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Objektiv: Temporomandibulär dysfunktion (TMD) utgör vanligaste formen av kronisk orofacial smärta. Kronisk TMD har negativ inverkan på det psykosociala tillståndet vilket påverkar livskvaliteten. Syftet är att utreda huruvida en korrelation mellan TMD, katastrofiering, kinesofobi och fysiska symtom föreligger. Material och metod: Studien baseras på data från TMJ Impact Project som utvärderar 401 individer (333 kvinnor, 86 män, medelålder 45.8) från den initiala studien The Validation Project som utvärderar diagnostiken enligt RDC/TMD, insamlingen utfördes på University of Minnesota, University of Washington och University of Buffalo (2003-2006). 218 individer hade smärtsam TMD, 111 icke-smärtsam TMD, 63 smärtfria kontroller och data saknades för 9 individer. Deltagarna genomgick diagnostik enligt RDC/TMD som inkluderar en klinisk- och radiologisk undersökning (axel I) och en psykosocial utvärdering (axel II). För att undersöka en potentiell korrelation mellan TMD, katastrofiering, kinesofobi och fysiska symptom användes följande instrument: Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, The Patient Health Questionnaire och Areas of Pain.Resultat: Deltagare med smärtsam TMD uppvisade statistisk signifikant grad av kinesofobi, somatisering och fysiska symtom jämfört med kontroller. Deltagare med smärtfri TMD uppvisade högre grad av kinesofobi jämfört med kontroller. Det råder en låg- till moderat positiv korrelation mellan katastrofiering och kinesofobi hos deltagare med smärtsam TMD (r=0,37 p<0,001) och smärtfri TMD (r=0,53 p<0,001).Konklusion: Resultaten uppvisar associationer mellan katastrofiering och kinesofobi hos patienter med TMD oberoende av smärtförekomst. Överlag föreslår resultaten att utvärderingen av kinesofobi och katastrofiering, utspridd smärta och multipla icke-TMD relaterade symtom kan vara av klinisk vikt vid utvärderingen av patienter med TMD. / Objectives: Temporomandibular disorders (TMD) are the most common causes of chronic orofacial pain and affects both psychological and social aspects of life. The aim was to investigate the possible relationship between TMD, catastrophizing, kinesiophobia and physical symptoms. Methods: The study was based on 401 participants (333 women, 86 men, mean age 45.8 years) in the TMJ Impact Project recruited at University of Minnesota, University of Washington and University of Buffalo 2003-2006. Of these, 218 had TMD pain, 111 non-painful TMD, 63 were pain-free controls and data was missing for 9 individuals. Participants were diagnosed in accordance with the Diagnostic Criteria for TMD, including a clinical and radiographic examination (axis I) and a psychosocial assessment (axis II). The possible correlations between TMD, catastrophizing, kinesiophobia and physical symptoms were evaluated with the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, the Patient Health Questionnaire, together with Areas of Pain. Results: Compared to controls, participants with TMD pain showed a statistically significant degree of kinesiophobia, somatic symptoms, and areas of pain and participants with non-painful TMD showed a higher degree of kinesiophobia. There was a positive, low to moderate correlation between catastrophizing and kinesiophobia for participants with TMD pain (r=0.37, p<0.001) and non-painful TMD (r=0.53, p<0.001).Conclusions: The results suggest an association between catastrophizing and kinesiophobia in individuals with TMD regardless of presence of pain. The findings suggest that evaluating fear of movement and catastrophizing, as well as widespread pain and multiple non-TMD symptoms can be useful in the assessment of patients with TMD.

