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Orientador: Florindo Stella / Banca: Sebastião Gobbi / Banca: Maria José D'Elboux Diogo / Resumo: Este estudo teve como objetivo analisar se o perfil de atividade física desenvolvido por pacientes com demência apresenta benefício na redução dos distúrbios neuropsiquiátricos e no desgaste mental dos cuidadores. Também foram analisadas as associações entre o perfil de atividade física desenvolvido pelos cuidadores na redução dos sintomas de ansiedade e de depressão. Foram estudados 118 sujeitos (59 pacientes com demência de Alzheimer, demência vascular e demência mista, e os 59 respectivos cuidadores). Os participantes foram recrutados no Ambulatório de Psiquiatria Geriátrica, Hospital das Clínicas, UNICAMP. Para coleta dos dados, foram utilizados os seguintes instrumentos: a) paciente - Inventário Neuropsiquiátrico - NPI (CUMMINGS et al., 1994) e o Mini-Questionário do Sono - MQS (ZOMER et al., 1985); b) cuidadores - Inventário Neuropsiquiátrico - NPI (CUMMINGS et al., 1994), o Mini- Questionário do Sono (ZOMER et al., 1985) e a Escala de Ansiedade e Depressão (ZIGMOND & SNAITH 1983). Ambos os grupos foram inquiridos quanto à prática de exercícios físicos mensurada pelo Questionário Baecke Modificado para Idosos - QBMI (VOORRIPS et al., 1991). A análise dos dados consistiu do teste U-Mann Whitney e da análise de regressão linear, do tipo stepwise. Admitiu-se nível de significância de 5% (p<0.05). Todos os participantes foram classificados em dois perfis de atividade física (segundo o QBMI): a) participantes com um perfil de menor atividade física; b) participantes com um perfil de maior atividade física. Os resultados indicaram que os pacientes com demência de Alzheimer, com perfil de maior atividade física apresentavam menos distúrbios neuropsiquiátricos e causavam menor desgaste mental no seu cuidador. Os pacientes com demência vascular, cujos cuidadores realizavam atividades aeróbias tinham um sono melhor. Os cuidadores de pacientes com demência mista e que tinham um perfil de maior atividade. / Abstract: This cross-sectional study aimed analyzing if the physical activity profile, developed by patients with dementia, would benefit the reduction of neuropsychiatric disorders and the mental burden of the carers. The associations between the physical activity profile developed by the carers in the reduction of mental burden and symptoms of anxiety and depression were analyzed. There were studied 118 subjects were studied (59 patients with Alzheimer dementia, vascular dementia and mixed dementia, and their 59 carers). The participants were recruited in the Clinic of Geriatric Psychiatry, Hospital das Clínicas, UNICAMP. To collect data, the following tools were used: a) patient - Neuropsychiatric Inventory - NPI (CUMMINGS et al., 1994) and the Mini-Sleep Questionnaire - MSQ (ZOMER et al., 1985); b) carers - Neuropsychiatric Inventory - NPI (CUMMINGS et al., 1994), the Mini-Sleep Questionnaire - MSQ (ZOMER et al., 1985) and the Anxiety and Depression Scale (ZIGMOND & SNAITH 1983). Both groups were asked about the practice of physical activities measured by the Modified Baecke Questionnaire for Older Adults - MBQOA (VOORRIPS et al., 1991). To analyze data, the test U-Mann Whitney was used as well as the linear regression stepwise. The meaning level 5% (p<0.05) was accepted. All the participants were classified in two physical activity profiles (according to MBQOA): a) participants who presented a low physical activity profile; b) participants with a high physical activity profile. The results showed that the patients with Alzheimer dementia, with a high physical activity profile, presented less neuropsychiatric disorders and caused less mental burden on their carers. The patients with vascular dementia, whose carers practiced aerobic activities, had a better sleep. Also, the carers of patients with mixed dementia and who had a high physical activity profile suffered less mental burden with their patients. / Mestre

