The Different Faces of Bulimia is a research project that has represented a journey. It began with the question “How do females experience bulimia as part of their lives?” and moved through rooms where different ‘faces’, or theories on bulimia, were met with and interviewed. There appear to exist, in literature concerning bulimia, five dominant faces on the matter. These are the Psychopathology face, the Psychoanalytic face, the Cognitive-behavioural face, the Cyberspace face, and the Narrative face. Each of these appeared to offer an individual and different meaning of bulimia. The research extended to include the sixth and seventh faces of C and L, two women who live with bulimia in their own lives, and the meaning that they attach to it. They represented the individual faces that existed in human interaction and not in the words of books, magazines, or computer screens. The meaning of bulimia in C and L’s lives was searched for in interviews with both women that were audio-recorded and transcribed. The analysis of these was done in line with narrative methodology which holds that our experience is constructed in collaboration with history (or past experience) and culture. Both history and culture is assumed to inform and co-author the narratives of bulimia in C and L lives, as well in the lives of the five dominant faces explored in this research. The analysis took the form of searching for the meaning that C and L attach to bulimia. The five dominant literary faces also became the history and culture that one supposes women living with bulimia to co-exist with, and their effect on their personal narratives became important. That is, whether the dominant literary faces had an effect on the stories told by the faces of these two women. In line with narrative methodology, this research’s aim was not to provide one final answer or conclusion to the research question, but rather to provide an analysis of the individual meanings contained in each face. It has, in effect, added another face of bulimia in it’s search for what bulimia means. / Dissertation (MA (Counselling Psychology))--University of Pretoria, 2007. / Psychology / MA / unrestricted

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-26T14:19:31Z No. of bitstreams: 1 camilasoareslimacorrea.pdf: 2489508 bytes, checksum: e12b749f06936dc865a6f6dea87eb4cf (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-27T11:03:59Z (GMT) No. of bitstreams: 1 camilasoareslimacorrea.pdf: 2489508 bytes, checksum: e12b749f06936dc865a6f6dea87eb4cf (MD5) / Made available in DSpace on 2016-01-27T11:03:59Z (GMT). No. of bitstreams: 1 camilasoareslimacorrea.pdf: 2489508 bytes, checksum: e12b749f06936dc865a6f6dea87eb4cf (MD5) Previous issue date: 2014-02-19 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A alta curabilidade do câncer do colo do útero (CCU), quando detectado precocemente associada aos recentes avanços científicos na terapêutica da doença têm contribuído para uma maior sobrevida das pacientes. Porém, seu tratamento pode levar a efeitos adversos tardios importantes, como disfunções sexuais, que comprometem de forma significativa a qualidade de vida (QV). Desta forma, torna-se essencial investigar a QV e a função sexual de sobreviventes ao CCU, visando verificar, de forma holística, as reais necessidades dessas pacientes e guiar as ações de equipes inter e multidisciplinares. E, com isso, oferecer um cuidado adequado, humanizado e que atenda a todas essas necessidades, pois não basta aumentar a sobrevida, é necessário ter qualidade nesta sobrevivência. Dentro deste contexto, o objetivo principal desta pesquisa foi avaliar a QV e a função sexual de mulheres submetidas ao tratamento para o CCU e comparar com um grupo controle de mulheres sem história de câncer. Trata-se de estudo epidemiológico observacional, analítico, do tipo caso-controle com amostra total de 74 mulheres divididas em grupo câncer - GCa (mulheres submetidas a tratamento para o CCU há, pelo menos três meses - n=37) e grupo controle de base populacional - GCo (mulheres sem história de câncer - n=37). Foram aplicados três questionários: um de caracterização geral da amostra; um questionário de avaliação da qualidade de vida, desenvolvido pela Organização Mundial da Saúde (WHOQOL-bref); e um instrumento de avaliação da função sexual (Índice de Função Sexual Feminina – FSFI). O grupo controle apresentou maior frequência de mulheres vivendo com companheiro (GCo=73%; GCa=51,4%; p=0,05) e de mulheres que consideravam o relacionamento com este como bom ou muito bom (GCo=93,1%; GCa=63,2%; p=0,02). As seguintes variáveis, que no GCa poderiam estar associadas a efeitos adversos do tratamento, foram diferentes entre os grupos (p ˂ 0,05), sendo mais frequentes no GCa: menopausa (GCo=59,5%; GCa=100%; p˂0,01); sangramento durante ou após a relação sexual (GCo=0; GCa=36,8%; p˂0,01); aumento da frequência (GCo=0; GCa=37,8%; p˂0,01), urgência (GCo=16,2%; GCa=37,8%; p=0,03), incontinência (GCo=10,8%; GCa=35,1%; p=0,02) e retenção urinárias (GCo=2,7%; GCa=21,6%; p=0,02); diarréia (GCo=0; GCa=43,2%; p˂0,01), urgência (GCo=0; GCa=37,8%; p˂0,01) e incontinência fecais (GCo=0; GCa=21,6%; p˂0,01); dor (GCo=0; GCa=21,6%; p˂0,01) e muco anais (GCo=0; GCa=18,9%; p=0,01); enterorragia (GCo=0; GCa=24,3%; p˂0,01) e linfedema em membros inferiores (GCo=0; GCa=35,1%; p˂0,01). Além disto, o grupo câncer apresentou piores resultados quanto a variáveis relacionadas à função sexual: 64,9% relataram vagina estreita ou curta demais; a maioria não era sexualmente ativa (59,5%) e, das mulheres que tinham relação sexual, 80% apresentavam disfunção. Foi encontrada diferença estatisticamente significativa entre os grupos nos domínios “Físico” e “Relações Sociais” do WHOQOL-bref, sendo que a média destes domínios foi superior no grupo controle. As médias do grupo câncer foram estatisticamente inferiores às do grupo controle em todos os domínios do FSFI e também no escore total do instrumento. Diante dos resultados encontrados, conclui-se que há impacto negativo do tratamento para o CCU na QV e função sexual das sobreviventes. A partir disto, pode-se contribuir para dar maior visibilidade a estes aspectos na prática clínica, buscando guiar as intervenções de forma a atender todas as necessidades destas pacientes, contribuindo para uma melhor qualidade de vida na sobrevivência. / The high curability of cervical cancer (CC), when detected early, coupled with the latest scientific advances in the treatment of disease, has contributed to increased survival of patients. However, its treatment can lead to significant late adverse effects such as sexual dysfunctions that compromise significantly the quality of life (QoL). Thus, it becomes essential to investigate the QoL and sexual function of survivors at the CC in order to verify, holistically, the real needs of these patients and guide the actions of inter and multidisciplinary teams. And with that, provide a convenient and humanizing care that meets all these requirements, it is not enough to increase survival, it is necessary to have this quality survival. Within this context, the main objective of this research was to assess quality of life and sexual function in women submitted to treatment for cervical cancer, and compare with a control group of women without a history of cancer. It is, analytical, observational, epidemiological study of case-control sample with a total of 74 women divided into cancer group - CaG (women submitted to treatment for cancer of the cervix for at least three months - n = 37) and population-based control group - CoG (women without a history of cancer - n = 37). Three questionnaires were applied: a general characterization of the sample, a survey for evaluating the quality of life, developed by the World Health Organization (WHOQOL-BREF), and an instrument for assessment of sexual function (Female Sexual Function Index - FSFI). The control group had a higher frequency of women living with a partner (CoG = 73%; CaG = 51.4%, p = 0.05) and women who considered the relationship even as good or very good (CoG = 93 1%; CaG = 63.2%, p = 0.02). The following variables related to potential adverse effects of treatment were more frequent in the cancer group: menopause (CoG = 59.5%; CaG = 100%, p ˂ 0.01), bleeding during or after intercourse (CoG = 0; CaG = 36.8%, p ˂ 0.01) increase in the frequency (CoG = 0; CaG = 37.8%, p ˂ 0.01), urgency (CoG = 16.2%; CaG = 37.8 %, p = 0.03), incontinence (CoG = 10.8%; CaG = 35.1%, p = 0.02) and urinary retention (CoG = 2.7%; CaG = 21.6%, p = 0.02), diarrhea (CoG = 0; CaG = 43.2%, p ˂ 0.01), urgency (CoG = 0; CaG = 37.8%, p ˂ 0.01) and fecal incontinence (CoG = 0; CaG = 21.6%, p ˂ 0.01), pain (CoG = 0; CaG = 21.6%, p ˂ 0.01) and anal mucus (CoG = 0; CaG = 18.9% p = 0.01), rectal bleeding (CoG = 0; CaG = 24.3%, p ˂ 0.01) and lower limb lymphedema (CoG = 0; CaG = 35.1%, p ˂ 0.01). Moreover, the cancer group had worse results as related to sexual function variables: 64.9% reported narrow or too short vagina most were not sexually active (59.5%) and women who had sexual intercourse, 80 % dysfunctional. Statistically significant difference between groups in the fields "Physical" and "Social Relations" WHOQOL-BREF was found, while the average of these areas was higher in the control group. The averages of cancer group were statistically lower than the control group in all domains of FSFI, and total score of the instrument. Considering the results, it is concluded that there is negative impact of treatment for CC in QoL and sexual function of survivors. From this, one can contribute to giving greater visibility to these issues in clinical practice, seeking to guide interventions in order to attend all the needs of these patients, contributing to a better quality of life in survivors.

