No description available.

Objective: Test changes in (a) perceived coping efficacy, (b) negative self-statements, and (c) interpretive biases to threat as potential mediators of the relationship between treatment condition and long-term follow-up (average of 6.5 years after intervention). Test moderating effect of age at time of randomization on mediational effect for the 3 putative mediators. Method: Participants included 301 youth who had participated in the Child/Adolescent Multimodal Study (CAMS) and agreed to participate in a naturalistic follow-up study beginning an average of 6.5 years after the end of the acute treatment phase. In the intervention phase, participants (ages 7 to 17) were randomized to cognitive behavioral therapy (CBT), pharmacotherapy (sertraline), combined CBT and sertraline, or pill placebo. Putative mediators were measured at 4 time-points over the course of the intervention phase. The follow-up study consisted of five annual assessment visits that included ratings of current anxiety based on an interview by an independent evaluator who was blind to the randomization of participants. Results: Reductions on a measure of interpretive biases to threat over the course of the combined intervention condition mediated anxiety outcomes at the first follow-up visit. No other significant mediated effects were found for any of the putative mediators. Age did not significantly moderate any mediated effects. Conclusions: The findings suggest that interpretive biases to threat, an often elevated characteristic of anxious youth, may be important to address as part of the treatment of anxiety in order to maintain reductions in anxiety in the years following treatment. The specificity of this finding to the combined CBT and sertraline condition offers support for the synergistic effect of CBT and sertraline when implemented in tandem to reduce anxiety-related cognitive factors with long-term implications. / Psychology

Objective: To examine the impact of treatment outcome and treatment condition (Cognitive-behavioral therapy, CBT; Sertraline, SRT; COMB, CBT and SRT; Placebo) for youth treated for anxiety disorders on global and domain-specific functioning across a 3 to 12 year, naturalistic follow-up. Method: A subset (319) of 488 families from the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008) participated in an average of 3.38 assessments during the follow-up period. All youth met criteria for a principal anxiety disorder pretreatment. Growth curve modeling examined the impact of treatment outcomes (response/remission) and treatment condition on global functioning, global and domain- specific impairment, and life satisfaction across the follow-up period. Logistic regression explored the impact of treatment response and condition on low frequency events (arrests/convictions) and educational achievement (high school graduation/college enrollment). Results: Growth curve analyses revealed that treatment responders/remitters demonstrated better global functioning, increased life satisfaction, and decreased overall impairment at their first follow-up assessment (growth curve mean intercept). The positive effect of treatment response on life satisfaction, but not global functioning or overall impairment, attenuated across the follow-up period. Treatment response also predicted decreased academic impairment at first follow-up. Participants in the COMB condition demonstrated improved functional trajectories with regards to family life and academic grade-point average. CBT participants demonstrated a greater decline in overall impairment and problems with self-care/independence across the follow-up. Treatment response and condition did not predict legal outcomes, school attendance, high school graduation, college attendance, occupational outcomes, or social/peer relationships. Conclusion: Response to early intervention is associated with improved overall functioning, as well as functioning within specific domains (academics) 3 to 12 years posttreatment. Treatment type differentially predicted functional trajectories. Findings support the positive impact of pediatric anxiety treatment on functioning during adolescence and emerging adulthood. / Psychology