Orientador: Florindo Stella / Banca: Hanna Karen Antunes / Banca: Lilian Teresa Bucken Gobbi / Resumo: A doença de Parkinson (DP) é um processo neurodegenerativo crônico e progressivo que leva a um comprometimento físico refletindo os principais sinais e sintomas da DP. O comprometimento das funções motoras representa um comprometimento da execução das atividades da vida diária. O exercício físico (EF) tem um impacto positivo para os indivíduos com doenças neurodegenerativas, especificamente com DP. Dois estudos foram realizados. O estudo 1 teve como objetivo comparar a mobilidade funcional, distúrbios relatados do sono e os níveis séricos de homocisteína (Hcy) em pacientes com diferentes níveis de atividade física. 41 pacientes entre os estágios um a três da escala de estagiamento clínico de Hohen & Yahr foram distribuídos segundo a participação programas regulares de exercícios físicos. 17 pacientes eram sedentários e 18 mantinham uma prática regular de exercícios físicos. Os distúrbios relatados do sono foram avaliados por meio do Mini Questionário de Sono; as atividades instrumentais foram avaliadas por meio do questionário de Pfeffer; o estagiamento clínico da doença e a condição clínica dos pacientes foram mensurados, respectivamente, pela escala Hoehn e Yahr e pela Unified Parkinson's Disease Rating Scale - UPDRS. A escala de Schwab & England foi aplicada para medir o percentual de funcionalidade. O Mini-Exame do Estado Mental e Teste do Desenho do Relógio foram aplicados para avaliar o funcionamento cognitivo. Os níveis de Hcy foram medidos por meio de técnicas laboratoriais a partir de amostras de sangue. Para a análise dos dados foi realizada uma ANOVA one-way e um teste post hoc de Tuckey para verificar diferenças entre os grupos. A correlação de Pearson e análise de regressão múltipla foram usados para verificar a associação entre diversas variáveis, como a concentração sérica de Hcy... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Parkinson's disease (PD) is a chronic, progressive and neurodegenerative process. With progression of the disease, there are physical implicantions that reflects in physical symptoms. The motor impairment has a negative impact and compromise the execution of activities daily living. Physical exercise (PE) has a positive impact for individuals with neurodegenerative disabilities, specifically in PD. Two studies were conducted. The study 1 aimed to compare the functional mobility, sleep reported disorders and levels of homocysteine (Hcy) in PD patients with different levels of physical activity. Forty-one patients between stages one to three of Hohen & Yahr scale were distributed by participation in a program of regular physical exercises. 17 patients were sedentary and 18 had a regular practice of physical exercises. Sleep reported disorders were evaluated by Mini-Sleep Questionnaire; Instrumental activities were evaluated by Pfeffer Questionnaire; Clinical stages and motor condition of patients were respectively measured by the Hoehn and Yahr scale and by the Unified Parkinson's Disease Rating Scale - UPDRS. Schwab and England scale were applied to measure the daily functionality. The Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT) were applied to evaluate the cognitive background. Levels of Hcy were measured by collection of blood and laboratorial techniques. The one-way ANOVA and Tuckey's post hoc was applied to verify differences between groups. Pearson correlation and stepwise multiple regression analysis were used to consider the association between several variables, as serum concentration of Hcy, motor condition, cognitive status, and L-dopa dosages. Patients who practice PE presented significant less sleep reported disturbances and lower levels of Hcy when compared... (Complete abstract click electronic access below) / Mestre

Tyrimo tikslas – atskleisti tėvų pablogėjusios nuotaikos (depresiškumo ir streso) bei ikimokyklinio amžiaus vaikų agresyvaus elgesio bei fizinių negalavimų tarpusavio sąsajas. Tyrime dalyvavo 110 tėvų, auginančių 3 – 6 metų amžiaus vaikus (95 moterys ir 15 vyrų). Tėvų vidutinis amžius 32 metai. Vaikų vidutinis amžius 4,5 metai; 57 berniukai ir 53 mergaitės. Tėvų apklausa buvo atlikta Kauno lopšelyje-darželyje „Naminukas“ ir Kauno menų darželyje "Etiudas". Tiriamiesiems buvo pateikiamas klausimynas kurį sudarė subjektyviai suvokto streso skalė, Zungo depresijos skalė ir elgesio ikimokykliniame amžiuje klausimynas. Taip pat buvo pateikti penki klausimai apie vaiko fizinius negalavimus ir du papildomi klausimai apie vaiko ligas. Tyrimo rezultatai parodė, kad ikimokyklinio amžiaus vaikams labiausiai būdingas fizinis nusiskundimas yra pilvo skausmas. Tirtų vaikų grupėje agresyvių vaikų nei neagresyvių yra daugiau. Lyginant berniukus ir mergaites, tiek neagresyvių vaikų, tiek agresyvių vaikų grupėje abiejų lyčių pasiskirstymas yra panašus. Esant pablogėjusiai tėvų nuotaikai (daug patiriamo streso ir didelis depresiškumas) ikimokyklinio amžiaus vaikams pasireiškia daugiau agresyvaus elgesio požymių nei tiems vaikams, kurių tėvai nepasižymi pablogėjusia nuotaika (mažai patiriamo streso ir mažas depresiškumas). Agresyvūs ikimokyklinio amžiaus vaikai patiria daugiau fizinių negalavimų – galvos, pilvo ir skrandžio skausmų – nei neagresyvūs vaikai. Esant pablogėjusiai tėvų nuotaikai... [toliau žr. visą tekstą] / The aim of the study was to assess the relationship between parent’s depressive mood and preschool age children aggressive behavior and physical symptoms. The subjects of the study were 110 parents who were growing 3 – 6 years old children. The mean of parent’s age was 32 year. The mean of children age was 4,5 year; 57 boys and 53 girls. Parents were quizzed in the Kaunas kindergarten “Naminukas” and Kaunas art kindergarten "Etiudas". There was given the questionnaire for the respondents which was made of tree scales: Perceived Stress Scale, Zung Self Rating Scale, Preschool Behavior Questionnaire (PBQ). Also five questions about child‘s physical symptoms and two extra questions about child’s diseases were given. The results showed that the most common physical symptom of preschool children is abdominal pain. There are more aggressive children than not aggressive children in the group of studied children. Comparing boys and girls the number of aggressive and not aggressive children is similar. When parent’s mood is depressive (high level of stress and depression) preschool age children show more symptoms of aggressive behavior than those children whose parents’ mood is not depressive. Aggressive preschool age children feel more physical symptoms than not aggressive children. When parent’s mood is depressive (high level of stress and depression) preschool age children feel more physical symptoms than those children whose parents’ mood is not depressive.