A qualitative, descriptive, explorative, and contextual research design was selected for this study. The purpose was to explore the phenomenon of mass hysteria among the Basotho in Lesotho and to develop guidelines which may facilitate early intervention and better management and control of mass hysteria outbreaks. The study area covered four of the ten districts in Lesotho. Four high schools where recent outbreaks of mass hysteria have been reported were included in the study. Semi-structured individual interviews and focus group interviews were conducted to collect the data. Purposive sampling was used to select young women in high schools who experienced mass hysteria; teachers who were present during mass hysteria episodes; a parent; and traditional healers and religious leaders who were involved in treating the affected.Thirteen individual interviews were held respectively with one victim of mass hysteria from a rural area, four school principals,a parent,five traditional healers, a priest and apastor. Three focus group interviews were conducted with thirty affected young women from three different high schools and two focus group interviews were held with twenty teachers from two different high schools.The data were transcribed verbatim and content analysis was done using open and axial coding. Four themes emerged from the findings, namely: manifestations of mass hysteria among the Basotho; interventions used by the Basotho to alleviate mass hysteria; Basotho’s views about the phenomenon of mass hysteria; and effects of mass hysteria onthe Basotho. The findings show that young women in Lesotho experience both physical and psychological symptoms during mass hysteria episodes and that it has a contagious effect. The interventions used by the Basotho to alleviate mass hysteria include traditional healing, herbal remedies, exorcism and prayer.The Basotho have different views about mass hysteria attributing it to either supernatural forces or natural illness. Episodes of mass hysteria have a negative impact on the victims,their families, and those who witnessed the episodes, causing confusion, fear and anxiety. Guidelines were compiled to assist teachersand health workers to improve the management and control of mass hysteria episodes in Lesotho. / Health Studies / D. Litt. et Phil. (Health Studies)

Poruchy příjmu potravy ve spojitosti s jinými diagnózami. Eating Disorders in Connection with other Diagnoses Bc. Marie Vavrušková The aim of this thesis, which focuses on the topic "Eating Disorders in Connection with Other Diagnoses," is to introduce the different types of eating disorders that have been previously diagnosed (anorexia nervosa, bulimia nervosa, psychogenic overeating and new forms of eating disorders), to specify the medical treatment offered to patients in the Czech Republic, and in particular to describe what other mental or somatic disorders are most commonly associated with eating disorders. The empirical part of the thesis presents a questionnaire which analyses the following aspects: type of eating disorder from which the clients of Centrum Anabell Praha suffer most frequently, where their medical treatment takes place, whether they suffer from another mental or somatic disorder associated with eating disorders, and whether eating disorders have a negative impact on their lives. The empirical part also presents a case report, which describes the life story, history and prognosis of a man who suffers from an eating disorder and other associated disorders.

