No description available.

M. Tech. / The main purpose of this study was: • To determine the different diagnostic techniques chiropractors use in Gauteng South Africa. Objectives included: • To determine chiropractics attitude and opinions regarding the different Diagnostic Techniques they use in their practices. • To determine any statistically significantly correlations between answers. • To develop a demographic profile of Chiropractors in Gauteng South Africa. In the world today there are 80 000 chiropractors who are the primary physicians performing manipulations in order to treat problems such as lower back pain. Incidentally 85% of the western world will suffer from at some stage of their lives (Hecker and Daniel, 2004). The identification of the common functional and structural components of the adjustable lesion is critical to the management of these conditions. Unfortunately it has also contributed to the misconception that all manipulative disorders have the same pathological basis (Bergman, 2002). A questionnaire-based study comprising a non-probabilistic, non-random, convenience sample was used to determine the diagnostic techniques used v by the chiropractors actively practicing in Gauteng South Africa. A total of 58 Chiropractors responded to the questionnaire, forming the sample population that was used to calculate results. According to this study, all the responding chiropractors practicing here in Gauteng South Africa (n=58/58 100%), examine the spine to identify areas or subluxations that require adjustments/manipulation. There are a variety of diagnostic techniques methods that they use in everyday practice. Most commonly motion palpation(96.5%), static palpation(93.1%), pain description of the patient(82.8%), leg length discrepancy(55%), neurological tests(77.6%), visual postural analysis(61.4%), orthopedic tests(75%), plain static and stress x-rays(44.5%) and kinesiology muscle testing(10.4%) are used. The perceived reliability of these diagnostic techniques are also considered to be good.

Purpose: The occurrence of similar speech and non-speech behaviors in some children with autism and Childhood Apraxia of Speech (CAS) calls for the consideration of CAS in some children with autism. The majority of research on CAS has been conducted with children who are otherwise typically developing. The purpose of this study was to determine whether and to what extent children with autism are being diagnosed with or suspected to have CAS as well as what assessment and treatment methods are currently being used with these children. Method: A nationwide survey of speech-language pathologists (SLPs) working with children ages 0-6 years was distributed through snowball sampling, e-mail distribution lists and Facebook discussion pages. The survey requested information on numbers of children served with autism and suspected CAS as well as the criteria used to identify CAS in children with autism and the treatment methods being used in intervention. Results: 132 surveys were received and analyzed. SLPs from across the United States participated in the study. The mean number of children with autism currently served per participant was 6 children and the mean number of children with autism and suspected CAS per participant was 1. Participants reported suspected CAS in 16% of children with autism. SLPs working in the field the longest and those serving more total children with autism were suspecting CAS in children with autism more often than other participants. Of the total participants, 80% indicated that they would begin assessment for CAS in a child with autism as soon as they notice specific signs of CAS. The most common markers used were difficulty combining and sequencing phonemes and inconsistent production of speech sounds. Participants reported using a wide range of assessment tools to assess for CAS in a child with autism. Participants tended to rely upon informal assessment measures for this population; the most common assessment tool was a connected speech sample. The most commonly used intervention technique with this population was AAC; participants also reported high familiarity with PROMPT as a treatment for CAS. The least commonly used intervention technique was integral stimulation; 62% of the participants indicated that they have no knowledge of the technique. Conclusion: Results revealed that on average, SLPs are suspecting CAS in approximately 1 in 5 children with autism but much fewer children with autism have a second diagnosis of CAS. The decision of when to assess a child with autism for CAS as well as the assessment tools used varied greatly across participants. Participants reported using up to 22 different diagnostic markers to identify CAS in a child with autism. It was also discovered that not all of the traditional diagnostic markers for CAS should necessarily be considered diagnostic markers of CAS in a child with autism (e.g. suprasegmental abnormalities). With no scientific research to date regarding treatment efficacy for the treatment of CAS in children with autism, SLPs are forced to rely on anecdotal data when selecting a treatment to target CAS in a child with autism; SLPs may not be using the most effective treatment methods for this population. Results of the study support continued investigation of CAS in children with autism. There is a strong need for the development of clear diagnostic guidelines for CAS in a child with autism as well as reliable assessment tools that should be used. Further studies are needed to identify the most effective treatment approach for children with CAS and autism and how an SLP should incorporate that treatment into an overall comprehensive treatment approach for autism.

