987 resultados para learning disorder
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Tese de Doutoramento em Engenharia de Eletrónica e de Computadores
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Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.
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OBJETIVO: O presente estudo teve como objetivo conhecer evidências de validade e precisão do Alcohol Use Disorder Identification Test (AUDIT). MÉTODOS: Contou-se com uma amostra de conveniência (não probabilística) de 547 estudantes universitários de Fortaleza (CE), com idade média de 21,6 anos (dp = 4,86; amplitude de 18 a 53), a maioria do sexo masculino (51,5%), solteira (91,4%) e católica (62,5%). Os participantes responderam ao AUDIT e a perguntas demográficas. Procurando conhecer a estrutura fatorial, além de estatísticas descritivas, realizou-se uma Análise de Componentes Principais. Adicionalmente, a fim de avaliar a precisão do instrumento, efetuaram-se cálculos de alfa de Cronbach (consistência interna), correlações de r de Pearson e coeficiente de correlação intraclasse - ICC (precisão teste-reteste). RESULTADOS: De acordo com a análise de componentes principais com rotação oblimin, a estrutura bifatorial do AUDIT mostrou-se coerente, com todos os itens apresentando saturações satisfatórias, superior a |0,40|, tendo o Fator 1 explicado 47,5% da variância total com alfa de 0,84 e o Fator 2 explicado 11,6% da variância total com alfa de 0,69. Os resultados do teste-reteste indicaram correlação forte entre os dados obtidos na primeira (t1) e segunda (t2) aplicação (r tt = 0,94, p < 0,01), sem diferença significativa de médias nos dois tempos (m t1 = 0,37, dp = 0,49; m t2 = 0,34, dp2= 0,47; p > 0,05), com ICC satisfatório (0,96). CONCLUSÕES: Os achados apoiaram a adequação psicométrica do AUDIT, com as análises fatoriais exploratórias apontando como mais satisfatória a estrutura com dois fatores, bem como atestaram sua boa estabilidade temporal.
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OBJECTIVES: Discuss pathophysiological aspects of cerebral calcifications (CC) and highlight its importance related to the occurrence of neuropsychiatric syndromes. METHOD: Single case report. RESULT: Man 52 years old, 20 years after going through a total thyroidectomy, starts showing behavioral disturbance (psychotic syndrome). He was diagnosed as schizophrenic (paranoid subtype) and submitted to outpatient psychiatric treatment. During a psychiatric admission to evaluate his progressive cognitive and motor deterioration, we identified a dementia syndrome and extensive cerebral calcifications, derived from iatrogenic hypoparathyroidism. CONCLUSION: The calcium and phosphorus disturbances, including hypoparathyroidism, are common causes of CC. Its symptoms can imitate psychiatric disorders and produce serious and permanent cognitive sequelae. The exclusion of organicity is mandatory in any psychiatric investigative diagnosis in order to avoid unfavorable outcomes, such as in the present case report.
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Objective To systematically review the scientific literature on the psychometric properties of international instruments for the assessment of autism spectrum disorder (ASD) in the Brazilian population. Methods A search of bibliographic references was conducted in six electronic databases: PsycINFO, PubMed, IndexPsi, Lilacs, Capes (theses and dissertations) and SciELO. The studies were selected by two independent researchers. Results The procedure identified 11 studies of the Brazilian population that encompassed six ASD assessment tools. Given the information provided, the adaptation of the M-CHAT, a screening instrument, was the best conducted. All steps of the adaptation process were described and the changes made to the final version of the instrument were presented, which was not addressed in other studies. In terms of reliability, all of the instruments that assessed internal consistency showed adequate values. In addition, the ADI-R and the CARS adaptations also satisfactorily contemplated inter-rater reliability and test-retest indices, respectively. Finally, all studies aiming to validate instruments showed evidence of validity and sensitivity, and specificity values above 0.90 were observed in the ASQ, ADI-R and ABC. Conclusion Considering both the psychometric aspects and the copyright information, the screening instrument that currently appears to be best indicated for clinical and research use is the M-CHAT. It was also noticed that there are still no specific ASD diagnostic tools available for use in Brazil. This lack of diagnostic instruments consists in a critical situation for the improvement of clinical practice and the development of research in this area.
