O carcinoma epidermoide de cabeça e pescoço, hoje considerada mundialmente uma das neoplasias mais frequentes desta região, tornou-se um problema de saúde pública, necessitando urgente de medidas a serem tomadas, a fim de melhorar a qualidade de vida dos pacientes acometidos, consequentemente aumentando a sobrevida, avaliada em cinco anos. O carcinoma epidermoide de cabeça e pescoço é uma doença complexa, e inclui vários fatores etiológicos, além de alterações moleculares, capazes de desencadear e dar continuidade a alguns eventos. No geral os carcinomas orais são tratados primeiramente com cirurgia excisional ou radioterapia individualmente, ou em combinação para os estágios mais avançados. As preparações dos extratos fermentados de Viscum album (VA), uma planta semiparasita da família das Lorantáceas, vêm sendo utilizada, principalmente em países da Europa, com resultados promissores no âmbito das terapias coadjuvantes, especialmente a medicina antroposófica. Em conjunto com as terapias convencionais, tem demonstrado uma melhora na qualidade de vida dos pacientes portadores de neoplasias malígnas. Estudos in vitro, realizados em células cancerígenas, têm demonstrado que vários tipos de VA podem apresentar citotoxicidade em células de carcinoma, sendo capazes de ativar a cascata apoptótica ou levando as células à necrose. Este estudo teve por objetivo verificar a ação de três tipos de extratos de VA (Iscador Qu Spezial, Iscador P e Iscador M), em linhagens celulares de carcinoma epidermoide de língua (SCC9 e SCC25). Para isso foi verificada a ação citotóxica do fármaco Iscador Qu Spezial, por meio do teste de viabilidade celular, para a obtenção da IC50. Em seguida foram realizados com os três fármacos: o teste de Tunel, para verificação de apoptose, Anexina V FITC/Iodeto de Propídeo, com auxílio de citômetro de fluxo, para a verificação quantitativa do índice de apoptose provocado pelos fármacos. Em seguida foi verificado o comportamento de cinco genes (Akt1, Akt2, Akt3, PTEN e Ciclina D1) por meio de análises feitas por qRT-PCR, e de seus produtos (pAkt, PTEN e Ciclina D1) pelas técnicas de Imunofluorescência e Western-Blot. Os fármacos, na concentração de 0,3 mg/mL (IC50) apresentaram resultados positivos na indução de apoptose nas células analisadas, e mostraram diferentes níveis de expressão para os genes analisados. Nos ensaios por Imunofluorescência, as proteínas exibiram diferentes localizações e comportamentos nos compartimentos celulares analisados. As análises quantitativas dessas proteínas, analisadas por Western-Blotting, mostraram diferentes níveis de expressão. Por meio deste estudo foi possível concluir que os fármacos Iscador Qu Spezial e Iscador M, possuem maior potencial citotóxico nas células das linhagens SCC9 e SCC25, quando comparados aos controles e ao fármaco Iscador P. As células da linhagem SCC9 exibiram um perfil mais resistente à ação dos fármacos analisados do que as células da linhagem SCC25. / Head and neck squamous cell carcinoma, one of the most common malignancies worldwide in this area, became a public health problem that requires urgent attitudes to be taken in order to improve the quality of life of the affected patients, increasing survival that today valued at five years. Head and neck squamous cell carcinoma is a complex disease which includes several etiologic factors and different molecular changes that may trigger and get on with some events. In general, oral carcinomas are treated primarily with surgical excision or radiotherapy alone or in combination for cases in more advanced stages. Preparations of fermented extracts from fermented Viscum album (VA), a plant from the Loranthaceae family have been used, mainly in European countries, with promising results as adjuvant therapies, especially in the Anthroposophy Medicine. In combination with conventional therapies, VA has lead to improvement in quality of life of patients with cancer. in vitro studies have demonstrated that various types of VA may have cytotoxicity in carcinoma cells being able to activate the apoptotic cascade or leading cells to necrosis. The present study aimed to verify the effect of three types of VA extracts (Iscador Qu Spezial, Iscador P and Iscador M) in squamous cell carcinoma of the tongue (SCC9 and SCC25). The cytotoxic action of Iscador Qu Spezial was verified by cell viability test obtaining the IC50. The three drugs were tested as follow: Tunnel to evaluate apoptosis, Annexin V and FITC/propidium iodide were evaluated by flow cytometry to quantify the apoptosis rate induced by the drugs. Then we verified the expression levels of five genes (Akt1, Akt2, Akt3, PTEN and Cyclin D1) by qRT-PCR and their products (pAkt, PTEN and Cyclin D1) by immunofluorescence and Western blot. The concentration of 0.3 mg/mL (IC50) of the drugs presented positive results in the induction of apoptosis and showed different expression levels for the genes analyzed. Immunofluorescence assays evidenced that the proteins exhibited different locations and behaviors in the cellular compartments analyzed. Quantitative analysis of these proteins by Western-Blot, evidenced that they presented different levels of expression. Through this study, it was concluded that Iscador Qu Spezial drugs and Iscador M have higher cytotoxic potential on SCC9 and SCC25 cell lines when compared to controls and the drug Iscador P. It could also be concluded that the SCC9 cell line was more resistant to the action of the drugs examined.