O presente estudo comparou o fluxo sanguíneo cerebral regional avaliado através da tomografia por emissão de fóton simples (SPECT) de pacientes com crises epilépticas temporais com pacientes com crises não epilépticas psicogênicas (CNEP). Todos os SPECT foram realizado no período ictal, tendo as CNEP sido induzidas por métodos sugestivos e de hipnose. Os grupos de pacientes com epilepsia e CNEP foram ainda comparados com um terceiro grupo, denominado grupo de sujeitos saudáveis. As comparações dos SPECT foram feitas através da análise visual (radiologista cego ao estudo) e semiquantitativa pelo programa Statistical Parametric Mapping (SPM). Os objetivos do estudo foram: (1) estabelecer a sensibilidade e a especificidade do SPECT ictal para o diagnóstico diferencial entre CNEP e crises epilépticas parciais complexas em pacientes com epilepsia do lobo temporal, em comparação com o VEEG associado a técnicas de hipnose; (2) avaliar através da análise quantitativa voxel a voxel do SPECT as alterações de perfusão cerebral dos pacientes com CNEP em relação aos pacientes com epilepsia, dos pacientes com CNEP em relação a um grupo controle de sujeitos normais e dos pacientes com epilepsia em relação a um grupo controle de sujeitos saudáveis. Foram estudados 30 pacientes no grupo com CNEP, 22 pacientes no grupo com epilepsia e 29 sujeitos saudáveis. Os resultados mostram que os SPECT ictais dos pacientes do grupo CNEP foram diferentes dos SPECT ictais dos pacientes com epilepsia. Na análise visual o SPECT ictal apresentou sensibilidade de 50% e especificidade de 91% para o diagnóstico de CNEP . Na análise comparativa voxel a voxel entre os grupos os resultados revelaram que: (a) houve aumento de perfusão cerebral em lobo temporal esquerdo e tronco cerebral nos pacientes do grupo epilepsia em relação ao grupo controle normal; (b) houve diminuição de perfusão cerebral no lobo frontal esquerdo e córtex anterior do cíngulo nos pacientes do grupo epilepsia em relação ao grupo controle normal; (c) houve aumento de perfusão cerebral no giro do cíngulo e precuneus á direita nos pacientes do grupo CNEP em relação ao grupo epilepsia; (d) houve diminuição perfusão cerebral em amígdala direita nos pacientes do grupo CNEP em relação ao grupo epilepsia; (e) houve aumento de perfusão cerebral na cauda do núcleo caudado esquerdo, giro précentral esquerdo e tálamo direito nos pacientes do grupo CNEP em relação ao grupo controle normal. Desta forma, após a análise estatística dos resultados concluímos que na análise visual, um SPECT ictal positivo em um paciente com suspeita de CNEP não confirma nem afasta tal suspeita, já que a sensibilidade do método foi baixa (50%). Na análise visual, um SPECT ictal negativo em um paciente com suspeita de CNEP afasta a possibilidade de epilepsia do lobo temporal com 91% de acerto (especificidade do método). O resultado da análise visual do SPECT ictal de CNEP revelou valor de sensibilidade abaixo do encontrado na literatura, e valor de especificidade superior ao encontrado na literatura. A análise quantitativa dos SPECT de crise epiléptica em comparação com os de sujeitos saudáveis em repouso, mostrou concordância com a análise visual em relação à lateralidade. Tal comparação revelou ainda ativação de áreas compatíveis com o que se encontra na literatura. A análise quantitativa dos SPECT ictais do grupo CNEP em comparação com os do grupo epilepsia revelou ativação de estruturas cerebrais posteriores (precuneus e giro cíngulo), não havendo comparação semelhante na literatura. A análise quantitativa dos SPECT ictais do grupo CNEP em comparação com os de sujeitos saudáveis em repouso, mostrou ativação do sistema estriatotalamocortical, achado em concordância com a literatura. A ativação do sistema estriatotalamocortical nos pacientes com CNEP mostrou ser um correlato neuroanatômico clinicamente relevante, com forte associação estatística. / The study compared regional cerebral blood flow assessed by positron emission tomography single photon (SPECT) in patients with temporal lobe epilepsy and patients with psychogenic nonepileptic seizures (PNES). All SPECT were performed in the ictal period, PNES having been induced by and suggestive methods of hypnosis. The groups of patients with epilepsy and PNES were compared with a third group, called group of healthy subjects. SPECT comparisons were made by visual analysis (radiologist blinded to the study) and semiquantitative analysis by Statistical Parametric Mapping (SPM). The study objectives were: (1) to establish the sensitivity and specificity of ictal SPECT for the differential diagnosis between PNES and complex partial seizures in patients with temporal lobe epilepsy, compared with VEEG associated with hypnosis techniques, (2) to assess by quantitative analysis of SPECT voxel to voxel changes in cerebral perfusion of patients with PNES compared to patients with epilepsy, patients with PNES compared to a control group of normal subjects and patients with epilepsy compared to a control group of healthy subjects. We studied 30 patients in the PNES group, 22 patients in the group with epilepsy and 29 healthy subjects. The results show that ictal SPECT of patients in the PNES group were different from the ictal SPECT of patients with epilepsy. The visual analysis of ictal SPECT had a sensitivity of 50% and specificity of 