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(Excerto) Olhando para o percurso do RadioActive, há uma ideia que parece ser transversal a todo o projeto. Referimo-nos a um princípio que chamaríamos de “identificação” e que foi determinante – é determinante – nos processos de investigação participativa. Falamos da identificação dos investigadores com os princípios da investigação-ação, da identificação das intervenções com as particularidades de cada contexto. Da imprescindível e progressiva identificação dos participantes com o projeto. Na verdade, sem esta multifacetada identificação é impossível pensar em resultados sustentáveis e persistentes. Investigadores e demais participantes têm de sentir que o projeto é “seu”, que os objetivos são “seus”, embora o façam necessariamente a velocidades diferentes. A aprendizagem, neste âmbito, expande-se sempre de dentro para fora, emerge dos interesses do sujeito e não de uma estrutura pré-concebida e imposta pelos que chegam (Ravenscroft et al., 2011), neste caso, os investigadores. Uma das diferenças das pesquisas participativas em relação às tradicionais é, precisamente, a atuação coletiva e não solitária do investigador. Os pesquisadores fazem parte de um processo participatório em que estão envolvidos numa estrutura (Cammarota & Fine, 2008: 5). Paulo Freire é o autor primordial em todos os projetos e países onde a RA101 foi aplicada. As suas concepções em torno da investigação-ação participativa tentam apontar sempre para uma ação e também para uma reflexão sobre os processos.
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Objectives To verify the prevalence of current posttraumatic stress disorder (PTSD) in young adults, the occurrence of comorbidities and its association with quality of life. Methods This is a cross-sectional population-based study. The targeted population consisted on individuals aged 18 to 24 years old, who lived in the urban area of Pelotas-RS, Brazil. Cluster sampling was applied. PTSD and its comorbidities were assessed using the Mini International Neuropsychiatric Interview (MINI 5.0), whereas quality of life was evaluated with the eight domains of the Medical Outcomes Survey Short-form General Health Survey (SF-36). Results A total of 1,762 young adults were selected. The prevalence of PTSD was 2.1% and current episode of depression was the most prevalent comorbidity (71.9%). The individuals with PTSD had lower scores in all domains of quality of life. Conclusion These findings indicate that PTSD is associated with other psychopathologies, especially depression, and it has a substantial impact over quality of life in a sample of young adults.
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We describe the case of a 44-year-old woman, without known previous psychiatric history, hospitalized after a significant hemorrhage caused by self-inflicted deep facial dermal lesions (with muscle exposition). Psychopathological possible explanations of this case, as in similar reviewed ones, are related to frustration, aggression, and impulsivity.
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ABSTRACT Objetive To identify potential clinical and epidemiological predictors of long-term response to lithium treatment. Methods A total of 40 adult outpatients followed in an university hospital, with confirmed diagnosis of bipolar disorder and with history of lithium use for at least a six months period, had their response to this medication assessed through the use of a standardized instrument. The ALDA scale is based on retrospective clinical data, in our study assessed through a thoroughly reviewed of the medical charts, and is used to evaluate the clinical improvement with the treatment (Criterion A), corrected by the acknowledgement of possible confounding factors, such as duration of the treatment, compliance and concomitant use of additional medications (Criterion B), in order to estimate the response that can be specifically attributable to lithium. Results Our study found an inverse relation between the number of mood episodes with psychotic symptoms and lithium treatment outcome. Conclusion The results reinforce the hypothesis that lithium seems to be less efficacious in patients with bipolar disorder who present psychotic symptoms.
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Relatório de estágio de mestrado em Ensino de Informática
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This text concerns a program about the Promotion of Social and Communicational Skills and Mediation (PSCSM) developed with children aged between 10 and 13 years in a non-formal educational institution. The program of intervention had, as its purpose, the promotion of social and communicational competencies and mediation, thus enabling the children involved to have a healthy and responsible sociability in the different contexts in which they find themselves: family, school, peer group, amongst others. It was developed over 13 sessions with objectives and activities intentionally planned with the view of promoting competencies of communication, co-operation, responsibility, a critical spirit, solidarity, autonomy, respect, integration, inclusion and the recognition of rights and duties. This work was carried out with an action-research methodology that resorted to various techniques and instruments to gather and record information. The results obtained showed the impact and benefits of the program and they also revealed the necessity of educational institutions investing in the promotion of an ethical literacy and the empowerment of the children and young people for healthy sociability and active citizenship.