O carcinoma epidermoide de cabeça e pescoço, hoje considerada mundialmente uma das neoplasias mais frequentes desta região, tornou-se um problema de saúde pública, necessitando urgente de medidas a serem tomadas, a fim de melhorar a qualidade de vida dos pacientes acometidos, consequentemente aumentando a sobrevida, avaliada em cinco anos. O carcinoma epidermoide de cabeça e pescoço é uma doença complexa, e inclui vários fatores etiológicos, além de alterações moleculares, capazes de desencadear e dar continuidade a alguns eventos. No geral os carcinomas orais são tratados primeiramente com cirurgia excisional ou radioterapia individualmente, ou em combinação para os estágios mais avançados. As preparações dos extratos fermentados de Viscum album (VA), uma planta semiparasita da família das Lorantáceas, vêm sendo utilizada, principalmente em países da Europa, com resultados promissores no âmbito das terapias coadjuvantes, especialmente a medicina antroposófica. Em conjunto com as terapias convencionais, tem demonstrado uma melhora na qualidade de vida dos pacientes portadores de neoplasias malígnas. Estudos in vitro, realizados em células cancerígenas, têm demonstrado que vários tipos de VA podem apresentar citotoxicidade em células de carcinoma, sendo capazes de ativar a cascata apoptótica ou levando as células à necrose. Este estudo teve por objetivo verificar a ação de três tipos de extratos de VA (Iscador Qu Spezial, Iscador P e Iscador M), em linhagens celulares de carcinoma epidermoide de língua (SCC9 e SCC25). Para isso foi verificada a ação citotóxica do fármaco Iscador Qu Spezial, por meio do teste de viabilidade celular, para a obtenção da IC50. Em seguida foram realizados com os três fármacos: o teste de Tunel, para verificação de apoptose, Anexina V FITC/Iodeto de Propídeo, com auxílio de citômetro de fluxo, para a verificação quantitativa do índice de apoptose provocado pelos fármacos. Em seguida foi verificado o comportamento de cinco genes (Akt1, Akt2, Akt3, PTEN e Ciclina D1) por meio de análises feitas por qRT-PCR, e de seus produtos (pAkt, PTEN e Ciclina D1) pelas técnicas de Imunofluorescência e Western-Blot. Os fármacos, na concentração de 0,3 mg/mL (IC50) apresentaram resultados positivos na indução de apoptose nas células analisadas, e mostraram diferentes níveis de expressão para os genes analisados. Nos ensaios por Imunofluorescência, as proteínas exibiram diferentes localizações e comportamentos nos compartimentos celulares analisados. As análises quantitativas dessas proteínas, analisadas por Western-Blotting, mostraram diferentes níveis de expressão. Por meio deste estudo foi possível concluir que os fármacos Iscador Qu Spezial e Iscador M, possuem maior potencial citotóxico nas células das linhagens SCC9 e SCC25, quando comparados aos controles e ao fármaco Iscador P. As células da linhagem SCC9 exibiram um perfil mais resistente à ação dos fármacos analisados do que as células da linhagem SCC25. / Head and neck squamous cell carcinoma, one of the most common malignancies worldwide in this area, became a public health problem that requires urgent attitudes to be taken in order to improve the quality of life of the affected patients, increasing survival that today valued at five years. Head and neck squamous cell carcinoma is a complex disease which includes several etiologic factors and different molecular changes that may trigger and get on with some events. In general, oral carcinomas are treated primarily with surgical excision or radiotherapy alone or in combination for cases in more advanced stages. Preparations of fermented extracts from fermented Viscum album (VA), a plant from the Loranthaceae family have been used, mainly in European countries, with promising results as adjuvant therapies, especially in the Anthroposophy Medicine. In combination with conventional therapies, VA has