In this study the phenomenon of persistent physical symptoms (PPS) has been examined by realist evaluation of research and practice. Nimnuan et al., (2001) have shown that up to 35% of patients in primary care and 66% in specialist out-patient clinics have presented with such ‘medically unexplained’ symptoms. The cost in medical investigation to reach diagnosis for PPS is an estimated 10% of the annual UK National Health Service budget (Bermingham et al., 2010) but poor patient outcomes prevail (Dwamena et al., 2009). Currently, PPS is linked to high comorbidity with anxiety and depression (DH 2011b) and Cognitive Behavioural Therapy (CBT) is advised as the evidence based treatment for PPS (IAPT, 2014). However, a shortfall in clinical skills to address PPS is also demonstrated and engagement could be improved (De Lusignan et al., 2014). Moreover, the pragmatic study of alternative therapy modalities and processes for PPS is recommended (Leichsenring, 2005). To obtain a broader knowledge of process for patients with or without co-morbidity, practice based experience suggests that one such alternative is a brief psychodynamic intervention (STPP) for PPS. A Realist Literature Synthesis (Wong et al. 2013) highlights effective psychotherapeutic STPP interventions in real world circumstances in 5 comparison with CBT interventions for heterogenous PPS. STPP for PPS is found at least as effective as CBT, with improved engagement rates. Additionally, common factors were discovered between ‘third generation’ STPP and CBT for effective PPS interventions and these were developed into a preliminary cross-modality theoretical analytical framework. In the realist contextual evaluation (Pawson and Tilley, 1997) of a psychosexual service delivery, the majority of PPS sufferers were found only moderately co-morbid with anxiety and depression. For complete investigative study, clinical tools are developed providing integrative CBT/STPP principles for engagement with PPS for teaching, training and practice. In conclusion, the findings suggest that the reflexive insider position of the realist Therapist-Evaluator facilitates systematically derived Practice-Based Evidence of PPS process, meeting recommendations of Deary et al., (2007) to explore and define process and outcomes with PPS. The findings contribute to development of a conceptual platform to support health professionals in overcoming physical/mental health barriers to addressing PPS and wider patient access to effective care (NHSE, 2014, 2015).

No description available.

Fatigue is a debilitating symptom of chronic illness that is deleteriously affected by perceived stress, a process particularly relevant to inflammatory disease. Hopefulness, a goal-based motivational construct, may beneficially influence stress and fatigue, yet little research has examined these associations. We assessed the relation between hope and fatigue, and the mediating effect of stress, in individuals with fibromyalgia, arthritis, and inflammatory bowel disease. Covarying age, sex, and pain, stress partially mediated the association between hope and fatigue; those with greater hope reported less stress and consequent fatigue. Therapeutically, bolstering hope may allow proactive management of stressors, resulting in less fatigue.