Made available in DSpace on 2014-06-11T19:22:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-12-11Bitstream added on 2014-06-13T18:08:42Z : No. of bitstreams: 1 oliani_mm_me_rcla.pdf: 664352 bytes, checksum: 5ebb3038bffde98e214660ca819dfd41 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Este estudo teve como objetivo analisar se o perfil de atividade física desenvolvido por pacientes com demência apresenta benefício na redução dos distúrbios neuropsiquiátricos e no desgaste mental dos cuidadores. Também foram analisadas as associações entre o perfil de atividade física desenvolvido pelos cuidadores na redução dos sintomas de ansiedade e de depressão. Foram estudados 118 sujeitos (59 pacientes com demência de Alzheimer, demência vascular e demência mista, e os 59 respectivos cuidadores). Os participantes foram recrutados no Ambulatório de Psiquiatria Geriátrica, Hospital das Clínicas, UNICAMP. Para coleta dos dados, foram utilizados os seguintes instrumentos: a) paciente - Inventário Neuropsiquiátrico - NPI (CUMMINGS et al., 1994) e o Mini-Questionário do Sono - MQS (ZOMER et al., 1985); b) cuidadores - Inventário Neuropsiquiátrico - NPI (CUMMINGS et al., 1994), o Mini- Questionário do Sono (ZOMER et al., 1985) e a Escala de Ansiedade e Depressão (ZIGMOND & SNAITH 1983). Ambos os grupos foram inquiridos quanto à prática de exercícios físicos mensurada pelo Questionário Baecke Modificado para Idosos - QBMI (VOORRIPS et al., 1991). A análise dos dados consistiu do teste U-Mann Whitney e da análise de regressão linear, do tipo stepwise. Admitiu-se nível de significância de 5% (p<0.05). Todos os participantes foram classificados em dois perfis de atividade física (segundo o QBMI): a) participantes com um perfil de menor atividade física; b) participantes com um perfil de maior atividade física. Os resultados indicaram que os pacientes com demência de Alzheimer, com perfil de maior atividade física apresentavam menos distúrbios neuropsiquiátricos e causavam menor desgaste mental no seu cuidador. Os pacientes com demência vascular, cujos cuidadores realizavam atividades aeróbias tinham um sono melhor. Os cuidadores de pacientes com demência mista e que tinham um perfil de maior atividade. / This cross-sectional study aimed analyzing if the physical activity profile, developed by patients with dementia, would benefit the reduction of neuropsychiatric disorders and the mental burden of the carers. The associations between the physical activity profile developed by the carers in the reduction of mental burden and symptoms of anxiety and depression were analyzed. There were studied 118 subjects were studied (59 patients with Alzheimer dementia, vascular dementia and mixed dementia, and their 59 carers). The participants were recruited in the Clinic of Geriatric Psychiatry, Hospital das Clínicas, UNICAMP. To collect data, the following tools were used: a) patient – Neuropsychiatric Inventory – NPI (CUMMINGS et al., 1994) and the Mini-Sleep Questionnaire – MSQ (ZOMER et al., 1985); b) carers – Neuropsychiatric Inventory – NPI (CUMMINGS et al., 1994), the Mini-Sleep Questionnaire – MSQ (ZOMER et al., 1985) and the Anxiety and Depression Scale (ZIGMOND & SNAITH 1983). Both groups were asked about the practice of physical activities measured by the Modified Baecke Questionnaire for Older Adults – MBQOA (VOORRIPS et al., 1991). To analyze data, the test U-Mann Whitney was used as well as the linear regression stepwise. The meaning level 5% (p<0.05) was accepted. All the participants were classified in two physical activity profiles (according to MBQOA): a) participants who presented a low physical activity profile; b) participants with a high physical activity profile. The results showed that the patients with Alzheimer dementia, with a high physical activity profile, presented less neuropsychiatric disorders and caused less mental burden on their carers. The patients with vascular dementia, whose carers practiced aerobic activities, had a better sleep. Also, the carers of patients with mixed dementia and who had a high physical activity profile suffered less mental burden with their patients.