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OBJECTIVE: To determine the influence of stress on teaching medical emergencies in an Advanced Cardiac Life Support (ACLS) course and to verify this influence on learning, and the efficiency of emergency care training. METHODS: Seventeen physicians signed up for an ACLS course. Their pulses were taken and blood pressure (BP) verified on the first day, before the beginning of the course, and on the second day, during the theoretical and practical test (TPT). Variations in pulse rates and BP were compared with students' test grades. Then, students answered a questionnaire of variables (QV) about the amount of sleep they had during the course, the quantity of study material and the time spent studying for the course, and a stress scale graphic. RESULTS: Seven students had a pulse variation less than 10% between the 2 periods and 10 had a 10% or more variation. Grades on TPT were, respectively, 91.4±2.4 and 87.3±5.2 (p<0.05). Six students had a BP variation less than 20 mmHg, and in 11 it varied more than 21 mmHg. Grades on the TPT were 92.3±3.3 and 86.2± 8.1, respectively (p<0.05). The QV dates did not significantly influence grades. CONCLUSION: Stress, as an isolated variable, had a negative influence on the learning process and on the efficiency of emergency training in this situation.
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El Trastorno por Déficit de Atención con Hiperactividad (ADHD) es un síndrome conductual de origen orgánico, que se manifiesta principalmente en niños. Está caracterizado por distracción moderada a severa, períodos de atención breve, hiperactividad, inestabilidad emocional e impulsividad. Los tratamientos se basan "paradójicamente" en psicoestimulantes. Las sustancias mas empleadas son metilfenidato y anfetamina. La sintomatología indica un mal funcionamiento en los circuitos dopaminérgicos que sería el resultado de factores genéticos como ambientales, ya que es común encontrar ADHD en niños expuestos prenatalmente al alcohol. Los modelos animales son importantes para estudiar patologías de etiología desconocida, en este sentido, estudios de nuestro laboratorio indican que ratones deficientes en p35 son hiperactivos y responden paradojalmente a psicoestimulantes. Cdk5/p35 participa en el desarrollo neuronal, liberación de vesículas, señales dopaminérgicas, etc. Además resultados preliminares indican que la experiencia prenatal con una dosis etílica moderada durante la gestación tardía, es suficiente para incrementar los patrones de actividad locomotora, semejantes a los descriptos en los modelos animales de ADHD. De acuerdo a estas consideraciones hipotetizamos que la exposición etílica prenatal a dosis moderadas y durante un periodo acotado de la gestación tardía, resulta en un patrón conductual similar al descripto en modelos de ADHD. Asimismo, drogas psicoestimulantes pueden revertir dichos efectos. Por otra parte, proponemos que estas alteraciones son consecuencia de los efectos ocasionados por el insulto etílico sobre el equilibrio en el funcionamiento del sistema de neurotransmisión dopaminérgio mesolímbico/cortical. Teniendo en cuenta que la etiología del ADHD aun no se conoce, el desarrollo de modelos animales, que recapitulen características clínicas de este trastorno, constituye una herramienta muy poderosa para el estudio de los mecanismos celulares y moleculares que subyacen a este síndrome, por lo tanto, en este proyecto nos proponemos obtener evidencias acerca de las alteraciones originadas a partir de efectos deletéreos de la exposición etílica prenatal, que recapitulan el desarrollo de fenotipos conductuales y bioquímicos descriptos en modelos para ADHD. Específicamente nos proponemos determinar, por medio de experimentos conductuales, si la exposición a distintas dosis moderadas de alcohol durante un periodo acotado de la gestación tardía, son suficientes para generar alteraciones conductuales características de ADHD y establecer si metilfenidato y anfetamina, son capaces de revertirlas. Evaluar, mediante métodos bioquímicos, si este modelo involucra cambios en algunos de los componentes claves de la neurotransmisión dopaminérgica, tales como niveles de dopamina y sus metabolitos, niveles de expresión de tirosina-hidroxilasa, de receptores y transportador de dopamina, del complejo cdk5/p35, entre otros. Esperamos recapitular características análogas a las observadas en sujetos diagnosticados con ADHD y que el tratamiento con psicoestimulantes re-establezca los niveles de conducta normales. Mediante ensayos bioquímicos, esperamos encontrar mayores niveles de dopamina en tejido estriatal, acompañados con un aumento en los niveles de sus metabolitos y mediante western blot y ensayos de actividad esperamos encontrar mayor nivel de expresión en D1, menor de DAT y alteraciones en la normal actividad y expresión de cdk5/p35, que podrían explicar los resultados comportamentales esperados. Dada la alta prevalencia de ADHD y que estos jóvenes pacientes son medicados con psicoestimulantes, junto con la poca información sobre las respuestas neuroadaptativas del cerebro inmaduro, es importante investigar los mecanismos que subyacen las alteraciones neurofisiológicas de este trastorno. Estos abordajes experimentales resultan centrales para el desarrollo de terapias mas eficientes para el tratamiento de este síndrome.
