. Four measurement times over a 10-day period (pre and post intervention) allowed for the determination of the babies’ ability to latch, the intensity of pain felt by mothers as well as any perceived side effects. Osteopathic lesions were documented in an effort to establish a profile T-tests and Chi-square tests as well as regression models were used to compare groups. Results: Babies having received the osteopathic intervention showed a clinically and statistically significant increase (p<0.001) in their ability to latch compared to the usual care group. Analyses did not show any statistically significant difference between groups with regard to the pain felt by mothers at the different measurement times. However, 3 days post intervention, the mothers in the intervention group perceived a significant decrease in their level of pain (p=0.001). A profile of osteopathic dysfunctions in these babies was generated with 84,5% of them found to have a posterior skull dysfunction. No serious or severe side effects were reported. Conclusion: Osteopathic treatment coupled with lactation consultations seem to be a promising avenue for mother-infant dyads with biomechanical sucking dysfunctions. Further research is needed to optimize osteopathic treatment in terms of targeting babies, timing and duration of interventions and also to better document and standardize areas with osteopathic lesions.

Bakgrund: Akupunktur är en gammal behandlingsmetod, beräknad ungefär 4100 år gammal och kommer från Kina. Elektroakupunktur är en något nyare behandlingsmetod där man för ström mellan nålarna. Denna behandlingsmetod används främst av fysioterapeuter. Behandlingarna som fysioterapeuten utför kräver ett vetenskapligt stöd, därför finns ett behov att granska den litteratur som behandlingsmetoden grundas på. Inom forskning och verksamhet använder man olika namn för denna metod, både “electroacupuncture” och “percutaneouselectricalnervestimulation” (PENS). Ryggsmärta är ett vanligt problem bland världens befolkning, det är beräknat att upptill 70% av befolkningen kommer någon gång i sitt liv uppleva ryggssmärta. Det är även beräknat att vara den vanligaste smärtförekomsten. Om elektroakupunktur fungerar mot ländryggssmärta kan terapeuter använda denna behandlingsmetod. Syfte: Syftet med denna studie var att undersöka vilket vetenskapligt stöd det finns för elektroakupunktur som behandlingsmetod vid ländryggssmärta. Metod: En systematisk sökning utfördes i databaserna CinAHL, PubMed, PEDro, Scopus och Web of Science angående elektroakupunktur och ländryggssmärta. Sökorden som användes var “electroacupuncture”, “lowback pain ”, “percuteaneous electricalnervestimulation” och “randomized controlled trial”. Resultat: Sammanlagt 15 RCT – studier inkluderades i denna studie. Sammanlagt 11 av 15 studier fann signifikanta skillnader i resultat. 8 studier behandlade kronisk ländryggssmärta, 4 behandlade diskogena besvär och resterande 3 behandlade andra ryggdiagnoser. Elektroakupunktur har visat ge en smärtlindring vid ländryggssmärta. Konklusion: Samtliga inkluderade studier fann smärtlindring av behandlingen, dock visade inte alla signifikanta skillnader. Det finns även metodologiska brister i den befintliga litteraturen vilket innebär att bör se resultaten kritiskt. Mer forskning inom området behövs.