<p>The purpose with this study is to describe what individual pupils with neuropsychiatric disorders, such as Asperger syndrome and ADHD (Attention Deficit/Hyperactivity Disorder), think of their time in the nine-year compulsory school. The intention is to, from a social and spatial point of view elucidate their experiences, on the basis of their specific needs and the commission and the curriculum of the compulsory school.</p><p>This study have a qualitative approach where I on two occasions have talked to three upper secondary school pupils with neuropsychiatric disorders about their time in the compulsory school. The work method for this study is life stories, a kind of interview that allows the pupils to speak more freely, and where the definitive question formulation appears gradually.</p><p>The result shows that the pupils in many ways experience that they have been misunderstood by both teachers and other pupils, first and foremost regarding teachers not having enough knowledge about how people with Asperger syndrome think and acts. In addition, all three have experiences of being bullied. At the same time the result shows that special adjustments to the pupils’ specific needs works and is a good thing, if they are based upon knowledge and understanding.</p><p>The conclusion is that genuine knowledge about neuropsychiatric disorders and the will to understand among the teachers is very important, and that adjustments of resources, demands and conditions is a good thing, and many times necessary. Many teachers do not have the adequate knowledge and the support to the students is inadequate. A proper, comprehensive and correct diagnosis is important to create knowledge of the specific individual needs.</p> / <p>Syftet med studien är att beskriva hur enskilda elever med neuropsykiatriska funktionsnedsättningar, i första hand Aspergers syndrom och ADHD (Attention Deficit/Hyperactivity Disorder), har upplevt sin tid i det obligatoriska skolväsendet. Avsikten är att ur ett socialt och ett rumsligt perspektiv belysa hur de upplevt sin skoltid, utifrån de specifika behoven och skolans uppdrag enligt Lpo94.</p><p>Studien har en kvalitativ ansats där jag vid två tillfällen samtalat med tre ungdomar i gymnasieåldern med diagnostiserade neuropsykiatriska funktionsnedsättningar om deras grundskoletid. Den metod som använts för genomförandet av studien är livsberättelse, en form av intervju som tillåter den intervjuade att berätta mer fritt, och där de definitiva frågeställningarna infinner sig efter hand.</p><p>Resultatet visar att eleverna på många sätt upplever att de blivit missförstådda av både lärare och andra elever, framför allt handlar det om att lärare inte haft tillräcklig kunskap om hur elever med Aspergers syndrom tänker och fungerar. Alla tre upplever dessutom att de varit utsatta för mobbing. Samtidigt visar resultatet att särskilda lösningar och anpassningar efter elevens specifika behov är bra och fungerar, om de bygger på kunskap och förståelse.</p><p>Slutsatser blir att gedigen kunskap om neuropsykiatriska funktionsnedsättningar och vilja till förståelse hos personalen är mycket viktigt, och att anpassningar av resurser, krav och villkor är bra och ofta nödvändigt. Många lärare saknar tillräcklig kunskap och stödet till eleverna är bristfälligt. En ordentlig, fullständig och korrekt diagnostisering är viktigt för att skapa kunskap om de specifika individuella behoven.</p>

The purpose with this study is to describe what individual pupils with neuropsychiatric disorders, such as Asperger syndrome and ADHD (Attention Deficit/Hyperactivity Disorder), think of their time in the nine-year compulsory school. The intention is to, from a social and spatial point of view elucidate their experiences, on the basis of their specific needs and the commission and the curriculum of the compulsory school. This study have a qualitative approach where I on two occasions have talked to three upper secondary school pupils with neuropsychiatric disorders about their time in the compulsory school. The work method for this study is life stories, a kind of interview that allows the pupils to speak more freely, and where the definitive question formulation appears gradually. The result shows that the pupils in many ways experience that they have been misunderstood by both teachers and other pupils, first and foremost regarding teachers not having enough knowledge about how people with Asperger syndrome think and acts. In addition, all three have experiences of being bullied. At the same time the result shows that special adjustments to the pupils’ specific needs works and is a good thing, if they are based upon knowledge and understanding. The conclusion is that genuine knowledge about neuropsychiatric disorders and the will to understand among the teachers is very important, and that adjustments of resources, demands and conditions is a good thing, and many times necessary. Many teachers do not have the adequate knowledge and the support to the students is inadequate. A proper, comprehensive and correct diagnosis is important to create knowledge of the specific individual needs. / Syftet med studien är att beskriva hur enskilda elever med neuropsykiatriska funktionsnedsättningar, i första hand Aspergers syndrom och ADHD (Attention Deficit/Hyperactivity Disorder), har upplevt sin tid i det obligatoriska skolväsendet. Avsikten är att ur ett socialt och ett rumsligt perspektiv belysa hur de upplevt sin skoltid, utifrån de specifika behoven och skolans uppdrag enligt Lpo94. Studien har en kvalitativ ansats där jag vid två tillfällen samtalat med tre ungdomar i gymnasieåldern med diagnostiserade neuropsykiatriska funktionsnedsättningar om deras grundskoletid. Den metod som använts för genomförandet av studien är livsberättelse, en form av intervju som tillåter den intervjuade att berätta mer fritt, och där de definitiva frågeställningarna infinner sig efter hand. Resultatet visar att eleverna på många sätt upplever att de blivit missförstådda av både lärare och andra elever, framför allt handlar det om att lärare inte haft tillräcklig kunskap om hur elever med Aspergers syndrom tänker och fungerar. Alla tre upplever dessutom att de varit utsatta för mobbing. Samtidigt visar resultatet att särskilda lösningar och anpassningar efter elevens specifika behov är bra och fungerar, om de bygger på kunskap och förståelse. Slutsatser blir att gedigen kunskap om neuropsykiatriska funktionsnedsättningar och vilja till förståelse hos personalen är mycket viktigt, och att anpassningar av resurser, krav och villkor är bra och ofta nödvändigt. Många lärare saknar tillräcklig kunskap och stödet till eleverna är bristfälligt. En ordentlig, fullständig och korrekt diagnostisering är viktigt för att skapa kunskap om de specifika individuella behoven.