Given the central role of panic attacks in the diagnosis of panic disorder, an adequate measure of panic attacks is essential. Panic frequency is routinely assessed either by simply asking individuals to estimate the number of panic attacks experienced during a given time in a questionnaire or assessment interview or by having them continuously self-monitor. Panic frequency obtained by such methods is unreliable and invalid or time-consuming, respectively. The purpose of this project was to investigate the reliability and validity of a Panic Attack Frequency Calendar (PAFC), modeled after a time-line follow-back (TLFB) procedure (e.g., Sobell & Sobell, 1979) that has been used for years to reliably and validly assess daily alcohol use through self-report over extended periods of time. The participants consisted of 74 adult individuals (ages 18-57) who indicated that they had experienced a panic attack within the past two weeks. Participants completed a battery of self-report questionnaires, including a retrospective frequency measure, and administered an 8-week PAFC. Participants were then randomly divided into either a self-monitoring group that recorded information in a diary about any panic attacks that they experienced over the following two weeks or a non-self-monitoring control group. All participants were administered another retrospective frequency questionnaire and a 10-week PAFC two weeks after the administration of the first PAFC. Reliability was determined from the two-week stability estimates across the PAFCs for the eight-week period that overlapped both assessments. This was done with several composite panic behavior variables; daily and weekly test-retest reliabilities were also calculated. Concurrent validity was established by comparing panic frequency from the PAFC with that obtained from the diary and the retrospective frequency measure. Further validity was established via correlating the PAFC with the self-report questionnaires. Results are discussed in light of their implications for the assessment of panic attacks. / Master of Science

Implementation of provider-made follow-up appointments for depression in primary care Rebecca Vaughn College of Nursing, East Tennessee State University; Whitson Hester School of Nursing, Tennessee Technological University Author Note Rebecca Vaughn https://orcid.org/0009-0007-0731-3316 College of Nursing, East Tennessee State University There are no conflicts of interest to disclose. Corresponding concerning this manuscript should be addressed to Rebecca Vaughn 108 Reed Mill Lane Monroe TN 38573 Zrev2@etsu.edu Abstract Depression is a common condition diagnosed and managed in primary care. Follow-up is inconsistent and low in these settings, creating a gap in care that impacts management, adherence to treatment, and patient outcomes. The purpose of this quality improvement project was to implement in-room scheduling of follow-- up appointments by providers of newly diagnosed depression patients. The project aimed to improve follow-up of newly diagnosed depression patients and adherence to treatment in primary care. The setting of the project was a primary care clinic care located in North-East Tennessee. The IRB determined that no approval was needed. A 12-week retrospective chart review was conducted to determine baseline rates and demographics for the project. During the six-week project , providers scheduled follow-up appointments and documented them on the data collection form. Providers were given a pre/post-test before and after implementation to measure providers confidence levels. While the study is ongoing , and results are pending, the expected outcomes include improved follow-up rates and improved adherence to treatment which will lead to improved outcomes in depression. Keywords: depression, primary care, follow-up, adherence

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2018-10-23T12:03:01Z No. of bitstreams: 1 Gessyka Wnaglon Veleda.pdf: 1641786 bytes, checksum: fcc4d51b17c8f41056d82f3ec8d5cec9 (MD5) / Made available in DSpace on 2018-10-23T12:03:01Z (GMT). No. of bitstreams: 1 Gessyka Wnaglon Veleda.pdf: 1641786 bytes, checksum: fcc4d51b17c8f41056d82f3ec8d5cec9 (MD5) Previous issue date: 2018-08-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Behavioral Cognitive Therapy (CBT) has been indicated as first-line treatments for Major Depressive Disorder (MDD), due to its effectiveness and effectiveness. However, little is known about the maintenance of these results in the medium and long term. These findings are of particular importance in view of the high rates of relapse and recurrence of depressive episodes throughout the subjects' lives. . The objective of this study is to investigate the efficacy and effectiveness of psychotherapeutic treatment from CBT for the response of post-follow-up depressive symptoms, indicating related clinical and social aspects. From a quasi-experimental study nested to a randomized clinical study, 94 patients were evaluated through the Beck Depression Inventory (BDI-II), 6 and 12 months post intervention of 16 sessions with CBT. There were significant differences between the median depressive symptoms of the baseline with the scores of all other follow-up moments (p <0.001). There were no differences in the scores of depressive symptoms at the end of treatment when compared to 6 (p <0.486) and 12 months (p <0.098). Only the initial BDI score was associated with a decrease in depressive symptoms (p <0.001). The findings indicate that CBT significantly reduces depressive symptoms by maintaining this condition for up to 12 months after the intervention. The intensity of depressive symptoms at the beginning of the therapeutic process is associated with a decrease in post-intervention depressive symptoms. / A Terapia Cognitiva - Comportamental (TCC) tem sido indicada como tratamento de primeira linha para o Transtorno Depressivo Maior (TDM), devido sua eficácia e efetividade. Contudo, pouco se sabe sobre a manutenção desses resultados a médio e longo prazo. Esses achados têm especial importância, tendo em vista, as altas taxas de recidivas e recorrência de episódios depressivos ao longo da vida dos sujeitos. O objetivo deste estudo é pesquisar a eficácia e efetividade do tratamento psicoterápico a partir da TCC para a resposta dos sintomas depressivos um ano pós-acompanhamento, indicando aspectos clínicos e sociais relacionados. A partir de um estudo quase experimental aninhado a um clínico randomizado, 94 pacientes foram avaliados, através do Inventário Beck de Depressão (BDI- II), 6 e 12 meses pós intervenção de 16 sessões com TCC. Houve diferenças significativas entre as medianas de sintomas depressivos do baseline com os escores de todos os momentos de acompanhamento (p < 0,001). Não houve diferenças em relação aos escores de sintomas depressivos do final do tratamento quando comparados com aos 6 (p < 0,486) e 12 meses (p < 0,098). Apenas o escore de BDI inicial estava associado à diminuição dos sintomas depressivos (p < 0,001). Os achados indicam que a TCC reduz significativamente os sintomas depressivos mantendo essa condição até 12 meses após a intervenção. A intensidade dos sintomas depressivos no início do processo terapêutico está associada a uma diminuição dos sintomas depressivos pós intervenção.