lead to improvement in quality of life of patients with cancer. in vitro studies have demonstrated that various types of VA may have cytotoxicity in carcinoma cells being able to activate the apoptotic cascade or leading cells to necrosis. The present study aimed to verify the effect of three types of VA extracts (Iscador Qu Spezial, Iscador P and Iscador M) in squamous cell carcinoma of the tongue (SCC9 and SCC25). The cytotoxic action of Iscador Qu Spezial was verified by cell viability test obtaining the IC50. The three drugs were tested as follow: Tunnel to evaluate apoptosis, Annexin V and FITC/propidium iodide were evaluated by flow cytometry to quantify the apoptosis rate induced by the drugs. Then we verified the expression levels of five genes (Akt1, Akt2, Akt3, PTEN and Cyclin D1) by qRT-PCR and their products (pAkt, PTEN and Cyclin D1) by immunofluorescence and Western blot. The concentration of 0.3 mg/mL (IC50) of the drugs presented positive results in the induction of apoptosis and showed different expression levels for the genes analyzed. Immunofluorescence assays evidenced that the proteins exhibited different locations and behaviors in the cellular compartments analyzed. Quantitative analysis of these proteins by Western-Blot, evidenced that they presented different levels of expression. Through this study, it was concluded that Iscador Qu Spezial drugs and Iscador M have higher cytotoxic potential on SCC9 and SCC25 cell lines when compared to controls and the drug Iscador P. It could also be concluded that the SCC9 cell line was more resistant to the action of the drugs examined.

<p>Den här studien fokuserar på komplementärmedicin ur fyra informanters perspektiv och med kopplingar till aktuella vetenskapliga diskussioner och strömningar. Bakgrunden till studien är en ökande användning av komplementärmedicin i samhället och livliga debatter kring dess vetenskapliga status. Syftet är att genom kvalitativa metoder belysa viktiga aspekter av informanternas användning av komplementärmedicin. Mycket uppmärksamhet ägnas åt informanternas syn på de olika metodernas effektivitet, hur denna definieras och vilka konkreta resultat informanterna strävar efter eller upplever.</p> / <p>This study focuses on complementary medicine from the perspectives of four informants, and with reference to topical scientific discussions and currents. The background of this study is to be found in the growing use of complementary medicine in the society. The main goal is to shed light on important aspects of the informants’ use of complementary medicine. Much attention is focused on their views regarding the efficacy of the various methods, how it is defined and what concrete results they are striving for, or experiencing.</p>

Den här studien fokuserar på komplementärmedicin ur fyra informanters perspektiv och med kopplingar till aktuella vetenskapliga diskussioner och strömningar. Bakgrunden till studien är en ökande användning av komplementärmedicin i samhället och livliga debatter kring dess vetenskapliga status. Syftet är att genom kvalitativa metoder belysa viktiga aspekter av informanternas användning av komplementärmedicin. Mycket uppmärksamhet ägnas åt informanternas syn på de olika metodernas effektivitet, hur denna definieras och vilka konkreta resultat informanterna strävar efter eller upplever. / This study focuses on complementary medicine from the perspectives of four informants, and with reference to topical scientific discussions and currents. The background of this study is to be found in the growing use of complementary medicine in the society. The main goal is to shed light on important aspects of the informants’ use of complementary medicine. Much attention is focused on their views regarding the efficacy of the various methods, how it is defined and what concrete results they are striving for, or experiencing.