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The current work entails the development of a novel high content platform for the measurement of kinetic ligand responses across cell signalling networks at the single-cell level in distinct PBMC subtypes ex vivo. Using automated sample preparation, fluorescent cellular barcoding and flow cytometry the platform is capable of detecting 21, 840 parallel cell signalling responses in each PBMC sample. We apply this platform to characterize the effects of neuropsychiatric treatments and CNS ligands on the T cell signalling repertoire. We apply it to define cell signalling network abnormalities in PBMCs from drug-naïve first-onset schizophrenia patients (n=12) relative to healthy controls (n=12) which are subsequently normalized in PBMCs from the same patients (n=10) after a six week course of clinical treatment with the atypical antipsychotic olanzapine. We then validate the abnormal cell signalling responses in PBMCs from an independent cohort of drug-naïve first-onset schizophrenia patients (n=25) relative to controls (n=25) and investigate the specificity of the abnormal PBMC responses in schizophrenia as compared to major depression (n=25), bipolar disorder (n=25) and autism spectrum disorder (n=25). Subsequently we conduct a phenotypic drug screen using the US Food and Drug Administration (FDA) approved compound library, in addition to experimental neuropsychiatric drug candidates and nutraceuticals, to identify compounds which selectively normalize the schizophrenia-associated cell signalling response. Finally these candidate compounds are characterized using structure-activity relationships to reveal specific chemical moieties implicated in the putative therapeutic effect.

Émotions et nouvelles technologies apparaissent le plus souvent comme une alliance impossible. Pourtant, ces dernières années, les nouvelles technologies, telles que les capteurs portés et les logiciels de reconnaissance d’activités, ont permis une évaluation plus fine des émotions. A travers cette thèse notre objectif était de développer et de tester divers instruments technologiques permettant l’évaluation et la prise en charge des émotions que ce soit au niveau comportemental, physiologique ou cognitif. Nous avons commencé par faire un état des lieux des nouvelles technologies disponibles pour l’évaluation et la prise en charge des troubles émotionnels. Nous avons ensuite recueilli les recommandations d’experts pour leur utilisation ainsi que l’avis des internes de psychiatrie et des médecins généralistes. Au sein de notre deuxième étude, nous avons développé un test informatisé permettant de mesurer les défauts de ressenti et de régulation des émotions propres aux composantes physiologique et cognitive des émotions. Notre troisième étude a consisté à élaborer une prise en charge des troubles émotionnels dans ces deux composantes par une immersion sensori-virtuelle et à étudier l’effet de cette dernière sur le langage de patients avec et sans troubles cognitifs. Enfin, notre quatrième étude a visé à développer une plateforme automatisée d’évaluation et de prise en charge des troubles émotionnels dans la composante comportementale. Nous avons développé et évalué l’intérêt des algorithmes de reconnaissance d’activité pour leur détection et des solutions non pharmacologiques basées sur l’aromathérapie, la musicothérapie et les serious games pour leur prise en charge. / Emotions and new technologies often sound as an impossible association. However, in recent years, new Information and Communication Technologies (nICT) such as wearable sensors and software for activity recognition have enabled to assess emotions more accurately. This dissertation aimed at developing and testing various nICT-based tools allowing a better assessment and management of emotions, either at the behavioral, physiological or cognitive level. I started with a literature review of the existing nICT for the assessment and management of emotional disorders. I then gathered recommendations for the use of nICT from experts in the field, as well from interns in psychiatry and general practitioners (Study 1). Next, I developed a computerized test to assess impairments in emotional experience and emotion regulation at the physiological and cognitive level (Study 2). Study 3 consisted in developing a tool to manage emotional disorders at the physiological and cognitive level by means of a multisensory, virtual immersion, and assessing the effects of this immersion on the verbal ability of patients with and without cognitive impairment. Finally, in Study 4 I developed an automated platform for the assessment and management of emotional disorders at the behavioral level. In this context, I developed and evaluated the interest of employing activity recognition algorithms for the detection of behavioral emotional disorders, and I evaluated the effects of nonpharmacological solutions based on aromatherapy, music therapy and serious games for the management of these disorders.

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