Introduction: Oral mucositis is an inflammatory and frequently ulcerative side effect of cancer therapy, which has been identified by patients as the most debilitating side effect of their treatment. Mucositis is a dose limiting toxicity which exerts a substantial clinical and economic impact and negatively affects patient quality of life. The patient experience of mucositis is under-reported in the literature. To date, no interventions have been identified that have proven successful in the prevention of mucositis for patients receiving all types of therapy. Vitamin E has shown conflicting results in clinical trials. This thesis combines appraisal of the literature and empirical research,and uses lessons learned from previous studies together with the results of a feasibility study to identify a best practice model for future trials. Methods: The Cochrane risk of bias (ROB) instrument was used to assess the ROB in the studies included in the Cochrane prevention review. A sensitivity analysis was conducted after studies assessed at unclear or high risk of overall bias were excluded. A systematic review of assessment instruments was conducted which identified 50 instruments. Consideration of the appropriateness of these instruments for the use in a clinical trial for the prevention of mucositis was based on the practicality, comparability, and reproducibility, and the impact of these instruments on patients. Three of these instruments were chosen for use in a clinical trial of adults undergoing stem cell transplant. Finally, a feasibility study was designed, developed and conducted which investigated vitamin E for the prevention of mucositis in patients undergoing conditioning for bone marrow transplantation. Through lessons learned from previous studies, consultations with medical professional, the MHRA, ethics committee and suppliers, a protocol was developed for a double blind RCT. The process of gaining MHRA and ethical approval, and the repackaging of intervention and placebo products to meet MA-IMP requirements are described. Results: 130 articles were assessed for risk of bias. Only ten studies were assessed as being at low overall risk of bias. Blinding of outcome assessors and adequate allocation concealment were identified to be important considerations in the planning of future studies. Although only nine patients were recruited into the feasibility study, a number of issues affecting the design and conduct of future trials were identified. Recruitment in particular was identified to be problematic. Strategies for overcoming this problem in future trials were discussed. The methods of blinding and allocation concealment employed were found to be feasible for use in future trials. Expected adverse events patients undergoing stem cell transplantation were also reported. Conclusion: Further studies are required to investigate interventions for the prevention of mucositis. It is of upmost importance that these trials are rigorous in both their methodology and subsequent reporting in order to elicit the maximum benefit for patients taking part in clinical trials, and future patients undergoing therapy for cancer.

abstract: Introduction: A diet high in fermented, oligio-, di-, monosaccharide, and polyols (FODMAP) has been shown to exacerbate symptoms of irritable bowel syndrome (IBS). Previous literature has shown significant improvement in IBS symptoms after adherence to a low FODMAP diet (LFD). However, dietary adherence to the LFD is difficult with patients stating that information provided by healthcare providers (HCPs) is generalized and nonspecific requiring them to search for supplementary information to fit their needs. Notably, studies that have used a combination of online and in-person methods for treatment have shown improved adherence to the LFD. Objective: To determine whether a novel artificial intelligence (AI) dietary mobile application will improve adherence to the LFD compared to a standard online dietary intervention (CON) in populations with IBS or IBS-like symptoms over a 4- week period. Methods: Participants were randomized into two groups: APP or CON. The intervention group was provided access to an AI mobile application, a dietary resource verified by registered dietitians which uses artificial intelligence to individualize dietary guidance in real-time with the ability to scan menus and barcodes and provide individuals with food scores based on their dietary preferences. Primary measures included mobile app engagement, dietary adherence, and manifestation of IBS-like symptoms. Baseline Results: A total of 58 participants were randomized to groups. This is an ongoing study and this thesis details the methodology and baseline characteristics of the participants at baseline and intervention start. Validation of the application could improve the range of offerings for lifestyle diseases treatable through dietary modification. / Dissertation/Thesis / Masters Thesis Nutrition 2020

