Background: Parkinson's disease (PD) is a debilitating progressive neurological disorder. The main clinical features of PD are: rigidity, bradykinesia, akinesia, and resting tremor. People living with PD often present with impaired gross- and fine upper-limb motor control and ocular tracking. The impaired motor control associated with PD results in difficulty performing basic- and instrumental activities of daily living (BADLs and IADLs). Virtual reality (VR) therapy is an emerging treatment strategy used to address movement impairment in people with neurological diseases, but has not been extensively researched in the rehabilitation of people with PD. This study aimed to determine the effectiveness of VR therapy as a treatment modality for the rehabilitation of upper-limb function during BADLs and IADLs and ocular tracking for people with PD, when compared to conventional physiotherapy. Methods: A single blind randomised control trial was done. Participants were randomly allocated to either the conventional therapy (control) or VR therapy (experimental) groups using the concealed opaque envelope method. Twenty-two participants who gave informed consent were included, if they met the following criteria: Confirmed PD diagnoses; scored above 24/30 for the Mini Mental State Examination; and did not suffer from uncontrolled co-morbid diseases. The control- and experimental groups underwent twelve intervention session of 45 minutes. The control group participated in conventional physiotherapy sessions and the experimental group used the X-box Kinect© VR apparatus during treatment. Participants were assessed at baseline and post-intervention (directly following the 12 session) with the: 9 Hole Peg Test (9HPT), Test d'Evaluation des Membres Superieurs De Personnes Agees (TEMPA) and the King Devick Test. Results: The TEMPA was used to determine unilateral- and bilateral upper-limb function during IADLs and BADLs. Three of the four items of the TEMPA that assessed bilateral upper-limb function indicated statistically significant improvement when the difference between the control and experimental groups were compared post-intervention (Task1 p=0.611; Task 2 p=0.0043; Task 3 p=0.0078; Task 4 p=0.0002). Similarly, three of the four items of the TEMPA that assessed unilateral upper-limb function indicated statistically significant improvement for the experimental group, when compared to the control- group post-intervention (Task 5 p=0.0151; Task 6 p=0.4118; Task 7 p=0.0064; Task 8 p=0.0009). The 9HPT assessed in-hand manipulation and fine upper-limb function. Results from the 9HPT for the left- and right hands of both groups showed clinically significant improvements from baseline to post-intervention, but there was no statistically significant difference between the two groups. The King Devick test was used to assess ocular tracking. The comparison of change between the two groups from baseline to post-intervention on the King Devick did not indicate clinically- or statistically significant change. Discussion and Conclusion: The findings from the bilateral IADL and BADL tasks as measured with the TEMPA are similar to findings in the literature. The results show that VR therapy improve motor control of the upper-limb significantly when both hands work together and when the upper-limbs are moving unilaterally. VR therapy might be more effective than conventional physiotherapy because it allowed for repetitive practice of functional activities, which aided the development of limb control and functional muscle strength. The VR therapy also allowed task-oriented training to occur repetitively. Task-oriented training is known to aid neural plasticity and facilitate functional rehabilitation. The insignificant differences between the groups on the 9HPT is an indication that the task performed for this outcome measure is not specific enough to detect hand function and grip strength. The King Devick test did not indicate change for the control- or experimental groups, which indicates that specific ocular tracking exercises should be included in therapy to address this impairment. / Dissertation (MPhysiotherapy)--University of Pretoria, 2016. / Physiotherapy / MPhysiotherapy / Unrestricted

The increasing demand for couples therapy and its present low success rate led to the question whether Glasser's reality therapy, with its innovative approach, could possibly be of value to couples therapy in South Africa. Glasser emphasizes the importance of healthy personal relationships, freedom of choice and responsibility. In therapy he focuses on the fact that each person has control of what he/she does and thinks and that he/she should take responsibility for it. On the basis of a limited qualitative study, it was found that, with certain reservations, this therapy could make a valuable contribution to the success of couples therapy. Professional persons should be encouraged to apply reality theory in couples therapy, training institutions should train their students in this regard and more comprehensive and in-depth research should be undertaken to determine its value in larger and more representative groups. / Educational Studies / M. Ed.

The increasing demand for couples therapy and its present low success rate led to the question whether Glasser's reality therapy, with its innovative approach, could possibly be of value to couples therapy in South Africa. Glasser emphasizes the importance of healthy personal relationships, freedom of choice and responsibility. In therapy he focuses on the fact that each person has control of what he/she does and thinks and that he/she should take responsibility for it. On the basis of a limited qualitative study, it was found that, with certain reservations, this therapy could make a valuable contribution to the success of couples therapy. Professional persons should be encouraged to apply reality theory in couples therapy, training institutions should train their students in this regard and more comprehensive and in-depth research should be undertaken to determine its value in larger and more representative groups. / Educational Studies / M. Ed.