91% for the diagnosis of PNES. In the voxel voxel comparative analysis between the groups the results showed that: (a) increased cerebral perfusion in the left temporal lobe and brain stem in patients of epilepsy group compared to normal control group, (b) a decrease in cerebral perfusion in the left frontal lobe and anterior cingulate cortex in patients of epilepsy group compared to normal control group, (c) increased cerebral perfusion in the cingulate gyrus and precuneus in the right group of PNES patients compared to epilepsy group, (d) decreased cerebral perfusion in the right amygdala in patients PNES group compared to the epilepsy group, (e) increased cerebral perfusion in the left tail of the caudate nucleus, left pre-central gyrus and right thalamus in patients in the PNES group compared to group normal control. Therefore, after statistical analysis of the results we conclude that in visual analysis, a positive ictal SPECT in a patient with suspected PNES neither confirms nor removes the suspicion, since the sensitivity was low (50%). In visual analysis, a negative ictal SPECT in a patient with suspected PNES rules out the possibility of temporal lobe epilepsy with 91% accuracy (specificity of the method). The result of visual analysis of ictal SPECT of PNES revealed sensitivity value below that found in the literature and specificity value higher than that found in the literature. The quantitative analysis of SPECT of seizures compared with those of healthy subjects at rest, showed agreement with visual analysis in relation to laterality. This comparison also revealed activation in areas consistent with that found in the literature. The quantitative analysis of SPECT ictal PNES group compared with the epilepsy group showed activation of posterior brain structures (cingulate gyrus and precuneus), with no similar comparison in the literature. The quantitative analysis of SPECT ictal PNES group compared to healthy subjects at rest, showed activation of the estriatotalamocortical, a finding in agreement with the literature. The activation of the estriatotalamocortical circuit in patients with PNES proved to be a neuroanatomical correlate clinically relevant, with strong statistical association

This dissertation explores the role of brainstem structures in the development and expression of generalized tonic-clonic seizures. The functional consequences of brainstem seizures are investigated using the kindling paradigm in order to understand the behavioral and cognitive effects of generalized seizures. <BR><BR> I begin by investigating the general characteristics of brainstem kindling. The first experiment demonstrates that certain brainstem sites are indeed susceptible to kindling and begins to delineate the features that distinguish brainstem seizures from those evoked at other brain regions. Further investigation of the EEG signal features using wavelet analysis reveals that changes in the spectral properties of the electrographic activity during kindling include significant changes to high-frequency activity and organized low-frequency activity. I also identify transitions that include frequency sweeps and abrupt seizure terminations. The changing spectral features are shown to be critically associated with the evolution of the kindled seizures and may have important functional consequences. The surprising responsiveness of some brainstem structures to kindling forces us to reconsider the overall role of these structures in epileptogenesis as well as in the healthy dynamical functioning of the brain. <BR><BR> In order to study the functional consequences, a series of experiments examines the changes in behavior, cognition and affect that follow these brainstem seizures. Although the results show no effects on spatial learning or memory, there are significant and complex effects on anxiety- and depression-like behavior that appear to be related to motivation. In order to further study the cognitive effects, a second set of behavioral experiments considers how context (i.e., the environment) interacts with the behavioral changes. The results indicate that changes in affect may only be apparent when choice between seizure-related and seizure-free contexts is given, suggesting that the environment and choice can play key roles in the behavioral consequences of seizures. This thesis also includes an appendix that applies synchrotron imaging to investigate the anatomical consequences of electrode implantation in kindling and shows that significantly increased iron depositions occur even with purportedly biocompatible electrodes widely used in research and clinical settings. <BR><BR> Examination of the role of brainstem structures in generalized seizures in this dissertation offers new perspectives and insights to epileptogenesis and the behavioral effects of epilepsy. The changes in EEG features, behavior, affect and motivation observed after brainstem seizures and kindling may have important clinical implications. For example, the results suggest a need to reexamine the concept of psychogenic seizures, a potential connection to Sudden Unexplained Death in Epilepsy (SUDEP), and the contribution of environmental factors. It is hoped that these findings will help elucidate the complex issues involved in understanding and improving the quality of life for people with epilepsy.