O objetivo deste estudo foi avaliar os fatores de risco, aspectos clínicos, imagenológicos e terapêuticos da osteonecrose dos maxilares associada ao uso dos bisfosfontos (ONMAB), bem como compará-los com o estado atual da doença, na busca de parâmetros que favoreceram o reparo tecidual. Foram avaliados retrospectivamente 40 casos de ONMAB de pacientes oncológicos encaminhados para avaliação estomatológica. Os dados demográficos, clínicos, imagenológicos, laboratoriais, histopatológicos e terapêuticos foram analisados. Foi realizada análise descritiva dos dados e para associar o estado atual da osteonecrose com as demais variáveis foi utilizado o teste exato de Fisher. O nível de significância estabelecido foi de 5% (p0,05). A ONMAB se mostrou mais comum em mulheres, com idade média de 59 anos e associadas mais freqüentemente ao de câncer de mama, seguido de câncer de próstata e do mieloma múltiplo. O principal bisfosfonato utilizado foi o ácido zoledrônico com média de uso de 23,54 meses. A exodontia, o tratamento quimioterápico e com corticóides foram associados com mais da metade dos casos. O aspecto clínico principal foi a exposição óssea com sintomatologia dolorosa associados ou não à drenagem de secreção, principalmente em mandíbula. Modificações no trabeculado ósseo, erosão da cortical e osteoesclerose foram os principais achados de imagem. Dentre todos os tratamentos realizados, a associação de cirurgia com plasma rico em plaquetas (PRP) e laser de diodo foi a mais utilizada (52,5%) e que mostrou alto índice de sucesso clínico (62,96%). A evolução dos casos tratados mostrou que 67,5% apresentaram reparo tecidual e mesmo aqueles que mantiveram a exposição óssea não mostraram sintomatologia dolorosa. A classificação clínica e o tipo de tratamento empregado influenciaram de forma significante a resolução da ONMAB. Conclui-se que medidas de controle local de infeccção, antibioticoterapia e pequenos debridamentos ósseos devem ser adotadas nos quadros de ONMAB, porém em conjunto com a utilização de bioestimuladores teciduais como o PRP e laser de diodo que promovem de forma mais eficiente o reparo tecidual. / The aim of this study was to evaluate the risk factors, clinical, radiological and treatment aspects of bisphosphonate-associated osteonecrosis of the jaws (BONJ) in cancer patients. Likewise, comparing the current state of the disease with the different variables in the search for parameters that favored the tissue repair. We evaluated retrospectively 40 cases of BONJ of cancer patients referred for stomatology evaluation. Demographic data, clinical, radiographic, laboratory, histopathological and treatment were analyzed. We performed descriptive analysis of data and to associate the current state of the osteonecrosis with the other variables we used Fisher\'s exact test. The level of significance established was 5% (p 0.05). The BONJ was more common in women, the mean age was 59 years and was more frequently associated to the breast cancer followed by prostate and multiple myeloma. Zoledronic acid was the main bisphosphonate used with average use of 23.54 months. The dental tooth, chemotherapy and corticosteroids history were associated with more than half of the cases. The clinical aspect was the main bone exposure associated with painful symptoms or drainage of secretions, especially in mandible. Structural alteration of trabecular bone, cortical bone erosion and osteosclerosis were the main radiological findings. Among all the treatments performed, the therapy combining bone resection, diode laser and platelet-rich plasma (PRP) was the most used (52.5%) which showed high rate of clinical success (62.96%). The evolution of treated cases showed that 67.5% had tissue repair and only 32.5% maintained the bone exposure, but all without painful symptoms. The clinical classification and type of treatment used significantly influence the outcome of BONJ . It is concluded that measures of infection local control, antibiotics and small bone debridement should be adopted in the BONJ but with the use of tissue stimulation using PRP and diode laser helps to promote more effective tissue repair.

Thesis (M.A.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 69-78). / viii, 78 leaves, bound 29 cm