Virtual reality exposure therapy (VRET) is a treatment often used to treat fear-of-flying (FOF), which research shows is effective for treating this phobia. Researchers have identified that the realism of the virtual environment is an important component in the efficacy of VRET and increased realism is likely to increase the efficacy of VRET. Guided by cognitive theory, emotional processing theory, and behaviorism, the purpose of this quantitative study was to demonstrate if a new generational technique called true reality-virtual reality exposure therapy (TR-VRET) is at least as efficacious as traditional VRET for treating the fear and anxiety associated with FOF. Repeated measures ANOVAs were used to compare the means between the pre-/posttests measuring fear and anxiety associated with FOF and between the control and experimental group. Both the active treatment experimental group (using TR-VRET) and the active treatment control group (using VRET) had a significant effect on reducing anxiety related to flying. The findings also revealed that both the active treatment experimental group and the active treatment control group had a significant effect on reducing fear related to flying. Notably, no significant differences were found between the active treatment experimental group and the active treatment control group, meaning the 2 treatments were equally effective at reducing the anxiety and fear related to flying. These findings can contribute to positive social change by allowing mental health professionals access to an advanced treatment tool (i.e., TR-VRET) that is just as effective as the older treatment tool (i.e., VRET). These findings can also contribute to positive social change by quickly allowing more tailored virtual environments to be created for clients at a lower cost.

University of Macau / Faculty of Education

Le trouble de l’usage de cannabis (TLUC) est une problématique complexe particulièrement lorsqu’il est comorbide à un trouble mental sévère (TMS). D’une part, aucune pharmacothérapie n’a été approuvée pour son traitement et d’une autre part, les psychothérapies existantes offrent au mieux une efficacité faible et non maintenue dans le temps. L’émergence de la réalité virtuelle (RV) en psychiatrie pourrait augmenter l’efficacité considérant le potentiel qu’elle a démontré pour une variété de conditions psychiatriques. Actuellement, aucune intervention ayant incorporé la RV visant le traitement du TLUC n’a fait l'objet de recherche. L’intervention Avatar pour le TLUC se veut une approche innovante utilisant la RV en tant qu’outil thérapeutique afin de faire des apprentissages et les pratiquer au moment où les cravings et les émotions sont d’intensité similaire à celle de leur quotidien. Cette intervention comprenant huit séances utilise des techniques provenant de thérapie recommandée (ex., thérapie cognitivo-comportementale, entrevue motivationnelle). Durant les périodes d’immersion, les participants ont interagi avec un avatar représentant une personne significative en lien avec leur consommation dont le thérapeute joue le rôle. Cet essai clinique pilote a visé l’évaluation de l’efficacité ainsi que la faisabilité et l’acceptabilité à court terme chez 19 participants ayant un double diagnostic de TMS et TLUC. Les résultats ont montré une réduction significative modérée de la quantité de cannabis consommée (d=0,545; p=0,017), laquelle a été confirmée par quantification du THC-COOH dans les urines. Une tendance a été observée pour la fréquence de l’usage (d=0,313; p=0,052). Concernant la sévérité du TLUC et la motivation aux changements, une petite (d=0,474; p=0,046) et modérée (d=0,523; p=0,046) taille d’effet ont été obtenues respectivement. Aucun effet significatif n’a été observé pour la qualité de vie et les symptômes psychiatriques sont restés stables. Les résultats à moyen et long terme seront évalués lorsque les participants auront terminé les suivis à 3, 6 et 12 mois. Un essai randomisé contrôlé à simple insu comparant l’intervention Avatar pour TLUC à une intervention classique en toxicomanie est en cours. / Cannabis use disorder (CUD) is a complex issue, particularly when it is comorbid with a severe mental disorder (SMD). On one hand, no pharmacotherapy has been approved for its treatment. On the other hand, existing psychotherapies offer, at best, low efficacy that is not sustained over time. The emergence of virtual reality (VR) in psychiatry could increase efficacy, given the potential it has demonstrated for a variety of psychiatric conditions. To date, no intervention incorporating VR for the treatment of CUD has been developed. The Avatar intervention for CUD is an innovative approach using VR as a therapeutic tool to learn and practice in real-time when cravings and emotions are of similar intensity to their everyday lives. This eight-session intervention uses techniques from commonly used therapeutic approaches (e.g., cognitive-behavioral therapy, motivational interviewing). During immersive sessions, participants interacted with an avatar played by the therapist, representing a significant person intrinsically linked with their consumption. This pilot clinical trial was designed to assess efficacy at short-term, feasibility, and acceptability in 19 participants with a dual diagnosis of SMD and CUD. Results showed a significant moderate reduction in the amount of cannabis consumed (d=0.545, p=0.017), which was confirmed by the quantification of THC-COOH in urine. Regarding the severity of TLUC and motivation to change, a small (d=0.474; p=0.046) and moderate (d=0.523; p=0.046) effect size were obtained, respectively. No significant effect was obtained for quality of life, and psychiatric symptoms remained stable. Once participants have completed the 3-, 6- and 12-month follow-ups, medium- and long-term results will also be assessed. A single-blind randomized controlled trial is currently underway to compare the Avatar intervention for CUD with a conventional addiction intervention.