This dissertation explores the role of brainstem structures in the development and expression of generalized tonic-clonic seizures. The functional consequences of brainstem seizures are investigated using the kindling paradigm in order to understand the behavioral and cognitive effects of generalized seizures. <BR><BR> I begin by investigating the general characteristics of brainstem kindling. The first experiment demonstrates that certain brainstem sites are indeed susceptible to kindling and begins to delineate the features that distinguish brainstem seizures from those evoked at other brain regions. Further investigation of the EEG signal features using wavelet analysis reveals that changes in the spectral properties of the electrographic activity during kindling include significant changes to high-frequency activity and organized low-frequency activity. I also identify transitions that include frequency sweeps and abrupt seizure terminations. The changing spectral features are shown to be critically associated with the evolution of the kindled seizures and may have important functional consequences. The surprising responsiveness of some brainstem structures to kindling forces us to reconsider the overall role of these structures in epileptogenesis as well as in the healthy dynamical functioning of the brain. <BR><BR> In order to study the functional consequences, a series of experiments examines the changes in behavior, cognition and affect that follow these brainstem seizures. Although the results show no effects on spatial learning or memory, there are significant and complex effects on anxiety- and depression-like behavior that appear to be related to motivation. In order to further study the cognitive effects, a second set of behavioral experiments considers how context (i.e., the environment) interacts with the behavioral changes. The results indicate that changes in affect may only be apparent when choice between seizure-related and seizure-free contexts is given, suggesting that the environment and choice can play key roles in the behavioral consequences of seizures. This thesis also includes an appendix that applies synchrotron imaging to investigate the anatomical consequences of electrode implantation in kindling and shows that significantly increased iron depositions occur even with purportedly biocompatible electrodes widely used in research and clinical settings. <BR><BR> Examination of the role of brainstem structures in generalized seizures in this dissertation offers new perspectives and insights to epileptogenesis and the behavioral effects of epilepsy. The changes in EEG features, behavior, affect and motivation observed after brainstem seizures and kindling may have important clinical implications. For example, the results suggest a need to reexamine the concept of psychogenic seizures, a potential connection to Sudden Unexplained Death in Epilepsy (SUDEP), and the contribution of environmental factors. It is hoped that these findings will help elucidate the complex issues involved in understanding and improving the quality of life for people with epilepsy.

The thesis deals with low-threshold youth work in the context of salesian pedagogy. Using secondary analysis examines the needs of adolescents recorded in official documents of low-threshold club Oráč. Needs are classified into the system of needs and research results are used to a comprehensive view of the declared needs of adolescents visiting low-threshold club of Salesian center in České Budějovice in 2012.