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Las Tecnologías de la Información y la Comunicación (TIC) han alcanzando una fuerte expansión en la última década y se convierten en una estrategia clave para la educación científica y tecnológica. Actualmente se realizan significativas inversiones en computadoras e insumos acordes a esta tecnología lo que no garantiza que éstas mejores disponibilidades sean necesariamente conducentes a propuestas educativas aceptables, ya que la incorporación de las TIC en la educación científica no puede consistir en un mero cambio de soporte sin que esto se acompañe de una renovación constructivista del aprendizaje. También se observa un escaso desarrollo y aplicación de las TIC tanto en la formación de grado de las carreras científicas, como en la formación permanente de los docentes. A partir de lo expuesto, nos planteamos los siguientes problemas: ¿cómo generar cursos de formación docente con alternativas virtuales que garanticen la construcción, actualización y transferencia de conocimientos en las disciplinas científicas? ¿qué diseño de materiales se requiere para potenciar aprendizajes flexibles de calidad?, ¿qué dimensiones, variables e indicadores dan cuenta de procesos de comunicación en estos entornos?, ¿Cuáles son las principales estrategias que promueven los desarrollos tecnológicos? ¿De qué manera se lleva a cabo el seguimiento y evaluación de los desarrollos tecnológicos? Para dar respuesta a estos interrogantes nos planteamos este proyecto que tiene por objetivos: diseñar, desarrollar, implementar y evaluar materiales basados en un modelo constructivista que utiliza como soporte las TIC el marco de la "Enseñanza para la Comprensión". Analizar las relaciones que se establecen en el intercambio comunicativo a través de las TIC, ya sea de manera síncrona o asíncrona e identificar las estrategias de aprendizaje utilizadas por los estudiantes cuando trabajan con entornos virtuales. Se profundizará en los siguientes temas: "La materia y sus cambios", "Biotecnología" y "Dilemas investigativos a los que se enfrentan los científicos". Los dos primeros módulos estarán destinados a la formación de futuros docentes en Ciencias y a la formación permanente de docentes en ejercicio. Los usuarios del tercer módulo serán los estudiantes del ciclo de nivelacion. Se propone desarrollar instrumentos de evaluación, adaptando indicadores que sirvan para evaluar el modelo, el diseño de los materiales, el medio tecnológico, la eficiencia de estos programas con TIC. Se van a definir variables que permitan identificar las estrategias de aprendizaje utilizadas por los usuarios de estos desarrollos tecnológicos y las relaciones que se establecen en el intercambio comunicativo de los entornos virtuales, haciendo hincapié en la lecto-escritura científica. Se utilizará la plataforma Moodle que permite la administración de los estudiantes, las interacciones sociales necesarias para integrar una comunidad de aprendizaje a través de los foros y correo electrónico y la evaluación continua de los aprendizajes. El desarrollo de los contenidos específicos y las actividades de aprendizaje se hará en CD interactivos elaborados con diferentes programas de computación. En el desarrollo de los materiales se incluyen algunas simulaciones interactivas que permiten comprender conceptos que habitualmente requerían experimentación fáctica. El estudio se enmarca en la combinación de dos enfoques metodológicos que integran técnicas y procedimientos de análisis tanto cuantitativos como cualitativos. Consideramos que esta investigación es una contribución teórica importante ya que propone mejorar un modelo para la enseñanza de las Ciencias Naturales introduciendo las TIC. Se espera realizar un aporte novedoso al campo de la Didáctica de las Ciencias con la obtención de los resultados y acciones tendientes a establecer una red de comunicaciones entre los docentes participantes y los investigadores involucrados en el programa, instalada en forma progresiva.