Made available in DSpace on 2014-06-11T19:22:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-08-27Bitstream added on 2014-06-13T19:28:20Z : No. of bitstreams: 1 nascimento_cmc_me_rcla.pdf: 1432963 bytes, checksum: 55462d1ab8de9af6599d592986a802b9 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A doença de Parkinson (DP) é um processo neurodegenerativo crônico e progressivo que leva a um comprometimento físico refletindo os principais sinais e sintomas da DP. O comprometimento das funções motoras representa um comprometimento da execução das atividades da vida diária. O exercício físico (EF) tem um impacto positivo para os indivíduos com doenças neurodegenerativas, especificamente com DP. Dois estudos foram realizados. O estudo 1 teve como objetivo comparar a mobilidade funcional, distúrbios relatados do sono e os níveis séricos de homocisteína (Hcy) em pacientes com diferentes níveis de atividade física. 41 pacientes entre os estágios um a três da escala de estagiamento clínico de Hohen & Yahr foram distribuídos segundo a participação programas regulares de exercícios físicos. 17 pacientes eram sedentários e 18 mantinham uma prática regular de exercícios físicos. Os distúrbios relatados do sono foram avaliados por meio do Mini Questionário de Sono; as atividades instrumentais foram avaliadas por meio do questionário de Pfeffer; o estagiamento clínico da doença e a condição clínica dos pacientes foram mensurados, respectivamente, pela escala Hoehn e Yahr e pela Unified Parkinson's Disease Rating Scale - UPDRS. A escala de Schwab & England foi aplicada para medir o percentual de funcionalidade. O Mini-Exame do Estado Mental e Teste do Desenho do Relógio foram aplicados para avaliar o funcionamento cognitivo. Os níveis de Hcy foram medidos por meio de técnicas laboratoriais a partir de amostras de sangue. Para a análise dos dados foi realizada uma ANOVA one-way e um teste post hoc de Tuckey para verificar diferenças entre os grupos. A correlação de Pearson e análise de regressão múltipla foram usados para verificar a associação entre diversas variáveis, como a concentração sérica de Hcy... / Parkinson´s disease (PD) is a chronic, progressive and neurodegenerative process. With progression of the disease, there are physical implicantions that reflects in physical symptoms. The motor impairment has a negative impact and compromise the execution of activities daily living. Physical exercise (PE) has a positive impact for individuals with neurodegenerative disabilities, specifically in PD. Two studies were conducted. The study 1 aimed to compare the functional mobility, sleep reported disorders and levels of homocysteine (Hcy) in PD patients with different levels of physical activity. Forty-one patients between stages one to three of Hohen & Yahr scale were distributed by participation in a program of regular physical exercises. 17 patients were sedentary and 18 had a regular practice of physical exercises. Sleep reported disorders were evaluated by Mini-Sleep Questionnaire; Instrumental activities were evaluated by Pfeffer Questionnaire; Clinical stages and motor condition of patients were respectively measured by the Hoehn and Yahr scale and by the Unified Parkinson’s Disease Rating Scale – UPDRS. Schwab and England scale were applied to measure the daily functionality. The Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT) were applied to evaluate the cognitive background. Levels of Hcy were measured by collection of blood and laboratorial techniques. The one-way ANOVA and Tuckey’s post hoc was applied to verify differences between groups. Pearson correlation and stepwise multiple regression analysis were used to consider the association between several variables, as serum concentration of Hcy, motor condition, cognitive status, and L-dopa dosages. Patients who practice PE presented significant less sleep reported disturbances and lower levels of Hcy when compared... (Complete abstract click electronic access below)

The purpose of this thesis was to examine the mediating effects of job-related negative emotions on the relationship between workplace aggression and outcomes. Additionally, the moderating effects of workplace social support and intensity of workplace aggression are considered. A total 321 of working individuals participated through an online survey. The results of this thesis suggest that job-related negative emotions are a mediator of the relationship between workplace aggression and outcomes, with full and partial mediation supported. Workplace social support was found to be a buffering variable in the relationship between workplace aggression and outcomes, regardless of the source of aggression (supervisor or co-worker) or the source of the social support. Finally, intensity of aggression was found to be a strong moderator of the relationship between workplace aggression and outcomes.

This dissertation used a person-environment fit theoretical framework to examine the influence of person-job misfit as an organizational stressor on strain and well-being outcomes for emergency responders. Independent variables consisted of job attributes such as skill variety, task identity, task significance, autonomy and job-based feedback. These job characteristics are often used in work redesign efforts as they are amendable to organizational change initiatives. Dependent variables included strain outcomes relevant to those working in emergency services: physical symptoms, burnout, and secondary traumatic stress. Also, to include a positive aspect of emergency services work, the well-being outcome of compassion satisfaction was examined. Data were collected from 358 emergency responders across the United States via online survey, including law enforcement, firefighters, police/fire/medical dispatch, emergency medical technicians, and paramedics. Methodology utilized polynomial regression analysis in which joint linear and curvilinear effects from two predictors upon one outcome correspond to a three-dimensional response surface reflecting the fit-outcome relationship. This approach allowed a detailed examination of the nature of fit and the nature of misfit for each job attribute in relation to strain and well-being. Maximum likelihood with bootstrapping was used to estimate model parameters and test response surface features. Findings identified several influential fit-outcome relationships including skill variety fit-compassion satisfaction (a1 = 0.366), task identity fit-burnout (a2 = -0.083), task significance fit-burnout (a1 = -0.241) task significance fit-compassion satisfaction (a1 = 0.496,), job-based feedback fit-physical symptoms (a1 = -3.807), job-based feedback fit-burnout (a1 = -0.323), and job-based feedback fit-compassion satisfaction (a1 = 0.391). In terms of misfit, task identity misfit was related to secondary traumatic stress (a3 = -0.209) and job-based feedback misfit was related to burnout (a3 = -0.234). Conclusions regarding identified fit-outcome relationships suggested a potential to reduce frequency of physical symptoms, burnout, and secondary traumatic stress and increase employees’ experience of compassion satisfaction by considering employees’ preference for these job characteristics. On the basis of these findings, opportunities for Emergency Services Management agencies to facilitate wellness for personnel, as well as future research directions are discussed.