O presente estudo comparou o fluxo sanguíneo cerebral regional avaliado através da tomografia por emissão de fóton simples (SPECT) de pacientes com crises epilépticas temporais com pacientes com crises não epilépticas psicogênicas (CNEP). Todos os SPECT foram realizado no período ictal, tendo as CNEP sido induzidas por métodos sugestivos e de hipnose. Os grupos de pacientes com epilepsia e CNEP foram ainda comparados com um terceiro grupo, denominado grupo de sujeitos saudáveis. As comparações dos SPECT foram feitas através da análise visual (radiologista cego ao estudo) e semiquantitativa pelo programa Statistical Parametric Mapping (SPM). Os objetivos do estudo foram: (1) estabelecer a sensibilidade e a especificidade do SPECT ictal para o diagnóstico diferencial entre CNEP e crises epilépticas parciais complexas em pacientes com epilepsia do lobo temporal, em comparação com o VEEG associado a técnicas de hipnose; (2) avaliar através da análise quantitativa voxel a voxel do SPECT as alterações de perfusão cerebral dos pacientes com CNEP em relação aos pacientes com epilepsia, dos pacientes com CNEP em relação a um grupo controle de sujeitos normais e dos pacientes com epilepsia em relação a um grupo controle de sujeitos saudáveis. Foram estudados 30 pacientes no grupo com CNEP, 22 pacientes no grupo com epilepsia e 29 sujeitos saudáveis. Os resultados mostram que os SPECT ictais dos pacientes do grupo CNEP foram diferentes dos SPECT ictais dos pacientes com epilepsia. Na análise visual o SPECT ictal apresentou sensibilidade de 50% e especificidade de 91% para o diagnóstico de CNEP . Na análise comparativa voxel a voxel entre os grupos os resultados revelaram que: (a) houve aumento de perfusão cerebral em lobo temporal esquerdo e tronco cerebral nos pacientes do grupo epilepsia em relação ao grupo controle normal; (b) houve diminuição de perfusão cerebral no lobo frontal esquerdo e córtex anterior do cíngulo nos pacientes do grupo epilepsia em relação ao grupo controle normal; (c) houve aumento de perfusão cerebral no giro do cíngulo e precuneus á direita nos pacientes do grupo CNEP em relação ao grupo epilepsia; (d) houve diminuição perfusão cerebral em amígdala direita nos pacientes do grupo CNEP em relação ao grupo epilepsia; (e) houve aumento de perfusão cerebral na cauda do núcleo caudado esquerdo, giro précentral esquerdo e tálamo direito nos pacientes do grupo CNEP em relação ao grupo controle normal. Desta forma, após a análise estatística dos resultados concluímos que na análise visual, um SPECT ictal positivo em um paciente com suspeita de CNEP não confirma nem afasta tal suspeita, já que a sensibilidade do método foi baixa (50%). Na análise visual, um SPECT ictal negativo em um paciente com suspeita de CNEP afasta a possibilidade de epilepsia do lobo temporal com 91% de acerto (especificidade do método). O resultado da análise visual do SPECT ictal de CNEP revelou valor de sensibilidade abaixo do encontrado na literatura, e valor de especificidade superior ao encontrado na literatura. A análise quantitativa dos SPECT de crise epiléptica em comparação com os de sujeitos saudáveis em repouso, mostrou concordância com a análise visual em relação à lateralidade. Tal comparação revelou ainda ativação de áreas compatíveis com o que se encontra na literatura. A análise quantitativa dos SPECT ictais do grupo CNEP em comparação com os do grupo epilepsia revelou ativação de estruturas cerebrais posteriores (precuneus e giro cíngulo), não havendo comparação semelhante na literatura. A análise quantitativa dos SPECT ictais do grupo CNEP em comparação com os de sujeitos saudáveis em repouso, mostrou ativação do sistema estriatotalamocortical, achado em concordância com a literatura. A ativação do sistema estriatotalamocortical nos pacientes com CNEP mostrou ser um correlato neuroanatômico clinicamente relevante, com forte associação estatística. / The study compared regional cerebral blood flow assessed by positron emission tomography single photon (SPECT) in patients with temporal lobe epilepsy and patients with psychogenic nonepileptic seizures (PNES). All SPECT were performed in the ictal period, PNES having been induced by and suggestive methods of hypnosis. The groups of patients with epilepsy and PNES were compared with a third group, called group of healthy subjects. SPECT comparisons were made by visual analysis (radiologist blinded to the study) and semiquantitative analysis by