Einleitung Die aneurysmale Subarachnoidalblutung und ihre Komplikationen stellen eine akut lebensbedrohliche Erkrankung dar. Aufgrund einer hohen Letalität und Morbidität sowie zahlreichen, nicht modifizierbaren Risikofaktoren und fehlenden eindeutigen Präventionsmaßnahmen bleibt diese Krankheit eines der aktuellen Themen der Neurochirurgie. Ziel Ziel dieser Studie ist der Vergleich der Behandlungsergebnisse von Patienten mit aneurysmaler SAB im Klinikum Chemnitz mit aktuellen Literaturdaten. Material und Methode In dieser Arbeit wurden die Daten von insgesamt 200 Patienten mit aneurysmaler Subarachnoidalblutung retrospektiv zusammengefasst. Es wurde eine Populationsanalyse zusammen mit einer Analyse der Korrelationen zwischen verschiedenen Ausgangs- und Verlaufsparametern mit dem allgemeinen Outcome und der Mortalität durchgeführt. Zusätzlich erfolgte eine Follow-up-Analyse der Mortalität und Morbidität bei 108 Patienten. Im statistischen Modell wurden eine Uni- und Bivariatanalyse sowie binäre und multinomiale logistische Regression angewendet. Kaplan-Meier-Kurven in Verbindung mit Cox-Regressionsanalysen wurden zur Beurteilung der Mortalität eingesetzt. Die Ergebnisse wurden mit Literaturdaten verglichen. Das Votum der Ethikkommission der TU Dresden liegt vor (EK 181052014 vom 15.09.2014). Ergebnisse Von 200 Patienten mit einem Durchschnittsalter von 52 J (20-82 J, Medianalter 51 ± 13,6 J) waren 69 Patienten männlich (34,5 %), 131 – weiblich (65,2 %). Das männlich : weiblich Verhältnis betrug 1:1,9. Der klinische Schweregrad der Patienten bei Aufnahme wurde durch die WFNS- und die HH-Skalen evaluiert. Zusätzlich wurden die BNI- und Fisher-Skalen zwecks Evaluation des radiologischen Schweregrades der aSAB eingesetzt. Die Patientendistribution anhand der WFNS-Skala war: WFNS °I – 42,0 %, WFNS °II – 10,0 %, WFNS °II – 16,5 %, WFNS °IV – 22,5%, WFNS °V – 9,0 %. Die Verteilung der Patienten durch die HH-Skala war vergleichbar. 14,5 % der Patienten hatten eine BNI 1, 41,5 % - BNI 2, 32,0 % – BNI 3, 10,5 % - BNI 4, 1,5 % - BNI 5 Blutung. Bei 5,5 % der Patienten lag eine Fisher 1, 10,5 %– Fisher 2, 28,0% - Fisher 3 und 56,0 % - Fisher 4 SAB vor. 77,5 % der Aneurysmata waren klein (<11mm), 18,5 % - groß (11-25mm), 4 % - Giant (>25mm). Die Aneurysmen war meist im Bereich der Acom (41,5 %) und MCA (36,5 %) lokalisiert. Insgesamt 94,5 % der Aneurysmen gehörten zur vorderen Zirkulation. Die primäre Mortalitätsrate betrug 14,5 %. 21,5% der Patienten hatten einen mRS von 0-1 bei Entlassung, 26,0 % - einen mRS 2-3, 38,0 % - einen mRS 4-5. Die mittlere Follow-up-Dauer betrug 71,3 ± 43,2 Monate (Spannweite 2-168 Monate). Von den initial Überlebenden und im Follow-up eingeschlossenen Patienten sind 10,2 % im Verlauf verstorben. 48,1 % hatten einen mRS 0-1, 30,6% mRS 2-3, 11,1 % - mRS 4-5. Diskussion Das Outcome der Patienten mit einer aSAB trägt einen multifaktoriellen Charakter. Die wesentlichen Prädiktoren des Outcomes sind das Alter, der klinische und radiologische Schweregrad der Blutung, die Notwendigkeit der Versorgung eines posthämorrhagischen Hydrozephalus (temporäre und dauerhafte CSF-Ableitung), ein Vasospasmus, DIND und Entgleisun-gen im Serum-Natrium-Spiegel. Die Mortalitätsrate bei der primären Versorgung der Patienten mit einer aSAB in unserer Ko-horte ist um etwa 5 % niedriger als in der Literatur angegeben. Die Mortalitätsrate steigert sich allmählich während der ersten 3 Wochen. Sie wird im Wesentlichen vom Patientengeschlecht, dem klinischen und radiologischen Schweregrad der Blutung, der Notwendigkeit einer Akutversorgung eines aufgetretenen Hydrozephalus, einem Vasospasmus, Entgleisungen im Serum-Natrium-Spiegel sowie der Notwendigkeit einer CSF-Dauerableitung beeinflusst. Die Notwendigkeit einer CSF-Außenableitung bei Aufnahme korreliert mit einem schlechten Zustand der Patienten bei Entlassung und im Follow-up. Der Vasospasmus ist ein unabhängiger Prädiktor eines primär schlechten Outcomes und einer hohen Mortalität, zeigt sich aber als nicht signifikanter Faktor im Langzeit-Follow-up. Die Shuntpflicht ist bei Patienten mit Elektrolytentgleisungen, beidseitigen EVDs und DIND 3-4fach erhöht, beeinflusst jedoch nur die primäre Morbidität/Mortalität. Entgleisungen im Serum-Natrium-Spiegel zeigten sich als unabhängiger Prädiktor eines schlechten Outcomes und erhöhter Mortalität sowohl während des stationären Aufenthaltes, als auch im Langzeit-Follow-up. Die Notwendigkeit einer dekompressiven Kraniektomie wiederspiegelt sich in einem niedrigen BI der Patienten im primären Outcome und ist Prädiktor eines schlechten Outcomes und erhöhter Mortalität im Langzeit-Follow-up.