Cognitive linguists posit that language as a system of meaning is closely related to cognition and to the associated perceptual and physiological structures of the body. From the cognitive semantic viewpoint, cognitive processes underpin and motivate linguistic phenomena such as categorisation, polysemy, metaphor, metonymy and image schemas. The pedagogical implication of the cognitive semantic perspective is that understanding these cognitive motivations facilitates language learning. This dissertation uses an applied cognitive semantic approach to `make sense' of a traditional knowledge system, Traditional Chinese Medicine (TCM). TCM views human physiology as a holistic and dynamic system that exemplifies the same principles as the cosmos-environment. TCM models result in a categorisation of physiological phenomena based on a complex system of experiential and cosmological correspondences. I suggest that the holistic epistemology of cognitive linguistics is well suited to an understanding of these holistic models. From a pedagogical viewpoint, I argue that an analysis of the cognitive motivations which underpin TCM categorisations and the polysemy of some key TCM terms can help the student make sense of TCM as a meaningful system of thought and practice. Both the theoretical and applied approaches explored in this dissertation should have relevance to other traditional knowledge systems, particularly traditional medical systems. / Linguistics and Modern Languages / M.A. (Linguistics)

Background: Bipolar disorder (BD) is a significant cause of perinatal morbidity and mortality. Because BD is hard to detect and treat, these individuals often go without care. This dissertation was designed to: (1) identify the prevalence rates of BD and bipolar-spectrum mood episodes in perinatal individuals, (2) understand pertinent barriers to mental healthcare, and (3) elucidate how to bridge healthcare gaps. Methods: Data sources included: primary qualitative and quantitative data from obstetric clinicians, encounter data from Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a program aimed at helping clinicians to provide mental healthcare to perinatal patients. Analyses included: descriptive statistics, systematic review and meta-analysis, qualitative data analyses, longitudinal regression analyses, and group-based trajectory modeling. Results: The prevalence of BD in perinatal individuals was 2.6% (95% CI: 1.2 to 4.5%). Twenty to 54.9% were found to have a bipolar-spectrum mood episode. Barriers to mental healthcare for perinatal patients with BD included the paucity of psychiatric resources, difficulties in assessing BD, and stigma towards pharmacotherapy. Obstetric clinicians reported that MCPAP for Moms has helped them feel more comfortable in treating patients with BD. Longitudinal analyses of encounter data corroborated these findings - utilization of the program predicted increased clinician capacity to treat BD. Conclusion: Clinicians for perinatal individuals are being called upon and stepping up to care for complex illnesses like BD. Programs like MCPAP for Moms can help them feel more confident in this role, helping to bridge gaps in perinatal mental healthcare and ensuring that individuals with BD are able to receive appropriate care.

<p>Psychiatric assistance dogs for military veterans with posttraumatic stress disorder (PTSD) currently make up over 19% of assistance dog partnerships globally. We conducted a systematic review of the literature relating to these partnerships, with specific aims to (1) summarize their characteristics, (2) evaluate the quality of existing evidence, and (3) summarize outcomes. A total of 432 records were independently screened (Cohen’s kappa=0.90). Of these, 41 articles (29 peer-reviewed publications and 12 unpublished dissertations) met inclusion criteria. Data extraction was conducted to address the research aims, including a meta-analysis (quantitative outcomes) and meta-synthesis (qualitative outcomes). All peer-reviewed publications on the topic of psychiatric assistance dogs for veterans with PTSD were published within the last five years. The majority of included articles were quantitative (53%), 41% were qualitative, and 6% employed mixed methods. Mean methodological rigor scores were 80% for peer reviewed articles and 71% for dissertations, where higher scores represent more rigorous methodology. Quantitative articles reported significant improvements in the domains of PTSD severity, mental health, and social health. Impacts on physical health and global quality of life appear inconclusive. Meta-analysis (9 articles) revealed that partnership with an assistance dog had a clinically meaningful, significant, and large effect on PTSD severity scores (<em>g</em>=−1.129; <em>p</em><0.0001). Qualitative meta-synthesis identified two third order constructs: (1) Impact on the individual: mental & physical health and (2) Impact beyond the individual: building relationships & connection. This synthesis of increasingly prevalent research on assistance dogs for veterans with PTSD provides support for the impact of this complementary and integrative health intervention on PTSD symptom severity, and signs of meaningful improvements in adjacent domains including mental and social health. Gaps between quantitative and qualitative findings, along with the need to report greater demographic detail, highlight key opportunities for future research.</p>