Statistical Parametric Mapping (SPM). The study objectives were: (1) to establish the sensitivity and specificity of ictal SPECT for the differential diagnosis between PNES and complex partial seizures in patients with temporal lobe epilepsy, compared with VEEG associated with hypnosis techniques, (2) to assess by quantitative analysis of SPECT voxel to voxel changes in cerebral perfusion of patients with PNES compared to patients with epilepsy, patients with PNES compared to a control group of normal subjects and patients with epilepsy compared to a control group of healthy subjects. We studied 30 patients in the PNES group, 22 patients in the group with epilepsy and 29 healthy subjects. The results show that ictal SPECT of patients in the PNES group were different from the ictal SPECT of patients with epilepsy. The visual analysis of ictal SPECT had a sensitivity of 50% and specificity of 91% for the diagnosis of PNES. In the voxel voxel comparative analysis between the groups the results showed that: (a) increased cerebral perfusion in the left temporal lobe and brain stem in patients of epilepsy group compared to normal control group, (b) a decrease in cerebral perfusion in the left frontal lobe and anterior cingulate cortex in patients of epilepsy group compared to normal control group, (c) increased cerebral perfusion in the cingulate gyrus and precuneus in the right group of PNES patients compared to epilepsy group, (d) decreased cerebral perfusion in the right amygdala in patients PNES group compared to the epilepsy group, (e) increased cerebral perfusion in the left tail of the caudate nucleus, left pre-central gyrus and right thalamus in patients in the PNES group compared to group normal control. Therefore, after statistical analysis of the results we conclude that in visual analysis, a positive ictal SPECT in a patient with suspected PNES neither confirms nor removes the suspicion, since the sensitivity was low (50%). In visual analysis, a negative ictal SPECT in a patient with suspected PNES rules out the possibility of temporal lobe epilepsy with 91% accuracy (specificity of the method). The result of visual analysis of ictal SPECT of PNES revealed sensitivity value below that found in the literature and specificity value higher than that found in the literature. The quantitative analysis of SPECT of seizures compared with those of healthy subjects at rest, showed agreement with visual analysis in relation to laterality. This comparison also revealed activation in areas consistent with that found in the literature. The quantitative analysis of SPECT ictal PNES group compared with the epilepsy group showed activation of posterior brain structures (cingulate gyrus and precuneus), with no similar comparison in the literature. The quantitative analysis of SPECT ictal PNES group compared to healthy subjects at rest, showed activation of the estriatotalamocortical, a finding in agreement with the literature. The activation of the estriatotalamocortical circuit in patients with PNES proved to be a neuroanatomical correlate clinically relevant, with strong statistical association

Univerzita Karlova Pedagogická fakulta Katedra Pedagogiky DIPLOMOVÁ PRÁCE Znalost záva nosti a d sledk poruch p jmu potravy ák Z Knowledge of the severity and consequences of eating disorders of elementary school pupils Bc. S tlana Z bransk Vedoucí práce: Mgr. Jana Ko , Ph.D. Studijní program: N7504: U itelst pro st edn kol Studijní obor: N-PG-VZ 2020 ABSTRAKT Na Z kladn kole v Praze, kterou jsem vybrala pro diplomovou práci, u uji p edm t V cho a ke zdraví druhým rokem. V diplomové práci jsem se rozhodla zmapovat nalosti a nosti a d sledk poruch p jmu potravy k 2. stupn e jmeno an kol . Teoretick st pr ce obsahuje informace z odborné literatury, vztahující se k problematice poruch p jmu potra (dále jen PPP). V ojo m l tnostem adolescence, významu primární prevence a obsahu koln ho d l ac ho pl nu p edm tu V cho a ke zdraví na zkoumané kole. Praktick st pr ce popisuje pr b h dota n ko ho et en , jeho se astnilo celkem 172 k . Hodnot nalosti k , pokud se týká charakteristiky, ri iko ch faktor , a nosti a d sledk PPP. Hodnotí p nos preventivních aktivit v rámci programu primární prevence zkoumané kol , ch ej c ho Národní strategie primární pre ence ri iko ho cho n d t a ml de e. áci kouman kol maj po dom o a nosti a d sledc ch PPP. V ichni ci , e poruch p jmu potra mohou b t onemocn n smrtelná. Z et en pl...