Web2.0的時代來臨，「使用者創作內容（UGC）」概念開始提出。照片分享服務Instagram出現，大量照片上傳至此。因此，本研究希望探討以下三個研究問題：社群媒體上的熱門影像風格是如何建立的？社群媒體上meme是如何保持和變化的？Meme是否會有一個特定的影像風格？本研究通過資料探勘和內容分析的方法建立了一個以圖片為主的研究方法。本研究選擇了現在在Instagram上熱門的“follow me to”的背面牽手照為例來進行分析。 通過比較分析原攝影師Murad Osmann“follow me to”照片和其仿拍者的照片，得出了熱門影像有以下幾個特點：1） 與社群媒體的平台特性做結合。2) 容易模仿。3) 注重服装和影像的敘事性。4) 有充裕的經濟資本找到全球的風景作為背景。5) 有高藝術美感和技術操弄的精細度。仿拍型meme在構圖和內容的部分上有較高一致。不同之處有以下幾點：1) 在景別、內容上相似但更豐富。2) 不注重影像的敘事性表達，只呈現景色和人。3) 個人仿拍者的場景變化度小。4) 不注重攝影技巧的模仿。總之，仿拍型Meme的不穩定性強，較難形成特定的風格，但有部分仿拍者有自己的特點。 / In the age of web 2.0, the concept of ‘the User Generated Content (UGC)’ is put forward. Now millions of images posted on the photo sharing service such as Instagram. We want to explore the following three questions: How is the style of hot images on the social media set up? How are memes on social media to maintain and change? Do memes have a specific image style? We performed the image-based method of data mining and content analysis to study the three research questions. We choose ‘follow me to’—the hot photos on Instagram— as an example for analysis. Though the comparative analysis of the ‘follow me to’ photos of photographer Murad Osmann and the imitators. The hot images on social media have characteristics: 1) They combine with social media platforms’ characteristics. 2) It’s easy to imitate photo’s composition and view. 3) Pay attention to model’s clothing and image narrative. 4) Have enough fund to take pictures around world. 5) Have arts beauty and skilled photography. The photos of imitators and photographer Murad Osmann have the same composition and contents. There also have some differences: 1) Richer in shooting scale and contents. 2) Not pay attention to image narrative. 3) Not have enough fund to take pictures around world. 4) Not have enough arts beauty and skilled photography. In conclusion, compare to hot photos, most of imitators’ don’t have their own characteristics. But some imitators have some characteristics.