No description available.

In this thesis I describe the reeducational processes in educational institutions, especially from the point of view of special pedagogy. In the theoretical part of thesis I define the behavioral disorders and then I deal with methods, techniques, approaches and forms of work with individuals with behavioral disorders. In the practical part, I used quantitative research method of questionnaires given to the educational institutions in Czech Republic. The aim was to check, if methods, techniques, approaches and forms are different in each of educational institutions and to check, if the selected theories are practically used

À l’heure où le numérique s’est totalement imposé dans notre quotidien, nous pouvons nous demander comment évolue notre bien-être. La réalité virtuelle hautement immersive permet de développer des environnements propices à la relaxation qui peuvent améliorer les capacités cognitives et la qualité de vie de nombreuses personnes. Le premier objectif de cette étude est de réduire les émotions négatives et améliorer les capacités cognitives des personnes souffrant de déclin cognitif subjectif (DCS). À cette fin, nous avons développé un environnement de réalité virtuelle appelé Savannah VR, où les participants ont suivi un avatar à travers une savane. Nous avons recruté dix-neuf personnes atteintes de DCS pour participer à l’expérience virtuelle de la savane. Le casque Emotiv Epoc a capturé les émotions des participants pendant toute l’expérience virtuelle. Les résultats montrent que l’immersion dans la savane virtuelle a réduit les émotions négatives des participants et que les effets positifs ont continué par la suite. Les participants ont également amélioré leur performance cognitive. La confusion se manifeste souvent au cours de l’apprentissage lorsque les élèves ne comprennent pas de nouvelles connaissances. C’est un état qui est également très présent chez les personnes atteintes de démence à cause du déclin de leurs capacités cognitives. Détecter et surmonter la confusion pourrait ainsi améliorer le bien-être et les performances cognitives des personnes atteintes de troubles cognitifs. Le deuxième objectif de ce mémoire est donc de développer un outil pour détecter la confusion. Nous avons mené deux expérimentations et obtenu un modèle d’apprentissage automatique basé sur les signaux du cerveau pour reconnaître quatre niveaux de confusion (90% de précision). De plus, nous avons créé un autre modèle pour reconnaître la fonction cognitive liée à la confusion (82 % de précision). / At a time when digital technology has become an integral part of our daily lives, we can ask ourselves how our well-being is evolving. Highly immersive virtual reality allows the development of environments that promote relaxation and can improve the cognitive abilities and quality of life of many people. The first aim of this study is to reduce the negative emotions and improve the cognitive abilities of people suffering from subjective cognitive decline (SCD). To this end, we have developed a virtual reality environment called Savannah VR, where participants followed an avatar across a savannah. We recruited nineteen people with SCD to participate in the virtual savannah experience. The Emotiv Epoc headset captured their emotions for the entire virtual experience. The results show that immersion in the virtual savannah reduced the negative emotions of the participants and that the positive effects continued afterward. Participants also improved their cognitive performance. Confusion often occurs during learning when students do not understand new knowledge. It is a state that is also very present in people with dementia because of the decline in their cognitive abilities. Detecting and overcoming confusion could thus improve the well-being and cognitive performance of people with cognitive impairment. The second objective of this paper is, therefore, to develop a tool to detect confusion. We conducted two experiments and obtained a machine learning model based on brain signals to recognize four levels of confusion (90% accuracy). In addition, we created another model to recognize the cognitive function related to the confusion (82% accuracy).

This study examines the relationship between adolescent depressive symptomology and substance abuse. From a literature study six hypotheses were developed. A quantitative empirical study, undertaken in a South African high school, investigated the level of adolescent depressiVe symptomology and substance abuse, as well as the relationship between the two. The influence of various moderator variables was also examined. In line with most international studies, the relationship between adolescent depressive symptomotogy and substance abuse was found to be significant. This research has shown that adolescent depressive symptomology is significantly and positively correlated with earlier age at onset of substance abuse as well as frequency of usage. There appear to be gender differences in the way adolescents deal with their depression in terms of substance abuse. In addition, risk factors for depression and substance abuse were confirmed. Recommendations have been made based on these results / Educational Studies / M.Ed.