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Separation anxiety disorder (SAD) is the most common and impairing childhood anxiety disorder. Left untreated, SAD is associated with heightened risk for the development of additional internalizing disorders as well as impairments in educational attainment and social functioning. Numerous clinical trials have demonstrated the efficacy of cognitive-behavior therapy (CBT) for the treatment of childhood anxiety disorders, including SAD. However, additional research is needed to enhance the compatibility (e.g., fit of the treatment to the patient population) and ultimate uptake of evidence-based interventions for anxious youth. The current research evaluates the feasibility and preliminary efficacy of an intensive, cognitive-behavioral intervention for school-aged girls with SAD provided within the novel context of a one-week camp-like setting. This alternative treatment format was predicated on evidence supporting the need for treatments that allow for creative and developmentally-sensitive applications of intervention components, incorporate a child's social context, target relevant parenting variables, and provide additional models for treatment delivery. Twenty-nine female children aged 7 to 12 with a principal or co-principal diagnosis of SAD were randomized to an immediate treatment (n = 15) or waitlist (i.e., delayed treatment; n = 14) condition during the course of this randomized-controlled trial. Measures were administered at pretreatment/ pre-waitlist, post-treatment/post-waitlist, and six weeks following treatment to assess changes in symptom reports, functional outcomes, and overall program satisfaction. Analyses of covariance were conducted to assess effects of treatment condition and repeated measures analyses of variance were conducted to evaluate change over the three data collection time points. Relative to waitlist, children in the immediate treatment group evidenced significant reductions in SAD severity by clinician report on a diagnostic interview measure. Moreover, treatment gains strengthened over time. Contrary to hypotheses, children receiving the intervention did not display significantly greater improvements relative to waitlist on parent-rated fear and avoidance scores or on parent or child self-report measures. Potential explanations for non-significant findings are discussed. Overall, the intervention's positive therapeutic response on SAD diagnostic status and severity suggests one possible delivery model for surmounting difficulties faced in the dissemination of standard, weekly treatments for this condition. / 2031-01-02

Orientador: Ana Carolina Pero Vizoto / Banca: Marco Antonio Compagnoni / Banca: André Gustavo Paleari / Resumo: Overdentures retidas por um implante têm sido apresentadas como uma opção de tratamento para pacientes que apresentam problemas relacionados à retenção e estabilidade de suas próteses totais inferiores, podendo representar uma alternativa à reabilitação com overdentures retidas por dois implantes. O objetivo deste estudo foi avaliar a movimentação da prótese total superior em usuários de overdentures mandibulares retidas por um ou dois implantes durante a mastigação de dois alimentos teste. Vinte e um pacientes usuários de próteses totais bimaxilares novas foram divididos em dois grupos e posteriormente submetidos à instalação de um (G1; n=11) ou dois (G2; n=10) implantes na região anterior da mandíbula. Após 4 meses foram instalados pilares o'rings sobre os implantes e realizou-se a captura das cápsulas e anéis de retenção por meio de alívio e reembasamento das próteses totais inferiores. Um cinesiógráfo foi utilizado para registrar a movimentação da prótese total superior, nos seguintes períodos: antes da cirurgia (baseline), 3, 6 e 12 meses após a ativação dos implantes, durante a mastigação voluntária de dois tipos de alimentos teste, pão e poliéter. O teste de ANOVA de três fatores de medições repetidas mistas seguido pelo teste de Bonferroni foram utilizados na análise dos dados (α=0,05). Para o eixo vertical, houve uma menor intrusão da prótese total superior quando os pacientes apresentavam prótese total convencional inferior (µ=0,60±0,28 mm), em comparação aos perío... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Overdentures retained by one implant have been presented as a treatment option for patients with problems related to retention and stability of their mandibular complete dentures, which may represent an alternative to rehabilitation with overdentures retained by two implants. The objective of this study was to evaluate the movement of the conventional maxillary complete denture among users of overdentures retained by one or two implants during chewing of two food test. Twenty-one patients received new maxillary and mandibular dentures and were divided into two groups and subsequently receive one (G1; n = 11) or two (G2; n = 10) implants in the mandibular arch. After four months, the ball attachments were inserted to the implants and a processed denture reline was made to incorporate the implant retention using retentive elements. A kinesiograph was used to record the maxillary complete denture movement in the following periods: before surgery (baseline), 3, 6 and 12 months after implants retention, during voluntary chewing two types of test foods: bread and polysulphide blocks. Data were analyzed using three-way ANOVA followed by Bonferroni test (α=.05). For the vertical axis, a lower vertical intrusion of the maxillary denture was observed when patients had convencional mandibular complete denture (µ=0,60±0,28 mm), in comparison with 3 months (µ=0,79±0,40 mm), 6 months (µ=0,89±0,63 mm) and 12 months (µ=0,93±0,71 mm) after implants retention. In addition, patients that receiv... (Complete abstract click electronic access below) / Mestre