O objetivo deste estudo foi avaliar os fatores de risco, aspectos clínicos, imagenológicos e terapêuticos da osteonecrose dos maxilares associada ao uso dos bisfosfontos (ONMAB), bem como compará-los com o estado atual da doença, na busca de parâmetros que favoreceram o reparo tecidual. Foram avaliados retrospectivamente 40 casos de ONMAB de pacientes oncológicos encaminhados para avaliação estomatológica. Os dados demográficos, clínicos, imagenológicos, laboratoriais, histopatológicos e terapêuticos foram analisados. Foi realizada análise descritiva dos dados e para associar o estado atual da osteonecrose com as demais variáveis foi utilizado o teste exato de Fisher. O nível de significância estabelecido foi de 5% (p0,05). A ONMAB se mostrou mais comum em mulheres, com idade média de 59 anos e associadas mais freqüentemente ao de câncer de mama, seguido de câncer de próstata e do mieloma múltiplo. O principal bisfosfonato utilizado foi o ácido zoledrônico com média de uso de 23,54 meses. A exodontia, o tratamento quimioterápico e com corticóides foram associados com mais da metade dos casos. O aspecto clínico principal foi a exposição óssea com sintomatologia dolorosa associados ou não à drenagem de secreção, principalmente em mandíbula. Modificações no trabeculado ósseo, erosão da cortical e osteoesclerose foram os principais achados de imagem. Dentre todos os tratamentos realizados, a associação de cirurgia com plasma rico em plaquetas (PRP) e laser de diodo foi a mais utilizada (52,5%) e que mostrou alto índice de sucesso clínico (62,96%). A evolução dos casos tratados mostrou que 67,5% apresentaram reparo tecidual e mesmo aqueles que mantiveram a exposição óssea não mostraram sintomatologia dolorosa. A classificação clínica e o tipo de tratamento empregado influenciaram de forma significante a resolução da ONMAB. Conclui-se que medidas de controle local de infeccção, antibioticoterapia e pequenos debridamentos ósseos devem ser adotadas nos quadros de ONMAB, porém em conjunto com a utilização de bioestimuladores teciduais como o PRP e laser de diodo que promovem de forma mais eficiente o reparo tecidual. / The aim of this study was to evaluate the risk factors, clinical, radiological and treatment aspects of bisphosphonate-associated osteonecrosis of the jaws (BONJ) in cancer patients. Likewise, comparing the current state of the disease with the different variables in the search for parameters that favored the tissue repair. We evaluated retrospectively 40 cases of BONJ of cancer patients referred for stomatology evaluation. Demographic data, clinical, radiographic, laboratory, histopathological and treatment were analyzed. We performed descriptive analysis of data and to associate the current state of the osteonecrosis with the other variables we used Fisher\'s exact test. The level of significance established was 5% (p 0.05). The BONJ was more common in women, the mean age was 59 years and was more frequently associated to the breast cancer followed by prostate and multiple myeloma. Zoledronic acid was the main bisphosphonate used with average use of 23.54 months. The dental tooth, chemotherapy and corticosteroids history were associated with more than half of the cases. The clinical aspect was the main bone exposure associated with painful symptoms or drainage of secretions, especially in mandible. Structural alteration of trabecular bone, cortical bone erosion and osteosclerosis were the main radiological findings. Among all the treatments performed, the therapy combining bone resection, diode laser and platelet-rich plasma (PRP) was the most used (52.5%) which showed high rate of clinical success (62.96%). The evolution of treated cases showed that 67.5% had tissue repair and only 32.5% maintained the bone exposure, but all without painful symptoms. The clinical classification and type of treatment used significantly influence the outcome of BONJ . It is concluded that measures of infection local control, antibiotics and small bone debridement should be adopted in the BONJ but with the use of tissue stimulation using PRP and diode laser helps to promote more effective tissue repair.

No description available.

Aus der Einleitung: A wide range of epidemiological community studies worldwide converge on several incontrovertible facts regarding anxiety disorders: they occur frequently, begin at an early age, significantly impair multiple areas of development and life, and are associated with numerous adverse correlates and consequences. Furthermore, evidence clearly points to the fact that the majority of patients who have anxiety disorders still go undetected and undertreated, despite considerable efforts over the last two decades to improve this situation. Less than half receive any treatment at all and only a fraction of those receive what can be considered even "minimally adequate treatment."

Objectives: In this study, we examine the public’s knowledge about different levels of depression severity in Germany. Methods: Data stem from a national telephone survey in Germany. A total of 1,009 persons participated, response rate was 46.8%. A vignette was presented with signs of mild, moderate or severe depression. Participants were asked what they think the person has, which persons and services are helpful and how effective different treatment options are. Differences between the three vignettes were tested with 95% confidence intervals and χ 2 -tests. Results: 55.3% of the respondents identified depression as the health problem in question. Participants who heard the vignette with moderate symptomatology recognized depression more often. Across groups, a general practitioner was named most frequently concerning helpful persons/services. Effectiveness of psychotherapy received high levels of approval, online therapy and books were less often rated as effective. There were only few significant differences between the three vignettes. Conclusions: This is the first study examining public depression literacy for different severity levels. Small differences between severity levels indicate a lack of knowledge, which may have adverse consequences for adherence to treatment, especially for mild depression.