Despite growing scrutiny of Environmental Impact Assessment (EIA) in Canada and worldwide, the follow-up and monitoring component remains under practiced, leaving EIA decision-makers and practitioners with little understanding of the accuracy of impact predictions made and the effectiveness of mitigation measures developed during the EIA project-planning phase. The Minister’s Expert Panel further highlighted the importance of enhancing follow-up and monitoring during the recent review of EIA processes in Canada. The research identifies six leading edge practices for next generation EIA follow-up and monitoring: public and Indigenous participation, continuous learning, clear roles and responsibilities, independent oversight, adaptive management and traditional knowledge. Approaches to implement those practices in a Canadian context are explored and supported by guidance that captures the learning potential of EIA follow-up and monitoring. The six practices are intended as a package and are presented with practical guidance for proponents, regulators, consultants and others involved in EIA. / May 2017

Name: Alice Oktábcová Supervisor: Mgr. et Mgr. Jaromíra Uhlířová Oponent: ……………. Diploma thesis: The Application of Robot-Assisted Therapy of Hand after Stroke: Follow-Up Trial of Application of AMADEO Instrument Key words: stroke, robot-assisted therapy, Amadeo Instrument, follow-up study, upper extremity In recent years, western countries noted a gradual increase in stroke survivors. Stroke can cause motor activity impairment and also senzoric and cognitive disorders which lead into restriction of participation of activities of daily living and also reduction of social and community activities. Functional improvment of upper and lower extremity after stroke is a very complex proces which has to be solved in multidiscplinary and multifactorial approach in result of every stroke survivor to live in the most independent way as possible. Robot-assisted therapy for motor recovery could be a successful way to improve motor activity of stroke survivors. Amadeo Instrument is one of robot-assisted therapy for hand rehabilitation of stroke survivors. This instrument can be described as final effector without exoskeleton which allows functional motor therapy for fingers and also a motivational feedback. Amadeo therapy can be passive, assisted, active and also interactive. The aim of this thesis is to...