Thesis (MPhil (General Linguistics))—University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The term "schizophrenia" refers to a psychiatric condition which affects an individual's thought and speech (Eaton and Chen 2006). The verbal expression of schizophrenics can therefore be used as a tool for insight into the nature of schizophrenia as well as the cognitive processes of schizophrenics (Wróbel 1990:1). This thesis reports on a comparative evaluation of three pragmatic assessment tools, namely the Pragmatic Protocol (Prutting and Kirchner 1987), the Profile of Communicative Appropriateness (Penn 1985), and the Framework for Assessing (Children's) Conversational Skills (Rumble 1988), in order to establish which of these tools is most suitable for assessing the first language (L1) and second language (L2) pragmatic abilities of late bilingual schizophrenics. Four late bilingual schizophrenic patients participated in this study. A thirty minute informal interview was conducted with each of the participants in both their L1 and L2 and the speech samples were transcribed and then analysed by means of each of the pragmatic assessment tools. A careful examination of the results yielded by the three assessment tools, showed, firstly, that when presenting the results of a pragmatic assessment of schizophrenic speech, it is crucial that both quantitative and qualitative information be included: if the latter is excluded, a significant amount of information is hidden from the clinicians and/or linguists doing the assessment, as well as the people to whom they report their findings. Secondly, with respect to the characteristics of schizophrenic speech, the three instruments used in this study show that whereas most of the aspects of schizophrenics' linguistic abilities seem intact, their pragmatic skills are definitely impaired. Thirdly, regarding differential symptomatology in bilingual schizophrenics, this study concludes that none of the three assessment tools contributes to a better understanding of this phenomenon, and that, in fact, it is highly unlikely that any pragmatic assessment tool would be able to capture this phenomenon. Finally, it is recommended that clinicians assess bilingual patients in both languages, whenever possible, in order to determine the full range of symptoms experienced by the patient, to gain a better indication of the severity of the illness and to track the progress of the illness. / AFRIKAANS OPSOMMING: Die term "skisofrenie" verwys na 'n psigiatriese toestand wat 'n individu se denkprosesse en spraak beïnvloed (Eaton en Chen 2006). Die verbale uitinge van skisofrene kan dus gebruik word om insig oor die aard van skisofrenie, sowel as die kognitiewe prosesse van skisofrene, te verkry (Wróbel 1990:1). Hierdie tesis lewer verslag oor 'n vergelykende evaluering van drie pragmatiese assesseringsinstrumente, naamlik die "Pragmatic Protocol" (Prutting en Kirchner 1987), die "Profile of Communicative Appropriateness" (Penn 1985), en die "Framework for Assessing (Children's) Conversational Skills" (Rumble 1988), om sodoende vas te stel watter een van hierdie drie die mees gepaste instrument is vir die assessering van tweetalige skisofrene se pragmatiese vaardighede in hul eerstetaal (T1) en tweedetaal (T2), spesifiek in gevalle waar die T2 later (d.w.s. nie binne die eerste sewe lewensjare nie) verwerf is. Vier sulke tweetalige skisofrene het deelgeneem aan die studie. Daar is met elkeen van die deelnemers 'n informele onderhoud gevoer vir 30 minute in hul T1, gevolg deur 30 minute in hul T2. Die onderhoude is getranskribeer en daarna geanaliseer deur middel van elk van die drie assesseringsinstrumente. 'n Noukeurige ondersoek en vergelyking van die resultate van die drie instrumente het eerstens getoon dat dit belangrik is om die resultate van 'n pragmatiese analise van skisofreniese spraak op beide 'n kwantitatiewe en kwalitatiewe wyse aan te bied: wanneer kwalitatiewe inligting weggelaat word, bly 'n betekenisvolle hoeveelheid van die informasie verborge vir die klinici en/of taalwetenskaplikes wat die assessering doen, asook die mense aan wie hulle hulle bevindinge rapporteer. Tweedens, met betrekking tot die eienskappe van skisofreniese spraak, wys die drie instrumente wat in hierdie studie gebruik is dat alhoewel meeste aspekte van skisofrene se taalvaardighede ongeskonde is, hulle pragmatiese vaardighede ooglopend aangetas is. Derdens, rakende differensiële simptomatologie in tweetalige skisofrene kom hierdie studie tot die gevolgtrekking dat geen van die drie instrumente bydra tot 'n beter begrip van hierdie verskynsel nie, en dat dit selfs hoogs onwaarskynlik is dat enige pragmatiese assesseringsinstrument hierdie verskynsel sou kon vaslê. Uiteindelik word daar aanbeveel dat klinici, wanneer dit ookal moontlik is, tweetalige pasiënte in beide tale behoort te assesseer om sodoende die volledige reeks van simptome wat 'n pasiënt ervaar vas te stel, om 'n beter aanduiding te bekom oor die erns van die siekte, en om die progressie van die siekte te volg.